Doctors and nurses helping patients die, despite the law – study
Some Kiwi doctors and nurses are deliberately hastening the deaths of terminally ill patients despite euthanasia still being illegal, new research shows.
Six-hundred and fifty GPs responded to a University of Auckland survey about the last patient they had been in contact with who died.
Of those, 547 had been in a position to make a decision about how to handle their patient's looming death. Two-thirds of them (359) did make a decision, with 16 prescribing, supplying or directly administering a drug explicitly for the purposes of hastening their patient's death.
In those cases, nurses were usually the ones tasked with delivering the drugs, sometimes in conjunction with a doctor. The study, published today in the New Zealand Medical Journal, notes this doesn't necessarily mean a nurse literally gave the patient a fatal injection; they could have been tasked with setting up the equipment that ultimately delivered the dose, but otherwise were conforming to standard palliative care requirements.
Half of the doctors who made a call on their patient's fate decided to withdraw treatment, and 88 percent increased the alleviation of pain or symptoms their patients were suffering, in the knowledge this would probably hasten their death.
University of Auckland professor of psychology Glynn Owens says the research shows lawmakers cannot continue to sweep the issue of euthanasia under the rug.
"What these results, like other results from around the world show, is that making assisted dying illegal does not, by waving some magic wand, miraculously stop it from happening. Rather, it simply means that the practice continues without any clear regulation, guidelines and, importantly, support for the practitioners involved," says Prof Owens. "The fact that practitioners are willing to risk their careers and their liberty by acting illegally reflects the severity of the perceived need in those cases where it occurs."
A select committee inquiry will look into attitudes towards voluntary euthanasia later this year, following the presentation of a 9000-strong petition to Parliament in June. The petition followed a high-profile court battle over the fate of Lecretia Seales, a terminally ill lawyer fighting for the right to die.
Her bid was denied on the grounds assisted dying was a decision for Parliament to make, not the courts, but she died before the ruling was made public.
While only 4.5 percent of the deaths covered in the recent study involved assisted dying, Prof Owens says that doesn't mean 95.5 percent of doctors don't do it.
"The data reflect deaths, not practitioners. The participants were asked only about the last death with which they had dealt; it is not unreasonable to assume that there were practitioners out there whose most recent patient death had been uneventful, but for whom a patient death preceding that one had involved some degree of assistance in dying."
The findings of this latest research are "strikingly similar" to those of similar study conducted early last decade, says Prof Owens. The biggest differences are that doctors nowadays more readily withdraw treatment, such as chemotherapy or dialysis, when it seems futile, and slightly more are willing to discuss end-of-life options with their patients.
Older doctors were more likely to discuss options with their patients.
Despite the survey being anonymous, many doctors left some questions unanswered, which "may indicate an unwillingness to state one's actions when these actions involve illegal or morally grey areas".