The Royal New Zealand College of General Practitioners submitted its response to the bill to the Parliament’s Justice committee on submission closing day and made 17 recommendations including for the Government to improve and strengthen palliative care services and invest more money in mental health services.
It also called for a public information campaign as members had expressed concern that the general public lacked understanding about the dying process, palliative care and what constitutes euthanasia or ‘assisted dying’.
The College’s submission was supported by a summary of members’ feedback which included GPs strongly supportive of euthanasia, GPs who supported euthanasia in principle but said they would find it personally or professionally “very difficult to be both the caring doctor and the ‘mechanic’ who performs the deed” to GPs who wholeheartedly opposed euthanasia and the bill.
Dr Tim Malloy, the president of the College which is the professional body for GPs who make up 40 per cent of the medical workforce, said College members – whether for or against euthanasia – were motivated by compassion.
“We believe that each general practitioner in New Zealand will have their own ethical view on whether euthanasia or physician-assisted suicide is right,” said Malloy.
“However, whether or not this Bill goes ahead, there are significant challenges that must be addressed. Fundamentally, New Zealanders need accessible, good quality palliative care. The Government should strengthen these services, so we can all experience a dignified, comfortable death.”
He said the College also made recommendations specifically pertaining to the bill including noting that it currently had a “poorly defined criteria for assisted dying”.
“Diagnosis is difficult, we sometimes get a diagnosis wrong. And knowing if a patient is able to make a rational decision, during their end of life care, can be incredibly difficult.”
“Parliament should consider our 17 recommendations carefully, given the strong apprehension from general practitioners about legalising euthanasia and physician-assisted suicide.”
The College’s general recommendations are:
- The Government improves and strengthens palliative care services for all New Zealanders.
- The Government provides more financial support for families caring for a family member at the end of their life.
- The Government invests in ensuring Māori have access to culturally appropriate palliative care.
- The Government implements a public information campaign to ensure New Zealanders understand what euthanasia and physician-assisted suicide are, who would be eligible for it, and the wider implications of any legalisation before the Bill progresses further through Parliament. This would be of particular importance if the Government holds a referendum on this issue.
- The Government invests more money in mental health services.
It makes additional recommendations for if the law is changed that:
- The Bill specifically prevents people with mental health conditions from qualifying for euthanasia or physician-assisted suicide.
- The Select Committee carefully considers the scope of medical practitioners and minimum practice experience of the practitioners who would offer euthanasia or physician-assisted suicide services.
- The Bill requires that medical practitioners receive appropriate training and support to enable them to provide quality advice and care to patients and their families.
- The minimum age of eligibility for euthanasia be set at 25 years.
- The Bill’s eligibility criteria are reconsidered to tighten the definition of who is eligible for euthanasia and for physician-assisted suicide.
- The Bill’s introduction be amended to remove the requirement for medical practitioners who do not wish to participate in euthanasia to refer patients to the Support and Consultation for End of Life New Zealand (SCENZ) Group.
- Patients seeking euthanasia or physician-assisted suicide be obliged to self-refer to the SCENZ register in the first instance to consult with a registered medical professional who is trained and willing to provide physician-assisted suicide and euthanasia services.
- Clause 8 be amended to recognise the difficulties of making accurate prognoses and to clarify whether medical practitioners’ advice to patients is limited to medical impacts.
- The Select Committee considers how to deal with situations where a patient with reduced decision-making capacity wishes to forgo the Advanced Care Plan made when they were mentally competent.
- Clause 15 be amended to make it explicitly clear if the Bill refers to euthanasia or physician-assisted suicide, and if both, when the legislation applies to either option.
- The Select Committee considers the complexities of euthanasia and/or physician-assisted suicide if something goes wrong.
- Clause 19 be amended to ensure the privacy and confidentiality of the medical professionals who elect to perform euthanasia or provide physician-assisted suicide.
The End of Life Choice Bill here was introduced by Act MP David Seymour in June last year and passed its first reading in December. You can read the bill here
You can read the College’s full submission here.