End-of-life process slanted to euthanasia

by NZ CATHOLIC staff  

The Ministry of Health has six full-time positions dedicated to “assisted dying”, but no team dedicated to palliative care, which alarms Dr John Kleinsman, director of the New Zealand Catholic bishops’ Nathaniel Centre for Bioethics.  

“Proponents of the End of Life Choice Act promoted its introduction as being all about choice,” said Dr Kleinsman. “But it’s a ‘Clayton’s choice’ if palliative care, which we know is effective, is not widely accessible.”  

Dr Kleinsman was commenting on the first Health Ministry report of data collected on people who sought euthanasia between the End of Life Choice Act taking effect last November 7, and June 30, 2022.  

The data showed 400 people applied for “assisted dying”, of whom 143 had an “assisted death”, 153 did not continue the process, and 101 were still in the process of assessment or preparation for euthanasia.  

The Catholic bishops of Aotearoa New Zealand strongly opposed the euthanasia law, saying that demand for it would be driven, not by pain, but by people worried they would be a burden on others. They supported the strengthening of palliative care to help people who faced dying in great pain.  

“An action plan for palliative care was developed after a review in 2017, but many health practitioners working in the palliative care sector are not seeing any action,” Dr Kleinsman said.  

Dr Kleinsman said that end-of-life “choice” was heavily weighted in favour of “assisted dying”, because of the increasing demands on New Zealand’s underfunded palliative care sector.  

“It has been well documented that palliative care is grossly underfunded in Aotearoa. The idea that assisted dying will become a solution to a lack of quality end-of-life care is extremely distressing, and frankly unethical. It undermines the notion of it being a choice.”  

Dr Kleinsman is also concerned at continuing calls to widen the criteria for euthanasia so more and more people could legally seek medical help to die: “This is precisely the pattern that has unfolded in other countries and something that many warned about.”  

He wants the ministry to collect a broader range of data on assisted dying, including people’s reasons for choosing euthanasia. Additional statistics could help safeguard against wrongful or unnecessary premature deaths, by helping to identify whether people felt a “duty to die” because they were a burden on family or caregivers.  

Interim Health New Zealand’s $3.1 million of one-off funding for hospice care, announced in June, has been met with gratitude from the sector and a call for more investment.   

“In light of our disappointment that hospices received nothing in Budget 2022, despite billions going to health, we are grateful for this contribution”, said Acting CEO, Hospice New Zealand, Wayne Naylor.   

“It gives our hospices some breathing space at a time when our communities are shouldering the burden of the increased cost to deliver quality palliative care.”   

While $3.1 million will not go far across the 27 hospices with government contracts, that together have a $170 million price tag to deliver free specialist palliative care to Kiwis at their end of life, Hospice New Zealand hopes this modest one-off investment signals the Government is listening to a sector which is struggling.   

“$3.1 million is merely a drop in the bucket towards the $81.6 million we need to raise in our communities to provide free palliative care. The last significant funding boost was in 2015. Since then, the cost of delivering care and support services has grown by over $30 million a year. The majority of these increased costs are being passed onto the community as hospices have to increase fundraising,” Mr Naylor said.  

“Hospice remains under-recognised by the Government and the Ministry of Health,” he added.   

“The longer-term funding pressures are not going away. Hospice New Zealand and the hospice sector is up for the challenge to work with Health New Zealand and the Māori Health Authority, to ensure specialist palliative care is valued and understood as an integral part of the health system.   

“Hospice needs fairer, more sustainable investment, so we can continue to deliver the very best palliative care services and support for Kiwis when they need it most.”