International experts: euthanasia undermines palliative care

As state governments in Australia consider bills to legalise euthanasia and assisted suicide, it is imperative that the views of doctors and palliative care health professionals, as the professions most affected by such radical changes to the law, are taken into account.

It is well known that the World Medical Association and 107 of its 109 National Medical Associations (including the American Medical Association and the Australian Medical Association) are opposed to euthanasia and assisted suicide. For example, the American Medical Association states that euthanasia is “incompatible with the physician’s role as healer”.

Palliative care professionals are also overwhelmingly opposed to the practice.

The International Association for Hospice and Palliative Care (IAHPC) is an international organisation that is dedicated to the global advancement and development of palliative care, and to working with “governments, civil society organisation, professional associations, agencies and individuals, to improve knowledge, increase access to resources, and foster opportunities in palliative care education, research, and training.” The IAPHC is a membership organisation which is in formal relationship with the World Health Organisation, and serves as an “adviser and observer to relevant discussions and expert committees.”

Its governing board is comprised of palliative care providers from different professions including nursing, oncology, palliative medicine, pharmacy, psychiatry and psychology.

The IAPHC has prepared a statement outlining its position on euthanasia and assisted suicide. The statement was prepared in recognition of the “powerful impact” that euthanasia and assisted suicide “can have on patients, caregivers and health care providers.” In particular, it states:

“The IAHPC believes that euthanasia and PAS undermine the integrity of the profession and the dedication to safeguard human life.”

“IAHPC believes that no country or state should consider the legalisation of euthanasia or PAS until it ensures universal access to palliative care services and to appropriate medications, including opioids for pain and dyspnea.

The organisation has come out strongly against legislation that compels medical professionals to provide euthanasia and assisted suicide. It also provides that these practices should not be provided as part of the “care” provided in palliative care units:

“In countries and states where euthanasia and/or PAS are legal, IAHPC agrees that palliative care units should not be responsible for overseeing or administering these practices. The law or policies should include provisions so that any health professional who objects must be allowed to deny participating.”

Instead, the focus for governments should be on providing universal access to palliative care and access to pain medication:

“The IAPHC maintains that in accordance with guidance from the WHO recommendations and the WHA Resolution, national governments must take steps to ensure that people have adequate access to treatment for moderate to severe pain, and ensure availability of and access to essential opioids such as immediate release oral morphine. Their failure to do so violates their obligation to protect, respect, and fulfil the right to health and to prohibit cruel, inhuman and degrading treatment.”(emphasis added)

This statement from the IAPHC is but one of many statements from medical and health organisations around the world which both oppose euthanasia and assisted suicide and recognise that euthanasia and assisted suicide do not, and should never, form part of the practice and discipline of palliative care.