The Royal New Zealand College of General Practitioners has submitted its response to the Justice Committee of Parliament today (6 March 2018). The submission is clear that the College does not endorse euthanasia or physician-assisted suicide, which it considers a matter for individual members’ consciences, within the law.
The submission makes 17 recommendations to the Justice Committee, in light of the state of palliative care in New Zealand, the effect legislation may have on vulnerable people, and the effect euthanasia and physician-assisted suicide has on the doctor-patient relationship. The submission also goes into detail to recommend changes to specific challenges the Bill, as drafted, poses. That includes criteria for assisted dying, conscientious objection, and the role of the medical practitioner.
Dr Tim Malloy, President of the Royal New Zealand College of General Practitioners, said:
“Whether for or against euthanasia, the College’s members are motivated by compassion – this is a key tenet of the profession. We believe that each general practitioner in New Zealand will have their own ethical view on whether euthanasia or physician-assisted suicide is right.
“However, whether or not this Bill goes ahead, there are significant challenges that must be addressed. Fundamentally, New Zealanders need accessible, good quality palliative care. The Government should strengthen these services, so we can all experience a dignified, comfortable death.
“The College has made several recommendations to the Justice Committee for its consideration on the Bill itself. The Bill, currently, has poorly defined criteria for assisted dying. Diagnosis is difficult, we sometimes get a diagnosis wrong. And knowing if a patient is able to make a rational decision, during their end of life care, can be incredibly difficult.
“Parliament should consider our 17 recommendations carefully, given the strong apprehension from general practitioners about legalising euthanasia and physician-assisted suicide.”
General practice is a medical speciality, and general practitioners (GPs) treat patients of all ages, from neonates to elderly, across the course of their lives. GPs make up 40 percent of the medical workforce.
The Royal New Zealand College of General Practitioners is the professional body for GPs, and is the largest medical college in the country. The College’s mission is improving the health of all New Zealanders.
The College’s submission to the Justice Committee can be read on its website. The College has also submitted a compilation of members’ submissions.
The recommendations are:
The Government improves and strengthens palliative care services for all New Zealanders.
The Government provides more financial support for families caring for a family member at the end of their life.
The Government invests in ensuring Māori have access to culturally appropriate palliative care.
The Government implements a public information campaign to ensure New Zealanders understand what euthanasia and physician-assisted suicide are, who would be eligible for it, and the wider implications of any legalisation before the Bill progresses further through Parliament. This would be of particular importance if the Government holds a referendum on this issue.
The Government invests more money in mental health services.
The following recommendations apply if the law is changed:
The Bill specifically prevents people with mental health conditions from qualifying for euthanasia or physician-assisted suicide.
The Select Committee carefully considers the scope of medical practitioners and minimum practice experience of the practitioners who would offer euthanasia or physician-assisted suicide services.
The Bill requires that medical practitioners receive appropriate training and support to enable them to provide quality advice and care to patients and their families.
The minimum age of eligibility for euthanasia be set at 25 years.
The Bill’s eligibility criteria are reconsidered to tighten the definition of who is eligible for euthanasia and for physician-assisted suicide.
The Bill’s introduction be amended to remove the requirement for medical practitioners who do not wish to participate in euthanasia to refer patients to the SCENZ Group.
Patients seeking euthanasia or physician-assisted suicide be obliged to self-refer to the SCENZ register in the first instance to consult with a registered medical professional who is trained and willing to provide physician-assisted suicide and euthanasia services.
Clause 8 be amended to recognise the difficulties of making accurate prognoses and to clarify whether medical practitioners’ advice to patients is limited to medical impacts.
The Select Committee considers how to deal with situations where a patient with reduced decision-making capacity wishes to forgo the Advanced Care Plan made when they were mentally competent.
Clause 15 be amended to make it explicitly clear if the Bill refers to euthanasia or physician-assisted suicide, and if both, when the legislation applies to either option.
The Select Committee considers the complexities of euthanasia and/or physician-assisted suicide if something goes wrong.
Clause 19 be amended to ensure the privacy and confidentiality of the medical professionals who elect to perform euthanasia or provide physician-assisted suicide.