As New Zealanders face the life and death decision on how to vote in the End of Life Choice referendum, a group representing providers of palliative care is coming forward to share their concerns on the misinformation and misunderstanding being put forward around end of life care.

“Over the past weeks we have become increasingly concerned around the misinformation around the use of pain medication and palliative sedation at the end of life. This does nothing to help people understand palliative care treatment and options – it just perpetuates people’s fear around death and dying.” Says Dr Ian Gwynne Robson, speaking on behalf of the Australian and New Zealand Society of Palliative Medicine (ANZSPM)

The Collaboration that includes Palliative Care Nurses New Zealand, Hospice New Zealand, Hospital Palliative Care NZ alongside ANZSPM agree it is really important people are accurately informed on end of life treatments ahead of the election referendum on the End of Life Choice Act.

Palliative care is a holistic approach to care that improves the quality of life of patients and their families and whānau living with life limiting illness. It involves the prevention and relief of suffering by means of early identification, impeccable assessment, and treatment of pain and other symptoms - physical, psychosocial and spiritual.

Many people are familiar with morphine as a medication used to relieve the symptoms of pain and chronic breathlessness. It is not used to intentionally hasten death.

“One of the most dangerous suggestions is that euthanasia is already happening within our health system. There is no evidence that euthanasia is already happening in Aotearoa New Zealand– it is illegal. Strong painkillers are given to address a person’s pain. They neither shorten, nor prolong life” explains Dr Gwynne Robson.

As providers of palliative care across a range of settings – hospital, community and hospice – members of The Collaboration want people to be aware that we already have the right to refuse life-sustaining treatments including the provision of medically assisted nutrition and/or hydration. Deciding not to continue such treatment does not constitute euthanasia or assisted suicide.

It is equally important that people know the use of palliative sedation in end of life care is seen as an extraordinary measure1. It is only ever initiated after careful consideration and discussion with the person and their whānau along with the multi-disciplinary team. There is no evidence to suggest that palliative sedation shortens life.2

“We strongly encourage everyone to find out more about palliative care, what the specialty of palliative care can do to support high quality care for people at the end of their life and what normally happens when we die.” The Chair of PCNNZ Dr Aileen Collier said.

Helpful resources and websites include:

• Hospice NZ video ‘What is it like to die?’ https://www.hospice.org.nz/what-is-hospice/weneedtotalkaboutdying/what-is-it-like-to-die/
• Dr Kathryn Mannix video ‘Dying is not as bad as you think’ https://www.youtube.com/watch?v=CruBRZh8quc

About the members of The Collaboration:

ANZSPM is a society for medical practitioners, aiming to improve health outcomes by working with and influencing the system and community around the person with a life-limiting illness. ANZSPM facilitates professional development for its members and promotes the practice of palliative medicine, in order to improve quality of care for people with a life-limiting illness. Our members are medical practitioners and include palliative medicine specialists, palliative medicine training registrars and other doctors such as general practitioners, oncologists, haematologists, intensivists, psychiatrists and geriatricians.

Palliative Care Nurses NZ (PCNNZ) is a society for all nurses providing palliative care in Aotearoa New Zealand. Its aim is to provide national representation of and promote collaboration of nurses providing palliative care across all care settings and to build the capacity and capability of the workforce in order to provide palliative care for all New Zealanders.

Hospital Palliative Care New Zealand (HPCNZ) is a supportive network for health care professionals providing palliative care in the hospital setting. There are no formal subscription fees, and anyone is free to join. HPCNZ focuses on advocating for the provision of palliative care in the hospital setting and provides education to all hospital-based staff to increase awareness and understanding of palliative care.

Hospice New Zealand is the national organisation representing all hospice services in Aotearoa. Our vision is for all New Zealanders with a life-limiting condition to have access to the best possible palliative care. Whilst our primary focus is on hospice services, our resources and education programmes are designed for all providers of palliative care. Our awareness raising work focuses on normalising dying and encouraging conversations about end of life for all. We also develop and monitor the Hospice NZ Standards for Palliative Care used by all hospices to ensure quality services are delivered to patients and families.

References:

1. ANZSPM Guidance – Palliative Sedation Therapy – 2017 http://www.anzspm.org.au/c/anzspm?a=da&did=1005077&pid=1587788101
2. Twycross R. Reflections on Palliative Sedation. Palliative Care: Research and Treatment 2019:12;1-16

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