A Hand Grenade into the NHS and Palliative Care
Excerpts from webinar on Assisted Dying
A Hand Grenade into the NHS and Palliative Care
Excerpts from webinar on September 1 2025
"The Assisted Dying legislation is putting a handgrenade into the NHS and Palliative Care". So claimed Professor Mark Taubert, Professor of Palliative Medicine in Wales in a thirty minute webinar held by OurDutyofCare.org.uk on September 1
He noted that the NHS is in a state of crisis, witness the lines of patients in “corridor care”. There is a sense of hopelessness among patients and health care professionals. There has never been a worse time to introduce assisted dying. Access to palliative care is patchy and unequal across the country. There are scenarios where people do not get access to specialist palliative care and where the outcome could have been much better with proper access to palliative care.
Because Assisted Dying will be an Act of Parliament, people will assume it will be alright. But if you are going to do it, then make it the “Safest Bill in the World”. Do not rush to get it over the line and seek to correct problems afterwards. This is a matter of life and death. Campaigners for assisted dying are completely scaremongering the public and insulting those of us who have spent our whole careers trying to support the best palliative care possible.
It is a key issue about the relation between the doctor and the patient. If assisted suicide becomes an option then many clinicians will stop looking for what else can be done to help a patient in distress. There is a great difficulty in accurate diagnosis and prognosis. People may be at ‘end stage’ but survive for many more years. Professor Taubert recalled that he had also seen patients completely misdiagnosed with a terminal condition ( including cancer) that was not the case.
A participant commented: “I fear the biggest coercion may come from the hopelessness of healthcare staff - the thoughts mentioned by the Dr Tauber are common to hear from doctors and nurses in the overstretched system. We have always fought against that in palliative care but the legalisation of Assisted Dying brings a new and frankly terrifying dimension to that fight as the health funding crisis worsens. Unintended coercion by healthcare staff themselves sadly seems inevitable if this goes through.”
People can have a sense of desperation, especially following a new serious diagnosis, and then come through it. Had they decided to ‘end it’ they would have missed life enhancing events – their granddaughter’s graduation or son’s marriage.
One participant noted: “My mother had severe dementia and contracted COVID. She was transferred back to her care home and died several days later having been managed by the staff and also some community nurses who visited regularly and gave her midazolam as needed. I was with her when she died and remembered thinking I was glad assisted dying was not an option. The campaigners for assisted suicide imply that everyone dies in some terrible pain or other and there is no one to help.”
The process of assisted dying is an ‘evidence-free’ zone. Evidence is not being captured about the moment of death. The drugs can have a paralysing effect so that even if, as is reported, the patient looks peaceful at the time of death, how do we know what they are feeling? What is going on in a person’s brain in their dying moments? We do not have any feedback on how peaceful is their death. There are very few reported data.
There is a sense that Assisted Dying is going to be a panacea. The downsides of what has happened are not documented or discussed. What if the person chokes or vomits? Who looks after then until they die? In Scotland it is to be nurses! These are unlicenced drugs for this purpose. Everywhere uses different drugs. Whatever happened to evidence based medicine?
Clinicians get horribly distressed in these situations. The moral injury for all Health Care Practitioners really concerned Dr Taubert: “I have had paramedics express concern about how they should respond in a home situation if AD is legalised. And what will the impact be for junior staff ?”
A participant commented that the Nuffield Trust report highlights that GPs are the most commonly involved clinicians in other jurisdictions. Yet the impact assessment associated with the bill does not seem to expect GPs to have much involvement at all from how training requirements have been set out. The Nuffield Trust are recommending considering amending the GP contract to ensure resourcing and equity of access to assisted suicide. GPs do not want to be involved in this yet it is clearly going to land at their doorstep. There seems to be a complete disconnect between what politicians are pushing for and what the workforce are prepared to do or have the ability to do.
Further webinars will take place on September 8 and 15