Palliative care doctors opposed to the assisted suicide Bill, which is set to be voted on next month, are warning that end-of-life care is unable to cope with a rise in demand and that palliative care requires significant investment.
Earlier this month, the Association for Palliative Medicine (APM) released its position statement on assisted suicide stating that it “opposes any change in the law that could lead to the supply or administration of lethal medications to deliberately end a person’s life”.
In particular, the APM listed its concerns about making assisted suicide legal, which included “protection of vulnerable, frail, elderly, disabled and terminally ill people”, concerns about lack of funding and availability of palliative care, and the impact that assisted suicide would have on the doctor-patient relationship.
Now, APM member and palliative care doctor, Sarah Foot, who is opposed to new laws allowing assisted suicide, is calling for greater Government investment in palliative care. She said “We shouldn’t need charities to fund it. We need to invest in the workforce and invest in the palliative beds so people can die comfortably”.
Hospice and palliative care forced to rely on “charity cake sales and sponsored marathons”
Rachel Clarke, a specialist in hospital palliative care, drew on her own experiences to warn of the consequences of failing to invest, saying “My concern is that if we change the law without adequate resourcing of palliative care, then there will be people who choose to end their lives because they weren’t being provided with the care they needed”.
“I sometimes see patients [near the end of life] who come into hospital in unspeakable agony and want their lives to end. It is not because their pain cannot be prevented, but because they are not getting the care they need”.
She also argued that palliative care relies on charitable giving, saying “The brutal truth is that only a tiny proportion of hospice and palliative care is NHS funded, the rest – unforgivably – relying on charity cake sales and sponsored marathons. So much for ‘from cradle to grave’. Rather than truly caring about dying people, then, we allow some of them to suffer avoidable pain, avoidable indignity, that could be averted by investment in threadbare services”.
These worries have been echoed by Dr Amy Proffitt, Consultant in Palliative Medicine at Barts Health NHS Trust and former President of the APM, who shared her concerns in September that “pumping money into assisted dying will mean that the NHS cuts back on cash for palliative care”. Dr Proffitt emphasised the lack of resources and attention being put into palliative care, saying “Better to focus on improving NHS palliative care rather than introducing assisted dying. Yet that doesn’t even seem to be on the agenda”.
“Kim Leadbeater should really be listening to the palliative care experts”
The warnings come as Health Secretary Wes Streeting, who voted for assisted dying in 2015, confirmed that he will vote against the Leadbeater assisted suicide Bill due to concerns over the state of palliative care.
Last week, the Health Secretary was asked whether the palliative care system was ready for a change in the law on assisted suicide.
An unnamed Labour MP said “Wes said that palliative care isn’t good enough, then added he hadn’t intended to get into the discussion about assisted dying, but told us his view”.
“He told us he wants to get to a point where people have a real choice at the end of life. At the moment, he said he doesn’t think it’s a genuine choice because palliative care is so bad. He did explicitly say he’d be voting against the assisted dying bill. He said he voted for it last time but he’s changed his mind”.
Another MP said that the Health Secretary had been “explicit” that he would vote against Leadbeater’s assisted suicide Bill, saying that the emphasis should be on palliative care.
With the debate on the legalisation of assisted suicide intensifying in the build-up to the vote on Kim Leadbeater’s Terminally Ill Adults (End of Life) Bill, research shows that demand for palliative care is set to increase. In 20 years’ time, there are expected to be 100,000 more people dying each year in the United Kingdom. Analysis by Marie Curie shows that by 2048, the number of people with palliative care needs in the UK will climb by more than 147,000 to over 730,000. Matthew Reed, chief executive of Marie Curie said the findings from the survey show that “care for dying people is in crisis”. Worryingly, according to Hospice UK, the UK hospice sector is facing a collective estimated deficit of £77 million in the financial year 2023-24.
Spokesperson for Right To Life UK, Catherine Robinson, said “Kim Leadbeater should really be listening to the palliative care experts and her own Health Secretary who are emphatically telling us that investing money and resources into palliative care is what is urgently required, not assisted suicide”.
“The focus at this time should be on providing high-quality end-of-life care to those who are suffering at the end of their lives, and not on assisting suicide”.
