NZMA Does Not Represent Doctors on Euthanasia. Further Correspondence.

I’ve written several posts on the New Zealand Medical Association’s negligent position on euthanasia, best summed up in this post on why it is urgent we have euthanasia law enacted (with links to my correspondence with the post chair of NZMA):

In this post and this post to Dr. Mark Peterson, Chair of the New Zealand Medical Association, I explained how the NZMA’s position against euthanasia is based upon a contradiction, or a conceit, rather, and as such, is an irresponsible, dangerous (for doctors and patients), ethical mess. That contradiction is NZMA opposing legal euthanasia, yet with that stance ‘justified’ by dint of the back-street provision they cite of it being ethical for doctors over-prescribing pain killers to keep pain at bay, even if to an extent that might hasten death, despite no threshold or certainty is provided as to what 'over-prescribe' or 'hasten' means. Incredibly on an official level it's the ‘we don’t need euthanasia legalised because it already unofficially occurs’ nonsense. This stance also draws the inference, repugnant to myself, that it's Dr. Peterson and his colleagues who know best and get to decide the circumstances of a death; that the decision over a dignified exit is not up to those dying.

Such a mealy mouthed wording, and professional arrogance, in a matter that concerns all of us at the most poignant part of our lives, dying, is as offensive as it is preposterous.

I’ve also written previously on Lecretia Seales who died this year after her unsuccessful legal action to be given the choice of dying with dignity. Yesterday her husband Matt significantly wrote this of doctors and the NZMA (my highlighting):

I had a chat with someone today, a healthcare professional, who was very clearly in favour of Lecretia having the choice she wanted. Here was a person on the front lines, working with a lot of dying patients, and completely familiar with the gap between the rhetoric and the reality of palliative care, as Dr Rodney Syme calls it. They knew and felt that a patient having that choice was not going to interfere with them being able to do their job, that it’s arrogant in the extreme to deny a patient choices, and yet the organisation that purports to represent them holds a completely inconsistent view. Sadly, given the number of doctors and nurses I’ve spoken to who are supportive and would want the choice for themselves are frightened into silence for fear of being reprimanded by these associations.

It’s only when doctors or nurses find themselves in a terminal situation, such as well-respected Auckland doctor John Pollock in 2010 or Australian palliative care nurse Ray Godbold earlier this year, that they find the bravery to speak out about the choices they want. I think some of these professional associations need to take a good hard look at themselves and figure out whether they really reflect the varied views of their members and what those members would want for themselves in a terminal situation, or whether their executives are using their position as spokespeople to advance their own beliefs. If that’s the case, I hope their membership summon the bravery to recognise that and call them out. Because it really isn’t on.

I hope NZMA will not be making a submission to the select committee against euthanasia. For them to do that would be callous, cruel, hypocritical, and unrepresentative. I note that since Dr. Childs took over as head of NZMA, I have had one correspondence with him on this topic; his reply was the below:

1)  As noted in our recent media statements, the NZMA fully respects the rights of patients to decide (patient autonomy) as included within our Code of Ethics.

2)  Therefore we fully respect the right of society to debate this topic and have made no attempt to stifle this discussion or to pass strong judgement on the outcome.

3) The medical profession respects the rights of patients to:

        A) refuse treatment

        B) to withdraw treatment and

        C) have relief of suffering via sedation and analgesia

        D ) access good palliative care services

4) Our only strong public stance pertains to the medical professionals ultimate involvement in the act of voluntary euthanasia or assisted suicide in which we hold the position that .." irrespective of the laws of the state, it is considered unethical for a medical professional to be involved in the intentional act of terminating life"

5)  Therefore, we disagree with those comments and positions that you have mistakenly attributed to the stance of the NZMA.

A better stance than the previous Dr. Peterson, but still appalling. The options for dying given in his point (3), particularly (a), and (b) are frankly inhumane, meaning in practical terms a patient starves to death sometimes over a period of more than a month, and by (c) he is (in main part) talking morphine which does not work for many, including this week Helen Kelly, and there is no recourse in this kindy of a country to cannabis oil as an alternative.

Regarding his point (4), as Matt writes above, NZMA does not talk for its membership on that point, not by any stretch. In the overseas jurisdictions where it is legal, many doctors are happy to ethically and compassionately - compared to the alternative of starvation - provide an assisted dying service. We all self-manage our health issues throughout our lives; this decision is merely the end of that process: let's grow up.

None of this is good enough.