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Assisted dying would ‘erode the trust’ between doctor and patient

By Michael Hayward, Stuff.co.nz, 13th November 2019

Phil Bagshaw, a Christchurch surgeon, is concerned that if the End of Life Choice Bill becomes law, it will erode the trust between doctors and their patients. He said he could not support any version of the bill.

“If terminally-ill people were deteriorating, there were ways to keep them comfortable and without distress, and to ease their death… it could be done by experts but it was “somewhat costly”, although the Government could afford it. Palliative services should be available to anyone who needed them, he said. 

He was concerned about a condition of the bill that said only those with “a terminal illness that is likely to end the person’s life within six months” would be able to ask for access to assisted dying, as it was “almost an impossibility to say with any degree of certainty” how long someone who was terminally ill had to live.

Bagshaw also raised concerns about the bill going to public referendum. He said the issue was complicated and thought “pressure groups” on both sides would promote it as more simple than it was.

“They [the public] will hear both sides from two groups, both of whom have strong views and will put those views across in a powerful way, and I think it will be very difficult for most people to discern what is the common sense way out of what is in fact a difficult situation.”

Read the full article here.

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Why I oppose the End of Life Choice Bill, in plain English

By Bill English, Stuff.co.nz, 13th November 2019

Former Prime Minister Sir Bill English has opposed the End of Life Choice Bill since its first reading.

“This bill, if it passes, will make New Zealand a less safe place for the old, the vulnerable, the depressed and the disabled”.

He gives, “Five reasons why this bill will not deliver compassion. Five reasons to vote No.”

Read the full article here.

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Major gaps persist in knowledge of the practice of assisted suicide and euthanasia

By Michael Cooke, BioEdge, 10th November 2019

More research must be undertaken about the decision making process and consequences of euthanasia and assisted suicide, and how this legislation “affects societal discourses regarding palliative care, suffering, old age and dying.”

Currently, research into euthanasia is difficult as some jurisdictions have no legally required reporting procedures, with some forbidding the mention of euthanasia as the cause of death on the death certificate. Euthanasia legislation “suffers from an under- reporting bias. Studies have estimated that, even several years after legalisation, from 1/5 (the Netherlands) to 1/3 (Belgium) [of] cases is [sic] not reported.”

“More in-depth knowledge overall is needed into the MAiD [Medical Aid in Dying] decision- making process, especially concerning vulnerable population groups such as the oldest old and people suffering from severe mental illness … most research on MAiD practice has been limited to interviewing or surveying physicians. More research exploring the narratives from patients and patients’ relatives is particularly needed to gain a more complete picture.”

There is an “important gap in our understanding of the process and consequences of the practice”. The influence of legalising euthanasia on palliative care, and patients feel pressure, fearing being a burden to relatives and society, must be examined.

Read the full article here.

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Teen says she maybe only knew her dad because euthanasia wasn’t legal

By Tom Hunt, Stuff,co.nz, 13th November 2019

“Glenn Major was a soccer dad and it’s down to him his 17-year-old daughter now represents Waikato and Bay of Plenty in the beautiful game. He doesn’t know this. He died nine years ago.”

“His daughter Rachel believes that if euthanasia had been legal when she was aged one there was a chance she would have never got to know her dad for the nine years they did have.”

“Rachel on Tuesday had a long list delivered to MPs, essentially asking if they realised how few safeguards there were in the  proposed final version of the End of Life Choice Bill. “

Read more here.

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New Zealand’s euthanasia bill is a step into the unknown for disabled people

By Wendi Wicks, The Guardian, 14th November 2019

“How can any MP be able to agree to a measure that endangers a whole community that they are not a member of?”

MPs have voted for a public referendum on the euthanasia bill, asking the vague question, “do you support this bill?”

“It’s to be hoped that the population at large can do a sound job, but that depends on the quality and range of information they get. MPs had a huge range of sound, factual information. But judging from their voting record, many clearly disregarded heaps of it.”

“Yes, there are many individual stories both for and against this bill. All deserve respect because telling them takes effort. But there’s more to good law than basing it on individual stories. It’s about the collective impact on our community. It should be good, safe law for all. That’s what MPs are there to do but didn’t.”

“The opposition we express is consistently based on concerns that society is full of negative, biased and discriminatory attitudes and behaviours, so that people think disabled lives are less worthy. Given this attitude as a basis, the state provides really limited support for us to live well. So it’s disturbing when laws are put up that mean the state will provide the means to die, not live. But that’s where we are now. We aren’t dead yet and we don’t want state-sanctioned death support.”

“A friendly QC commented on my vulnerability to the law thus: “You’re toast.” Me and how many other disabled people?”

Read the full article here.

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Expert letter highlights risk of assisted dying increasing suicides​

Mental Health experts and researchers have written an open letter to MPs highlighting the risk of assisted dying increasing suicides. 

