Personally , I worry about the dire circumstances of palliative care services , or what’s left at least. I agree that there have in my experience been a lot of people who are told they do not have long to live who do in fact live and live with some quality of living .

The work force we have cannot hope to cope with any new role and so I fear many people who may be at a critical and vulnerable point in life may wish to end it without the best support being available , and this giving them the broadest choice available.

Any role created would have to be uber neutral and very specialised with the best training we have available and palliative care services need a huge boost in funding .

I bumped into two workers recently raising funds on their day off for the local hospice which is brilliant . We need to have a rethink – like urgently , this is no way to run services . You cannot bring in such an Act without a proper ethically constructed and considered provision of care and support to those who may be at such a vulnerable point in their life . There are of course concerns about those who can afford the best services and support and have the best clinical advice , and those who will not and this affecting — driving your decision .

We will certainly have to rethink safeguarding as a start .

This is a minefield

The APCSW’s decision to neither endorse nor oppose the legislation is rooted in its commitment to advocate for holistic and compassionate care for individuals and families at the end of life. However, I believe this neutrality risks diluting our obligation to champion the foundational principles of palliative care and safeguard against the erosion of accessible end-of-life services for all.

First, the proposed role of an Approved Palliative Care Professional (APCP) is formulated to help address ethical concerns around safeguarding and informed decision-making. This is already central to what we do whatever the state of mind or intention of the individual before us. There is a risk that to specialise these functions will signal acquiescence with the prevailing ethic. It also raises practical questions about the strain on an already overstretched workforce. Social workers, especially those in palliative care, are at the heart of multidisciplinary teams, supporting individuals holistically amidst complex psychosocial, spiritual, and existential challenges. Adding the APCP role, even if phased in, will divert resources away from our core mission of enhancing the quality of life without hastening or delaying death.

The current landscape of palliative care provision in the UK is troubling. Recent redundancies in a nationwide palliative care charity—including the dismissal of all social workers, face to face counselling, and spiritual care leads—highlight systemic vulnerabilities. Without substantial investment in services, we risk creating a two-tier system where assisted dying becomes the default option for those unable to access comprehensive care. This scenario fundamentally contradicts social work values of equality and justice, particularly for vulnerable populations facing compounded end-of-life pressures in relation to their social role and sense of value.

Research from countries like Belgium and Canada demonstrates the risk of “scope creep” in assisted dying laws, where initial safeguards expand to encompass non-terminal conditions or psychological distress. In my view these developments are inevitable and although not immediate, they will inadvertently shift societal attitudes towards end-of-life care.

Finally, there is the matter of professional identity. Palliative care social workers excel in fostering trust, advocating for the vulnerable, and navigating ethical complexities. Taking a clear position against assisted dying, as opposed to neutrality, would allow the profession to uphold these values unequivocally. It would also signal a collective commitment to improving palliative care access and quality, rather than being seen as tacitly accepting practices that could undermine these efforts.

I accept that the debate around assisted dying is nuanced and am pleased that Community Care has created a space for these discussions. However, I urge the profession to reflect critically on the broader implications of neutrality. By opposing the legislation while advocating for safeguards and improvements in palliative care, we reaffirm our dedication to protecting vulnerable individuals and maintaining the integrity of our practice.
Yours sincerely

David Williams

Independent Palliative Care Social Worker

Exactly Baker.

Your write up has been my thoughts all this while. Hhmmmmm.