Palliative care is grossly underfunded

Assisted Dying Service

Serious concerns have emanated from the first annual report of the Assisted Dying Service.

The Assisted Dying Service which came into force last November has just released its first annual report for the period from November to March.

By the end of June, 400 people had applied for an assisted death, 143 had died and 68 were deemed ineligible.

John Kleinsman, a bioethicist at The Nathaniel Centre, is particularly concerned that the Ministry of Health has six full-time positions dedicated to assisted dying – and there is no dedicated team for palliative care.

“There is an action plan for palliative care developed after a review in 2017 but many health practitioners working in the palliative care sector are not seeing any action,” he says.

“Proponents of the End of Life Choice Act promoted its introduction as being all about choice, but it’s a ‘Clayton’s choice’ (no choice) if palliative care, which we know is effective, is not accessible.”

Kleinsman says that end-of-life “choice” is heavily weighted in favour of assisted dying, because of the increasing demands on New Zealand’s underfunded palliative care sector.

“Demand is projected to rise 50 per cent in the next 10-to-12 years and access is uneven depending on where you live,” he says.

“It has been well documented that palliative care is grossly underfunded in Aotearoa.

“The idea that assisted dying will become a solution to a lack of quality end-of-life care is extremely distressing and frankly unethical and undermines the notion of it being a choice.”

The Assisted Dying Service’s report also notes many want the threshold for accessing euthanasia lowered – they complain the End of Life Choice Act is too restrictive.

“The legislation is not as enabling as some people were hoping for with the criteria making an assisted death more restrictive than overseas jurisdictions,” the report says.

Kleinsman says this is precisely the pattern that has unfolded in other countries and something that many warned about.

He says he hopes the Ministry will collect a broader range of data on assisted dying, including people’s reasons for choosing the service.

At present, statistics are collected on applications, numbers accepted for assisted dying and those who don’t qualify or died before being able to make use of the Service.

Additional statistics could help safeguard against wrongful deaths by helping to identify whether people felt a “duty to die” because they were a burden on family or caregivers, he says.

The Assisted Dying Service’s first annual report says patients and family members say they are happy with the Service, the support from doctors and the “peaceful” and “dignified” deaths of their loved ones.


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