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Trial highlights risks for health professionals

Trial highlights risks for health professionals

The Lesley Martin trial highlights the risks when a health professional provides care for a terminally-ill family member, the New Zealand Medical Association says.

"Health professionals face huge pressures if they provide professional care for their loved ones. The conflict between the two roles -- that of health professional and that of a loving family member can cause intolerable pressures. This is a conflict of roles that the NZMA advises all doctors to avoid,” said Dr Tricia Briscoe, NZMA Chairman.

"The NZMA policy on Self and Family Treatment advises that it is not good clinical practice for doctors to treat themselves or members of their families unless there is no other available and appropriately qualified medical practitioner. The policy warns that in treating a family member, a doctor may risk impaired judgment and lack of objectivity.

"These issues would no doubt be the same for a nurse treating her terminally ill mother,” Dr Briscoe said.

"We have great sympathy for the distress felt by people who are caring for family members who are dying. However, this does not excuse them trying to kill them. There needs to be good palliative care and support available to both patients and their families.”

While euthanasia was not raised as a defence in the trial, the NZMA stands by its view that doctor-assisted euthanasia is unethical.

“Euthanasia would start us down a dangerous medical, legal and ethical slippery slope,” Dr Briscoe said. “How a society treats it weakest, most in need, and most vulnerable members tests it moral and ethical tone.”

Doctors have a duty to ensure that terminally ill patients’ last days are as pain-free and stress-free as modern medicine allows, Dr Briscoe said. Palliative care in New Zealand is of very high quality, but it is unfortunately not easily accessible to all. To this end, greater resources must be invested in the provision of good palliative care.

It is also important that patients understand they have the right to decline life-prolonging treatment.

“There is a clear ethical distinction between giving as much strong pain relief as is needed to achieve comfort, even if it could shorten life, and deliberately giving an overdose of pain relief to a patient who does not need it in order to kill them. Necessary pain relief treatment does not involve a primary intention to kill the patient, but euthanasia does,” Dr Briscoe explained.

The World Medical Association last year reaffirmed its opposition to euthanasia, expressing the strong belief that euthanasia is in conflict with basic ethical principles of medical practice and urging medical practitioners not to become involved, even in countries where it is legal.

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