The real issue about the doctor-patient relationship

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It appears that at least one person is not happy at all with the election statement from the New Zealand Catholic bishops titled “Step Out and Vote”. That person is ACT Party leader David Seymour, the MP behind the End of Life Choice Bill that has been drawn from Parliament’s members’ bills ballot.

NZ Catholic has seen a message he sent to the bishops’ conference, in which he accuses the bishops of peddling a falsehood in their statement “Legalisation of assisted suicide undermines trust in the medical profession . . . .”

To back up his accusation, Mr Seymour cited a 2004 YouGov poll for the UK Voluntary Euthanasia Society study.

The poll asked if the law were to be changed to allow assisted suicide, would respondents trust their doctors more, less or the same?

Seventy per cent said their trust in their doctors would not be affected and nine per cent said they would trust their doctors more and nine per cent would trust them less.

Mr Seymour then refused to respond to any of the other issues in the bishops’ statement, on the basis of his previous accusation.

NZ Catholic asked Robert Preston, the director of the UK’s Living and Dying Well think tank, what he made of Mr Seymour’s case and of the issue of the doctor-patient relationship under an assisted dying regime.

Mr Preston, a recent visitor to New Zealand, who spoke to several of our MPs, responded that he understood “the point that the bishops are making”.

But he added: “It seems to me that the way it is expressed invites the response which Mr Seymour has made. Opinion surveys do indeed indicate that people would continue to trust their doctors if ‘assisted dying’ were to be legalised — and, where it has been legalised, that they do so.”

But Mr Preston said that is “not really the point at issue”.

“Patients trust their doctors, not because the law says this or that, but because they need medical care and their doctors have been judged qualified to treat them.  In the same way, we trust the pilots of the airliners in which we fly, not because we have examined the rules governing flight safety, but because we need to travel by air and they have been cleared to fly us.  What we are looking at here is trust born of necessity.

“But it is the very existence of this doctor-patient trust which makes ‘assisted dying’ dangerous. Patients look to their doctors, not just for treatment, but also in many cases (and especially where they are seriously ill) for guidance.

“How a doctor responds to the ‘give me something to end it all’ request makes all the difference. A good doctor will try to get to the root of the matter and discuss with the patient how to make tomorrow better than today. Under an ‘assisted dying’ regime, however, a busy doctor could respond by discussing how to bring the patient’s life to an end.

“To the resolute and determined patient who is intent on death this may make little difference.

“But most seriously-ill people aren’t like that. They sometimes ask for ‘help to end it all’, not because they are serious about dying, but to show they are up against it and to seek reassurance. They are looking to the doctor, not for treatment, but for guidance. If a doctor responds by taking forward an apparent request for ‘assisted dying’, he or she risks sending the message, however unintended, that the patient’s condition and outlook are every bit as bad as the patient fears and that death is the best option.

“This is the point about doctor-patient trust, not that patients won’t trust their doctors. It’s more subtle, but it’s the real issue.”

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NZ Catholic Staff

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