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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.”

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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.

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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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Report: 60% of Patients Needing Palliative Care Do Not Receive It

By Jim Parker, Hospice News, 3 July 2019

Close to 60% of patients who would benefit from palliative care do not receive those services, despite the availability of community-based palliative care as well as hospital-based palliative care, according to a new report from the New England Journal of Medicine Catalyst Insights Council. 

Lack of awareness is a major barrier to palliative care expansion. A Journal of Palliative Medicine study, published in April, found that as many as 71% of people in the United States have little to no understanding of what palliative care is, including many clinicians in a position to refer patients to palliative care or hospice. 

How can euthanasia be proposed when good palliative care is not easily accessible for everyone?

Read the full article here.

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The euthanasia debate: Death is not a black-and-white issue

By Dr Amanda Landers, Stuff.co.nz, 24th June 2019

In reading social media pages, I have realised there are many misconceptions that have taken root in our community which need weeding out. One of these misconceptions is that euthanasia and withdrawing medical intervention is one and the same.

The answer to bad deaths is not euthanasia. The answer is a better understanding of basic medical ethics, of palliative medicine, of what happens to the body when it is dying, and how to care for  someone at the end of life.

Read the full article here.

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We can’t let voluntary assisted dying negate our commitment to the ill

By Natasha Michael, The Age, 22 May 2019

Palliative care doctor Natasha Michael discusses how euthanasia will impact palliative care from her personal experience with death, patients and palliative care.

The introduction of the voluntary assisted dying legislation in Victoria on June 19 will remind us of the occasional failure of medicine. Healthcare was designed with disease in mind, not people. The legislation introduces three major threats to healthcare: validating suicide as an acceptable choice; accepting substandard medical care by supporting the lack of rigour in defining eligibility; and finally, introducing into the healthcare curriculum the intentional ending of life as acceptable medical treatment. Hereby, a new generation of healthcare professionals abdicate their commitment to the sick.

For the patient, the convolutions of modern medicine, the uncertainty of therapeutics, the conundrum of multiple doctors across multiple sites bring an uncertain horizon and instil existential anguish. Their journey of illness is ultimately alienating and lonely. For many, it is the desperation for the restoration of dignity and the return of normality that drives the desire for death: “I want to die, let me die.” Not: “Kill me.”

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Palliative care experts say euthanasia not the answer

By Nick Butterly, The West Australian, 25 May 2019

Douglas Bridge — regarded as the leading palliative care expert in WA — said the introduction of laws allowing euthanasia would pose a huge ethical problem for medical professionals.

“Euthanasia and assisted suicide are not medical treatments and most emphatically not part of palliative care.”

“We reaffirm our commitment to our patients: we will continue to care for you to the best of our ability, guided by your choices, but we will not kill you,” Dr Bridge said.

Read the article here.
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Palliative care experts say euthanasia goes against core belief that death and dying are ‘natural part of life’

by Hawke’s Bay Today, 19 May 2018

We don’t talk enough about dying and we need to change that. We think it would help if people knew a bit more about the actual process of dying and what to expect
We suspect a lot of the current debate is fueled by fear of the unknown, and a lack of information about what care is available and what actually happens when someone dies.

“In our experience a good safe death is peaceful, dignified and a natural process.

“People advocating for a law change talk about choice, compassion, and dignity, as if euthanasia were the only way to achieve these things. But these are the founding tenets of Hospice services: you can have choice, compassion, and dignity at the end of your life, and you don’t have to kill yourself for them, or have someone kill you to achieve this.”

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Being exquisitely careful…

by Henry Cooke, Stuff, 22 May 2018

Tawa doctor and chair of the Health Professionals Alliance Catherine Hallagan submitted strongly against the bill.

“It is a bad bill that cannot be fixed,” Hallagan said.

She said doctors and other health professionals did not want the law. No safeguards built into the law would be sufficient to make sure patients were not being coerced into choosing death by family or others.

“Doctors cannot prove that coercion does not exist,” Hallagan.

Sinead Donnelly, a palliative care doctor, agreed with Hallagan, saying coercion would be impossible to avoid.

“We have no doubt that coercion occurs in daily life. The older, the mentally ill, the frail, are more susceptible to coercion, which can be extremely subtle,” Donnelly said.

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Pediatric palliative care: living with hope and quality throughout illness

by Amanda Alladin, Miami Herald, 24 April 2018

Pediatric palliative care is a specialty that aims primarily to relieve the burden of suffering for children and families living with any chronic, complex or critical illness. Although we tend to equate suffering only with physical pain, suffering can take many different forms.

Pediatric palliative specialists seek to provide an extra layer of support for these families struggling to cope with their child’s illness by addressing the many different forms that coping can take, assisting them through the difficult decision making and, at the same time, focusing on symptom management to improve quality of life.

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