This is the text of the written submission made by Dr Mary English to Parliament’s Health Select Committee concerning their Ending of Life inquiry.
by Dr Mary English
I am a general practitioner, working in Wellington and I have been practising for 26 years. It has been my privilege to work with patients and their families and alongside other health professionals on cases dealing with chronic and terminal illness. On a personal note I was closely involved with supporting my younger brother, also a medical doctor, until his death from aggressive cancer, in 2014. Peter was 48 years of age and his last few months were extremely difficult.
In 2015, my family and I have also supported my 28-year-old sister in her battle with ovarian cancer and while she has completed four cycles of strong chemotherapy, we await the outcome with the test of time.
As both a medical professional and a member of the human race, I am totally opposed to the state sanctioned killing of those who are sick and vulnerable, either by assisted suicide or euthanasia.
I have seen at first hand my patients concern about being a burden and I have witnessed that not all families are supportive, willing or able to provide emotional and practical support. It is my strong opinion that legally sanctioning “assisted suicide” and “euthanasia” will tip the balance of presumption by the patient of alleviation and assistance to one of a “duty to family and everyone else” to not be a burden.
One day you and I will be sick and vulnerable as we discover what will determine our mortality. We will need to know that our health professionals and society are united in being supportive of us as we become less “useful” and more “expensive” in terms of assistance needs and financial costs of care.
The current law and medical services are protective for both the patient and the doctor. After 26 years of practice I have never had any family member say to me that they wished their sick relative had gone and taken their own life or that they wished that I had put an end to their loved one’s life.
I worked for six years in a Decile 1 school-based clinic with mainly Maori and Pasifika students and I often had to deal with mental health issues. It is a bizarre contradiction to contrast years of working alongside young people to prevent them from becoming another suicide statistic with legislative moves which expect doctors to assist with or directly carry out the suicide of those who are sick and terminally ill.
I continue to deal with young people dealing with depression and anxiety. I spend time telling my young patients that killing themselves is not the answer and is damaging to those around them. In my experience, the majority of these young people feel an overwhelming despair and inability to cope with their current state of psychic pain and it is the same for those suffering psychic or physical pain and for whom assisted suicide or euthanasia is the preferred way out.
Some argue for the availability of assisted dying as a choice, yet our New Zealand society rightfully abhors the idea of having the same attitude to the young adult who is equally distressed. It is a current assumption of medical practice and public policy that youth suicide is a failure of prevention and that we must always screen for risk and prioritise intervention accordingly, and as a doctor I do. We have had the public awareness campaigns, the high profile fundraisers and online support tools.
Despite the best efforts of mental health professionals and family members, people can and do commit suicide if they are absolutely determined to. New Zealand’s high suicide rates attest to this fact.
It is both inconsistent and cynical to legally signal that suicide is good for old and/or sick people, but bad for young and distressed people. It is no surprise that mixed messages can lead to confusion and that suicide rates in some jurisdictions where euthanasia is permitted have increased.
A more consistent position for the medical profession and for society is the position that gives hope and meaning for both groups.
It is the position where death with dignity is the respect and care expressed in a palliative care setting NOT a prearranged ,medicalised suicide scenario. It is where the disabled and chronically ill can look forward to a presumption of assisted living, NOT assisted dying.
The key issue for politicians to consider is not about whether sick and vulnerable people should be allowed to commit suicide (they are), but whether the law should permit, require or compel another person to be a party to the suicide or bluntly; to kill another human being. That other person is a doctor. A doctor’s vocational brief is to cure sometimes, comfort often and care always. The law should never permit, require or compel my profession to kill the message by killing our patients.
Dr Mary English is a GP from Wellington. She also addressed the select committee in person last year.
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