Three or so years ago our local hospice ran an appeal based on the claim that some of their patients were dying in pain because there was not enough money to buy effective medication. The appeal letter could not be found when I asked for a copy a few months later. And, of course, it was not entirely factual. A year or so later the then Prime Minister asserted that “We don’t need Voluntary Euthanasia; we have hospice”.
That, too, was a bit naive. We know now—as I personally found out after surgery a few years ago— that not all pain can be controlled. Indeed the World Health Organisation suggests that up to 25% of pain may be untreatable. So the palliative care movement cannot be expected to deal with all pain. And the dilemma for the hospice movement is what can they do with patients who unhappily fall into that category?
My answer would be that hospice should think about embracing the medical aid in dying movement for such patients as wish to avail themselves of it. I know all the traditional Hospice arguments against such a course. It would involve a sea change of thinking. But studying the values and aims of the hospice movement I can now point to a lot of hospice principles that could be honoured by taking palliative care to its logical conclusion in every case, instead of only in five out of six patients.
Respect, dignity and compassion are values that apply as well to a good programme of medical aid in dying as they do to palliative care. And, perhaps, at the end, for some people for whom pain is uncontrolled and who choose for another option, they apply more to the former than the latter.
Where could we find a more appropriate organisation to offer the qualities of nursing and pastoral care, support and judgment that will be required when Parliament has passed an appropriate law?
Dave MullanRed Beach, Hibiscus Coast, New Zealand
Retired Presbyter of Methodist Church of New Zealand. Passionate pioneer in Local Shared Ministry, consultant in small churches, publisher of niche market books, producer of prosumer video, deviser of murder mystery dinners and former private pilot. I trained for the Methodist Ministry at Trinity Theological College and eventually completed MA, Dip Ed as well. Bev and I married just before my first appointment in Ngatea where our two children arrived. We went on to Panmure and Taumarunui. Longer terms followed at Dunedin Central Mission and the Theological College. During this time I was also involved as co-founder and second national President of Family Budgeting Services and adviser to the (government) Minister of Social Welfare. My final four years were part-time, developing the first Presbyterian or Methodist Local Shared Ministry unit in this country and promoting the concept overseas. Retirement has brought a whole lot more opportunities and challenges. We are now living in our own villa in Hibiscus Coast Residential Village.