3News 20 February 2015
Nearly half of Kiwi doctors are in favour of euthanasia, or physician-assisted dying (PAD), according to a survey covered in the New Zealand Medical Journal today.
This lags well behind public support for PAD, which was measured at 82 percent in January by researchers at the University of Auckland.
But the survey’s validity is being questioned by the NZMJ’s editors, who say it does “relatively little to further our knowledge”.
According to a letter to the NZMJ from Voluntary Euthanasia Society chairman Dr Jack Havill, 200 GPs in the Waikato District Health Board area were sent letters presenting three different scenarios concerning PAD. The survey’s results were based on 78 responses.
The first question asked: “Given adequate safeguards against abuse, do you support the passing of a law to allow a medical practitioner to give assistance to die, on request from a competent patient, 18 years and older, where the patient has end stage terminal disease (eg cancer), or is suffering from irreversible unbearable suffering (eg motor neurone disease, end stage respiratory failure)?”
Thirty-seven GPs (47.3 percent) said they support PAD in this situation. An equal number oppose it, and four are unsure.
The second question posed a similar scenario, except this time the patient – while still able to do so –writes a directive authorising PAD in the event they become incompetent.
The same number of GPs – 47.3 percent backed PAD in this circumstance, with fewer opposed (43.6 percent) and more unsure (9 percent).
The third question asked doctors if they would support PAD in the following scenario, provided the patient had given approval while still competent: “If I develop severe dementia resulting from Alzheimer’s disease, or degenerative brain disease due to arterial disease or other agency, where my mental competence has deteriorated to the extent that I am no longer able to recognise close relatives or friends, and am totally dependent on others for basic physical needs e.g. eating food and drinking fluids, spoon feeding, toileting for incontinence, dressing, I would request that I be given medical assistance to die.”
Only 31 of the 78 doctors said they’d support PAD in this case (39.5 percent), with half opposed and the rest unsure.
Dr Havill says the results show nearly half of GPs “support or would probably support” euthanasia in certain circumstances, and that it is “reasonably certain” that New Zealand will adopt some form of PAD law in the next few years.
“Hopefully our professional medical and nursing bodies can take part in the framing of the law and regulations as this happens.”
But the study’s methodology has been questioned by editors of the NZMJ, who say the survey’s response rate was “poor”, and it is likely that “only those GPs with firm views, supportive or otherwise, who bothered to reply”.
“But nonetheless, that about 40 Waikato GPs would be willing to hasten the deaths of their patients, even if they are mentally incompetent, is noteworthy,” writes Assoc Prof Sandy Macleod of the Health Sciences Centre at the University of Canterbury.
“We certainly need to manage the dying better. We need good research, wise expert opinion and fair legislation. We lack these. Dying is not invariably easy, and clumsy medicine can aggravate it.
“But is it best to give up and terminate life by the violence of non-physiological pharmacology?”