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A new study has dispelled concerns people who choose euthanasia are driven by social or economic vulnerability, researchers say.
The average age of people who received euthanasia in Ontario was 74.4, versus 77 for all people who died in the province during the study period.
The research, published in the Canadian Medical Association Journal, found those who accessed euthanasia tended to be younger, wealthier, more likely to be married and far less likely to live in an institution than members of the general public who died during the study period.
Of the 2241 people who chose to die with medical assistance in the Canadian province of Ontario between June 2016 and October 2018, 74 per cent were receiving palliative care from a physician or nurse, according to the study.
This suggested a request for euthanasia was unlikely to be driven by social or economic vulnerability, the researchers said.
New Zealanders will vote in a referendum later this year on whether the End of Life Choice Act should come into force. The Act, put forward by Act MP David Seymour, passed its third reading last November and would give people with a terminal illness the option to access assisted dying subject to certain conditions.
Supporters say people experiencing harrowing pain should have the choice to end their life with dignity, while opponents, including many in the palliative care sector, have argued opening the door to euthanasia could result in the vulnerable, aged and disabled being coerced or feeling pressure to end their lives.
A spokeswoman for Seymour said the Canadian study showed palliative care provision and assisted dying could work together, and the evidence should allay fears vulnerable groups would be at heightened risk.
ACT MP David Seymour has championed the End of Life Choice Bill.
"People who use assisted dying laws are overwhelmingly those who have had choice over their lives, and are now suffering from a terminal illness and seeking choice in how they die."
Nurse Maude Christchurch hospice palliative care service manager Jane Rollings said she strongly opposed the End of Life Choice Act "because I do not wish killing to be legalised in New Zealand".
In her 18 years caring for people with life limiting illness, Rollings could only recall a handful of patients who expressed a desire for euthanasia. "Of these patients, what really drove the desire was fear."
"The acknowledgement of these fears, the acknowledgement of the value and worth of these amazingly brave people's lives and their contribution to society and the gentle guidance through their fears of what might happen to their dying body, alleviated any such desire for intentional death."
There was inequity of access to good palliative care in New Zealand, she said, and there needed to be sufficient funding so it could be provided to everyone who needed it
Medically assisted dying was legalised in Canada in June 2016. As of October, 2018, 6749 Canadians had accessed euthanasia.
For the study, researchers analysed clinical and socioeconomic data from 2241 people in Ontario who received euthanasia and data from all 186,814 people who died during the study period.
Of the people who accessed medically assisted dying, the average age was 74.4 versus 77 in the general population and they were more likely to live in a higher income neighbourhood. Almost two thirds of patients had cancer, 12 per cent had a neurodegenerative disease, 8.5 per cent had cardiovascular disease and 7.5 per cent had respiratory disease.
The researchers said people who chose euthanasia reported physical or psychological suffering as the primary reason, despite three-quarters of patients receiving palliative care. This suggested for many patients requests for euthanasia were not because of poor access to palliative care, they found.
Dr Phil Bagshaw, founder of the Canterbury Charity Hospital but speaking in a personal capacity, said he was not aware of the quality of palliative care or access in Canada but cautioned against drawing any comparisons with New Zealand.
Bagshaw opposed the End of Life of Act. "It's a basic tenant of medicine that doctors are there not to terminate life, but to alleviate distress and cure where they can," he said.
"I think that euthanasia is a mistake, and easy access to good palliative care is the way to go, it's as simple as that."
* An earlier version of this story incorrectly stated this year's referendum question would ask whether euthanasia should be legal in principle. The referendum will ask if the End of Life Choice Act should come into force.
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