A doctor and former Labour minister has argued that assisted dying should not be introduced until palliative and social care systems in England and Wales are fixed, warning that the current legislation offers an "appearance of choice" rather than genuine agency.
Zubir Ahmed, a transplant surgeon and former parliamentary under-secretary at the Department of Health and Social Care, wrote in an opinion piece that a person's wish to die is shaped by their circumstances, including whether they have access to proper palliative care. He said that in England and Wales, too many people do not have such access.
Concerns over the assisted dying bill
Ahmed said that as a doctor, he has spent much of his professional life caring for people at vulnerable moments and has seen the anxiety surrounding the prospect of dying. He argued that true compassion demands asking what kind of society is being built if a system designed to help people die is introduced before fixing the systems designed to care for them.
He said the system is not ready or equipped to answer this question, and noted that Andy Burnham has been right to raise it as a priority issue at the start of his tenure as prime minister. Burnham has said assisted dying should not be introduced while palliative care and social care systems remain under strain.
Ahmed said that as parliament prepares for another vote on assisted dying in England and Wales on 11 September, he fears the offering has been mis-sold to the public. He said a state-controlled medicalised dying process is still a process, with risks of complication and suffering, and that the reality is more complex than the promise of a perfectly controlled death.
Medical bodies raise flaws
Ahmed said many people imagine a system where a person facing a terminal illness can choose the exact moment and manner of their death, but the legislation does not and cannot provide that certainty. A patient who self-administers medication may still experience complications, the process may take time, and it may require medical intervention.
He said he is far from the only medical professional worried about assisted dying being available on the NHS. Among those raising concerns about the bill's flaws have been the Royal College of Physicians, the Royal College of Psychiatrists, the Complex Life and Death Decisions group from King's College London, the Royal College of Pathologists, the British Geriatrics Society and numerous other medical bodies and care authorities.
The same concern comes up again and again, he wrote: is it really a "free choice" when palliative care and social support fall short?
Care systems and the vote
Ahmed said a person's wish to die does not happen in isolation from their circumstances. It can be shaped by whether they feel supported, whether they fear becoming a burden, whether their family is coping, and whether they have access to the care they need.
Timely access to palliative and social care remains too often determined by where someone lives rather than what they need, he said. Some families have excellent end-of-life support, while others, particularly in rural areas and constituencies with high inequality, experience waiting, uncertainty and having to fight for services that should be guaranteed.
Ahmed noted that in Scotland, 85% of Labour MSPs voted against the legalisation of assisted dying in Holyrood in March. He said the bill introduced in Westminster by Kim Leadbeater, the Labour MP for Spen Valley, in October 2024 did not fare much better, with the House of Lords unwilling to rubber-stamp the flawed text.
He said that on 11 September, MPs will face another vote on assisted dying before the care systems are improved to a level which even makes that debate appropriate. He said Andy Burnham has his priorities right, calling it the wrong debate at the wrong time, and that he and many others will vote against the bill in pursuit of comfort, dignity and appropriate care for people who are vulnerable and dying.
