The MacDoctor received an interesting survey today from Auckland University. It purported to be a survey about end of life issues but it was clearly structured to ascertain whether doctors were covertly euthanising their patients, either with excessive doses of medication, or by withholding the necessities of life. Readers of this blog will know that I have an interest in palliative care and take a dim view of the idea of euthanasia, passive or active. I find it interesting that researchers want to concentrate on euthanasia to the exclusion of the rest of the complex issue of end-of-life. To my mind, euthanasia cannot be debated until we have properly addressed all the issues that hinder the provision of adequate terminal care in New Zealand. These issues include:
- inadequate funding of terminal care
- inadequate training of doctors in palliative care, especially GPs
- The inadequate legal position of living wills
- The inadequate provision of backup care facilities (hospice, hospital hospice beds and trained caregivers) for terminal patients
Until these issues are properly and thoroughly tackled, any debate on euthanasia will be driven by the horrors of poor palliative medicine rather than the ethics and appropriateness of doctors and the state being permitted to kill their patients. Terminal care is hard work for both doctors and caregivers and expensive work from the point of view of government. But it is work that affirms the value and dignity of human life and it should not be allowed to be subverted by the “quick fix” of euthanasia.
There may well be a valid argument for euthanasia in a select few cases but let us not allow this extremely final solution to paper over the glaring cracks in the care of the terminally ill.