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.”
Read more:
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Assisted dying law ‘unworkable’ and ‘naive’
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.
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UK
‘No evidence’ malign activity caused Wednesday’s air traffic disruption, says transport secretary
There is no evidence that malign activity was responsible for yesterday’s outage of air traffic control systems, the transport secretary has said.
Heidi Alexander said she has spoken with the chief executive of National Air Traffic Service (NATS), Martin Rolfe, and added that what happened was an isolated incident.
NATS has apologised for the IT problems after thousands of passengers suffered extensive travel disruption during one of the busiest times of the year.
The technical glitch led to more than 150 flight cancellations, leaving airlines reacting furiously.
Transport Secretary Heidi Alexander
Ms Alexander wrote on X: “I have spoken with NATS CEO Martin Rolfe who provided further detail on yesterday’s technical fault.
“This was an isolated event and there is no evidence of malign activity.
“I know that any disruption is frustrating for passengers.
“Flights are now resumed and I am grateful to airlines who are working hard to get people to where they need to be.
“I will continue to receive regular updates. Passengers should check with airlines before travelling.”
Read more: Flight delayed or cancelled? These are your rights
Officials said a “radar-related issue” caused the air traffic control failure.
A spokesperson for NATS said: “This was a radar-related issue which was resolved by quickly switching to the back-up system during which time we reduced traffic to ensure safety.
“There is no evidence that this was cyber related.”
The problem occurred at NATS’ control centre in Swanwick, Hampshire, and affected the vast majority of England and Wales.
Aviation analytics company Cirium said 84 departures and 71 arrivals were cancelled to or from UK airports up to 10pm on Wednesday, with several flights diverted to other European airports.
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Travel expert Paul Charles: This is a major outage
There was limited disruption on Thursday, with a handful of British Airways flights cancelled because aircraft and crew were out of position.
Heathrow and Gatwick airports said they had resumed normal operations.
Affected passengers are unlikely to be entitled to compensation as the disruption was outside of airlines’ control, but they will be able to claim expenses for a reasonable amount of food and drink, a means to communicate and overnight accommodation if required.
Martin Rolfe in 2023. Pic: PA
Ryanair has called on Mr Rolfe to resign, claiming “no lessons have been learnt” since a similar systems outage in August 2023.
The airline’s chief operating officer Neal McMahon said: “It is outrageous that passengers are once again being hit with delays and disruption due to Martin Rolfe’s continued mismanagement of Nats.”
Airlines have reacted furiously after a technical glitch in air traffic control systems led to more than 150 flight cancellations.
The National Air Traffic Service (NATS) has apologised for the IT problems – and said systems were back up and running 20 minutes after the “radar-related issue” was detected at 4.05pm.
But with thousands of passengers suffering extensive travel disruption, during one of the busiest times of the year, airline executives have warned this isn’t good enough.
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Departures resume after ATC problem
Ryanair’s chief operating officer Neal McMahon has called for NATS chief executive Martin Rolfe to resign – and claimed Wednesday’s incident was “utterly unacceptable”.
He said: “It is outrageous that passengers are once again being hit with delays and disruption due to Martin Rolfe’s continued mismanagement of NATS.
“It is clear that no lessons have been learnt since the August 2023 NATS system outage, and passengers continue to suffer as a result of Martin Rolfe’s incompetence.”
Mr McMahon was referring to a glitch that affected more than 700,000 passengers two years ago – and said that, if Mr Rolfe refuses to step down, the government should intervene.
“Heidi Alexander must act without delay to remove Martin Rolfe and deliver urgent reform of NATS’ shambolic ATC service, so that airlines and passengers are no longer forced to endure these preventable delays caused by persistent NATS failures,” he added.
The Department for Transport says Ms Alexander does not have any direct control over NATS – and no powers over staffing decisions at the service.
Martin Rolfe in 2023. Pic: PA
EasyJet’s chief operating officer David Morgan added: “It’s extremely disappointing to see an ATC failure once again causing disruption to our customers at this busy and important time of year for travel.
“While our priority today is supporting our customers, we will want to understand from NATS what steps they are taking to ensure issues don’t continue.”
NATS is yet to comment on the calls for Mr Rolfe’s resignation – but has stressed that the glitch is not believed to be “cyber related”.
“This was a radar-related issue which was resolved by quickly switching to the back-up system during which time we reduced traffic to ensure safety,” a spokesperson had said.
Departures at airports across the country have now resumed – but passengers are being urged to check with their airline before heading to terminals.
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Travel expert: This is a major outage
John Carr, from Stourbridge, was on his way from Heathrow to Norway to help arrange his brother’s wedding when he discovered his flight was cancelled after checking in.
“I’m pretty gutted,” he said. “We’ve got loads of stuff in the suitcases to set up the venue, because we’re obviously flying to Norway. We’ve got the wedding rehearsal to do. It’s quite stressful.”
Liberal Democrat leader Sir Ed Davey called for an urgent investigation and also referred to the “utterly unacceptable” disruption two years earlier.
“With thousands of families preparing to go on a well-earned break, this just isn’t good enough. The public deserve to have full confidence in such a vital piece of national infrastructure.”
Listen to The World with Richard Engel and Yalda Hakim every Wednesday
Flights departing or arriving at a UK airport, or aircraft operated by a UK airline arriving in the EU, are subject to rules concerning delays or cancellations.
Airlines may have to provide compensation, although there are exemptions for “extraordinary circumstances”, according to the UK’s Civil Aviation Authority.
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