Auckland hospice prepares for assisted dying

Source: Q and A

Totara Hospice in Manurewa, the sole hospice to host assisted dying this week, says that putting the patient in control of their care means letting them have access to every available option.

Tina McCafferty, who heads Totara Hospice in Manurewa told Q+A that the decision to offer assisted dying was not take lightly. Their team has been “working, debating, discussing” the issue in earnest since at least 2015.

Prior to the most recent referendum there had been multiple other bills and a high court case around the End of Life Choice Act which “really raised awareness of the ethical, moral, clinical complexity of this [issue].”

Totara Hospice gathered as much information as they could before reaching a decision. “We looked around the world, we looked at what’s happening in 28 jurisdictions and counting, and why, and we looked at our philosophy and our approach, which is holistic.

“We believe that each of our patients is a unique human being, a unique individual, and as such they should be free to make the choices that are fight for them because we deliver patient-centred care where our approach is that the patient is always the driver of their own journey, we don’t conscientiously object.”

McCafferty says while assisted dying will be available from this week, not everyone will make that choice. “Less than five per cent of people who access the right to do this, actually do it".

“It’s about a sense of control, a sense of dignity, a sense of what is tolerable as defined by an individual.”

Those fighting against the legalisation of euthanasia are hoping opposition will grow in the weeks leading up to September's referendum.

Dr James Jap, Totara Hospice’s medical director, says initially other community practitioners and partners will be delivering assisted dying services at the hospice. He doesn’t see the option as being inconsistent with the Hippocratic Oath taken by doctors.

“Patients that may be accessing this service they have been diagnosed to be ‘dying’ by modern medicine. Modern medicine is not able to save them, is not able to fix them, is not able to cure them, so that are dying anyway. And in my mind a person’s dying wishes is really really important.”

Ahead of the law coming into effect this week 96 doctors and 8 nurses have indicated they are willing to be involved. New Zealand has more than 5,500 doctors.

Health Minister Andrew Little says those numbers are roughly in line with what he was expecting. He says the medical profession is still wrestling with the issue.

“Participating in something that brings life to an end is not something that comes naturally to a lot of health professionals. There are others who think there’s a legitimate choice here and this is a legitimate way to manage somebody in their terminal days.”

The minister says he’s confident everything is ready for the law to take effect this week. He says there’s funding in place to bring practitioners to people who require assisted dying if they can’t access support locally.