COMMENT By Dr John McMenamin
The planned referendum on the End of Life Choice Bill will require careful thought. Polemic viewpoints around a contentious issue are expected, but our voting needs to be a considered choice.
Central to our decision is an understanding of life itself – whether it belongs solely to us or if we hold it in trust. Certainly the concept of life in trust is informed by religious belief, but not only.
Understanding life and indeed our Earth and our world as entrusted to us to care for is also informed by our culture, our experience and our life philosophy. So too is our view on whether choices belong solely to us as individuals or whether we must consider and involve and hear other voices.
This wider perspective is partially captured in the traditional concept of the family doctor, whose heath care service was focused on patients within the context of their family.
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Current concepts in health care go beyond this – those of us involved in providing health care must respond to the needs of the person as an individual while carrying a real awareness of that person within their family/whānau and with an awareness of how their care will affect significant others.
The medical profession is legislated into this bill, so this is a good starting point for considering its effects. The New Zealand Medical Association, the largest group representing doctors in New Zealand, opposes euthanasia.
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These doctors do support wise and sensible medical planning at the end of life and this already includes ethically appropriate decisions to withhold treatment that will unnecessarily prolong life; it also includes a person's right to refuse treatments; and further includes situations in which treatment for symptom control may in effect hasten death.
These doctors are not unaware of cases where individuals feel they are making a valid decision to end their life. But the wishes of individuals does not balance the harm done to the profession and to society by deliberately taking life.
There is a profound change in direction for doctors to shift from a lifetime focused on preserving life to being involved in taking life.
The relationship between patients and doctors must be built on trust – people entrust us with their problems, concerns, expectations and in many cases with their life. We cannot stand in both places – the very nature of the trusting relationship demands we commit to respecting life whether this comes from religious, cultural, or philosophical perspectives, or whether it is just because that is what inherent in entering this profession.
It is not possible for us to hold these values and at the same time support the deliberate taking of life.
*Dr John McMenamin is a Whanganui GP with long term experience in clinical practice and end of life care. He is a member of New Zealand Medical Association and supports its position on euthanasia.