Good palliative care and assisted dying can go hand in hand | Letters

[Integrated End-of-Life Care: Advancing Palliative Services and Legitimizing Assisted Dying] Jane Turner is correct that end-of-life care in the UK requires urgent reform. MPs acknowledged the crisis in their 2029 report, and it demands immediate correction. My late husband, John, died at age 43 after nearly six years of bowel cancer treatment. Over seventy chemotherapy cycles, he remained intensely focused on seeing our children mature through adulthood. During his final weeks in a hospice, he received exemplary palliative care, yet endured unimaginable suffering. Once, he screamed continuously for nearly an hour in an enclosed bathroom before relief became effective. As his disease progressed, he slowly suffocated despite his awareness and repeated consent to continue. Throughout those final hours, I resorted to earplugs merely to buffer against his distressing gasping.
Improved care and legalised assistance must coexist rather than compete.
Liz Wilson
Coventry

The economics of this gap highlight pressing needs. The Nuffield Trust reports the United Kingdom allocates £6.6 billion yearly to emergency hospital treatment in the twilight of life—far exceeding the £1.1 billion supporting England’s 204 hospices. Former unit coordinators estimate a specialist palliative suite serving 250,000 residents costs roughly £5 million annually. Delivering uniform high‑quality care could redirect resources toward preventive planning, guiding patients to preferred residence settings; a ten percent reduction in fatal admissions would generate significant savings nationwide.
Stephen Kirkham
Lytchett Minster, Dorset

Critics raise legitimate concerns about patients whose suffering transcends therapeutic reach. I manage incurable secondary breast cancer and an opioid allergy. Post‑childbirth surgeries rendered my postoperative pain uncontrollable, creating fear and desperation. If enhanced palliative protocols prove insufficient for someone experiencing intolerable anguish, the argument that better care eliminates the need for assisted dying collapses.
Sophie Blake
Hove, East Sussex

Yet excellent palliative services transform lives. Their absence forces many into premature dying. Simultaneously, legal pathways must exist for those whose prognosis is terminal irrespective of clinical intervention.
Liz Wilson
Coventry

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