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Tagata Pasifika: Debate on End of Life Choice Bill featuring Dr Ate Moala and Togi To’o

This week’s talanoa (dialogue) we are joined by Dr Ate Moala, who is against The End of Life Choice Bill and social work student, Togi To’o who strongly supports the Bill. The End of Life Choice Bill would give people with a terminal illness or a “grievous and irremediable medical condition” the option to request assistance to die.

Marama T-Pole: Well, as we saw earlier, the End of Life Choice Bill is going through Parliament and I think it has really brought up a lot of emotions in our community.

Well, joining me on Talanoa (Dialogue) to give their thoughts on the Bill is Dr Ate Moala, who is against it, and social work student Togi To’o who strongly supports the Bill. Well, in a nutshell, because it is such a complicated one, this Bill gives people with a terminal illness or a “grievous and irremediable medical condition” the option to request assistance to die.

Thank you both for coming on the show. First of all, Dr Ate Moala, you're against the Bill; why do you feel that way?

Dr Ate Moala: Thank you very much, Marama. I feel very passionately against it. It will be the first time in the history of Aotearoa, and of course will flow over to our South Pacific nations, for doctors to be allowed to legally kill their patients – and death then will become a medical treatment for doctors to do. And in the current constraints of the District Health Boards, New Zealand healthcare resources, a death will be cheaper. So over a thousand doctors have already said “No”.

Marama: Some of these decisions are already being made now, aren’t they, currently in hospital? We've heard about the slow walk to a medical event or in terms of choosing not to give treatment or and how it has been given. It has already been made?

Dr Ate: I think that's the point. The most recent survey they've done, over 95% of the people who were for the Bill, they thought it includes turning off life support, 80% thought that it includes withholding treatment – so that's two different things. When doctors and healthcare workers withhold treatment for different reasons, whether the patient is dying (Do Not Resuscitate orders) but the surveys show that 8 to 9 out of 10 of the people who are for the Bill thinks this is the same thing as turning off life support or withholding treatment or Do Not Resuscitate so it's important that our community understands that.

Marama: Togi, you are very clear on why you support the Bill. Tell us your reasons.

Togi To’o: I think what’s formed my views around it is just based on my personal experience in dealing with someone who’s suffered a terminal illness.

Marama: Tell me about that. So this was a close relative?

Togi: Yeah, close relative of mine. My grandma was diagnosed with a sarcoma which is cancer of the tissue in the bone. She also had her leg amputated and was given a short amount of time to kind of live. You know, so I think seeing the deterioration of her health rapidly drop, yeah, kind of changed my views in terms of the dignity – her dignity – I mean, she ended up, you know, having to have nurses wash her down every day and the change of nappies. I think, you know, when you're looking on the outside and you're just thinking about those kinds of things that kind of does a lot…

Marama: It moves your viewpoint?

Togi: Yeah, it does, it does. You know, and I can understand everyone has their own experience, um, but yeah, it’s a tough topic to really…to really, yeah.

Marama: And even your grandmother actually stated that she..

Togi: Yeah, kind of at the end, you know, even going into Hospice and palliative care, um, I think palliative care didn't do much, I mean, we went to see her, she wasn't really conscious, you know, like she wasn't aware who was around her, um, so I kind of think, yeah, just the care, the care of it just prolonged the process of death, like literally.

Marama: And that’s the one issue that you want to, you know, see in this Bill, to have people make that, you know, choice of a dignified death?

Togi: Yeah, that’s right. I think it's based on a human right to kind of, um, decide how we, I mean, we, we, you know, we choose how we live, so we should be able to choose how we die. That's my personal opinion on that.

Marama: What do you say about that, Ate, hearing, you know, these kinds of stories are quite common. A lot of people say have said they have seen a loved one suffer and we wouldn't let an animal go through that.

Dr Ate: Absolutely. I'm so sorry to hear, you know, your grandma and totally understand it. You know in the 34 years of working as a Medical Doctor, you see people suffer but I think it's important – I mean we’re not denying what your family went through – there's a couple of things. I believe that the debate is not against suffering because when you look at the results from Oregon, for example, it showed that over 95% of those – you know, so that's 9 of 10 – have chosen it because they felt that they couldn’t continue on. But I think in New Zealand, especially for Pacific people, the issue for us is the barriers of access to care. And with this Bill, you know, Pacific people do not have that much choice, you know, compared to other people. Not just Pacific but those who are vulnerable. When it’s happening in the public hospital, you don't choose your doctor.

Marama: What do you say to that? I know there is a group worried about the threat this Bill poses to Māori as well, the elderly, the poor, also for mental health reasons. What do you say to that in terms of Pasifika communities, Togi?

Togi: Pasifika,I think, yeah, they need their input and they need to be involved in how they would try and support the Bill I know it’s, um, there's a lot of conflict.

Marama: Even you're not happy with how it’s been written, isn’t it.

Togi: Yeah, I’m kind of not, like, I agree that for terminal illness only but then when you're focusing on other things it kind of opens it up to the vulnerable and the suicide, kind of, idea.

Marama: We, we, we saw in the story online with the march – a lot of Pasifika people there – and even we had a poll online which showed a lot of people are who are Tagata Pasifika Facebookers were really against the Bill compared to those who support it. Listening to those in our community who hold a lot of those conservative views, do you think that really holds water still or is it a valid issue?

Dr Ate: It is important for Government to understand the barriers that we have as Pasifika to access care. Where there is suffering and pain in New Zealand there’s quality palliative care and I think it's important that our community be able to access that.

Marama: I see you, Togi there, feeling a bit uncomfortable hearing that, but is it an issue, you think, that we should be having more conversations about death?

Togi: Yeah, I think death should be a healthy topic to talk about, but I mean, in terms of New Zealand law, it doesn't prevent people that have terminal illnesses or want to pass go to other countries, you know, that euthanasia is legalised, you know, so that's an option. It’s an option for people.

Marama: There's still so much we haven't covered. I know there's a lot of issues there and I know even now MPs, you know, there's still time if you want to go and talk to them about whatever your view is about it as well.

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