How the assisted dying debate is dividing doctors as politicians prepare to vote on bill
There are few issues more controversial, more divisive.
Assisted dying polarises opinion.
But it’s a difficult conversation that needs to be had because ultimately death affects us all.
Even if you are fortunate enough to never be directly impacted by an assisted death you will almost certainly be indirectly affected if the End of Life Bill passes into law.
It would be the biggest social change to British society many of us would ever see in our lifetimes.
And after patients and their immediate families, it’s the country’s doctors who will be the most affected by any change in the law.
Like society, the medical community is divided on the issue.
One senior doctor said: “It’s like Brexit, but worse.”
Another told me: “Emotions are running high”.
These are the milder, reportable comments.
There is bitterness and mistrust. The deep-rooted anger leads to each side accusing the other of deliberately spreading misinformation, “what-iffery” and “shenanigans” in the lead-up to the final vote next week.
We asked two senior doctors to share their views on assisted dying with us and each other.
Dr Mark Lee is a consultant in palliative care.
“I have worked in this field for 25 years and looked after thousands of patients at the end of their lives. I am against the assisted dying bill because I believe it poses risks to patients, to families, to doctors and to palliative care.”
Dr Mark Lee
‘We can get this right’
Dr Jacky Davis is a consultant radiologist and a campaigner for assisted dying legislation in this country.
One of the arguments put forward by opponents of assisted dying is that Britain ranks highest among countries in its delivery of palliative care. And there is no need for such a radical change in end of life care.
It is not an argument Dr Davis accepts.
She said: “The status quo at the moment means a number of people are dying bad deaths every day. 300 million people around the world have access to assisted dying and more legislation is in the pipeline and no place that has taken up a law on assisted dying has ever reversed it. So we can learn from other places, we can get this right, we can offer people a compassionate choice at the end of life.”
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Dr Jacky Davis
Most deaths in palliative care ‘peaceful’
Dr Lee accepts palliative care has its limitations but this is a result of underfunding. This national conversation, he argues, is an opportunity to address some of those failings and improve end of life care.
“I think the NHS currently is not resourcing the situation enough to be able to provide the patients with the choice that they need to get the care that they needed and that is because they are not getting the choice and because palliative care is patchy. But in my day-to-day work, and I’ve worked in palliative care for 25 years, normal death is peaceful, comfortable, and does not involve people dying in pain.”
“I absolutely agree with Mark,” Dr Davis responded. “The vast majority of people will die a peaceful death and do not have the need for an assisted death. And I absolutely am with him that palliative care in this country has been treated abysmally. Nobody should have to hold a jumble sale in order to fund a hospice. That’s terrible.
“What I didn’t hear from Mark is, while the vast majority of people will die a peaceful death and have got nothing to fear facing death, there are people who have diagnoses where they know that they are likely to face a difficult death and will face a difficult death.
“What are you offering to the people who aren’t going to die a peaceful death? And what are you offering to people who are so afraid that that’s going to happen that they will take their own lives or will go abroad to seek an assisted death?”
Concerns about pressure on NHS
One important voice that has been missing from the national assisted dying debate is that of the NHS.
Senior leaders will not speak on the issue until the fate of the bill is decided. And its understandable why. It is not clear what role the health service would have if the bill passes.
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From 9 June: Doctors ‘really concerned’ about assisted dying bill
Dr Lee warned that his NHS colleagues were “extremely worried”, going further to say assisted dying would “break the NHS”.
He added, that the country’s already under-pressure hospice sector would struggle to cope with staff “walking away from the job if they are forced to be involved in any way”.
Dr Davis refuses to accept these warnings, arguing that the challenge to the health service is being overstated.
“I think it’s really important to take a step back and say this would be a very small number of deaths. And this is very small in terms of the other things that are coming through big drug discoveries, big new surgeries, all the rest of it this would be very small in terms in terms of money.”
The two doctors did agree on one thing. That every patient is entitled to a pain free and dignified death.
