On Friday, the UK Parliament passed the second reading of the Assisted Dying Bill with a majority of 50. There’s still a long way to go until it becomes the law in England and Wales, but I wonder why I feel so uncomfortable with what it proposes.
It’s not the usual religious objections about the sacredness of life that’s forefront in my mind, though I find the idea of life as a gift compelling, especially if it continues to prevent the sale of blood or organs. God forbid we ever find ourselves in the mess of the US system and allow human bodies to become commodities to be bought and sold to the highest bidder.
What disturbs me most is that is feels like another instance of healthcare for the sharp-elbowed. If it goes through, this Bill will require the approval of two doctors and a high court judge before any assistance can be given to end a life. How long will it be before lawyers become a part of the deal and legal fees begin to escalate? In that scenario, access becomes the privilege of whoever can afford it.
My experience of the NHS over the last few years is that it is increasingly hard to get access to treatment without a struggle. I never thought that I would have to read the NHS Constitution, let alone quote it in an appeal to being removed from a waiting list (of 3-7 years)! I succeeded - after a six-month correspondence - but I know all too many who wouldn’t even know where to begin challenging decisions made about them by clinicians or those who commission NHS services. It may explain why my uneducated, elderly father spent four years on a 13-week waiting list for hip replacements.
‘Free at the point of need’ is a great slogan but it only works if those in need are able to ask for it. I’m far from alone in spending hours online trying to access treatment and this is in an era where digital poverty is still a reality for millions (up to 19 million according to a 2023 Deloitte report). Even if digital, cultural, class or other barriers are overcome, there is often still the need for a great deal of resilience, determination and, if you’ll excuse the pun, patience.
This is not an attack on the fantastic workers in the NHS, quite the opposite. But they can only work with the resources they’re given and, in the case of palliative medicine, it is far from enough. A report commissioned by the charity, Sue Rider, in 2021, reckoned that government funding only covered about a third of the total costs of care (£350m out of an annual bill of £947). The current gap in funding is filled by charities and those able to pay from themselves and inevitably many fall through the cracks.
I suppose what I’m really anxious about is whether the choices the Assisted Dying Bill offers to those nearing the end of their lives are a reality rather than a theory, and will be available equally to all in need. And if the reality doesn’t match the ideal, what are the consequences, and how are they to be mitigated? It’s sad to reduce everything to money, but equal access to health - including assisted dying and palliative care - costs.
Like many, I’ll be following the debate with interest over the coming weeks, as someone who has held the hand of people as they slipped away. I want to see people die with as much dignity and as little pain as humanly possible. I hope, therefore, that any decision made about assisted dying, also involves a commitment to the proper funding of all end of life care.
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