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  • 23 Apr 2021 10:02 AM | EOLC Admin (Administrator)

    OPINION PIECE – Gisborne Herald

    Jack Havill

    Doctors for End-of-Life Choice New Zealand are dismayed and frustrated to see ongoing efforts to misinform the public about the November 7 introduction of legally-available voluntary assisted dying (VAD).

    Taxpayer-funded national broadcaster RNZ's investigative journalist Guyon Espiner has put forward a series of unfounded “concerns” on behalf of a group described as “palliative care”.

    He raises fears that insufficient doctors will be found to deliver assisted dying services and that doctors will be poorly trained “as in Victoria”. The Ministry of Health found recently that nearly 30 percent of doctors surveyed were willing or potentially willing to provide assisted dying services. That's about 5000 doctors. Given our strict eligibility criteria, very few patients will qualify for assisted dying. By way of comparison, Victoria which has a population 28 percent larger than that of New Zealand, completed 124 assisted deaths in the first year of availability.

    Regarding Espiner's relayed criticisms on training, upskilling in the 21st century is routinely undertaken via online courses and is generally thought to be a satisfactory means of delivery. We cannot imagine why this should be different for assisted dying.

    The Ministry's medical advisers are currently working out which drugs to use for greatest safety and efficacy. Espiner reports that, if oral ingestion is chosen by the patient, this will be a compound of “unapproved” drugs. The compounding (mixing) of drugs is common pharmaceutical practice and is undertaken using familiar components that are used in everyday medical practice. Victoria solved the problem by opting for a single point of compounding and distribution: the Alfred Hospital in Melbourne. Their compounded medication works as intended. New Zealand could simply do likewise.

    After two years of VAD practice in Victoria, there have been no failed administrations, even though most patients there self-administer orally. The June-December 2020 report tells us that 94 percent of the loved ones of patients who died a VAD death described the service as excellent, and the remainder described it as good.

    Doctors generally prefer the intravenous delivery of any drug that has the potential to be poorly tolerated if orally ingested. It is salutary, then, that our End-of-Life Choice Act offers the option of intravenous delivery.

    Espiner's interviewees anticipate “ethical and legal” conundrums in the extremely rare case of failed administration. They suggest that consent should be reconfirmed if a second attempt needs to be made.

    Palliative care's own answer to assisted dying is terminal sedation, the practice of deeply sedating the patient while discontinuing all nutrition and fluids. It can take two or more weeks to die in this way. While consent to continue is sometimes sought after the first few days, it would be downright unethical to re-awaken the patient in the later stages of starvation and dehydration. Yet palliative care feels comfortable to continue terminal sedation without re-confirmed consent.

    In jurisdictions culturally close to New Zealand, assisted dying has been overwhelmingly described by doctors, patients and families as a swift and peaceful release.

    Spain and the state of Tasmania passed assisted dying legislation in March. South Australia, Queensland and NSW will be debating similar legislation this year. The clock will not be turned back on assisted dying in the world of Westernised medicine. Patients want it. Doctors see the need for it.

    We respect our palliative care colleagues and fully support the expansion of their services. Some of them are members of our group. We do not support evangelisation of the anti-assisted dying rhetoric by a group purporting to speak for all palliative care practitioners. Above all, we do not support our national broadcaster being used to sow seeds of doubt where there need be none.

    ■ Dr Jack Havill is spokesman for Doctors for End-of-Life Choice NZ. He is a retired intensive care medicine specialist and lives in Hamilton.

  • 21 Apr 2021 12:26 PM | EOLC Admin (Administrator)

    Dr Gary Palinda

  • 20 Apr 2021 6:08 PM | EOLC Admin (Administrator)

    Unapproved use of an approved drug is often called “off-label” use. This term can mean that the drug is:

    • Used for a disease or medical condition that it is not approved to treat, such as when a chemotherapy is approved to treat one type of cancer, but healthcare providers use it to treat a different type of cancer.
    • Given in a different way, such as when a drug is approved as a capsule, but it is given instead in an oral solution.
    • Given in a different dose, such as when a drug is approved at a dose of one tablet every day, but a patient is told by their healthcare provider to take two tablets every day. (source:

    Dr Gary Payinda

  • 20 Apr 2021 11:06 AM | EOLC Admin (Administrator)

    In early April, Dutch activist group, CLW launched legal action against the Dutch state arguing that the prohibition on assisted suicide and assisted suicide drugs should be abolished. The Pushback: Towards a New Human Rights Debate is the topic of Exit’s 21st Podcast.

