A consultant has called for a pragmatic approach to the assisted dying bill to prevent misunderstandings and underfunding of palliative care.
As the second reading of the Terminally Ill Adults (End of Life) Bill passes in the House of Lords, community palliative medicine consultant Dr Sara Robbins, 38, of St Christopher’s Hospice has advocated for prioritisation of the safety of patients, relatives and professionals.
Dr Robbins condemned public misconceptions of palliative care.
She said: “By introducing an assisted dying law, will you almost conflate palliative care and end-of-life care with assisted dying and deepen the misconception that palliative care is hastening people’s lives?”
The contentious bill designed to legalise assisted dying states those seeking it out will be offered a referral for a palliative care assessment.
St Christopher’s, who adopt a neutral stance, gave evidence to the House of Lords and encouraged them to establish a stronger requirement of assessment.
The aim is to ensure the terminally ill have access to palliative care prior to pursuing assisted dying.
However, the consultant warned against the subordination of end-of-life patients.
She said: “If you go for an assisted death, the bill says a doctor will be with you until the moment that you die.
“If you have a normal death, you won’t necessarily get a specialist palliative care assessment, you won’t necessarily see several doctors, you might see a GP, you might not and you probably won’t have a healthcare professional with you when you die.”
During the bill’s first reading, The Lord Bishop of London DBE urged Peers to listen to Robbins’ advice.
She said: “I am deeply concerned that so many in Parliament are not heeding the voices of professional and representative bodies that are raising the alarm.
“Above all, the bill fails in its central claim that it delivers choice.
“A meaningful choice would see the measures in the Bill set alongside equally available, fully funded palliative and social care services.”
Dr Robbins reiterated the importance of distinguishing assisted dying from palliative care.
The consultant said: “I think we all feel deeply concerned about the idea that assisted dying would be fully funded by the NHS and plans of end-of-life care remain not fully funded.
“The moral position of that feels very, very difficult for us and deeply unfair.”
The consultant also expressed concerns that anti-assisted dying donors could withdraw funding.
It is unclear whether hospices can dictate their engagement with assisted dying services, as individual professionals can.
Robbins questioned whether hospices partially funded by the NHS will be required to provide assisted dying support.
The Lord Sandhurst KC argued against assigning responsibility to the NHS.
He said: “It will likely damage the delivery of palliative care, which should be our focus.
“We shall be left with a national death service, and a poor one at that.”
Dr Robbins emphasised the assisted dying debate spans beyond a binary of support or opposition.
She said: “How does it get implemented safely and properly?
“How do we make sure that society thinks and talks more about death and dying and end-of-life care gets the funding it deserves?”
As the Bill moves into the Committee Stage, Dr Robbins added: “I want whatever we come up with to feel safe for patients and their relatives, of course, but also to feel safe for staff so that they’re not in the position where they’re thinking, ‘Oh my goodness. Are we making the right decision?’”
Featured image courtesy of Annie Spratt on Unsplash
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