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News BMA annual representative meeting

BMA votes to poll members on its assisted dying stance

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l4398 (Published 25 June 2019) Cite this as: BMJ 2019;365:l4398

Re: BMA votes to poll members on its assisted dying stance

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.[3] 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.[4]

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

03 July 2019
Simon N Etkind
ST4 in Palliative Care
London