Dr Jack Havill: Euthanasia would not harm doctors asked to assist

Many patients simply want a good death with those they love around them and the ability to say goodbye with dignity while conscious. Photo / 123RF

Opinion

• Dr Jack Havill is a former intensive care medicine specialist with more than 30 years' experience of watching people die associated with critical illness. He is a past president of the End-of-life Choice Society.

Opponents of medically-assisted dying typically resort to emotive misleading language in their bid to continue denying choice to the majority of New Zealanders who want a compassionate change in the law.

Dr Paul Moon's article on Friday was no exception and by linking the state's long-gone death penalty for capital crimes with the End of Life Choice Bill currently before Parliament's justice select committee he made some bizarre assertions and does those who desire a serious debate on the issue a disservice.

He chooses to forget that voluntary assistance in dying (VAD) is at the request of a competent patient. Dr Moon suggests, without any evidence, that the psychological effects on past executioners could be the same for doctors performing VAD. It is a fact that every day, intensive care doctors and others undertake compassionate acts which cause the death of patients.

Let us look at some facts. People die cruel, agonisingly painful, deaths in New Zealand every day. Many suffer horribly for days, some for weeks, while others linger at death's door for months, even years, awaiting merciful relief.

Scientifically-conducted opinion polls show that at least 75 per cent of New Zealanders do not believe this is right in a modern civilised society and thousands explained why in submissions to an inquiry conducted by the last Parliament.

In moving testimony they recounted terrible tales of family members and friends dying in conditions that a number observed would provoke criminal charges if the sufferers were animals.

Parliament is not being asked to take a leap into the unknown. One-in-six Americans now have end-of-life choice in their states — California, Oregon, Washington, Montana, Vermont and Colorado, as well as the District of Columbia. VAD is legal in Canada and Colombia and in the European nations of the Netherlands, Belgium, Luxembourg and Switzerland and will be legalised in the Australian state of Victoria next year.

Oregon has allowed VAD for 20 years with no official complaint that its strict safeguards protecting the elderly and disabled are not working. The numbers accessing the law are small and only about two-thirds of those who get a prescription for a lethal drug use it. It seems that for many the knowledge that they can end their suffering if things become unbearable is enough.

The Victorian State Parliament's select committee, whose members travelled to overseas jurisdictions where VAD is legal to study the situation for themselves, talked to a wide range of people on both sides of the debate and specifically rejected opponents' oft-claimed fears of a "slippery slope" threatening the vulnerable.

The Human Rights Commission told Parliament it supports VAD in principle and the last Government's Attorney-General, Chris Finlayson, when exercising his obligation to review the validity of all proposed legislation, said David Seymour's bill would not infringe basic human rights.

It is well recognised that palliative care cannot relieve all suffering of the terminally ill and surveys show 70 per cent of New Zealand nurses support VAD. From my soundings, I estimate about half of general practitioners support a law change. (Only 20 per cent of doctors belong to the NZ Medical Association, which opposes it, and they have not been surveyed for their opinions).

Palliative care specialists who oppose VAD reject claims that doctors use morphine to end patient's lives, but other more powerful drugs such as midazolam, fentanyl and methadone are often used. Their use can lead to death, even if the doctor pretends that they don't intend this result which is known as the "double effect".

Even though palliative care cannot always relieve suffering, hospices commonly sedate persons heavily while trying, and some are even anaesthetised by the drugs, while relatives sit at the bedside hoping that death will come quickly to end their misery.

Many patients simply want a good death with those they love around them and the ability to say goodbye with dignity while conscious. That is what this End of Life Choice Bill is all about, not about misleading and emotive claims of "state-sanctioned killing".