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Newstalk ZB: Palliative Care experts say we shouldn't allow euthanasia

With Larry Williams & Sinead Donnelly.

First, Palliative Care experts say we shouldn't allow euthanasia – using Canada as an example, with lots of unwanted outcomes. David Seymour’s End of Life Choice Bill is in lots of aspects based on Canadian law; the Justice Select Committee has only recommended minor changes, but said it could not decide on many of these substantial issues. Dr Sinead Donnelly is a Palliative Care Doctor in Wellington, and Sinead ‘hi’ to you and thank you very much, appreciate it.

Dr Sinead Donnely:
You're welcome.

Larry: So, tell us what we have learnt – or what we can learn – from the Canadian situation?

Sinead: Well, David Seymour who's the sponsor of the Bill, in New Zealand Euthanasia, has cited the Canadian law in his favour saying that it is one we’re copying. And the Bill that he's proposing is very similar to the legislation in Canada and the Canadian doctors who have written and published on it have said that Canadian laws caused confusion, doubt, conflict and, crisis. The Canadian legislation of Euthanasia has been there for about 2 and a half years and in that time they’re already getting quite a bit of pressure to expand or to expand the rules that mean other people can be included. So, originally the safeguards were written that it was for people – similar to this law in New Zealand – that is was for people with grievous or irremediable conditions and who were potentially going to die in the foreseeable future. So, now that's been challenged in Canada so they dropped the ‘death and foreseeable future’, so there's no limitation in regards to prognosis. In addition, there have been challenges in the courts in Canada, so that they want it to be available to mature minors – that’s children who are about 12 and 13 years of age who they consider to be able to make mature decisions, and actually in the Toronto Childrens Hospital they have prepared draft guidelines (it's an internationally recognised major centre for children's care), they’ve produce draft guidelines for euthanasia, for mature minors, including the fact that a mature minor (someone 13 and 14 years of age) doesn't actually have to tell their parents – they can make the decision on their own and the parents would find out afterwards.

Larry: Yeah, there’s no suggestion Dr that is going to happen here? I mean, are you saying that it’s the thin edge of the wedge, and that this is what it’s going to branch into later down the track?

Sinead: I think so.

Larry: Do you?

Sinead: If the State, society, or the legislature – the 120 MPs – decide that you have to have euthanasia (a doctor intentionally ending the life of a patient) because someone is suffering intolerably in their view, and that they have an irremediable condition – now an irremediable condition is something you can't cure – so it's not really a medical term because it covers something like arthritis: you can't cure a osteoarthritis, so that's a irremediable condition. Diabetes is an irremediable condition, you can't actually cure it, you can only manage it. So the legislation that David Seymour has produced (the Bill) if interpreted in law, will be extremely broad, and as I said if you then legislate for that and say well then it's for those over 18, they’re going to challenge in the court afterwards and say, “Well, what about the young people who are suffering intolerably? That's unfair on them – that's discrimination”.

Larry: Okay, right, well this has to be refined yet doesn’t it? So we don’t actually know what we’re going to end up with, so as I understand it, it’s for terminally ill people have have less that 6 months to live?

Sinead: Sorry Larry, it’s also for people who have an irremediable condition. So that’s a hugely broad category. It covers even people with disability, who are enjoying life who aren’t dying.

Larry: Well, with respect, I thought that the disability thing had been taken out. But, let’s go back to basics here. Isn’t it still up to an individual to end their life? It’s not mandatory, it’s a choice here.

Sinead: The problem about legislation – and I'm not a legislator, I'm a doctor who cares for people every day – is that when you introduce law, it’s not for one person or a few people, who might be a white middle-class, well-educated professionals who can feel empowered to make choices like this: this may potentially cover a large group of people – because I meet people each day, for example older people who say to me, “Oh, don't do much for me. I feel I’m a burden on the family.” Those people are vulnerable. Now you introduce euthanasia legislation: look at Oregon where they have assisted suicide, and the common cause or reason for the people requesting it, is it that they feel a burden, loneliness, sense of isolation, and their fear of losing independence.

Larry: I have an email from a doctor who emails me regularly, who says “Doctors will not be coerced – end of story”. Can I ask you this: is your view based on your experience as a palliative care doctor, or is it a religious thing?

Sinead: My experience of 27 years experience in palliative medicine as a physician. My grandfather is a doctor; my two sisters and two brothers are doctors; so I've really committed my whole life to caring for people, so that’s where I have huge experience for caring for people who are vulnerable, who are suffering – and I know how to care for them, and I also know how vulnerable they are.

Larry: I respect your views on this, and your expertise and experience. What do you think about a referendum  on this issue then?

Sinead: The people in a way have spoken – around 39,000 people submitted to the Justice Select Committee their written opinion, and some of them the, more than 1,000 spoke. So, they have taken the trouble to write in. They’re the people who are probably the most – who feel hugely on this topic. So 90% of those people are opposed to euthanasia and wrote and explained why in their submissions to the Justice Select Committee. The concerned about the referendum is that it's a very complex topic – and to just tick a box ‘yes’ or ‘no’ on a topic that’s so complex, doesn't really do it justice. Because the risks are huge to the vulnerable in New Zealand society. Today, there was a rally outside Parliament of the Pasifika people who articulated extremely well how their approach to this, because they are already feeling in the healthcare system vulnerable, and this will further limit or reduce their trust in the healthcare professionals.

Larry: Doctor, thank you very much for coming onto the programme. I appreciate your help, thanks Doctor. That is a Dr Sinead Donnelly, Palliative Care doctor.


Dr Sinead Donnelly also appeared recently in the Care Alliance's "icare" series in which Dr Donnelly shares how euthanasia would impact the way she works with her patients and responds to suffering (below).

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