As a renal physician who has worked in a transplant ward, I share many experiences with Zubir Ahmed; however, I hold a different perspective on the topic of assisted dying (As a doctor, I say this: before we even consider assisted dying, fix how we care for the most vulnerable, 26 August).
It is widely accepted that patients with the capacity to make informed decisions should have the right to determine their treatment options. If individuals can comprehend relevant information and communicate their choices effectively, their decisions should be respected. Physicians must provide a comprehensive explanation of potential alternatives and their expected results in an impartial manner.
My day-to-day responsibilities, similar to those of many NHS professionals and healthcare workers globally, involve striving to deliver the best care possible despite limited resources. The constraints facing palliative care and social services stem from inadequate funding and staffing. Suggesting that patients should be denied the option of assisted dying until a standard deemed acceptable by individuals like Mr. Ahmed is met raises numerous concerns and undermines patients’ autonomy to make choices about their lives now.
As a kidney specialist, I care for patients undergoing dialysis, which can significantly enhance their quality of life for many years. However, when the burden of living becomes overwhelming, it is not unusual for these patients to choose to discontinue treatment. One of the most poignant expressions I have received from a patient was, “Thank you for looking after me so well, and for letting me go.”
While it is crucial to integrate safeguards into any legislation permitting assisted death, our focus should be on developing these protections rather than denying patients the right to choose. Dr. John Firth, Cambridge
Zubir Ahmed is correct in asserting that palliative care requires increased funding and development before further discussions on assisted dying can take place. Anxiety surrounding poor end-of-life experiences has intensified as NHS services face unprecedented pressures. Lauren Edwards’ proposal to allocate NHS funds for assisted dying could further diminish other essential services. The availability of specialist palliative care across the UK is inconsistent, and the quality of care in generalist services varies widely.
When a physician declares, “there’s nothing more that can be done,” many patients are unaware that they can seek a specialist’s opinion. Regrettably, several healthcare providers lack knowledge of advancements in specialist palliative care and the resources available to alleviate suffering.
Without access to sufficient symptom management and competent psychological support, patients may not have a true choice when assisted dying is presented and facilitated by the very clinicians who should be focused on enhancing their quality of life.
Research indicates that elder abuse is prevalent, yet Edwards’ proposals do little to address the detection of such abuse and coercion. Notably, her bill does not mandate that cases of assisted dying be reported to a coroner, resulting in a lack of oversight regarding the circumstances surrounding these cases. Over the past 15 years, 209 instances of assisted suicide have been referred to the director of public prosecutions, with only eight prosecuted for homicide or serious crimes (nearly 4%). How will these incidents be identified under the proposed framework? Andy Burnham raises a valid point: this bill is an inappropriate distraction. Sheila Hollins and Ilora Finlay, House of Lords
With over 30 years of experience as a nurse and NHS midwife, and currently a full-time unpaid caregiver for my 88-year-old mother with dementia, I concur that a choice holds value only when viable alternatives are available.
We justifiably worry that individuals suffering from severe illnesses or disabilities may feel they are burdens. However, we must confront the root causes of this anxiety: social care that is limited, unaffordable, or simply unavailable, while families are expected to fill these gaps at the expense of their own well-being and futures.
My decision to become a full-time caregiver was not made freely; I felt compelled to care for my mother when appropriate, reliable, and affordable support was lacking. These circumstances are not synonymous with choice.
I now provide well over 35 hours of care each week for a carer’s allowance of £86.45, equating to merely £2.47 an hour based on the minimum qualifying hours. Caring has cost me my salary, pension growth, financial independence, and much of my personal freedom. Yet, the state continues to view family caregiving as an inexhaustible free resource.
A compassionate social care system would ensure that all individuals in need receive appropriate professional support, regardless of whether they have relatives available. This would empower families to decide how much care they can provide and when they need assistance. Caregivers should receive adequate financial support, pension security, and meaningful respite.
Before parliament introduces another end-of-life option, it must guarantee genuine choices throughout life. No vulnerable individual should fear being a burden due to the absence of adequate care, and no family member should have to sacrifice their entire future to prevent such a scenario. Jacqueline Hylton, Leeds
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