Risks to the terminally ill

A blunt instrument targeting those facing death?

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Eligibility makes terminal patients the most at-risk group of legislation-backfire. Wrongful deaths are inevitable because this law fails to address misdiagnosis, inaccurate prognosis, lack of good healthcare, and the psychological and emotional challenges faced during every end-of-life journey.

Eligible but not ideal

The most threatened group at risk are those who have terminal illnesses.

Under the law they already fit the bill, they are more likely to pass the eligibility criteria, and at times their request may seem understandable. But hidden from clear view are the terrible truths that lay behind their request. The real reasons why they need proper care, not death.

Undiagnosed mental illness

One in six people who use assisted suicide in Oregon are clinically depressed.

Receiving a terminal diagnosis is one of the most devastating things that can happen to a person. So many emotions and fears can race through their minds and those of their loved ones. And on top of that, they may be dealing with a whole host of physical and mental difficulties – such as pain, nausea, exhaustion, confusion and intense emotions. We hear this from the diverse range of those standing with us in the #DefendNZ movement.

It’s no surprise that depression is common among the terminally ill.

The suicide of anyone suffering from a mental health condition is a tragedy. Yet this law does not offer any protection for these people. There is no required mental health screening or support included in the process.

Why people choose assisted suicide

The most commonly reported reason for a person seeking assisted suicide in Oregon is because of ‘a loss of enjoyment in life’ (90%). More than 60% also list ‘fear of being a burden on loved ones’.

In The Netherlands, ‘loneliness’ is often listed as one of the primary reasons for euthanasia.

Loneliness is fast becoming one of the biggest threats to this generation with three-in-five people saying they suffer from it. Research shows loneliness is worse for your health than obesity and smoking. It’s likely to increase your risk of death by 26%.

These are not the reasons this law in New Zealand was introduced, and these symptoms are going undetected and untreated. Instead, we offer death.

I remember thinking to myself; ‘what if I killed myself?’, I would have missed out on this day. If I had gone to a doctor during one of those dark times and euthanasia was an option... that would be awful. It’s like handing nooses to people at a suicide clinic.
— Vicki Walsh, Brain cancer fighter

Misdiagnosis and misprognosis

To be eligible for assisted suicide or euthanasia a person must have a life expectancy of six months or less. Posed as a clear line in the sand to define and protect... yet scientifically this boundary is farcical.

Ask any doctor about the accuracy of prognosis and you will discover how weak a measuring stick it actually is. In fact, studies show that between 75% to 80% of prognoses given by doctors are incorrect. Prognostication is essentially a guess. A human being is a very complex thing, and there are all sorts of things that influence the prognosis.

Prognosis isn’t the only thing that can go wrong – every year a number of people are completely misdiagnosed. People have been diagnosed with a terminal condition they do not have.

One of my first patients in palliative care was a man completely misdiagnosed. He was told he was dying... in fact, he was completely healthy.
— Professor Roderick MacLeod MNZM, Palliative care specialist

Lack of good palliative care

While the End of Life Choice Act is “all about choice” – it’s ironic that there’s no choice for those who can’t get good palliative care.

You don’t have to look far to find out about major shortages in palliative care services across New Zealand. The Ministry of Health itself says there are inequalities in access to palliative care services, particularly age, ethnicity, geographic and diagnosis groups.

As a vital service, Hospice NZ, one of our country’s biggest private palliative care groups, is only funded in part by the Government, relying on fundraising to cover the shortfall.

Other major flaws in palliative care include a lack of recognition that people who are dying can benefit from palliative care services, cultural barriers – in particular for Māori and Pasifika peoples, lack of services in rural areas, funding barriers between personal health and disability support services, poor integration and a lack of coordination of services.

Whilst palliative care provision in New Zealand is highly regarded internationally, the sector is facing significant challenges around inequities in services across the country, particularly in rural and remote regions. More direct action could be taken immediately to invest in workforce and resource challenges that are already known within the sector.
— Dr Rachel Wiseman, The Australian and New Zealand Society of Palliative Medicine (ANZSPM) Committee Chair

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