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From 1 June: ‘I’ve never felt conflicted about assisted death’
Dr Lee said: “I look at the whites of the eyes of people every day with that. I stand in that place every day. And that is shameful that anyone in this day and age should die in that position. Jacky and I can agree on that. That is unacceptable. But it still doesn’t justify the response that we meet suffering with killing someone, rather than addressing the needs that are in front of us.”
Dr Davis responded by saying: “You say you’ve looked in the whites of patients’ eyes at the end, and I’d say looking into the whites of patients eyes and listening to what they’re asking for when they’ve been offered everything that you can offer them and they’re still saying, ‘I’ve had enough’, then we should follow the example of other countries and say, ‘we will help you’.”
These are the two very divided opinions of two NHS doctors, but these are the same arguments that will be taking place in hospitals, hospices, offices, factories and living rooms across the country.
In about a week’s time, it will be down to the politicians to decide.
The UK’s Supreme Court is set to deliver a landmark ruling today that could have billion-pound consequences for banks and impact millions of motorists.
The essential question that the country’s top court has been asked to answer is this: should customers be fully informed about the commission dealers earn on their purchase?
However, the Supreme Court is only considering one of two cases running in parallel regarding the mis-selling of car finance.
Here is everything you need to know about both cases, and how the ruling this afternoon may (or may not) affect any future compensation scheme.
PA file pic
What is the Supreme Court considering?
The Supreme Court case concerns complaints related to the non-disclosure of commission. This applies to 99% of car finance cases.
When you buy a car on finance, you are effectively loaned the money, which you pay off in monthly instalments. These loans carry interest, organised by the brokers (the people who sell you the finance plan).
These brokers earn money in the form of a commission (which is a percentage of the interest payments).
Last year, the Court of Appeal ruled in favour of three motorists who were not informed that the car dealerships they agreed finance deals with were also being paid 25% commission, which was then added to their bills.
The ruling said it was unlawful for the car dealers to receive a commission from lenders without obtaining the customer’s informed consent to the payment.
However, British lender Close Brothers and South Africa’s FirstRand appealed the decision, landing it in the Supreme Court.
Pic: iStock
What does the second case involve?
The second case is being driven by the Financial Conduct Authority (FCA) and involves discretionary commission arrangements (DCAs).
Under these arrangements, brokers and dealers increased the amount of interest they earned without telling buyers and received more commission for it. This is said to have incentivised sellers to maximise interest rates.
The FCA banned this practice in 2021. However, a high number of consumers have complained they were overcharged before the ban came into force. The Financial Ombudsman Service (FOS) said in May that they were dealing with 20,000 complaints.
In January 2024, the FCA announced a review into whether motor finance customers had been overcharged because of past use of DCAs. It is using its powers to review historical motor finance commission arrangements across multiple firms – all of whom deny acting inappropriately.
The FCA also said it is looking into a “consumer redress scheme” that means firms would need to offer appropriate compensation to customers affected by the issue.
An estimated 40% of car finance deals are likely to be eligible for compensation over motor finance deals taken out between 2007 and 2021, when the DCAs were banned.
To find out how you can tell if you’ve been mis-sold car finance, read the following explainer from our reporter Megan Harwood-Baynes.
Read more from the Sky News Money blog
Pic: iStock
How does the ruling affect potential compensation?
In short, the Supreme Court ruling could impact the scale and reach that a compensation scheme is likely to have.
The FCA said in March that it will consider the court’s decision and if it concludes motor finance customers have lost out from widespread failings by firms, it is “likely [to] consult on an industry-wide redress scheme”.
This would mean affected individuals wouldn’t need to complain, but they would be paid out an amount dictated by the FCA.
However, no matter what the court decides, the FCA could go ahead with a redress scheme.
The regulator said it will confirm if it is proposing a scheme within six weeks of the Supreme Court’s decision.
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What impact could this have on lenders?
Analysts at HSBC said last year the controversy could be estimated to cost up to £44bn.
