New Zealand is going grey, along with a lot of the world.
We increasingly hear about the upcoming challenges of an ageing population.
It is therefore encouraging that a recent report titled The Quality of Death from the Economist Intelligence Unit, ranks New Zealand third of 40 countries for our quality of end-of-life (palliative) care.
The report points out that palliative care makes financial sense, but perhaps more importantly, it challenges us to ask important questions about life and death.
A doctor’s job is, appropriately, to preserve life.
But death is also a reality for every person, and must be faced.
The ‘Quality of Death’ Report ranks various countries’ performances in end-of-life care, using a few key indicators. These include public awareness about death, quality of care available and cost and availability of such care.
New Zealand comes in third behind the UK and Australia. Countries that rank particularly poorly tend to face the challenge of negative taboos or cultural perceptions about death that make palliative care very difficult.
Some countries also are challenged by restrictions around the use of painkillers, resulting from concerns about drug trafficking and illicit use.
‘Quality of Death’ argues that palliative care is of benefit, because of its capacity to improve the quality of someone’s life as it comes to its end.
The Report also argues that palliative care is of financial benefit, as it does not attempt to throw every available technology or medication at a sick person, when such intervention is unlikely to help and may actually diminish a person’s quality of life.
The arguments for palliative care must not be confused with those of euthanasia.
Caring for someone at the end of their life is different to hastening their death.
The New Zealand Herald reported recently the story of John Pollock, a terminally ill doctor who, with just a few months left to live, has begun to advocate for euthanasia. He argued that the laws of this country mean he must face a death he cannot control.
He said his suffering could go to such a level that if an animal were not “put-down” under such circumstances, it would be considered cruel, possibly even criminal.
Doctor Pollock has asked for a law change.
His challenge is confronting.
But palliative care can offer much comfort and respite to terminally ill people and their families, by medicating people without deliberately causing death.
This is a crucial distinction.
Palliative care does not attempt to postpone death through curative medical intervention, but neither does it attempt to hasten death.
In fact, according to ‘Quality of Death,’ over 90% of palliative care doctors in the UK are opposed to euthanasia. They draw a distinction between relieving a person of suffering and distress, and administering drugs with the intention of killing a person.
They also say it is very difficult to decide what someone would wish for, when they are in such a frail state.
In a culture that wants to control life and death either through a myth of never-ending cures, or through allowing a person to ‘choose’ how and when they die, palliative care is incredibly valuable.
It reminds us of the reality of death, the beauty of life, and our inability to control either of these. It is encouraging that New Zealand is doing fairly well in this regard.
-Maxim Institute
Photo : Dr Jack Pollock: The Right to Die
