[00:00:26] Speaker A: Welcome to the Pulse Podcast. We're keeping you up to date on the latest pro life news and stories in New Zealand.
Euthanasia and assisted suicide bailed under the term assisted dying in New Zealand has been operating within our country since November 2021. We know that more than 1,210 Kiwis have been killed by assisted dying in hospitals, aged care facilities, private residences and one hospice, as well as in one public outdoor location.
Before the law was introduced, there was a strong outcry from doctors and health care practitioners who traditionally don't speak out on controversial issues or often in fear of creating a difficult work environment for themselves. The loudest protest came from those who are actually walking alongside the dying, those working in palliative care. So when the legislation put the responsibility of carrying out the intentional killing of patients into the hands of doctors, we knew that there would be difficulty.
For the first time, a senior clinician from one of our country's leading tertiary hospitals has spoken out publicly about his direct experience navigating this issue inside his workplace.
Voice for Life recently interviewed him. Take a listen to hear firsthand about how assisted dying is affecting him and his colleagues. Please share this episode what has the
[00:01:36] Speaker B: introduction of the End of Life Choice act looked like for people practicing in the medical field?
[00:01:43] Speaker C: I got into this to save lives, to try and cure, while at the same time suffering. You know, the people that I see, basically, they want to live and that's probably their first priority, if possible. They want more time, they want more time to do the things they want to do. They want more time with their families.
And so unfortunately, when you're in that situation, the treatments are not easy. You know, you're undergoing major surgery, for example, or some chemotherapy or some radiotherapy.
So it is, it's a bit of a battle for them to, you know, first up, face the diagnosis. So that's a life changing diagnosis. And then having to pick themselves up and then face the treatment.
Part about part of my job is actually just cheering them on saying, yeah, you can do this. There is a load of the inner tunnel that can get you through it. Also. It's draining. It's draining psychologically and physically.
And Tambie Journey financially was more than just a treatment we're providing. We're like the cheerleaders who focused on life, preserving life, saving lives.
Suddenly we start to kill people and I.
Can't.
Yeah, I'm kind of shocked, to be honest.
I'm shocked at a professional level, but a personal level. I just, you know, it's like having Abortions, I guess, on the maternity ward.
[00:03:23] Speaker B: There's an irony within your own ward where you are trying to do everything you can to bring life.
[00:03:29] Speaker C: Super focused on saying, we're doing these really expensive, really complicated investigations, interventions, you know, going the extra mile, thinking, what can we do? What can we do?
And then right on the same ward at someone that you just. Basically, we're surrendering them up to get killed. We're still quite shocked that our colleagues are so neutral.
As far as we can tell, there
[00:03:56] Speaker B: is a group of doctors that come in. They've chosen to practice euthanasia.
Often they're from the outside brought in to do the task.
[00:04:05] Speaker C: They're entirely from the outside. I don't. I cannot read their mind. All I can say is that. All I could say that they seem very enthusiastic to get the thing in quickly and sometimes even faster than the process should actually go, and they're finding ways to do shortcuts or.
It's just my own impression that there's no.
There's not much room given to try now. Slow the process down a bit, maybe think again.
They just seem in such a hurry that all I can think of. What's the enthusiasm?
[00:04:38] Speaker B: Is there a case that you can actually recall that happened to you like one of your patients?
[00:04:45] Speaker C: So, yeah, the patient was living a pretty good quality of life, independence and all that, but the cancer was showing all signs of progressing. Then suddenly something happened and he started losing the use of his legs.
He's older and his wife's also older and a bit frailer, so that therefore meant that he's no longer able to be at home, which is where he wanted to be.
Otherwise there was no pain. You know, it's really this loss of independence.
There's a little bit of loss of dignity as well, because, you know, he wasn't able to control his bowels, so there was a bit of that sort of nursing care that was needed.
His wife was too frail to look after him, but that was a sudden change. So that was quite a shocking change for him. So immediately he talked about the process of euthanasia.
He was pretty devastated, actually, by this change in function and change in his independence, as you would if you had suddenly lost all of that stuff.
But suddenly he started to make noises about doing this thing, but I don't think he actually wanted to go. This is my impression. I just think he was so devastated by all the changes that he needed sometimes to adjust. And then secondly, I did ask him, you know, if we could get you home with the appropriate Nursing support and everything you needed was actually, you know, would you still be making this decision?
And him and his wife were like, no, if we had enough money. And the wife was, no crying, I wish I had enough money to pay for the care, but we just can't.
This just made me so angry.
And so there's all sorts of pressures going on, you know, as well as the financial pressure, because, yeah, he wanted to make sure his wife was going to be okay financially when he's gone.
So I had to hand this care over to another colleague
[00:06:48] Speaker B: once he made that decision.
[00:06:51] Speaker C: Yeah, yeah. And he asked me about it and asked me, you know, why do you not want to do this? He asked me, have you got religious objections? And I said, no, I've got moral objection and I've got professional objections to this.
Especially this.
We should be looking after you properly instead of you feeling like you need to, you know, speed up the process because I'm able to provide the proper care.
The second thing is I said, well, also I fear for the next generation of doctors that this is such an easy solution that shortcuts the hard thinking work and the advocate and that you've got to do to get the right resources for the, for the people. It's just too easy to just surrender and pull the pill. One of the issues is how much coercion is there on the patient, from the family onto the patient.
[00:07:53] Speaker B: Coercion, again is another issue because it's very difficult to measure. It's been a case from the beginning with this piece of law. The concern of how do you even check for coercion? How do you know when you're a doctor that's coming in, taking ticking a box and then giving a drug, how do you check for coercion? But you guys, you're the health practitioners that are around the patient, that see family members, you see how they're being treated, you hear the conversations they're having in the hospital around death. And so of anyone, you will have far more information.
