OPINION: New Zealanders will have to make a life-changing decision when they vote in the referendum on the End of Life Choice Act at the general election in September.

For decades, hospice services across the world have upheld a philosophy of care that aims to neither hasten nor postpone death.

Staying true to this founding tenet has never been more important or challenging in the face of a potential law change to allow euthanasia.

When Hospice NZ reviewed the End of Life Choice Act, we were deeply concerned with the lack of clarity and detail when it came to the potential application of the act. Following legal advice, Hospice NZ took an unprecedented action to seek clarity from the High Court on how the act could work, should it pass into law.

We sought a declaratory judgment seeking clarity on whether an organisation, such as a hospice, can conscientiously object to assisted dying. We asked whether the acts mandatory obligations on a health practitioner override their ethical, clinical or professional judgments and obligations under the Code of Health and Disability Consumers Rights.

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Hospice NZ chief executive Mary Schumacher says determining how long a person has to live with a terminal illness is very problematic and often inaccurate.

Taking this action was a difficult decision, as not-for-profit organisations do not enter into legal action lightly. But it was necessary, as the gaps in this proposed act, which will not return to Parliament for any further changes, left us unsure of how it could work in practice.

Following the hearing and deliberation, Justice Jill Mallon released her findings in mid-June and now we are focusing on sharing this information as widely as possible ahead of the vote.

The judgment confirmed:

Organisations such as hospice have a right to hold conscientious objection

The court ruled that organisations such as hospice can have an entrenched moral ethos that qualifies for protection under the right to freedom of conscience in the New Zealand Bill of Rights Act 1990.

This means that organisations like hospice services, aged care facilities or GP practices can object to assisted dying, as set out in the End of Life Choice Act, happening on their premises or by their staff.

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The End of Life Choice Bill passed into law last November. The referendum in September will decide whether the End of Life Choice Act comes into force.

There are a range of health care providers who may wish to create a safe space for patients, whnau, staff and volunteers, who do not wish to be exposed to the practice of euthanasia while receiving care, in their place of work or, in the case of aged residential care residents, their home.

The mandatory provisions in the act do not override the Code of Health and Disability Consumers Rights

Justice Mallon made it clear that the acts mandatory obligations do not override the standard ways in which a healthcare practitioner determines competency and informed consent without coercion. The proposed act sets a much lower standard for both as part of the assessment process.

However, a practitioner must decline to follow a direction in the act if they are not satisfied under ordinary professional standards.

The attending medical practitioner must have appropriate qualifications and experience to undertake assisted dying services

Justice Mallon clarified the definition of attending medical practitioner as one whose scope of practice includes care of the dying and who has been involved in the patients care. They must also have sufficient skill, expertise and knowledge of the patient to be able to properly undertake the assessments, provide the advice, and reach the opinions required of them. Any doctor who does not meet these requirements would be expected to transfer on the patients care to someone appropriately qualified and experienced.

Whilst this clarity is very helpful in terms of understanding how the act could work in practice, we still believe this act is fundamentally flawed. The safeguards are inadequate or absent. Determining how long a person has to live with a terminal illness is very problematic and often inaccurate. People with mental health issues, living with disability and a terminal illness will qualify for euthanasia.

Most importantly, people living with a terminal illness should be supported to live in whatever way is important to them, their family and whnau, and make the most of their remaining life and not be subjected to pressure to end their life prematurely.

People should have access to good palliative care support regardless of where they live, but we know that this is not the case currently in Aotearoa New Zealand. We need to address issues of access to care, social isolation, and lack of support for family carers before we give people the means to choose death.

The words of the founder of the modern hospice movement, Dame Cicely Saunders, have never been more relevant when we think of dignity and compassion at the end of life: You matter because you are you, and you matter to the end of your life. We will do all we can not only to help you die peacefully, but also to live until you die.

Mary Schumacher ONZM is chief executive of Hospice NZ.

Originally posted here:

Euthanasia referendum: Why Hospice NZ went to court over law - Stuff.co.nz