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Reports of people who have requested euthanasia experiencing prolonged, traumatic end of life experiences say euthanasia medication may be to blame.
This information is included in Radio New Zealand’s (RNZ) research into how prepared New Zealand is to introduce assisted dying.
In some cases concoctions of unregulated and “off label” medicines are being given to patients. The mixtures are not approved by regulator Medsafe.
People who chose to swallow or ingest the fatal medicines, rather than taking them intravenously, are given drugs compounded (mixed up) by a pharmacist.
The Ministry of Health says those who opt for an injection are given Medsafe-approved drugs – but their approval is for a different purpose. In these cases, the medicines the patient is provided with are being used for an unapproved, or “off label”, use.
Hundreds of pages of documentation, much of it heavily redacted, was released under the Official Information Act as part of RNZs investigation.
Among the documents is an email from Dr Bryan Betty (pictured), medical director at the Royal New Zealand College of GPs.
Betty warns that mixing concoctions of drugs had led to traumatic deaths.
His warning to the Ministry of Health used the example of American states not being able to access death penalty drugs due to cost and availability.
“So they made up their own concoctions initially, with examples of prolonged processes until fine-tuned.
“Belgium had a standard process but [this was] not used by many doctors for some years, also resulting in prolonged, distressing deaths.”
Betty says it is important to develop strong guidelines in New Zealand to avoid traumatic end of life experiences.
New Zealand could mitigate those risks upfront and be very prescriptive about what could be used and an end of life situation, he argues.
“You need to get it right. And you need to get it right the first time. I don’t think we can accept room for error in this space.”
Ministry of Health documents show sourcing medicines is identified as a “key risk” to the assisted dying regime.
By January this year, a Ministry of Health implementation project team warned medicines “will not be available on day 1” unless a tight time frame was met. They pointed out it takes up to 18 months to regulate a new medication.
Records of a meeting of Pharmac, Medsafe and ministry officials show international companies could be reluctant to provide the drugs on ethical grounds.
The Ministry of Health’s regulatory assurance manager is seeking a literature search on what medicines were used overseas, including “medications given for death sentences” by lethal injection.
At present, euthanasia preparations are experiencing a worldwide disruption.
This occurred after parts of Europe called a halt to exporting drugs being used in the United States for executions.
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