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Hospice Palliative Care Association advises access to quality palliative care not euthanasia

Author: Dr. Liz Gwyther | CEO HPCA
22 September 2017

HPCA is concerned to see a call for the legalising of euthanasia in South Africa. We are saddened to hear of Dr Sue Walter’s diagnosis and offer her every assistance at this difficult time. However, we believe that pursuit of legalising euthanasia in South Africa is irresponsible.

International discussion on the issue has resulted in the majority of countries rejecting euthanasia and assisted suicide and proposals to change laws designating these acts as illegal.

The recent debate in New Zealand included a submission from Dr Martin Sullivan, a lecturer in Disability Studies & Social Policy at Massey University, stating that “euthanasia and assisted suicide will place already vulnerable people – disabled people, elderly people, people with chronic conditions, sick people – in an even more vulnerable position when they are sick or near the end of life. We live in society which valorises the ‘able-body’ and ‘able-mind’ to the extent that to be disabled in any way is to be highly devalued, to the extent that it is better to be “dead than disabled.” The ‘right to die’ could become the ‘duty to die’ for these people. 

In South Africa, Prof Daniel Ncayiyana, wrote an editorial in the South African Medical Journal in 2012, describing a “pervasive lack of an ethos of respect for human life” in South Africa. Together with severe constraints on health care facilities, this means that there is “a real risk of euthanasia becoming a substitute for proper care” in the South African situation. He also notes that “euthanasia seems to be a concern among a small, largely white elite in South Africa” and that legalizing “euthanasia in South Africa will potentially reflect the inequalities of the country ‘benefitting’ only the well-off while opening up the potential for perverse application among the poor and other vulnerable groups”.

Calls for legalising euthanasia make the statement that there will be checks so that there is no abuse of a new law. However, crossing the line to allow euthanasia or assisted suicide violates the societal injunction against killing another person. Once the mind-set has changed to accept this, additional reasons to allow euthanasia follow. For example, a proposal was recently put to parliament in the Netherlands that elderly people who ‘have completed their life’ should be allowed to ‘benefit’ from euthanasia even if they are in good health. Fortunately, the Royal Dutch Society for the advancement of medicine opposed this suggestion concerned about “feelings of insecurity amongst the elderly and the stigma of old age.”

We recognise that significant emotional adjustment is required when facing a serious diagnosis.  We have been concerned for some time by the isolated practice of some palliative care specialists and the loneliness of this position, without the support of a multi-disciplinary palliative care team.

HPCA supports personal autonomy but we recognise that an individual’s choice is not in isolation of other people, and there is a need to consider relational autonomy and the impact of individual autonomy on others.

It is always hard to make an adjustment from clinician to patient and to accept assistance, but I am aware that hospice in Johannesburg would be willing to assist both Dr Walter & Mr Harck with holistic palliative care at this sad and challenging time.

The Supreme Court of Appeal judgement overturning the Fabricius ruling in November 2016, made the point amongst many others that Adv Stranstham-Ford, who applied for a ruling to allow euthanasia, had benefitted from palliative care and towards the end of his life had expressed ambivalence about euthanasia for himself.

For media enquiries, contact:

Eric Watlington (HPCA Communications Officer)

eric@hpca.co.za

(021) 531 0277

About HPCA South Africa: The Hospice Palliative Care Association (HPCA) of South Africa is an association that was founded in 1987 as a membership organisation for South African hospices. It was created in response to a need expressed by hospices to share best practices and to support the development of a hospice movement in South Africa that provides effective, supportive care to communities in need. The vision of the association is to provide “quality palliative care for all.”

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