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Home / Whanganui Chronicle

Election 2020: End of Life Choice - Health professionals' take on the euthanasia referendum

Lucy Drake
By Lucy Drake
Whanganui Chronicle·
6 Sep, 2020 05:00 PM6 mins to read

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This election New Zealanders will vote on whether or not to legalise euthanasia.
Vote2020

With the 2020 election pushed back a month, voters now have more time to decide where they sit on the End of Life Choice referendum, a law that if 50 per cent tick yes will affect not only the terminally ill but health professionals as well.

Reporter Lucy Drake sat down with two local former health professionals who shared their views on the bill and what it would mean for those in the health profession if it was to be made legal.

"You spend most of your life trying to make people better, to live a bit longer and of course people are living a bit longer and then you're being asked, even if the person wants it we hope, you're then asked to give somebody an overdose and kill them when most of your life you've been very carefully learning your drugs so you never give them an overdose and kill them."

Retired Whanganui doctor of 60 years, Jonathan Hartfield has read over the bill and believes there can never be enough safeguards in place.

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He said it starts with an impossibility that a doctor has to say to a person they have six months to live, and believes nobody really knows how long someone has to live.

"So it starts with somebody making a guess and they could be very wrong."

Retired Whanganui doctor Jonathan Hartfield opposes the legalisation of euthanasia. Photo / Lucy Drake
Retired Whanganui doctor Jonathan Hartfield opposes the legalisation of euthanasia. Photo / Lucy Drake

But Sue Walkinton, a former South Taranaki Hospice trained palliative care community nurse of 51 years, believes it is very safe as there will be very few people who will be able to go through the whole process and achieve the directive.

"I want to emphasise there are so very few people eligible and the public needs to understand that because the criteria are so absolute and any suggestion of anybody who might be depressed or who might not be able to be totally mentally competent, they're simply not going to get through the hoops."

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She said although the word "terminal" has become very broad, and a terminal illness can be difficult to determine, she believes medical people know when a patient is dying and when their symptoms indicate a patient is in their last stages of life.

"The six months thing has always been challenged so doctors are more cautious now and when this comes into law they will be more cautious."

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From working as a district nurse and taking patients from post-operative care through to their treatments, and often at times being a celebrant at their funeral or tangi, she believes she knows when a person is dying and a patient knows it too.

"I believe that most people know where their sort of line is, where they feel they can cope up until."

But what about a doctor's oath?

At age 25 Hartfield decided he would not join the army, because he was never going to kill any other person.

"Doctors choosing to do this have got to realise they actually have to be prepared to kill this particular person themselves which is all against our training and all against healthy human beings."

But Walkinton said supporters of the Bill see it as a way of relieving suffering and that is within the doctors' oath.

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"I guess it again is interpretation. The oath has been modernised now because the issue these days is, as a patient said to me, medicine has kept me alive and now medicine must allow me to die."

For her, it comes down to giving people the choice.

"That's why I feel strongly about it because people didn't have a choice."

She said around 5 per cent of the people she had looked after had asked her to help end their pain and suffering; however, she said ultimately they probably would not choose to be euthanised, but they never had that choice.

"It's interesting when looking at research that, when it becomes legal and people go through the process and they are able to have a choice, they find that one-third of those people actually follow it through with it."

Former South Taranaki Hospice community nurse Sue Walkinton is in favour of the End of Life Choice Bill. Photo / Lucy Drake
Former South Taranaki Hospice community nurse Sue Walkinton is in favour of the End of Life Choice Bill. Photo / Lucy Drake

But for those who do choose to go through with it, Hartfield said, research has shown around 15 per cent of doctors have had to intervene in the process because of complications such as the patient waking up, vomiting or having convulsions.

He said doctors would have to be prepared to administer the lethal medication themselves.

"I think some of them will certainly need support. Doctors can object and institutions through a court case can object, so Hospice can say 'we can conscientiously object'."

But he worries about the times a doctor who has been part of the process may wake up in the middle of the night, when people tend to have thoughts running around in their heads, and start to question their decision.

"Will they think, was that person actually a dear little old lady a little bit coerced by her family? Did I get that wrong? And did I get the date right? Could she have lived another year?

"I'm sure some doctors will have those sorts of thoughts especially with the difficult thing such as coercion and the difficult thing of asking if people are competent to make a decision."

But he said some doctors will get used to it because, as human beings, he believes we can get used to anything which can be a danger.

Walkinton also believes that some health professionals are going to struggle but she said surveys have shown some doctors have hastened death.

"I'm saying that to legalise this is going to protect doctors and nurses who usually give the medication - that actually it's beneficial for the doctors and the medical people as well."

When it comes to the Bill, Hartfield believes there is no need for euthanasia as he believes the focus should be on palliative care.

Voters will be asked in the 2020 election if they are for or against the End of Life Choice Bill. Photo / Bevan Conley
Voters will be asked in the 2020 election if they are for or against the End of Life Choice Bill. Photo / Bevan Conley

"You can deal with most pains or bad symptoms but we still haven't got palliative care covered all over the country so I'm told, it's underfunded and I think we ought to be putting our energy back into palliative care - and extensive palliative care - so everyone can be covered."

Hartfield said another option could be palliative sedation which is a drug that keeps a patient who is in pain alive but puts them into a deep sleep without killing them and they have the choice.

But Walkinton said the difference is huge between palliative sedation and euthanasia when it comes to patients having a choice.

"We are saying euthanasia is patient-centred. Terminal sedation from my understanding is medically advised. I think there's a huge difference."

Walkinton said for her it comes back to the patient having a choice.

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