Whilst some of us share concerns on the principle of the Bill, we are all concerned that the Bill as currently framed does not have sufficient safeguards to protect the vulnerable from coercion. We fear that the Bill  makes a fundamental change to the relationship between healthcare providers and patients that will erode both trust in and access to healthcare, with the most vulnerable in our society being the most at risk. 

We add our voices to those of the British Geriatrics Society who emphasised concerns that the bill does not provide sufficient safeguards from coercion. [1] Coercion is not only experienced by people in abusive situations, but also those who feel that they are a burden on their family or on society. We see frequently in the course of our work that people struggle to access the care that they need, particularly social and palliative care. This struggle has been highlighted recently by the Prime Minister. [2] To introduce assisted dying in this context would be to expose people to a form of structural coercion, whereby requests to end life may be driven by poor access to care or other unmet needs, such as mental illness, loneliness or financial hardship. These concerns were echoed by the Royal College of Psychiatrists who suggested a requirement for assessment of such unmet needs as part of any assisted dying process during the passage of the previous bill. [3] Such a requirement remains absent in the present (2026) Bill. 

We also have concerns regarding the negative impact that the Bill could have on the doctor-patient relationship, and therefore on the willingness of people to access health care generally and palliative care specifically. Even in the absence of availability of assisted dying, our experience is that many people fear that use of medication to shorten life is commonly practised in palliative care, when this is not the case. This fear leads to reluctance to access palliative care services, and necessitates building of trust. This trust would be significantly more difficult to build should assisted dying be legalised, and people would feel less able to access the services that are available.  This impact is likely to be worsened by the way that the current Bill embeds assisted dying in existing healthcare structures, akin to a treatment. We are encouraged by a recent change in BMA policy stating that assisted dying is not a form of ‘medical treatment’. [4]

The impact of this potential loss of trust in services would be felt by communities which are already disadvantaged. [5] Further, the Bill leaves hospices unable to opt out of involvement with assisted dying even if assisted dying would be thought to be detrimental to equitable access, having considered local population needs and preferences. Hospices in the East Midlands are already under significant financial pressure. [6]  In the absence of adequate funding from the NHS, they rely on community engagement not only to raise funds, but also to build the hard won trust that is needed to deliver the care that people vitally need at the end of their lives. Any move to erode this invaluable trust must be avoided. 

The debate around and interest in how we care for those reaching the end of their lives, about which we care deeply, is welcome. We ask that you vote against the Bill at Second reading and instead join in the drive to provide the best palliative and social care for all,  supporting people to live more fully until they die. 

(Please note that the views expressed are those of the individual signatories and do not necessarily reflect the views of their respective employers.)

Yours sincerely,