I was walking with a senior doctor last Friday as we left one of the geriatric wards. He was in a good mood, and turned to me with a grin on his face. Half jokingly, he said to me, “You need to learn how to look after your parents”.
Joke aside, I think he was right. As a whole, our country does poorly at looking after our older people and elderly.
Elder abuse, just one of the forms of coercion older people have to negotiate, is common. A recent Massey University study involving 4,000 participants found that 18.0% of older New Zealanders experienced elder abuse in 2015 (Yeung, Cooper & Dale, 2015).
The same study found that the sicker an older person was, the more likely they were to experience abuse.
Any suggestion that a person should choose or commit suicide is a form of abuse. Even when offered with the best of intentions, suggestions like these tell the person on the receiving end that society thinks that life would be better for everyone if they were gone.
Our Parliament is currently considering a change to our laws around suicide which will make it even more likely older people will face this form of abuse. The End of Life Choice Bill would allow people with a self-defined “grievous and irremediable medical condition” a doctor’s help in committing suicide.
My supervisor told me about a New Zealand patient he had once treated who was being cared for in a hospice. This patient was in no pain, was alert, and was adored by his family. He was visited almost every day. A month or so before he died, this patient had his 92nd birthday. His family organised him a small party, but my supervisor was surprised to see how subdued and even resentful this party was. After the patient’s birthday, his family never visited again. None of the medical staff could understand this, until the patient explained to a nurse that his family had been desperately hoping he would die before his 92nd birthday so they could collect his $200,000 life insurance policy – which had expired on his birthday. The psychological abuse was real, but was undetectable to outsiders, even those who were spending a lot of time with this man.
If the End of Life Choice Bill had been law at the time, the man’s abusive family would have undoubtedly suggested this patient choose assisted dying. He may have given in from constant pressure, despite him desiring to see his 92nd birthday. The abusive family would probably have walked away with $200,000.
Such scenarios are common, not rare, as the research shows – yet the Bill proposed provides no protection for our older people. Section 8 of the End of Life Choice Bill states that an attending medical practitioner will
do his or her best to ensure that the person expresses his or her wish free from pressure from any other person by—
- talking with other health practitioners who are in regular contact with the person; and
- talking with members of the person’s family approved by the person.
This provision does not require an objective standard to be met, so will prove unenforceable in practice. I believe, based on my experiences studying in a hospital, that allowing the End of Life Choice Bill to become law would be a grave injustice.
If you haven’t made a submission on the End of Life Choice Bill yet, you can do that here. There’s two days left!
Guest post by Callum Hammond, 4th year medical student at the University of Auckland
Yeung, P., Cooper, L., & Dale, M. (2015). Prevalence and associated factors of elder abuse in a community-dwelling population of Aotearoa New Zealand: A cross-sectional study. Aotearoa New Zealand Social Work, 27(3), 29-43.