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Understanding the bill.

I WOULD like to respond to Juliet Darroch's letter, "Does public understand bill?", in the February issue. From some of the phrases she uses, it appears Darroch does not understand the End of Life Choice Bill herself.

The term "euthanasia" implies killing against the will of the patient, which is not in the bill. The term "assisted suicide" suggests that voluntary assisted dying (VAD) is similar to irrational suicide. VAD does not have the same characteristics, and that is why the bill does not use the term.

Irrational suicide is impulsive, often violent, and causes extreme distress to family and friends. Almost always, the mental illness which leads to the act is treatable and hence reversible. This type of suicide is of great concern to everyone.

VAD happens where, at the request of the patient, the physician prescribes the drug, and the patient takes it to end their life, or the physician directly administers the drug, usually intravenously. Both types of VAD are beneficial to the patient, prevent suffering, and are an act of compassion by the doctor. They are respectful of the patient's autonomy, are a logical extension of medical treatment, and allow the relatives and friends to say goodbye before the ravages of disease and intense sedation make this impossible. They also allow some ceremony and spiritual and religious involvement.

Knowing such an option is available to them--even if eventually they do not use it--also gives the patient peace of mind and may actually promote prolongation of life.

I know of no supporter of VAD who advocates for irrational suicide, yet opponents of VAD in New Zealand constantly use the words "assisted suicide" in a pejorative manner.

Does VAD encourage irrational suicide? Evidence shows no link between the legalisation of VAD and increased suicide rates. Suicide rates have remained unchanged or have fallen in countries or regions where VAD has been legalised.

In terms of patient vulnerability, all the evidence, including from voluntary bodies representing the elderly and the disabled in countries where VAD has been legalised, shows a complete lack of coercion and abuse associated with it. Two doctors actively looking for signs of coercion in a competent patient are well able to prevent abuse of the VAD process.

The only people likely to be vulnerable at the moment are those who are slowly dying with unbearable suffering from irremediable illness. Where extended palliative care is not adequate or not wished for, the End of Life Choice Bill offers a chance of a peaceful death.

Jan Gilby, RN, Hamilton

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Title Annotation:Tell us what you think
Author:Gilby, Jan
Publication:Kai Tiaki: Nursing New Zealand
Article Type:Letter to the editor
Date:Mar 1, 2018
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