MPs must focus on palliative care provision, however they vote on assisted dying
3 min read
Tomorrow, the country will find out whether the assisted dying for terminally ill adults bill passes its Second Reading.
Hospice UK has, for over a decade, been neutral on whether or not the law on assisted dying should change. But the decision will be of immense significance to patients and those working and volunteering in the country’s 200-plus hospices.
MPs and the wider country have been presented compelling and compassionate reasons to change the law, and compelling and compassionate reasons to leave things as they are. All we can therefore say for sure about Friday’s vote is that the result will please many people and devastate many others.
No one’s choice to request assisted suicide should stem from fear – be it real or imagined – of lacking necessary pain relief or palliative care
A vote against, and those devastated will include individuals currently receiving palliative care or bereavement support with a passionate belief rooted in their own experience that they and people like them are again being denied the autonomy to choose the manner and the time of their death in the face of terminal illness.
A vote in favour, and those devastated will include many vulnerable members of our communities and their advocates. As Gordon Brown said a few days ago: “An assisted dying law, however well intended, would alter society’s attitude towards elderly, seriously ill and disabled people, even if only subliminally.”
While views among those working in hospice care are mixed, a vote for a change in the law will also devastate many hospice colleagues for whom the very notion of physician-assisted suicide runs viscerally counter to all their beliefs about palliative care and medicine, as well as all their professional experience to date.
The true test of this generation of MPs, society, and our institutions will not be Friday’s vote but how well they address the fears and concerns of those who are disappointed in the years ahead. If the law stays as it is, we must intensify efforts to demonstrate the many choices good palliative care offers individuals and their families daily.
A vote in principle to change the law would usher in a period for the hospice sector to work through the immense operational complexity of the details of how this would work in practice, and walk a tight rope over competing considerations before it comes in.
Regardless of the vote's outcome, the hospice movement must build on the shared goal of ensuring everyone has better understanding and fair access to palliative and end-of-life care, which is currently delivered by GPs, hospitals, district nurses, care homes, and hospices.
The well-known gaps and inequalities in access to palliative care are an obvious and significant risk factor if MPs vote to change the law. Because if the law changes, no one’s choice to request assisted suicide should stem from fear – be it real or imagined – of lacking necessary pain relief or palliative care.
The choice of assisted suicide under those circumstances would be the most devastating outcome for an individual, as well as the starkest moral and practical failure for our country.
There seems to be a consensus among MPs and commentators on all sides of the assisted dying debate that palliative care should be available to all those who need it. So, how much longer can we stretch our current way of funding hospice services?
In the event of a “yes” vote on Friday, we face an entirely plausible scenario in England and Wales whereby a future assisted dying service might be both provided and fully funded by the NHS to anyone eligible, while core and specialist hospice care would still be funded only by donations and charity shop profits.
That would be utterly unacceptable – on so many levels.
Toby Porter is CEO of Hospice UK
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