THINKING THE UNTHINKABLE
Hugh Thorpe’s description of the death of his wife with dementia was very moving ( Letters, August 4). It suggested the use of advance directives to allow medical aid in dying in cases of severe dementia.
It is true that the present
End of Life Choice Bill does not have such a provision, which is a deficiency. There is strong public support to allow an end-of-life advance directive. In a May 2017 Horizon Poll on assisted dying, 67% of respondents supported a proposal for end-of-life advance directives that would be triggered by degenerative brain diseases such as Alzheimer’s where the patient no longer recognised close relatives or friends and was totally dependent on others to remain alive.
The chronic nature of Alzheimer’s and other forms of dementia is a more difficult issue than terminal disease.
But the symptom end points of severe dementia are clear and anyone in the family can recognise them, not only a doctor. It is even possible that the Family Court could be involved in ensuring the legitimacy of the advance directive.
At the moment, as in my own advance directive, it can be written so that should the patient have to be spoon or tube fed, this must cease, causing death by starvation (not a preferred option). This is legitimate under present law, where a patient can refuse treatment.
Dr Jack Havill (Hamilton)
Jenny Sims wonders if assisted dying would be part of the public health service ( Letters, July 21). Let’s reframe the question and wonder if it would occur in public hospitals.
Precisely where an assisted death would occur is one of many questions left unanswered by the End of Life Choice Bill. I’m guessing the bill’s drafters left that point open for terminal patients who want to die at home with loved ones nearby.
But what if assisted deaths were contracted out to private end-of-life providers? Nimbys take note: a private euthanasia clinic could be coming to a neighbourhood near you, and there’s nothing in the bill to let you try to stop it.
James Braund (Remuera, Auckland)