BMJ supportive & palliative care · 2026
Disadvantaged ethnic minority communities and legalising assisted dying: coercion, trust and equity in end-of-life care.
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Hussain Jamilla Akhter, Jacob Ikhlaq, Khalid Rubina, Balaz Natalie, Peltier Carol, Jensen Mercia, Grewal Bhajneek, Brara Amrita, Hackett Julia
Аннотация
OBJECTIVES: To explore perspectives on assisted dying legislation among disadvantaged ethnic minority communities in a UK city with high ethnic diversity and socioeconomic deprivation to inform deliberation of the Terminally Ill Adults (End of Life) Bill in England and Wales.
METHODS: Three community consultations were facilitated using semistructured discussions. Groups consulted included: (1) 98 adults from ethnic minority communities living in disadvantaged areas; (2) 24 ethnic minority women with experience of domestic abuse and (3) 15 parents of young people aged ≥18 years who are autistic and/or have learning disabilities. Findings were analysed thematically.
RESULTS: Across all consultation groups, participants expressed both compassion for people experiencing severe suffering who want assisted dying, alongside concerns about how assisted dying might be experienced by marginalised groups. Four themes were developed: fear and mistrust of healthcare systems; risks of direct and indirect coercion, including structural and interpersonal forms; concerns about decision-making, capacity and family involvement; and unintended consequences for trust in palliative care services.
CONCLUSIONS: Consultations provide insights into how assisted dying legislation may affect groups experiencing end-of-life inequalities. Findings suggest that without attention to equity, trust and safeguards, assisted dying policy risks widening disparities and undermining engagement with palliative care.
METHODS: Three community consultations were facilitated using semistructured discussions. Groups consulted included: (1) 98 adults from ethnic minority communities living in disadvantaged areas; (2) 24 ethnic minority women with experience of domestic abuse and (3) 15 parents of young people aged ≥18 years who are autistic and/or have learning disabilities. Findings were analysed thematically.
RESULTS: Across all consultation groups, participants expressed both compassion for people experiencing severe suffering who want assisted dying, alongside concerns about how assisted dying might be experienced by marginalised groups. Four themes were developed: fear and mistrust of healthcare systems; risks of direct and indirect coercion, including structural and interpersonal forms; concerns about decision-making, capacity and family involvement; and unintended consequences for trust in palliative care services.
CONCLUSIONS: Consultations provide insights into how assisted dying legislation may affect groups experiencing end-of-life inequalities. Findings suggest that without attention to equity, trust and safeguards, assisted dying policy risks widening disparities and undermining engagement with palliative care.