Hospice Southland Position Statement on the End of Life Choice Act and Assisted Dying (Euthanasia)
Hospice Southland encourages people to read the End of Life Choice Act before voting in the referendum on 17th October 2020, as voters are being asked whether to legalise this particular legislation, not whether they agree with the concept of assisted dying.
The End of Life Choice Act would profoundly and fundamentally change the role of doctors in New Zealand from that of healers companioning patients and families/whanau through the dying process to that of agents who can legally bring about premature death for certain patients.
The Act places clinical, administrative, legal, ethical, and moral responsibility for the process and consequences almost exclusively on individual doctors without mention of education, training, and support. If assisted dying is legalised, it should be a health system issue and not the responsibility of individual doctors.
Doctors are not ideally suited to identify and address issues of possible coercion when it comes to requests for assisted dying. Further, the Act specifies that patients must select a particular date and time to receive assisted dying, which could be considered a form of coercion.
Many terminally ill patients who express a desire for an assisted death do so out of concerns that they will be a burden to others or lose control or dignity, and not for physical symptoms like pain. In US states where assisted suicide is legal, many who request assisted dying never actually take the prescribed medication.
By mandating a set date and time for an assisted death, the Act could arguably be seen as legislation that would lessen a terminally ill patient’s sense of control over his or her illness and death.
The End of Life Choice Act outlines a process for assisted death but does not offer funding or support for other end of life care options. Hospice Southland urges voters to instead support measures that improve funding for and equitable access to symptom management medications, illness screening and treatments, hospice and palliative care, mental health services, aged residential care, and home-based supports.
The Act emphasizes autonomy (the right of individuals to choose what happens to themselves) but does little to consider other ethical principles like beneficence (doing what is best for patients), non-maleficence (avoiding harm to patients), justice (doing what is best for society), and Maori tikanga and kawa.
If the Act becomes law, family, friends, whanau, and community supports would only be brought in to support a patient who requests assisted dying if the patient allows that involvement.
Patients could potentially request and receive an assisted death without any emotional, relational, or spiritual support. Isolated, depressed, and lonely patients may be more likely to see an assisted death as their only viable option for end of life care.
This September, New Zealanders will have to make a life changing decision when they vote in the referendum on the End of Life Choice Act at the general election.
It is important to be clear, your vote is not about the concept of euthanasia.
Your vote is on this Act specifically. Is this the best possible legislation to keep people safe?
No matter the outcome of the referendum it is important to know hospice will continue to support people regardless of their desire for euthanasia.
For more information on these, please see below: