Latest topical issues and news from the NZ Health Professionals Alliance.
Originally published in The Age, 9 October 2017
by Marion Harris
Most patients with incurable cancer battle to the end. They exhaust all evidence-based active treatment options and clinical trials before being told that supportive care measures are now best.
A request to die is uncommon, and is often driven by poorly controlled pain
Originally published in the NZ Herald, 2 June 2016
Margaret Wong is a practising midwife who has also been a neonatal intensive care nurse and Plunket nurse during the past 40 years.
Lizzie Marvelly is right; every woman should be able to make her own choices. Certainly in New Zealand, we have more choices
Originally published on ABC, 12 May 2016.
By Rachael Wong
Independent MP Rob Pyne has introduced a private member ‘s bill to amend Queensland’ s abortion laws, which may allow women to undergo abortions through all nine months of pregnancy – up until birth.
Pyne, who called the current law “archaic,” has said that his bill does not
Travis Weber and L. Lin
“LGBT rights” are being elevated above conscience rights when the two come into conflict—but this trend is to the detriment of human rights, which can stand the test of time only when they are grounded in transcendent, fixed authority.
In the realm of international human rights law, major conflicts
Rachael Wong is a lawyer from Auckland who is currently working as a legal consultant with the Law Reform Commission in Samoa. She has recently completed a Master of Bioethics and Health Law for which she wrote her dissertation on freedom of conscience in health care. She maintains that a health professional’s exercise of
Dr Samantha Murton, an NZHPA member and General Practitioner from Wellington, reflects on a recent death in her family.
I was busily involved in our own personal experience of a gracious death with my Mother-in-Law. If I could say something now to the Health Select Committee on its Investigation into the Ending of One’s
Caroline Downey is a Kiwi currently based in London. In her submission to the Health Select Committee on the investigation into ending one ‘s life in New Zealand, she writes “we have to start talking about the problem of suicide in New Zealand – not the need for assisted suicide.”
I oppose any legalisation of euthanasia or assisted suicide in New Zealand.
On the 19th of October 2015, The Guardian published an article titled “’ We have to start talking about it’: New Zealand suicide rates hit record high”.
Beneath the title is the following brief explanation:
“The country has second highest rate of youth suicide
Dr Lucia Mitchell is a General Practitioner and Palliative Care Doctor who works in Richmond, Nelson, New Zealand. She shares with us her submission to the Health Select Committee on the investigation into ending one’s life in New Zealand.
I oppose any legalisation of euthanasia or assisted suicide in New Zealand.
Death has in
By John Fox
I’ve been sharing this when asked in various fora lately. If anyone wonders what I think of David Seymour’s iniquitous Bill, here it is.
To begin with I should say two things; first, this is not abstract for me. I live with a mild form of cerebral palsy and various associated
The NZHPA strongly encourages all New Zealand doctors to sign the Open Letter published by the Care Alliance opposing medical involvement in euthanasia and assisted suicide. The Care Alliance’s press release and Open Letter are re-published below:
Wednesday, 9 December 2015, 3:47 pm
Press Release: Care Alliance
Doctors say no to assisted suicide
By Neil Vaney
A recent post from Terry Bellamak, new president of the Abortion Law Rights Association of New Zealand (ALRANZ), questions why health professionals such as doctors and nurses should be legally able to use the claim of freedom of conscience in refusing to provide contraceptive or abortion advice or services. (http://wp.me/x1XY6w-z1,
Want to make a submission to the Health Select Committee on the investigation into ending one’s life in New Zealand, but not sure where to start? Carolyn Moynihan, a journalist who supports the work of NZHPA, has written this excellent submission:
8 November 2015
Submission on: The investigation into ending one’s life in NZ
By Michael Cook
Because media coverage of suicide could easily lead to copycat suicides, in 2008 the World Health Organization issued a long list of guidelines for journalists. It advises them to: “Avoid language which sensationalizes or normalizes suicide, or presents it as a solution to problems”, “Avoid providing detailed information about the site
Fourteen month old, twin Iraqi boys suffering from a progressive and incurable neurodegenerative disorder have died after the UK High Court ruled that doctors could switch off their life support against their parents ‘ wishes.
In line with decisions made in similar cases, Justice Holman considered that the suffering and complications the boys experienced as a result of both their condition and the artificial ventilation, made prolonging such treatment “not only futile but unjustifiable.” Agreeing with the boys’ doctors, he ruled:
“It seems to me that artificially to prolong their lives in this particular case lacks any purpose, confers no benefit at all apart from the fact of physical survival, and involves perpetuating the infliction of pain and discomfort for no gain or purpose. It is not in the best interests of either boy that the process be artificially prolonged, and it is in their best interests that nature should now be permitted to take its inevitable course.”
The boys’ parents argued that it was against their Islamic faith to withdraw life support before the children’s brains had stopped working and that turning it off was effectively killing them. To this Justice Holman responded:
“Several times in the present case the father has said that to withdraw the artificial ventilation, now that it has been commenced, involves killing the child. I completely understand how he perceives it that way and, indeed, that may be the viewpoint also of his Islamic faith. However…there is, and can be, no legal (nor indeed ethical) distinction between a decision to withhold artificial ventilation and a decision to withdraw or discontinue it once started. In neither case does the decision involve killing the child. The child is not killed. He dies because of the natural result or effect of his underlying disorder or disease.”
NZHPA considers that this judicial decision is highly relevant to the current discussion on end of life issues in New Zealand. To clarify for the purpose of present debate, not only is this not a case of killing these children, but neither is it a case of euthanasia (as some mistakenly consider switching off life support to be). Euthanasia is intrinsically different from a situation where futile or unduly burdensome life-prolonging treatments are withheld or withdrawn. In these situations, the intention is to reject the futile or unduly burdensome treatment, not to kill the patient.
Euthanasia is similarly distinct from a situation where a patient is given medication in order to alleviate his or her suffering, even if this risks hastening their death. Here the intention is to alleviate the patient’s suffering via the medication, not to kill them by administering a lethal dose of drugs. If the intention is in fact to kill the patient via the medication or by withholding or withdrawing treatment, it would correctly be called euthanasia.
Such examples have been confused as constituting euthanasia and have been used by pro-euthanasia advocates to say that euthanasia is happening already and that it should therefore be legalised. The fact that something unlawful happens in society is not sufficient reason to legalise it, and as noted above, such examples are not euthanasia as the intention to put the patient to death is absent.
Some people criticise those who distinguish between intended and unintended hastening of death. However, to understand the distinction one only needs to consider the intentions of leaders who sent their soldiers to fight the Nazis. These leaders would have known that they were sending their soldiers into situations where many deaths were inevitable, but the leaders’ intention was to defeat the Nazis, not to cause the deaths of their soldiers.
Let’s be crystal clear that we
Dr Catherine Hallagan, Chair NZHPA
General Practitioner, Wellington
Many health professionals will have recently received an invitation from their professional organisation to participate in an online survey regarding “physician-assisted dying”.
The research approved by the University of Auckland’s Human Participants Ethics Committee (UAHPEC) appears to have process and methodology flaws that should be of
According to the 2014 Annual Report by the Netherlands’ regional euthanasia review committees, there were 5,306 reported cases of assisted dying in 2014, a 10% rise on the previous year, and double those reported in 2009 (2636).
A spokesman for the review committees said that the increase may be due to a growing social
The Health Select Committee at Parliament is holding an investigation into Ending One ‘s Life in New Zealand. It will investigate:
1. The factors that contribute to the desire to end one’ s life.
2. The effectiveness of services and support available to those who desire to end their own lives.
3. The attitudes of New Zealanders toward the ending of one ‘s life and the current legal situation.
4. International experiences.
The Investigation is being held in response to a petition promoted by the Voluntary Euthanasia Society. Please make your own individual submission to the Health Select Committee Inquiry. You can do this by writing a submission for email or for posting to Parliament.
*Head your submission “Health Select Committee: Petition of Hon Maryan Street and 8,974 others”
*Attach a covering letter with your name, home address, email address and day-time phone number
*State whether you would like to make an oral submission
*Send two hard copies
(a) State your general position.
(b) Stick to the four areas in the HSC Terms of Reference outlined above.
(c) Discuss a few key points. You do not need to write on all four areas of reference.
(d) Submissions can be as short as one sentence, and ideally, not longer than two pages.
(e) State your views in personal words. Don’ t just cut and paste someone else’s views.
(f) Prepare a
NZHPA is very pleased that the Royal College of General Practitioners in England is opposed to the Legalisation of Euthanasia and Assisted Suicide. NZHPA hopes that health professionals here will follow the example of the RCGP. It believes that the medical and nursing professions should be united in rejecting any moves to legalise Euthanasia and Assisted Suicide in New Zealand.
Read about the RCGP’s position in the link
Abortion rates are declining in the United States and in New Zealand. The reasons are varied and complex. NZHPA readers will find the statement below is relevant when they reflect on the drop in abortion numbers. The statement was made by Richard M. Doerflinger in Public Discourse on Feb 10th 2014. He was commenting on the American situation but the explanation can also be applied to Aotearoa – New
Here is the official Declaration from the ICPCN (International Children’s Palliative Care Network). It outlines the Network’s opposition to the Euthanasia of Children. Legislation to this effect was passed by the Belgian Parliament on 12th Feb 2014.
THE ICPCN MUMBAI DECLARATION 2014
We believe that all children (neonates, children and young people) have the right to the best quality of
Swedish Nurse takes a Stand on Conscience Rights: Read about this midwife who believes that health professionals must be allowed to refuse to assist at abortions.
Below is an interesting article published with permission from its author, Dr Dave Andrusko. It was first published in the National Right to Life News Today on Nov 7th 2013. The headline reads: Pro-lifers and others in Victoria push to protect right of conscience for physicians who want no part in any abortion
Dr. Mark Hobart
Last month NRL
Some academics have recently suggested that conscientious objection is an unwarranted barrier to the provision of reproductive health care. In April 2013, the American Journal of Public Health published an article “Abortion Law Around the World: Progress and Pushback.” The authors perceive that there has been a rise in “unregulated conscientious objection” . They consider that this is a barrier for women trying to access lawful abortions. NZHPA believes that one inference that can be drawn from the article is
Please read the following link and view its associated video to learn about the illogical language used in euthanasia legislation. NZHPA maintains that Conscientious Objection must be protected for all health professionals who want nothing to do with the provision of euthanasia and assisted suicide.
Health professionals need to practice ethics of a high standard in order to provide excellent health care. They must have empathy with their patients. Empathy is a human emotion that connects people positively to one another. No matter what one ‘s role is as a health professional eg a nurse, a physician, a physiotherapist or a pharmacist, each health practitioner must show empathy in caring for a patient. An NZHPA mantra could be “Every health professional needs empathy!” You’ re invited to click on the link as it portrays this message in a beautiful way.
Once euthanasia or assisted-suicide is legalised for a select group, before long the argument is put that it’s discriminatory not to allow it for others, including those incapable of giving consent. Legalising euthanasia in any form will inevitably lead to euthanasia in all forms. Is this what we really want for New Zealand? Read here to see
Professor D Robin Taylor, University of Otago, Graduation Address
Chancellor, Vice Chancellor, Mayor, Members of the University Council, academic colleagues, graduating students, family members and friends – tena koutou, tena koutou,tena koutou.
It is a great privilege to have been asked to give this graduation address. It is a special occasion for you
Negative attitudes towards Alzheimer ‘s disease are an undue influence on the euthanasia debate, claims an Australian bioethicist and Professor of Nursing at Deakin University.
Professor Megan-Jane Johnstone has examined the ‘ Alzheimerisation ‘ of the euthanasia debate in a new book, Alzheimer’ s disease, media representations and the politics of euthanasia: constructing risk and selling death in an aging society.
“Alzheimer’s has been portrayed as the ‘disease of the century’ that is poised to have a near catastrophic impact on the world’s healthcare system as the population ages,” Professor Johnstone said.
“This representation of the disease – along with other often used terms such as ‘living dead’, a ‘funeral that never ends’ and a ‘fate worse than death’ – places Alzheimer’s as a soft target in the euthanasia debate because it plays to people’s fears of developing the disease and what it symbolises. It positions Alzheimer’s as something that requires a remedy; that remedy increasingly being pre-emptive and beneficent euthanasia.”
Professor Johnstone acknowledges that euthanasia is a polarising and emotive issue, however she warns that the public could be unduly swayed by the
Watch this topical debate on Conscientious Objection following a recent landmark Court ruling in the United Kingdom. Scotland Tonight looked at the issue of conscientious objection after the successful appeal by two midwives against an order to delegate, supervise, or support staff involved in providing abortions. NZHPA is very pleased to learn of the positive outcome to this case.
Click on the
A proposed new law allowing euthanasia and assisted suicide would put both nurses and vulnerable patients at risk says Julie Maher, RN, BA, MA. She is postgraduate co-ordinator and senior lecturer, postgraduate certificate in Hospice Palliative Care, Whitireia Community Polytechnic, Porirua, New Zealand. Julie is also a Member of NZHPA.
Labour MP and health
Iona Heath president, Royal College of General Practitioners (RCGP). The RCGP is the professional membership body for family doctors in the UK and overseas.
Campaigns in support of assisted dying seem to be predicated on an excessively rosy view of society and the individuals within it, says Iona Heath, writing in a personal capacity.
Consultant in Palliative Medicine, Capital & Coast District Health Board (CCDHB), Wellington
Adjunct Professor, School Biological Sciences, Victoria University, Wellington
Senior Clinical Lecturer, Otago School of Medicine, Wellington
This article was originally published in the Journal of the New Zealand Medical Association, 23-November-2012, Vol 125 No 1366
I come from a long line
Dr Catherine Hallagan
BA MBChB Dip Obstetrics FRNZCGP
I will give a doctor’s view of the issues from a personal and professional perspective since the two are closely intertwined. My approach is to discuss:
Conscience and Conscientious Objection
New Zealand Laws relevant to Conscientious Objection
Key Moments in my professional journey
Sean Murphy – Administrator of the Protection of Conscience Project – www.consciencelaws.org
Presented at the Obstetrics and Gynaecology Conference
New Developments – New Boundaries
Banff, Alberta (November 9-12, 2001)
Sponsored by Department of Obstetrics and Gynecology, Faculty of Medicine, University of Alberta, and the Department of Obstetrics and Gynecology, Misericordia Hospital, Edmonton, Alberta.
Dr Paula Cummings
B Pharm MBChB FRNZCGP
Adapted from a presentation given to students and young-professionals in December 2012.
Thank you for this opportunity to speak on aspects of general practice that challenge my professional medical ethics but that lie at the very heart of why I chose medicine as a career.
Below are excerpts from a eulogy given in honour of Dr John Crowley. He was an Obstetrician and Gynaecologist from the Manawatu who was a member of the New Zealand Health Professionals Alliance. He was a mentor to many colleagues and he always upheld the right to conscientious objection while following best practice guidelines
New Zealand Health Professionals Alliance Incorporated
Te Hononga Mātanga Hauora o Aotearoa
The New Zealand Health Professionals Alliance Inc (NZHPA) opposes euthanasia and assisted suicide.
Euthanasia is the deliberate ending of a patient’s life by a health professional. Participation in this practice is unethical. It remains wrong, regardless of a request for it from
Do hospitals and hospices already effectively practice euthanasia through administering pain relief or withholding medications?
Radio New Zealand interviews Sinead Donnelly of the Australian and New Zealand Society of Palliative Medicine and Anne Morgan of Hospice NZ.
The cost of legal action has led the Medical Council to abandon its proposed statement on the advice doctors should give when they have a conscientious objection to abortion.
Having spent more than $214,000 defending its draft statement in court, the council decided it must balance financial prudence with the desire to provide guidelines,
Media statement: Dr Catherine Hallagan, a General Practitioner from Wellington and spokesperson for the New Zealand Health Professionals Alliance, told NZ Doctor that the NZHPA is very pleased that the Medical Council has abandoned its appeal.
Dr Hallagan said that she had felt strongly about challenging the Medical Council ‘s draft statement on “Beliefs and medical practice”since first reading it in 2009. “I was shocked at what I read and I believed that the Medical Council was planning to do something which would overstep the law. If published, I thought that the obligations imposed by the guidelines would override a doctor’ s lawful right to conscientious objection, especially
Media statement from Catherine Hallagan
Dr Catherine Hallagan, a General Practitioner from Wellington and spokesperson for the New Zealand Health Professionals Alliance, told NZ Doctor that the NZHPA is very pleased that the Medical Council has abandoned its appeal.
Dr Hallagan said that she had felt strongly about challenging the Medical Council ‘s draft statement on “Beliefs and medical practice”since first reading it in 2009. “I was shocked at what I read and I believed that the Medical Council was planning to do something which would overstep the law. If published, I thought that the obligations imposed by the guidelines would override a doctor’ s lawful right
Sean Murphy – Administrator, Protection of Conscience Project – www.consciencelaws.org
It appears that most people are willing to grant that a health care worker who has serious moral objections to a procedure should not be compelled to perform it or assist directly with it. However, many people find it more difficult to understand why some
Sean Murphy – Administrator of the Protection of Conscience Project – www.consciencelaws.org
Many people, grappling with concerns about freedom of conscience, agree that health care workers should not be forced to participate in procedures or services to which they object for religious, moral, or ethical reasons. However, their agreement is frequently qualified by the condition that
Legal debate is set to resume over a doctor ‘s obligations when consulted about abortion.
The Medical Council has appealed last year’ s High Court judgement requiring it to change its guidance to doctors with a conscientious objection to abortion.
Talks have failed so far
Talks are continuing between the council and those who brought a case against it, says council chair John Adams.
“We have always been hopeful of a resolution, but have lodged the appeal.”
The Medical Council is appealing a High Court judgment that it must change its advice to doctors who conscientiously object to abortion.
Council chairman John Adams said Tawa Medical Centre GP Catherine Hallagan and the New Zealand Health Professionals Alliance had last year instigated a judicial review which challenged the council ‘s advice to doctors on abortion and their own personal beliefs.
Wellington High Court judge Justice Alan MacKenzie ruled in their favour, saying when a woman requests an abortion, the proper course for a doctor who has a conscientious objection is to decline to embark upon the process and to inform her she can obtain the service from another health practitioner or from a family planning clinic.
But the Medical Council wanted doctors to be required to be sure they were referring the patient to another doctor who could give information on all the options.
“The council had argued its statement recognised a doctor’ s right to
The Medical Council is considering amendments to its draft statement on how doctors with a conscientious objection to abortion must respond to a patient requesting an abortion.
Conscientiously objecting doctors have successfully challenged the statement in court, saying it wrongly requires them to give advice that might facilitate the patient obtaining an abortion.
The High Court has upheld the right of doctors who object to abortion to opt out of giving advice to patients seeking the procedure.
The court last month heard a case taken by Wellington GP Catherine Hallagan, who objected to proposed changes to Medical Council guidelines regarding beliefs and medical practice.
Her lawyer said
The High Court has upheld the right of doctors with a conscientious objection to abortion to opt out of giving advice to patients seeking the procedure.
The case, which was heard last month, was taken by a Wellington GP who objected to proposed changes to Medical Council guidelines on how doctors deal with abortion
New Medical Council guidelines for doctors dealing with the issue of abortion have overstepped the law and need to be amended, the High Court has ruled.
Among the requirements in the council ‘s beliefs and medical practice statement, doctors were required to ensure patients were aware that abortion was an option if they were concerned about their pregnancies.
Doctors who did not want to provide the service could refer the request elsewhere, informing the person it could be obtained from another health practitioner, or a family planning clinic.
A group of doctors raised objection to the statement in a judicial review at the High Court in Wellington last month, saying it wrongly required them to give advice that might facilitate the patient obtaining an abortion.
The group’ s lawyer, Harry Waalkens, QC, said the statement was not in line with the Contraception, Sterilisation and Abortion Act itself, which excluded
The Medical Council has overstepped the law in its draft statement on how doctors who hold a conscientious objection to abortion must respond to a patient requesting an abortion.
The statement must be amended, says a ruling from High Court judge Alan MacKenzie, released today.
The judge has accepted some of the arguments of
Doctors with a conscientious objection to abortion have asked the court to stop the Medical Council from requiring them to give patients more information than they consider reasonable.
The council ‘s Beliefs and Medical Practice statement misinforms doctors on their obligations toward women seeking abortion, according to Tawa Medical Centre GP Catherine Hallagan and a group called the New Zealand Health Professionals Alliance.
They were the applicants in a judicial review hearing in the High Court at Wellington last month. Justice Alan MacKenzie reserved his decision.
The Medical Council had got it wrong, said Harry Waalkens QC on behalf of the applicants.
The council’ s most recent statement, kept confidential until the hearing, tells doctors with a conscientious objection to abortion that, if consulted by a pregnant woman
The Medical Council is standing by its requirement that doctors ensure women have access to information on abortion services.
It is not sufficient for doctors with a conscientious objection to inform a patient requesting an abortion that she can go to a Family Planning clinic or another doctor, the council ‘s lawyer told the High Court at Wellington today.
Mary Scholtens QC is responding for the council to a challenge to its latest Beliefs and medical practices statement.
Statement compatible with doctors’ and patients ‘ rights – defence lawyer
The council statement requires a doctor who chooses because of a conscientious objection not to provide a service, to give a patient the names and contact details of doctors who do provide the service.
In this case, the council says the details are of doctors who provide information on a woman’ s
New Medical Council guidelines for doctors dealing with the issue of abortion are being challenged in the High Court. Among the requirements in the Beliefs…
Doctors have been misinformed on their obligations toward women seeking abortion, says the lawyer in a High Court challenge to the Medical Council.
The council ‘s “Beliefs and Medical Practice” statement had got it wrong, said Harry Waalkens QC on behalf of doctors challenging the statement in a judicial review in the High Court at Wellington today [1 November].
Tawa GP Catherine Hallagan and a group of like-minded health professionals are taking the case.
The council’ s most recent statement, kept confidential until now, tells doctors with a conscientious objection to abortion, if consulted by a pregnant woman who wishes to have an abortion, they
Anti-abortion doctors have gone to court to challenge new Medical Council guidelines on how physicians with personal objections to abortion must deal with patients.
The doctors filed an application in the High Court last week for a judicial review of the guidelines, titled “Beliefs and Medical Practice” .
The Medical Council is withholding the guidelines until the