Melissa Cunningham in TheAge writes that people living in hospitals, palliative care units, health facilities and aged care homes are being denied their right to die.
Institutional objection to euthanasia laws cause ‘emotional suffering’ for dying
Gravely ill people seeking to take their own lives under Victoria’s assisted dying laws are being blocked by both religious and non-religious nursing homes, hospices and hospitals because of moral objections to them doing so on their premises.
An Australian study, which for the first time examined the implications of hospitals, palliative care units, health facilities and aged care homes conscientiously objecting to Victoria’s euthanasia laws, found patients were frequently reporting such refusals.
Such objections were causing “harm and emotional suffering” to seriously ill patients, who intended to end their own lives. Some were left scrambling to try and transfer to another facility so they could take the lethal medication, the researchers found.
In some instances, dying people were so sick it was “physically unbearable” for them to transfer to a facility where they were allowed to take the medication, despite the scheme granting them approval.
Some patients gave up on the process after making a difficult choice between ending their own life or staying in a health service able to provide optimal care for their pain.
In some cases, institutions opposed to the practice had turned away pharmacists attempting to deliver the lethal medication to those given state-endorsed permits to die. Meanwhile, healthcare workers qualified to assess the dying for eligibility of the scheme were blocked from entering some premises.
The study, led by Professor Ben White from the University of Queensland’s End-of-Life Law and Regulation, found objections generally occurred in Catholic-owned facilities, although there was also opposition reported in some non-religious organisations. This included hospital palliative care units, where there was a strong moral opposition based on a palliative care philosophy.
Doctors, as well as palliative care, aged care and healthcare centre operators, have the right to object to euthanasia laws in Victoria, but researchers warned that profound power imbalances existed between the institutions and their patients.
“Institutions by definition are more likely to be powerful than terminally ill suffering patients,” White said. “Their interests are likely to trump.”
Researchers conducted in-depth interviews with 33 family members and caregivers, and a terminally ill patient. In 17 of those interviews, participants reported objections by institutions at varying stages of the voluntary assisted dying process.
Alan Clark finally got approved for Victoria’s voluntary assisted dying scheme after spending almost a year trying to access it. He was diagnosed with progressive supranuclear palsy in 2020, a rare neurological disorder that affected his muscles, walking and balance and eventually killed him.
Alan, who lived in Warragul, in south-east Victoria, was adamant he wanted to take his own life when the pain got too much.
“When we found out that he could not access it there I was stunned. I said ‘What will we do now?’” Zenda said. “They said: ‘We’ll just transfer him home,’ but I was so concerned he would be extremely uncomfortable.”
Alan went downhill quickly and died at the facility without using the medication on November 3 last year. He was 83.
“It was horrendous,” Zenda said. “You would not wish it on your worst enemy. The way Alan passed away in the end was just about his worst nightmare.”
“Such an outcome is inconsistent with the wider policy goals of the Voluntary Assisted Dying Act,” the researchers wrote.
Section seven of Victoria’s Voluntary Assisted Dying Act outlined that although health practitioners have a duty of care to provide clinically indicated treatment, they are not under any obligation to provide voluntary assisted dying.
Zenda said changes were “desperately needed,” and argued the onus should be on facilities to inform people if they object to voluntary assisted dying.
Melbourne renal physician Margaret Fraenkel has helped several of her patients obtain permits to die. She said some of the city’s largest palliative care organisations – including the not- for-profit Eastern Palliative Care, which is affiliated with the Order of Malta and Catholic Church and has received government funding – refused to verify their patients’ deaths if voluntary assisted dying occurred at home.
This meant, in some cases, police had to be called to verify deaths, a situation she described as “extremely distressing for family and immoral.“
Source: Institutional objection to euthanasia laws cause ‘emotional suffering’ for dying
Melissa Cunningham | TheAge
April 2, 2023 — 6.00am