International meeting on end of life choice

Today was the introductory evening of the annual conference of the world federation of right to die societies. (#WFRTDS)

Whether you call it medical assistance in dying, end of life choice, or even euthanasia, it’s a reality in every country in the world. It’s a legalised and regulated in something like two dozen countries so far, and the numbers are growing by the year. A few more Australian provinces are set to join this year.

Some countries have had it for decades, like the Netherlands or Switzerland, others have just gotten it, like New Zealand, and still others are trying to get access to medical assistance in dying, like Spain, Germany, and the UK.

At this conference there’s representation from literally dozens of countries. Some are just private citizens who’ve had experiences with the death of a loved one that they think could have gone better with medical assistance in dying, others are here because they’ve had great experiences with MAID, and still others work with organizations representing patients suffering at the end of life, often despite the best in palliative care.

Tonight I met representatives and experts from Iceland, the Netherlands, the UK, the United States, Canada, and other countries.

We learned that some countries will allow medical assistance in dying only for patients with a terminal illness likely to cause their death within 6 months (an example would be New Zealand), while others allow it for anyone with a “grievous and irremediable condition”. In some cases these can even include psychiatric conditions such as depression.

But the numbers of these are typically extremely small, because the patients have to prove that they’ve exhausted other treatment options, and that their symptoms are unbearable, which can be very challenging. It’s a very high hurdle, which means that very few people actually can avail themselves of the service.

We also heard about the language differences and terminology around assisted dying. If you call it medically assisted dying, you may picture one thing. If you instead translated it as “Mercy Murder”, you can paint it as a very different picture. Words matter, and we should be using the terms the patients themselves prefer.

In my own experience no patient dying of end stage cancer, called medical assistance in dying, ‘suicide’ or ‘murder’.

They understand only too well that their cancer is killing them, and what they are doing is simply choosing to take a medicine which will save them having to suffer through a few more weeks or months of unbearable agony. In New Zealand these are not patients with vibrant lives and years left to live, these are most often people whose bodies are literally riddled with cancer, where the tumor has often spread to their liver, lungs, bones, and/or brain, and where they’re not seeking to end their life early, they’re just seeking to shorten the dying process and eliminate some of the suffering.

A final interesting conversation I had was regarding France. I’m told they’re creating a citizens convention of around 150 randomly chosen citizens, to hear the evidence both for and against medical assistance in dying.

The reality in the New Zealand experience, was that the vast majority of people supported medical assistance in dying, and had for years. But you’d never known it from reading the media, which don’t sell newspapers or internet ad clicks by representing the reasonable and caln opinions of the majority. Media thrives on conflict, it’s how it makes money.

So too often, in countries like New Zealand, the UK, the US, and Iceland just to name a few, you have a situation where a tiny minority of people (perhaps religious leaders, politicians, specialist doctors, or zealots) are given more time to broadcast their message, than the vast majority of normal & regular folks, who never decide to answer a survey or get interviewed on television.

The voices of the reasonable get drowned out and the voices of the fringe extremists get amplified.

I love the idea of randomly sampling a population to see what the majority actually want and believe, rather than just those who shout the loudest.

Overall it was an interesting and thought provoking first evening for the world federation of right to die societies’ annual conference. The next 4 days should be enlightening, a master class in international politics, culture, human rights, and health care.

#eolc #maid #euthanasia