Pain is cited as a fundamental rationale behind the campaign for ‘assisted dying’ (assisted suicide and euthanasia). However, current legislative proposals for England and Wales before the Westminster Parliament are silent on pain and on suffering. For patients to have real choice, they must be able to access the care they need, not feel coerced into viewing an early death as their only option. Yet current palliative care provision is dependent on voluntary donations, with severe deficits in some areas that urgently need to be addressed.
Van Den Beuken-Van EverdingenMHJHochstenbachLMJJoostenEAJ, et al.Update on prevalence of pain in patients with cancer: systematic review and meta-analysis. J Pain Symptom Manag2016; 51: 1070–1090.
3.
World Health Organisation (WHO). WHO guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents. WHO: World Health Organisation, 2019.
4.
Clause 38 terminally ill adults (end of life) bill [bill 212, 2024–25]. House of Commons. https://bills.parliament.uk/bills/3774 (accessed 16 June 2025).
5.
ClarkD. ‘Total pain’, disciplinary power and the body in the work of Cicely Saunders, 1958–1967. Soc Sci Med1999; 49(6): 727–736.
6.
StrangPStrangSHultbornR, et al.Existential pain—an entity, a provocation, or a challenge?J Pain Symptom Manag2004; 27(3): 241–250.
7.
FinlayIRichardsMMaskellR, et al. Palliative Care and End-of-Life Care: Opportunities for England (Volume 1), The Commission on Palliative and End-of-LifeCare. 2025.
8.
FrenchMKeeganTAnestisE, et al. Exploring socioeconomic inequities in access to palliative and end-of-life care in the UK: a narrative synthesis. BMC Palliat Care. 2021; 20: 179.
9.
Focaldata poll Care Not Killing survey on the assisted dyingbill 2024 accessed17 June 2025.
10.
Oregon Death with Dignity Act, 2023 data summary. Year 26 Oregon Health Department 2024.
11.
StukalinIOlaiyaORNaikV, et al. Medications and dosages used in medical assistance in dying: a cross-sectional study. CMAJ open. 2022; 10(1): e19-e26. DOI:10.9778/cmajo.20200268.
12.
ForwardCBayleyZWalkerL, et al. Homecare workers needs and experiences in end of life care. Rapid Review BMJ Supportive and Palliative Care. 2024; 14: e2330–e2340.