    If self-determination is a fundamental human right, CLW argue and if a nation State keeps this so-called right un-exercisable, it makes the right a false one and the State is, thus, acting unlawfully. The April ‘The Pushback: Towards a New Human Rights Debate’ Podcast seeks to examine the recent constitutional court decisions in Germany and Austria – decisions which serve as the model for the recent Dutch actions of group CLW. We examine, too, the plans of Ultime Liberte in France to follow suite, arguing that ‘fraternity’ a concept enshrined in the 1958 French Constitution is similarly worthy as a basis for a legal challenge towards individual autonomy.

  • 14 Apr 2021 10:08 AM | EOLC Admin (Administrator)

    Andrew Denton investigates the stories behind Victoria’s landmark Voluntary Assisted Dying (VAD) law: Who seeks to use it, and why? Who are the doctors stepping forward to help them? And how does the Church continue to resist a law it describes as ‘evil’?

    New episodes out Tuesdays and Thursdays.

    More here »

  • 12 Apr 2021 12:19 PM | EOLC Admin (Administrator)

    The End of Life Options Act was approved by Governor Lujan Grisham in the USA state of New Mexico on 8 April 2021. The legislation was originally named for the late Hon. Elizabeth Whitefield, a distinguished and trailblazing member of the New Mexico legal community, who in her later years, after a terminal cancer diagnosis, became a fierce public advocate for dignity in dying. She died in 2018. 

    Read more »

    Judge Elizabeth Whitfield and her husband.

  • 29 Mar 2021 10:44 PM | EOLC Admin (Administrator)

    Monday, 29 March 2021, 9:04 am

    End-of-Life Choice Society President Dr Mary Panko is pleased to see that the percentage of New Zealand doctors willing to provide assisted dying services has increased from 24% in 2018 to 30% in 2021. “This was anticipated, as it happens in every jurisdiction where assisted dying is legalised”, she said. “As doctors begin to realise that some of their patients may request active assistance to die under circumstances of intractable, irreversible suffering, they begin to prepare themselves to assist.”

    In March 2018, the NZ Doctor publication commissioned a survey by Horizon to determine the level of support among doctors for providing assisted dying services. The results showed that 24% would be willing to provide life-ending medication to an eligible patient for self-administration while 12% would be willing to directly administer the medication to the patient.

    But a survey of 1,900 doctors by the Ministry of Health in March 2021 shows the number of possibly or definitely willing doctors has risen to 30%.

    “The Society is working with Minister of Health Andrew Little during the establishment phase of the regulation,” said Dr Panko. “We want to ensure that fully protective safeguards are in place and also that access to the service is fairly and equitably distributed.”

    “Given the tightness of the eligibility criteria, we anticipate that only about 5% of patients will qualify for assisted dying. It may be that fewer than that will request it. So we believe, along with Minister Little, that an adequate workforce will be found.”

    Listen to EOLC President Mary Panko speaking on RNZ »

  • 24 Mar 2021 4:53 PM | EOLC Admin (Administrator)

    Man-of-the-hour Tasmanian MP Mike Gaffney was delighted that his voluntary assisted dying bill passed in the Legislative Council on 23 March 2021.  “It’s been a wonderful journey” he said, “as smooth as I could have hoped for”.

    Tasmanian assisted dying bill passes unanimously - Dying with Dignity Western Australia

    His Independent member’s End-of-Life-Choices bill was unanimously passed in 2020 by Tasmania’s Legislative Council (Upper House).   It then went to the Legislative Assembly (Lower House) for further examination.    A number of amendments were made and the bill eventually made its way back to the Council for approval. 

