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Dr. Libby Smales is a palliative care specialist with more than 20 years of experience as the director of Cranford Hospice in Hawke’s Bay. On behalf of the Yes for Compassion group, she responds to Nelson Tasman Hospice’s column (September 5) on the End of Life Election Act referendum.
OPINION: I agree with Nelson Tasman Hospice that hospice / hospice is often the best option for dying patients and their families. However, it doesn’t work for everyone. In my opinion, hospice / palliative care should revise its “no” stance on the End of Life Choice Act.
I was a director of Cranford Hospice for more than two decades. I know the invaluable contribution that hospice / palliative care, and all those dedicated people who work in it, can make to kiwis at the end of their lives and their loved ones.
Supplied
Palliative Care Specialist Dr. Libby Smales supports the End-of-Life Choice Act.
However, I also know that palliative care has its limits. A report from Palliative Care Australia in 2018 shows that despite excellent care, a small and significant group of patients suffer excruciatingly as they die, somewhere between 2 and 5 percent.
READ MORE:
* Why Hospice Opposes Proposed End-of-Life Law
* Euthanasia referendum: the arguments for and against the legalization of assisted death
* Acting ‘offers choice, not obligation’
* The choice of the end of life comes down to compassion
* Hospice Specialists reject End of Life Choice bill
There is no shame in this, but it is shameful that hospice / palliative care continues to ignore the needs of some of our patients by saying a blanket “no” to the end-of-life choice. As Professor Emeritus Ian Maddocks says, “the profession must solve itself.”
For those for whom hospice / palliative care cannot alleviate their suffering, the End of Life Choice Act offers an additional option; a “just like,” or a “Plan B,” as one local farmer put it in a Rotary talk earlier this week. Hospice / hospice care and voluntary assisted dying can and should work together.
Increasingly, the medical profession recognizes that people are in the best position to make decisions about their own care and treatment. We call this “patient autonomy.” So why not also trust that kiwis taste better when it comes to controlling how we die? Polls from the past 20 years show consistently high public support for terminally ill New Zealanders to have the option to end their lives if they suffer excruciatingly when they die.
Research shows that people nearing the end of life do not fear death, but they do fear how they die. Just knowing that they won’t suffer against their wishes provides great relief, even if they don’t need to use it, which is about 25 percent of the time.
Consistent data abroad shows that voluntary assisted death laws are safe, effective, and do not change over time. The US state of Oregon has had the same voluntary assisted death law for more than 20 years. International law shows that the vulnerable are not a target, suicide does not increase, and trust in doctors increases rather than erodes.
There are no studies that have revealed that coercion is a problem. New Zealand’s legislation is limited in scope, has passed three readings in Parliament, and has strict built-in safeguards. Similar laws work well for over 150 million people around the world, so why not here?
CHRISTEL YARDLEY
Waikato Hospital doctors speak out on the euthanasia referendum.
When hospice / palliative care was introduced more than 50 years ago, some of my medical colleagues didn’t think it was necessary. Many thought they were handling death adequately, although symptom control was poor.
Now, hospice / hospice as a profession is valued and admired, and rightly so. But the profession itself now needs to adapt and be open to the change that some of our patients need.
Some of the opposition to the End of Life Choice Act comes from the Catholic Church, which encouraged its congregations to sign and submit submissions against pre-printed publications when the bill was passing through Parliament.
It is important to note that if your personal belief system makes it impossible for you to ask for help to end excruciating suffering while you die, nothing needs to change for you. Everything will remain the same, except that hospice / palliative care may be better funded and more accessible to all of us, as we have seen in the two Australian states where voluntary assisted dying has been legalized.
I hope that in the future hospice / palliative care will recognize the End of Life Choice Act as a necessary and valuable component of end-of-life care, and that voluntary assisted dying may be another option for Kiwis with illnesses. terminals.
I think we all want the same thing; the option for each of us to choose what suits us best.