Alongside Close Brothers, firms that could be affected include Barclays, Santander and the UK’s largest motor finance provider Lloyds Banking Group – which organises loans through its Black Horse finance arm.
Lloyds has already set aside £1.2bn to be used for potential compensation.
The potential impact on the lending market and the wider economy could be so great that Chancellor Rachel Reeves is considering intervening to overrule the Supreme Court, according to The Guardian.
Treasury officials have been looking at the potential of passing new legislation alongside the Department for Business and Trade that could slash the potential compensation bill.
The Treasury said in response to the claim that it does not “comment on speculation” but hopes to see a “balanced judgment”.
Heathrow Airport has said it can build a third runway for £21bn within the next decade.
Europe’s busiest travel hub has submitted its plans to the government – with opponents raising concerns about carbon emissions, noise pollution and environmental impacts.
The west London airport wants permission to create a 3,500m (11,400ft) runway, but insists it is open to considering a shorter one instead.
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January: Third runway ‘badly needed’
In January, Chancellor Rachel Reeves announced that the government supports a “badly needed” expansion to connect the UK to the world and open up new growth opportunities.
But London mayor Sir Sadiq Khan is still against a new runway because of “the severe impact” it will have on the capital’s residents.
Under Heathrow’s proposal, the runway would be constructed to the northwest of its existing location – allowing for an additional 276,000 flights per year.
The airport also wants to create new terminal capacity for 150 million annual passengers – up from 84 million – with plans involving a new terminal complex named T5XW and T5XN.
Terminal 2 would be extended, while Terminal 3 and the old Terminal 1 would be demolished.
The runway would be privately funded, with the total plan costing about £49bn, but some airlines have expressed concern that the airport will hike its passenger charges to pay for the project.
EasyJet chief executive Kenton Jarvis said an expansion would “represent a unique opportunity for easyJet to operate from the airport at scale for the first time and bring with it lower fares for consumers”.
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A long history of Heathrow’s third runway plans
Thomas Woldbye, the airport’s chief executive, said in a statement that “it has never been more important or urgent to expand Heathrow”.
“We are effectively operating at capacity to the detriment of trade and connectivity,” he added.
“With a green light from government and the correct policy support underpinned by a fit-for-purpose, regulatory model, we are ready to mobilise and start investing this year in our supply chain across the country.
“We are uniquely placed to do this for the country. It is time to clear the way for take-off.”
The M25 motorway would need to be moved into a tunnel under the new runway under the airport’s proposal.
Pic: Reuters
London mayor still opposed
Sir Sadiq says City Hall will “carefully scrutinise” the proposals, adding: “I’ll be keeping all options on the table in how we respond.”
Tony Bosworth, climate campaigner at Friends of the Earth, also said that if Sir Keir Starmer wants to be “seen as a climate leader”, then backing Heathrow expansion is “the wrong move”.
Earlier this year, Longford resident Christian Hughes told Sky News that his village and others nearby would be “decimated” if an expansion were to go ahead.
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January: Village to be levelled for new runway
It comes after hotel tycoon Surinder Arora published a rival Heathrow expansion plan, which involves a shorter runway to avoid the need to divert the M25 motorway.
The billionaire’s Arora Group said a 2,800m (9,200ft) runway would result in “reduced risk” and avoid “spiralling cost”.
Transport Secretary Heidi Alexander will consider all plans over the summer so that a review of the Airports National Policy Statement can begin later this year.
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It also comes after Sky News reported on a Heathrow Airport-funded group sending leaflets supporting a third runway to thousands of homes across west London.
The group, called Back Heathrow, sent leaflets to people living near the airport, claiming expansion could be the route to a “greener” airport and suggesting it would mean only the “cleanest and quietest aircraft” fly there.
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Who’s behind these Heathrow leaflets?
Opponents of the airport’s expansion said the information provided by the group is “incredibly misleading”.
Back Heathrow told Sky News it had “always been open” about the support it receives from the airport. The funding is not disclosed on Back Heathrow’s newsletter or website.
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