    It is expected to come into force in 18 months’ time.  

    The Tasmanian Act is slightly more permissive than the New Zealand End of Life Choice Act 2019, in that it also gives assisted dying access to those suffering with a neuro-degenerative disease likely to end their life in 12 months or less.  Both Acts allow access to assisted dying for those with other terminal diseases likely to end their life in 6 months or less.

    This was Tasmania’s fourth attempt at passing assisted dying legislation.   After Victoria and Western Australia, Tasmania will now become the third Australian state to adopt assisted dying laws.  

  • 19 Mar 2021 1:29 PM | EOLC Admin (Administrator)

    End of Life Choice Society president, Dr Mary Panko, today congratulated Spanish lawmakers on passing their assisted dying bill into law. “This is the sign of a compassionate society” she said.

    Spain’s legislation is expected to come into force in June. Its eligibility criteria are more liberal than those of the New Zealand End of Life Choice Act which will come into force on 7 November 2021.

    “Religious and far-right political groups have threatened challenges to the Spanish legislation, as expected” said Dr Panko, “even though a 2019 poll indicated 90 percent support for assisted dying legalisation among Spanish citizens. It is the usual case of an ultra-conservative minority attempting to suppress the will of the more progressive majority.”

    Spain follows a number of other European countries where assisted dying is permitted, namely Switzerland, the Netherlands, Belgium and Luxembourg.

    “The right to die with dignity is an expanding social and medical movement across the world of westernised medicine”, said Dr Panko. “We expect a number of other jurisdictions to legalise assisted dying this year, especially in Australia and the US.”



    Dr Mary Panko

    President, End of Life Choice Society

    Mob: 027 419 7802


  • 30 Jan 2021 1:52 PM | EOLC Admin (Administrator)

    Source: RTE

    Portugal's parliament has passed a law allowing medically assisted dying, putting the Catholic-majority country on course to become the fourth in Europe to legalise euthanasia.

    Before coming into force the bill must first be signed into law by President Marcelo Rebelo de Sousa, a staunch Catholic and conservative who was re-elected only last weekend.

    However, the president - who has yet to make public his position on the issue - could also either use his veto against the legislation, or refer it to the country's constitutional court for further study.

    The bill was adopted in parliament by 136 votes to 78 with four abstentions - thanks largely to a majority of votes from the ruling Socialist Party which had allowed its MPs to vote freely.

    If the president did decide to veto, a second vote by lawmakers would override it.

    Politicians had approved proposals aimed at changing the law in February, setting up the vote despite a campaign by the Church for a national referendum on the issue.

    Socialist MP Isabel Moreira, a constitutional law expert who helped draft the law, said that it would respect "free choice and every individual's independence".

    The bill legalises access to assisted suicide for adult patients in a situation of "extreme suffering and irreversible damage".

    Several doctors must green-light the procedure, while a psychiatrist would be called in if there are doubts about the patient's ability to make a "free and informed" choice.

    Euthanasia is legal in three European countries - Belgium, The Netherlands and Luxembourg - while others allow terminally ill people to refuse life-maintaining treatment or to have help to die.

    "People deserve the right to be able to choose," retired oncologist Jorge Espirito Santo, who has campaigned for years to make euthanasia legal in Portugal, said before the vote.

    He said he was expecting a "historic day".

    The Catholic Church, which predominates in Portugal, campaigned against the bill both among its own faithful and those of other denominations.

    Its bishops' conference immediately expressed outrage at parliament's approval of the legislation, calling the law an "unprecedented step backwards".

    In December, parliament in neighbouring Spain voted by a wide margin to approve a bill that will allow euthanasia under strict conditions, despite fierce opposition from the Catholic church and conservative parties.

Better Off Dead

 – Andrew Denton

Season 2

Andrew Denton investigates the stories behind Victoria’s landmark Voluntary Assisted Dying (VAD) law: Who seeks to use it, and why? Who are the doctors stepping forward to help them? And how does the Church continue to resist a law it describes as ‘evil’? 

Listen to Season 1 »

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