In a disturbing development affecting our already under-resourced palliative care service, Health New Zealand is looking to sack the only two people focused on improving the already under-funded and under-supported palliative care system. And a new report warns that children are not receiving the palliative care they deserve.
The Post understands a Health New Zealand restructure proposal would disestablish the two national roles that look after the care of the dying – a palliative care system design manager and senior adviser.
Experts say, the plan to axe the two people dedicated to fixing the postcode lottery of care for dying Kiwis is disturbing, retrograde and potentially disastrous.
The national palliative care adviser was appointed in 2022, after palliative care experts called services for dying Kiwis a neglected, underfunded mess.
Hospital Palliative Care Aotearoa chairperson and palliative care specialist Sinead Donnelly said the plan was “disturbing, demoralising, distressing and retrograde”.
Donnelly said specialists were also upset at the staffing imbalance between palliative care and assisted dying, which has a team of around five dedicated staff. Of the 38,000 Kiwis who die every year, less than 2% use assisted dying services.
“It looks as if Te Whatu Ora is interested in developing assisted dying as a service, and they’re not interested in developing palliative care as a service … So that’s profoundly disturbing to us as well.”
Hospice New Zealand chief executive Wayne Naylor said removing palliative care’s national voice was “potentially disastrous” and could jeopardise 18 months of work to improve services for the dying.
“For the people who want to have a safe and supported death, and who don’t choose assisted dying, this is like a kick in the face to them, like the Government and Health New Zealand doesn’t actually care.”
A report last month reiterated the urgent need for a national palliative care service for children, with three out of four dying children missing out on specialist help.
Its author, child palliative care specialist Amanda Evans, was deeply disappointed by the Health NZ proposal and worried it would further delay – or kill off – any hope of a national paediatric palliative care service.
“My concern is that it’s going to be overlooked, and people wind up worse off than where we are now.”
The national palliative care adviser role was a bridge between all the different services caring for the dying, including family doctors, hospitals and hospices, Evans said.
Health Minister Shane Reti said he remained committed to developing a nationally consistent approach to palliative care. Asked whether the planned staff cuts were acceptable, his office said Health NZ was still consulting on proposed changes, and referred queries to them.
Health NZ national director of planning, funding and outcomes, Dale Bramley, said Health NZ was “committed to moving toward a more sustainable future for New Zealand healthcare”.
Original article: https://www.thepost.co.nz/nz-news/360527404/experts-slam-planned-palliative-care-staff-cut
New government data reveals that medically-assisted dying (MAID), also known as voluntary euthanasia, accounted for 4.7% of all deaths in Canada in 2023, marking a significant increase in the number of assisted deaths since euthanasia was legalized in 2016. The report, the fifth annual release since legalization, shows that approximately 15,300 people chose medically-assisted death last year, up nearly 16% from 2022.
The majority of those who opted for assisted dying were elderly, with a median age of over 77. Around 96% of cases involved individuals whose death was deemed “reasonably foreseeable,” usually due to terminal conditions like cancer. A smaller group, however, sought euthanasia despite not being terminally ill, citing long-term, debilitating illnesses that severely affected their quality of life.
Canada remains among a few countries to have introduced assisted dying laws in recent years, alongside nations such as Australia, New Zealand, Spain, and Austria. Under Canadian law, consenting adults with a serious and irremediable medical condition can request assistance in dying, provided two independent healthcare providers confirm their eligibility.
In 2023, over 320,000 people died in Canada, with 15,300 opting for assisted death, about one in every 20 deaths. Despite the increase, the growth rate of assisted deaths slowed considerably in 2023 compared to previous years, with a 16% rise instead of the usual 31%. The reasons for this slowdown remain unclear.
For the first time, the report also provided data on the ethnic and racial makeup of those who chose assisted death. It found that approximately 96% of those who died by euthanasia identified as white, despite white people making up only about 70% of Canada’s population. The second-largest group were East Asians, who represented 1.8% of assisted deaths, compared to their 5.7% share of the total population.
Quebec continued to lead the country in the use of medically-assisted death, accounting for nearly 37% of all euthanasia deaths, even though the province represents only 22% of Canada’s population. Quebec has launched a study to explore why its euthanasia rate is disproportionately high.
While the number of assisted deaths grows in Canada, the country still lags behind the Netherlands, where euthanasia accounted for 5% of total deaths last year. In the UK, MPs recently voted to approve a bill allowing terminally ill adults in England and Wales the right to seek assisted death, though it faces months of further scrutiny before becoming law.
Some critics of Canada’s euthanasia system, such as the Christian think tank Cardus, have raised concerns about the rapid growth of assisted dying, calling it alarming. The report comes as Canadian provinces have expressed reservations about expanding the program to include those with mental illnesses, a move initially scheduled for earlier this year but delayed after concerns about system capacity.
In Ontario, a controversial report highlighted cases where individuals were granted assisted dying despite not being terminally ill. One case involved a woman in her 50s with depression and a chemical sensitivity who requested euthanasia after struggling to find housing that met her medical needs. In another instance, a Nova Scotia cancer patient revealed that she was repeatedly asked if she considered assisted dying during her mastectomy surgeries, which she described as “inappropriate.”
Concerns have also emerged over the potential for people with disabilities to consider euthanasia due to inadequate housing or disability benefits. As the number of medically-assisted deaths continues to rise, the slippery slope of euthanasia is seen in the debate over the ethics and the seemingly increasing erosion of safeguards around assisted dying.
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