WORKING GROUP OF THE JUSTICE PEACE AND DEVELOPMENT

GROUPPALMERSTON NORTH DIOCESE

Write to Life: Be Heard

Overview

Euthanasia; what are we talking about?Clarifying misconceptions around death and

dyingSo Why Not….Catholic moral teachingHow to write a submission

Euthanasia

The intentional causing of death in order that suffering may be eliminated.

An act undertaken by someone with the specific intention of ending another person’s life.

Physician Assisted Suicide (PAS)

A person self-administers a lethal substance that has been prescribed by a physician.

What does research tell us about patients who consider an early termination of life? (Schroepfer, Linder & Miller, 2011)

Loss of autonomy/ feelings of uselessness Loss of ability to enjoy life activities that give pleasure Loss of meaning in life/ loss of hope Loneliness/ Few social supports Loss of control over bodily functions Feeling one is a burden Perception of care giving needs as high Higher level of anxiety/ depression Loss of control over manner of death The fear of uncontrollable symptoms or pain

These are all issues that supportive palliative care can help with

What to expect when someone is dying

The majority of us will die from a life limiting illness – approximately 10% die sudden death

The Last Stages of Life:o Increasing tirednesso Visions and Hallucinationso Decrease in appetite/food intakeo Decreasing fluid intakeo Confusion, Restlessness, and Agitationo Changes in Breathing, Congestion in Lungs or Throato Change in Skin Temperature and Colouro Change in Bowel and Bladder Functionso Change in consciousness

Common Misconceptions regarding end of life care

1. Pain and suffering - use of medication and sedatives

2. Hydration and nutrition – withdrawing and withholding food and fluids

Pain and suffering

a) Misconception: Pain is inevitable and cannot be managed

Concept of pain = sufferingPhysical, emotional, existential

b) Misconception: Use of pain relief medication at end of life = hastens death

When the intention is the relief of pain, then the use of pain relief treatment that is appropriately titrated to relieve symptoms

is not euthanasia

EuthaEuthanasia Defined by Euthanasia Defined by Intention

Hydration and nutrition

Natural for people to reduce intake prior to dyingChallenging as eating and drinking is part of nurturing

Misconception: “They are dying because they are not eating and drinking”

In reality: “They are not eating and drinking because they are dying”

People have the right to refuse life-sustaining treatments including the provision ofmedically assisted nutrition and/or hydration

Withdrawing artificial hydration and/or nutrition that is burdensome for a person

is not euthanasia.

Euthanasia Defined by Intention

Why Not?

1. Right to die = duty to die. The vulnerable and those without a voice are at risk of; coercion, elder abuse

2. We are all connected

3. Changes the norm of death and dying. What constitutes good end of life care?

4. Goes against everything health professionals are committed to

1. Right to Die = Duty to Die

BLOGGERS/Monica:“Burnt out adults, under pressure with work, debts,and raising their own kids telling dear old mom in a gentle way, "yes, I hate the idea BUT it would be better for you to go, mom." Mom is vulnerable, exhausted, helpless, physically and mentally fragile, influence-able, emotional, and now broken-hearted. She doesn't want to be a burden …

1. Right to Die= Duty to Die

Given that families are becoming increasingly fragmented, the elderly are becoming more socially isolated, and we are being constantly reminded about the scarcity of health care resources, the burden of

proof will inevitably shift onto the older person to justify their continued existence…

Elder abuse rates in NZ are climbing3-10% of older people are abused

1. Right to Die = Duty to Die

BLOGGERS/Alma:

“In my 30 years as a doctor, never mind my 60 years as a human being, I have learned that many families are selfish, cruel and manipulative. There is absolutely no doubt that older people will be dispensed with for a range of perceived benefits to those they leave behind. The fact is that an old, weakened and tired person can seldom resist this kind of pressure from children and others.”

Source: http://www.bioedge.org/index.php/pointedremarks/view/10566#sthash.AMYNkJOg.dpuf

2. We are connected to others

Never completely autonomous

Evidence in the Netherlands - the grandchildren of those who opted for euthanasia are over-represented in drug use and suicide when corrected for other variables (Ilora Finlay, 2014)

Evidence suggests those who are bereaved following euthanasia experience isolation, lack of support and they had no bereavement follow up (Belgium research, 2015)

3. Change in end of life care

Rate of euthanasia doubled in Belgium between 2009 -2013. The rates of unreported euthanasia in Belgium were around 50% (Chambre et al, 2015)

The Netherlands has had an increase of 60% in five years. (Onwuteaka-Philipsen et al, Lancet, 2012). A disproportionate increase in non-terminal diseases, mental disorder increased by 200% (Euthanasia Annual report, 2013)

Switzerland 2014, assisted suicide associated with living alone and divorce more frequent in women. 16% of deaths by AS no medical condition was listed (Steck et al, 2015)

Who pays for End of Life Care? Currently NZ Hospices are part funded = Local Hospice 62%

4. Health Professionals view

Australian and New Zealand Palliative Medicine

NZ Medical AssociationPalliative Care Nurses NZHospice NZ

What can I do?

Kindness and compassion go a long way Be connected in your community Visit folk in rest homes/ in your neighbourhood Join with St Vincent de Paul Join Faith and Light – a community which

supports those with disabilities Join Hospice as a volunteer