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Plea for ‘honest debate’ of bill

26 Jul 2019 10:14 AM | Philip Patston (Administrator)

by Dr Mary Panko
Published: July 26, 2019 

COLUMN – Gisborne Herald

In a few days’ time, July 31, the third round of David Seymour’s End of Life Choice Bill will be debated in Parliament and the Committee of the Whole House (CWH) gets to vote on a range of amendments.

There will be a large number of these, some coming from David Seymour himself but most from those opposed to any law change to permit medically-assisted dying. Maggie Barry has already said she plans to raise 120 amendments intending to get the Bill talked out — a method known as filibustering originally introduced by some long-discredited American politician. The filibuster tries to talk a bill to death so that it runs out of Parliamentary debating time.

However, for those who listened to the 20 MPs who spoke on the subject during the second reading (passed by 70 votes to 50), it was clear that there are honestly-held doubts on both sides of the argument — whether the bill goes far enough or if it provides enough safeguards — which make it worthy of an honest debate.

The nearest place to New Zealand which has a similar law is Victoria in Australia and it is worth comparing it to the proposed bill.

Many of its fundamentals are similar; to qualify a patient has to be a resident of the state, aged 18 or over, suffering from terrible pain as a result of a terminal illness and demonstrably not being coerced.

But the Victorian law has at least 68 safeguards, making it the most conservative of all international legislation, some of them pretty strange. Firstly, the patient’s doctor cannot tell them about the potential option of assisted dying. This is a bit like Basil Fawlty’s “Don’t mention the War”. So a dying and suffering patient may be informed about a range of options from palliative care to terminal sedation (oh yes — that’s legal) but not a word about medical-aid-in-dying.

It was argued that if a doctor mentioned this, it could be viewed as coercion. Therefore, people unaware of this possibility will not be permitted to find out about it. Unfortunately, David Seymour appears to think this proviso will persuade one or two additional MPs to vote for the bill and so has scooped up this clause into his own Supplementary Order Paper.

A further level of craziness in Victoria prevents any discussion of assisted dying by phone, text, Internet or, presumably, via carrier pigeon. This means that a dying person living far away from Melbourne and already approved for medical assistance, is barred from discussing any concerns or queries with their doctor. It is to be hoped that we can avoid this problem.

Further, once a patient has been approved for assisted dying in Victoria, the process ceases to be the business of the patient’s doctor or nurse practitioner and is handed over to a pharmacist from the main Melbourne hospital which has been given sole responsibility for dispensing the required lethal drug.

At this point, the dying person is expected to travel to Melbourne to collect the drug and instructions on how to administer it. If the patient is unable to do this, the law says the pharmacist will take it to them. How they can find out that this is necessary, if they wish to avoid federal prosecution for a forbidden discussion, is not clear.

Now, I have the utmost respect for the pharmacy profession as I lectured in a pharmacy department for 20 years, but having to understand and remember a number of complex instructions about a series of drugs which have to be measured and mixed and ingested in a desired sequence is asking too much of most of us. Let alone if we were on the point of death.

Furthermore, pharmacists’ instructions are probably the most ignored of any profession in a day-to-day sense. The pharmacist is also not required to be present while the dying patient attempts to mix and swallow the medication. Will they remember to take the anti-nausea draught first? Will they choke with no one there to help them?

As our MPs prepare to debate this issue again, I ask them to remember that a clear majority of their constituents (two-thirds to three-quarters, according to all reputable scientific opinion polls) want a law change to allow the suffering sick to end their lives painlessly and with dignity.

I also beg them to think compassionately and sensibly about those 2000 New Zealanders who die in unremitting pain every year and allow the tiny proportion who are likely to opt for medical assistance to die, to have the choice this bill would provide.

  • Dr Mary Panko is President of the End-of-Life Choice Society of New Zealand

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