Jay Kuten: End of Life Choice debate rages on

An End of Life Choice Bill debate at the Central Baptist Church in Whanganui last year.

Columnist Jay Kuten responds to a recent Whanganui Chronicle column about the End of Life Choice Act.

Recently, (Chronicle, November 27) John McMenamin, a well-regarded Whanganui GP, gave his opinion in opposition to the End of Life Choice Act. I disagree.

At the outset I want to acknowledge where we agree. His acknowledgment of religion as fundamental to opposition to the act is welcome. I also agree that trust is of basic importance in the work of doctors and patients - as it is in any complex human interaction.

Where we disagree is about substance but also about method.

Dr John McMenamin

Dr McMenamin's perspective on the EOLC appears to be its effects not on patients but on physicians.

He cites "the New Zealand Medical Association as the largest group representing doctors as opposing euthanasia". But it should be noted the NZMA membership is at most 17 per cent of the 18,000 New Zealand registered doctors.

One fundamental flaw in McMenamin's argument is that his focus starts and ends with the perspective and interest of the doctor, his vulnerability to alleged harm, his potential alleged loss in trust and an alleged loss to the entire profession of medicine.

The person who is dying and suffering is somehow forgotten.

John goes further. The interests of the patient are secondary. Acknowledging that such a patient, "may feel (emphasis mine) they are making a valid decision to end their life. But the wishes of individuals do not balance the harm done to the profession and to society by deliberately taking life." The word "feel" devalues the validity of the patient's dying wishes.

Beyond the condescension of minimising the patient's right to determine how his last moments are to be and who will have control over that finality, is what is in my opinion McMenamin's serious misrepresentation of the EOLC and the actions of physicians who would assist their dying patients.

The author uses the phrase "taking life" several times, falsely applying it to the EOLC.

While life may be taken as a result of accident or surgical complications, deliberate taking of life is permitted only to military at war, police in dangerous circumstances or a citizen in self-defence. Even that last is qualified. Deliberate taking of life is otherwise murder.

The EOLC Act requires that the request for physician assistance in dying must come from the patient, a person who is both competent and suffering from terminal illness. At least two doctors must agree to the eligibility of the patient (not mentally ill, not unduly influenced, etc).

Patients' consent must be competent, informed, and continuous. Patients remain in control throughout and their wishes constantly respected. That's the opposite of taking life. It's mitigating the fear of dying, the loss of autonomy and of dignity.

To dispel the fear from Dr McMenamin's predictions of harm to society and to medicine we have only to look at the 25-year history of the law in the US state of Oregon, the source of our EOLC bill. None of his predicted harms came to be. Initially opposed by religious groups, it is now widely accepted - and copied.

Relatively few dying patients avail themselves of the law. Among those deemed eligible 18 per cent changed their minds and did not accept the prescription. Many expressed gratitude for the comfort afforded by the option.

The arguments by doctors on both sides of EOLC may well be dismissed as "he said and he said". Instead, echoing Greta Thunberg's words on climate change, "Don't listen to me. Inform yourselves."

The EOLC Act can be found here . Read it and decide. I believe informed New Zealanders will do the right thing.

• The End Of Life Choice Act was initially referred to in this column as the End of Life Choice Bill.