Palliative care and pain management are key to assisted dying debate

‘With much of palliative medicine based in charitable hospices outside the NHS, access is a problem, as hospices rarely employ pain medicine specialists.’ Photograph: Paul Slater/Alamy

As pain medicine specialists who have worked with palliative medicine specialists, we believe the debate on assisted suicide (How are cabinet ministers likely to vote on assisted dying?, 18 November) must recognise the significant gap between what is currently provided and what should be provided in end-of-life care. In Oregon, poorly controlled pain is an important symptom in one in three patients who request medical assistance to die, and a factor in determining the requests of 59% of Canadian patients.

The Health and Care Act of 2022 mandates the provision of palliative care in England by specialists. It is as yet inadequately commissioned.