Assisted dying is a ‘positive change’ and a ‘continuum of care’
Australia and NZ medics to advise Dáil committee
DOCTORS from Australia and New Zealand have hailed assisted dying as a ‘continuum of care’ that has been ‘a positive change’ for patients.
The special Oireachtas committee set up to examine legalising assisted dying in Ireland will today hear that assisted dying has ‘overall been a positive change in the Australian and New Zealand health landscapes’.
The Voluntary Assisted Dying Australia and New Zealand (VADANZ) group represents 150 medical practitioners across the two countries. Voluntary assisted dying (VAD) is legal across New Zealand and in all Australian states; however, is it not yet legal in the Australian Capital Territory or the Northern Territory.
Dr Cameron McLaren, founder of VADANZ, warns that legislation of this type is ‘not without its challenges, and if introduced in Ireland, I encourage you to anticipate the need for evolution’.
‘This may be interpreted as some as advocating for a “slippery slope”, but I firmly believe that the slope does not need to be slippery – simply patient-centred and allowed to evolve as all patient care does over time,’ he adds.
‘VAD is not seen, and nor should it be seen, as an alternative to palliative care – it is seen, and discussed, as an option at the end of a palliative care journey.’
Dr McLaren says he trained in VAD after the laws were passed in Victoria in 2017. ‘The reason that I underwent the training was that I had been educated and trained in the paradigm of patient-centred and patient-led care,’ his opening statement to the committee reads. ‘Involvement in VAD, to me, was a natural extension of that.’
However, he says that since the introduction of VAD there have been ‘unintended issues with access... for the very people for whom our legislation was intended’. He says: ‘Otherwise-eligible people have been excluded from eligibility on mere formalities due to the overbearing nature of some of our states’ legislation.’
He adds that this has led to issues with access to VAD that can only be resolved through legislation. He encourages the Irish lawmakers to be clear on the eligibility criteria and overall process if they introduce it here.
However, he also encourages legislators ‘to establish and enable avenues of appeal or discretion’,
Dr Peter Allcroft, a palliative care doctor of 20 years, says that in the past week a patient who received an assisted dying assessment said he had his best night’s sleep in months, ‘secure in the knowledge that there were options available for him if it all became too overwhelming’.
Politicians on the assisted dying committee previously heard from the Irish Palliative Medicines Consultants Association.
They said their members were ‘fundamentally opposed’ to assisted dying, and believe it would ‘significantly and negatively’ impact on the trusted doctor-patient relationship. However, Dr Allcroft, who worked in palliative care before VAD was introduced in South Australia in 2023, says: ‘I see VAD as a continuum of care, with the VAD process encompassing a small but important aspect of a patient’s end-of-life journey.’
He said that in the first 12 months of VAD being operational in South Australia, he had personally been involved with 36 patients who requested it.
Dr Laura Chapman from VADANZ says she was ‘deeply concerned’, when assisted dying was introduced, that she would feel like a ‘bad doctor’ when she helped a patient to die. However, she adds: ‘To my surprise, I felt like a good doctor, as I had worked with my patient to achieve the death he desired, peaceful and at home, surrounded by his family.’
Irish Medical Council president Dr Suzanne Crowe will also present for TDs and senators today. She will outline the new ethical code in place for doctors, which has removed the paragraph: ‘You must not take part in the deliberate killing of a patient.’
The Medical Council does not have a position on assisted dying, and Dr Crowe will tell politicians about how the removal of this clause should not be interpreted as the organisation ‘paving the way’ for assisted dying.
‘The removal of this sentence does not diminish the law,’ Dr Crowe will say. Politicians on the committee have until March to produce a report with recommendations on whether Ireland should legislate for assisted dying.
‘Option at the end of palliative care’ ‘I felt like a good doctor’