BMA votes to poll members on its assisted dying stanceBMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l4398 (Published 25 June 2019) Cite this as: BMJ 2019;365:l4398
All rapid responses
Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
The BMA agreed last week to poll its members on assisted dying, with the proposer of the motion stating that that ‘even if everyone had access to the best hospice care, at least 5,000 people per year would die in unrelieved pain’. But access to palliative and hospice care is far from universal; an estimated 92,000 people in England who might benefit from palliative care currently die without access to it.[1,2]
This is a moving target; palliative care need is set to rise 42% by 2040 in England and Wales, meaning that if service provision doesn’t change, tens of thousands more people will miss out on high quality care at the end of their lives. Further, the funding of palliative care services remains limited and inconsistent, with hospices receiving only one third of their income from the NHS, and needing to raise one billion pounds per year from charitable donations to cover running costs.
The inequity of care provision at the end of life is neglected in the debate about assisted dying. Surely any consideration of a change in stance towards assisted dying should have as a prerequisite a demand for universal access to palliative care.
1. Dixon J, King, D, Matosevic T, Clark M, and Knapp M. Equity in the Provision of Palliative Care in the UK: Review of Evidence Josie Dixon, Derek King. 2015. Personal Social Services Research Unit London School of Economics and Political Science
2. Hughes-Hallett T, et al. Funding the right care and support for everyone – creating a fair and transparent funding system: the final report of the Palliative Care Funding Review. An independent review for the Secretary of State for Health. London: Department of Health, 2011.
3. Etkind SN, Bone AE, Gomes B, Lovell N, Evans CJ, Higginson IJ, & Murtagh FEM. How many people will need palliative care in 2040? Past trends, future projections and implications for services. 2017 BMC medicine, 15(1), 102.
4. Hospice UK https://www.hospiceuk.org/about-hospice-care/media-centre/facts-and-figures. (Accessed July 2019)
Competing interests: No competing interests