What do people with life-limiting illness considering euthanasia think about treatments at the end-of-life?

Jessica Young1, Dr Janine Penfield Winters1, Associate Professor Chrystal Jaye2, Dr Richard Egan, Mr Tony Egan2

1Bioethics Center, University Of Otago, North Dunedin, Dunedin, New Zealand; 2Dunedin School of Medicine, University of Otago

Euthanasia is currently a topic of wide interest, debate and legislative proposals.  The aim of this presentation is to describe what a group New Zealanders with life-limiting illness, who want or would consider euthanasia, think about the provision of end of life services, including assisted death, euthanasia, withdrawal of life-prolonging treatment and symptom management with morphine or palliative sedation.

We recruited fourteen New Zealanders with life-limiting illness and life expectancy of less than a year.  Their mean age was 61 years (range 34-82) and six were enrolled in Hospice.  An additional six family members were also interviewed and included in analysis.  We asked them about why they would consider euthanasia if it was available. Interview transcripts were inductively analysed consistent with interpretive phenomenological analysis.

Two-thirds of the participants viewed current palliative care practices, such as pain relief with morphine and symptom management with palliative sedation, as hastening death.  Some stated these were done without patient consent.  The participants did not articulate this as murder, but several emphasized that they wanted to choose the time of death rather than having their doctor choose for them.

There is a divide in what hospice and palliative medicine and what patients perceive as euthanasia. Participant’s beliefs about morphine were not aligned with decades of medical research showing that standard therapeutic doses of morphine do not hasten death and they did not recognize the ‘principle of double effect’. Whether or not there is a law change, the finding that patients may have different views of end of life practices has implications for preferences in care, communication and palliative care practice.


Biography:

Jessica Young is a PhD Candidate and Research Fellow at the Dunedin School of Medicine, University of Otago.  She is an emerging qualitative researcher working in the field of healthcare. Her background and research expertise lie at the intersection of sociology with medicine, health and illness. Jessica’s PhD is an exploration of the perspectives of people with a life-limiting illness who would consider euthanasia/assisted dying if it was available to them. As well, she has researched and published in patient’s care networks, medical education, weight discourses, public health and health promotion, ageing and longevity.

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The Australasian Association of Bioethics and Health Law (AABHL) was formed in 2009.

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