In a monumental shift, Members of Parliament in England and Wales have voted in favor of a bill to legalize assisted dying for terminally ill patients. The move has been hailed as a compassionate step forward by supporters, who believe it will give those suffering at the end of life more control over their final days. However, the vote has also cast a glaring spotlight on the chronic underfunding of palliative care services in the UK, with experts warning that without urgent investment, many patients may feel assisted death is their only option.
A Bittersweet Victory
For campaigners who have long fought for the right to assisted dying, the MPs’ backing of the bill marks a historic triumph. “This is about giving dying people the choice to end their suffering on their own terms,” said one activist. “No one should be forced to endure against their will.” The bill will now progress to the next stage of legislative scrutiny.
Yet the celebrations are tempered by the stark realities facing those with terminal diagnoses under the current system. While assisted dying may soon be an option, what many patients need most is high-quality palliative care to manage symptoms, provide support, and improve quality of life in their final months, weeks and days. But as it stands, access to such care is patchy at best.
The Palliative Care Postcode Lottery
“Palliative care in this country is woefully underfunded,” said Dr. Rachel Clarke, a palliative medicine specialist. “It’s a postcode lottery. In some areas, brilliant hospice and community teams provide round-the-clock support. In others, patients are lucky to see a specialist nurse once a fortnight.” She warns this could leave some feeling death is their only escape.
We cannot continue to fail dying people by grotesquely underfunding palliative care.
Dr. Rachel Clarke
The NHS spends around £1.4 billion a year on palliative care, but experts say much more is needed to plug staffing gaps and expand services to ensure universal access. Without this, they argue any assisted dying law is inherently unequal – a choice only for those who can afford private care.
Funding Pledges Fall Flat
Successive governments have failed to heed warnings that palliative care is buckling under rising demand. Despite repeated pledges to boost budgets, hospices and community teams remain overstretched and underfunded. “It’s been all talk and no action,” said one charity director. “Fine words mean nothing to patients in pain without support.”
Now, say campaigners, the assisted dying vote must be a catalyst for change. Some want funding commitments written into the bill as a precondition. Others are lobbying MPs to launch a separate funding drive alongside the new legislation. All agree, palliative care can no longer be sidelined.
A Holistic Approach
But it’s not just about money. Experts say any expansion of assisted dying must go hand-in-hand with efforts to destigmatize palliative care and reframe societal attitudes towards death. “For too long, we’ve pushed death to the margins, made it something to fear or avoid,” said one lead researcher. “Palliative care is about helping people live well, on their own terms, for as long as possible. It’s an ethos we need to mainstream.”
That means raising awareness of what modern palliative care can offer, expanding training for medical professionals, investing in research to continue improving therapies, and empowering communities to support loved ones at the end of life. A holistic approach, argue advocates, is the only way to ensure that assisted dying represents a genuine choice, not the last resort of a broken system.
The Debate Goes On
As the assisted dying bill progresses through Parliament, the arguments for and against will continue to rage. Both sides are steadfast in their convictions. But on one point there is near universal agreement – palliative care can no longer be the poor cousin of the health service. Investment, many believe, is a moral necessity.
“How a society cares for people at the most vulnerable point in their lives reflects our values and priorities,” said one hospice chaplain. “Do we close our eyes to suffering or do we do all we can to support people? Do we let them feel abandoned or wraparound them with compassion? These are the fundamental questions we have to grapple with now.”
The MPs’ vote may have fired the starting gun on assisted dying in England and Wales. But it’s only the first step in a much wider battle to transform end of life care. For campaigners, clinicians and patients alike, the race is now on to ensure that whatever the law says, everyone facing terminal illness can live and die with dignity, on their own terms.