So if you are having questions, collision
[00:08:31] Speaker C: is so hard to prove.
You just have this feeling that, oh, something's not right, you're uncomfortable and you always will be wondering now, but when you tell the story to your colleague, you're like, oh, there's something wrong.
[00:08:50] Speaker B: Yeah, so coercion is definitely something lurking in corridors.
How many cases have you been seeing now, now of people choosing assisted dying?
[00:09:01] Speaker C: How many? I don't know how many are on our ward, but there's three that have caused major issues, major dramas in the service so if.
And some of the dramas were around lack of communication and lack of consideration of the staff. One of the issues was we were trying to get a bit of separation between the people that are fighting for life and the people who were being killed on the ward being turned down by the hospital authorities. And then they had sort of written up some policies about how they would give people plenty of time so that those who are objecting to the thing can take steps to protect themselves. They were meant to communicate a bit more openly and earlier, but that hadn't been happening. One of our colleagues who was an objective, for example, ended up having to be involved in that patient because there was no one else around.
That happened twice.
It's like if you believe something evil is happening and you're forced to stand around and witness it, That is the feeling in the system that you trust that should deliver healthcare is preparing someone for getting killed.
It's horrible. It's a horrible feeling.
[00:10:26] Speaker B: How has that colleague handled that scenario?
[00:10:30] Speaker C: Not well.
Not well.
That person had to take sick leave.
It was terrible.
That put stress on the rest of them as well. Yeah, it was terrible, actually. Really terrible.
This policy. This policy, you've got all the policy documents in the world, but unless actually someone does it, then stuff doesn't occur as it should.
And this is a very, very sensitive issue. And so there needed to be much more energy and precision.
But that is also a reflection of the stress that the system is under.
[00:11:06] Speaker B: How heavily does this weigh on you in your daily practice?
Is this something you have to consider?
[00:11:12] Speaker C: I was really thinking about quitting. Honestly.
Yeah, I didn't feel like going into work.
Yeah, it was a real blow, actually. Our lives, our energy goes into that because it is so hard. It's such hard work.
It's almost a spiritual. I don't want to go make it ugly spiritual. But in a.
It's more than just a physical problem.
All of person problems. You're lifting up their spirits as well, and their body might be suffering, but if the spirits are right, they can get through this.
[00:11:52] Speaker B: You know, I think some people, when they observe someone like the patient that you mentioned, that has lost the ability to have that level of independence that is adjusting.
Some people think, well, if he thinks his life is over, then fair enough, just let him make that decision.
But how do you measure what the value of life is?
[00:12:14] Speaker C: It's just too soon as well, you know what I mean?
It takes a while to get used to some major changes in your life. I mean, you take a few months, you change Countries, you change house.
That takes months to get used to it.
This is even more profound and very, very. And if it happens quickly, you know, it did take a while, but I know that. I've seen, you know, people go through that.
They have to do some work of rethinking, well, what really matters to me and can I adjust my life and actually still have a really, you know, meaningful, fulfilling life.
But there is this dip in the road that you've got to walk through, and I just feel it's our responsibility to help them get through that.
There's a bit of uncertainty as well, like me and my colleagues, as to how far can we push our encouragement.
[00:13:15] Speaker B: Yes. Before it becomes coercion in itself.
[00:13:17] Speaker C: Yes. Today they just say no.
So there is an absolute.
Patient says, no, that's fine, but at least you've raised it. Patient wants to have a treatment that I offer and I say, this is a bad idea. I think you'd be worse off. Let's not do that. That's what I ordinarily do, but I don't know. Do I have the same freedom?
[00:13:37] Speaker A: Yeah.
[00:13:37] Speaker B: You would normally be able to say if there was a treatment option on the table and in your professional opinion, which is what you're there for, is that it wouldn't be effective, it wouldn't achieve the outcome that would be good for them. You would tell them, but with euthanasia, you're not able to do the same thing.
[00:13:56] Speaker C: I can understate the moral distress that it has, and with the teams, that's going to be a problem, because that moral distress, if that moral distress about what's happening goes away, that means something about me has changed. That's not good either. I actually feel to have moral distress in the situation is actually normal as the reasonable human response.
It dies in me. Something bad, something's gone wrong.
I just don't understand how we got here, how we got to the point where doctors are killing their patients. What happened to us?
I've got a lot of worries and I may end up leaving the profession.
Won't be just me, that'd be quite a few.
But then we leave no resistance. So that's what's keeping me here.
We've got to be so careful. We've had this conversation before. We've talked about all the risks, about the undetected coercion or even the quite suspicious coercion that you can never quite prove, though to the satisfaction of the law, the lack of proper psychological care. I don't think we're treating depression in these patients because one of the major symptoms that we look up for is actually suicidal ideation. But now, honestly, what am I supposed to do now when someone expresses their wish to commit suicide?
Ordinarily I would come alongside and say, hey, what are you talking about? Why are you thinking like that?
Should I still be doing that or am I breaking the law?
[00:15:40] Speaker B: Now, what would you say to other healthcare professionals?
[00:15:43] Speaker C: We all have a different threshold for where we say, that's it for me.
So it's talking with like minded people and just hearing you're not crazy to feel this way.
[00:16:00] Speaker D: The Pulse podcast is brought to you by Voice for Voice for Life New Zealand. If you enjoyed this show and you think that having a strong pro life voice in the public square is essential, then please support this podcast and all of the other important pro life work that Voice for Life is engaged
[email protected] nz donate that's voiceforlife.org nz donate link in the show notes thanks again for tuning in. We'll catch you next. Next time on the Pulse.
