Incurable pain: Is euthanasia the answer?


Christchurch psychologist Dr Mark Ottley, says the best medications, psychological help and palliative care did not always work for patients.

Ottley leads psychological pain management services at Southern Rehab.

He outlined his views in a submission to the Health Select Committee inquiry into euthanasia legislation.

Confusion of Terminology

The director of The Nathaniel Centre Dr John Kleinsman said that there seemed to be considerable confusion in the terminology and arguments Ottley puts forward.

“In the first instance it is a classic example of using hard cases to justify a law change.

“As any lawyer will tell you, ‘Hard cases make bad law’.”

Secondly, he seems to be confusing ‘incurable pain’ and ‘psychological suffering’.”

Extremely rare for people to die in pain

Kleinsman said he  has discussed the question of pain management with many skilled palliative physicians who repeatedly tell him that palliative medicine has now developed to the point where it is extremely rare for people to die in pain.

“In those rare instances where pain is difficult to control there is always the option of using palliative sedation.”

“The ability of palliative medicine to address physical pain is well understood now by most proponents of euthanasia and assisted suicide – they readily accept that the issue is about suffering and the desire to exercise control rather than about physical pain,” says Kleinsman.”

“One only needs to look at the government statistics from places like Oregon and Washington State to realise that the people requesting assisted suicide do so for reasons other than physical pain.”

Psychological suffering can be effectively dealt with

Kleinsman says the major reasons people give relate to things like fear of becoming a burden, loss of dignity, loss of autonomy, feelings of worthlessness, social isolation and various forms of psychological suffering – issues that relate to psychological and social concerns.

He says this suffering can also be effectively dealt with, and without advocating a regime that institutionalises premature death as a socially desirable and even dutiful thing to do.

Changing the law send out the wrong message

“Changing the law to allow euthanasia and/or assisted suicide will send a message to our society that killing one-self or being killed by another is an acceptable way of dealing with suffering,” says Kleinsman.

“Firstly it will undermine our efforts to prevent suicide in vulnerable groups such as young persons and the elderly.”

“Secondly, it will actually make it harder to help people who are trying to come to terms with an advanced progressive illness or disability.”

Kleinsman point to countries like Belgium and the Netherlands where the same sort of argument based on the hard cases  were advanced when they first discussed a law change.

“We only need to look at how widely available euthanasia is in those countries to know that it does not stop at the hard cases.”

“Their laws have been continually expanded to include many categories of people who are not dying, including now a push for anyone over 70 to be eligible without any specific reason.”

“It is not about where we start with respect to any law around assisted suicide and euthanasia but where it will take us and where we will end up.”


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