Professor warns that gaps in end-of-life care could leave the vulnerable with no real choice.

As the controversial Assisted Dying Bill edges closer to becoming law, experts are raising alarms over the state of palliative care in the UK. Professor Cara Bailey, a leading voice in end-of-life care from the University of Birmingham, argues that the current system is far from equipped to handle the consequences if assisted dying becomes legal.

More than 600,000 people in the UK need palliative care each year, a number that’s expected to rise sharply with an ageing population and the increasing complexity of terminal conditions. Yet only 14% of those who need palliative care worldwide receive it, and the UK isn’t immune to the shortfalls.

Experts warn that the already-strained system could crumble under the weight of new demand unless urgent reforms are implemented. Here are the five critical priorities that must be addressed to ensure assisted dying is a choice, not a forced alternative.

1. Equal Access to Palliative Care for All

The cornerstone of a fair system is equity, yet palliative care in the UK is anything but. Integrated Care Boards are required to commission end-of-life care, but services remain patchy, particularly in rural and disadvantaged areas. Non-cancer-related conditions are often overlooked, leaving many to suffer in silence.

Professor Bailey insists, “Without accessible and quality palliative care for everyone, assisted dying cannot be a genuine choice. It’s a necessity, not a luxury.”

2. Stable Funding for Hospice Services

Hospices, the backbone of palliative care, are being forced to cut back essential services due to insufficient funding. The current reliance on charitable donations is unsustainable, especially as demand grows. Experts estimate that the cost of meeting this demand could reach a staggering £947 million annually over the next decade.

If these financial gaps aren’t addressed, more people may feel pressured to choose assisted dying simply because they lack access to proper care.

3. Educating the Public and Professionals

Surveys suggest that while a majority of Britons support assisted dying, many don’t fully understand what it entails or who it will benefit. Shockingly, only 43% of people surveyed had an accurate understanding of the term.

Health and social care professionals also lack adequate training on the subject. With assisted dying likely to become a hot topic in end-of-life discussions, better education is essential to support patients and their families.

4. Legal Safeguards to Protect the Vulnerable

Legalising assisted dying is fraught with ethical and societal challenges. Safeguards must be robust enough to protect those who might feel coerced into such decisions due to age, frailty, or financial dependence.

Professor Bailey highlights the risk: “It’s the most vulnerable—older adults and those with severe disabilities—who could feel like a burden and opt for assisted dying as their only way out.”

5. Research to Back Policy Decisions

Without solid research into the implications of assisted dying, the UK risks rushing into legislation without understanding its long-term effects. Studies are urgently needed to examine its impact on patients, families, and healthcare providers, as well as the societal attitudes towards ageing and death.

A Public Health Crisis in the Making?

Assisted dying is fast becoming a public health issue, and the stakes couldn’t be higher. While proponents see it as a progressive step towards “a dignified death,” critics warn it could undermine the very fabric of palliative care and the value society places on its most vulnerable members.

As the Assisted Dying Bill progresses through Parliament, one thing is clear: urgent action is needed to fix the cracks in the palliative care system before it’s too late. For now, the debate rages on—will the UK rise to the challenge, or will vulnerable individuals be left with no real choice at all?