Rammya Mathew: The debate on assisted dying must not overshadow care at the end of life

We often talk about pressures facing the NHS in terms of waiting lists, workforce shortages, and hospital overcrowding. But one uncomfortable truth sits quietly behind many of these conversations: up to a third of the people in hospital beds are in their final year of life.1 Many of them are undergoing investigations and interventions that offer little meaningful benefit. At the same time, surveys consistently show that many people would prefer to spend their final months, and often their final days, at home. The gap between these two realities tells us something important about how our system is organised.Advance care planning is often presented as the solution. If we discussed ceilings of treatment earlier with patients, clarified decisions around resuscitation, and recorded people’s preferences about where they would like to be cared for, we might avoid some of the admissions and treatments that they neither want nor benefit from. But…