Editorial

Assisted dying debate highlights need for palliative care improvements

Evidence given by nurse with motor neurone disease in support of changing the law on assisted dying highlights the need to invest in palliative care, whatever the court’s decision, writes managing editor Elaine Cole

Evidence given by nurse with motor neurone disease in support of changing the law on assisted dying highlights the need to invest in palliative care, whatever the court’s decision, writes managing editor Elaine Cole

Nurse Alison Pickard’s experience makes for difficult reading. She has been diagnosed with motor neurone disease (MND) and gave evidence in support of a change to the law on assisted dying in a High Court case in London.

Despite the failure of the Assisted Dying Bill in 2014, this issue, divisive for nurses, is not going away.

Some nurses argue that changing the law would not be necessary if better palliative care was accessible to all. But for Ms Pickard, not all end of life symptoms can be controlled. Pain is not the only distressing symptom, she says, pointing out that people with MND face breathing difficulties, inability to communicate and total immobility.

Last option

If we accept that there are cases in which symptoms or distress cannot be eased, significant investment in palliative care becomes even more important.

The vast majority of people want to die at home, but NHS workforce statistics published in June show district nurse numbers continue to decline steadily.

Research published by consultants Christie & Co last week found a 44% drop in district nurses since 2010 has contributed to a severe reduction in care and support in the community. And Nursing Standard’s own research with the Marie Curie charity this year showed only 40% of nursing staff had received training in end of life care.

Dramatic action is needed to address these gaps so there are enough nurses, with the appropriate training, to ensure patients receive dignified end of life care, whatever the court’s decision – and to ensure that if assisted dying is legalised, it really is the very last option for patients.


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