In the press release, spokesperson Dion Howard “says he has first-hand experience of his young clients using the same justifications for their suicidal inclinations as euthanasia advocates.”

“We feel a professional responsibility to present overseas statistical evidence regarding the relationship between assisted dying and suicide rates, the evidence is not conclusive because no-one has yet done the research and it is complex, but there is suggestive evidence which indicates that, over time, as the rates of assisted dying increase, there is a corresponding increase in suicide rates.”

“It’s a critical issue here in New Zealand because we have some of the highest suicide rates in the world, particularly for Māori, and they are still rising.”

The group want MPs to wait until more research is done before considering a law change.

“It is too risky to legislate for euthanasia or assisted suicide in New Zealand until evidence can show there’s no causal effect on New Zealand’s already high suicide levels.”

Read the letter here, and the press release here.

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MP Alfred Ngaro tables amendment to uphold principles of The Treaty of Waitangi in the euthanasia bill

There is no cookie cutter situation in a world with legalised euthanasia. Every patient is different, bringing their own concerns, views, background and support systems with them in any health decision they make. Integral to this is the patient’s cultural background.

Currently, nothing in the bill requires a medical practitioner, when dealing with Maori, to be culturally competent and carry out assessments in a way that considers Maori culture. Previously, David Seymour has said that cultural considerations and competencies are a serious issue, but has also stated it’s for the people to choose. MP Alfred Ngaro points out that such action is dismissive of real concern about the inequities Maori people face in the current health system. If this isn’t addressed in the euthanasia bill, the system won’t allow for the complexities of Maori language and culture, in assessing cases of euthanasia. Alfred Ngaro has tabled an amendment to the euthanasia bill to address this, by including a part on cultural considerations. This will ensure a practical commitment to uphold the principles of the Treaty of Waitangi is cemented in law.

Watch MP Alfred Ngaro’s speech here.

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Euthanasia is symptom of society which does not care

By Breda O’Brien, The Irish Times, 21st September 2019

Read article here.

Is euthanasia simply a symptom of a society which doesn’t care?

Euthanasia is often advocated for under a banner of compassion and care. Overseas, we see this ‘care’ extending to cases of patients suffering from dementia, mental illness and even failed sex-change operations. In the Netherlands, a court recently decided that an advanced directive was sufficient consent, even if the woman suffering from Alzheimer’s was forcefully objecting, and had to be held down to receive the lethal injection.

This leaves us wondering, what makes the difference between those who request euthanasia, and those with similar symptoms expressing a strong desire to live? Instead of widening the grounds for euthanasia, why not replicate conditions that make life worth living despite suffering?

In statistics where women, elderly and the disabled are more heavily represented requesting euthanasia, Breda O’Brien writes, “we must question whether medical killing is motivated by love, or by cold functions of sexism, ableism and ageism.”

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Polling reveals country voters want palliative care fixed before euthanasia legalised

By Nathan Hondros, WA Today, September 3, 2019

Read the full article here.

No one would say good palliative care is a bad thing.

We all know death isn’t always easy. But whilst death isn’t always easy, there is no doubt that good palliative care makes a difference. Not only treating physical illness, but also providing mental and emotional support to patients and those surrounding them.

Polling in regional Western Australia reflects this, showing that only one person out of every four believe euthanasia should be legalised before palliative care is improved. Clearly, euthanasia should never be the first option. If better alternatives exist to treat illness, alleviate pain, and increase comfort, these should be taken. If medical care is under-performing or under-resourced in NZ, this should be fixed.

“No terminally ill person should ever find themselves in the position of being unable to experience quality palliative care but able to access assisted dying.”

Good palliative case isn’t always easily accessible in NZ. What will legalising euthanasia do about it?

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‘Voluntary assisted dying’ legislation could put lawyers at our deathbeds

By Mary McComish, WA Today, 5th August 2019

Under the Victorian law, the two assessing doctors (in WA it may involve a doctor and a nurse practitioner) have to assess and certify as to around a dozen eligibility criteria and other things.

For example was the person a resident in Victoria, did the person have decision-making capacity (not compromised by depression or other mental health condition), was the person acting voluntarily and without coercion, did the person suffer from a disease, illness or medical condition, was it expected to cause death within six months, was it causing intolerable suffering?

… Any of these assessments or acts could be open to question, especially things like prognosis, capacity and absence of coercion in the decision.

Answering the questions could well involve extensive bedside interviews in the presence of opposing lawyers.

Read the full article here.

The legal implications of legalising euthanasia are much more complex than people think, as seen in Victoria, Western Australia. Many different variables and assessments are open to question, coercion and error.

Surely it is better to support and resource our health professionals instead of turning to such a problematic and inherently dangerous piece of legislation?

Once this path is taken, there will be no going back.