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Most of us GPs voted against the assisted dying legislation in 2020. I did.
I believed that palliative care services provided all that people needed, that having this option would undermine public confidence in the system, and that it would reinforce the fear that people have of the end of life.
As a lapsed Catholic, within a limescale of residual beliefs, I still hold onto the idea of the sanctity of life and have faith that the challenging confusion and suffering that surround us is part of a bigger picture which we do not understand. (Maybe semi-lapsed.)
Once the legislation was passed, none of us could ignore the process. At the very least, we had to understand what it involved, and in my clinical leader role, I had to pass this on to colleagues and develop policy and procedure guidance for various teams.
I examined my moral compass, talked to trusted people, and came to understand that my conscience would allow me to do this
As I watched the system develop, took part in the planning, and thought more about what was being made available to patients, a stronger feeling developed. I wanted to ensure that this was done properly and for the right reasons. I recognised that my training, clinical experience and expertise enabled me to do the work.
I could assess whether someone was in a state of irreversible decline in their physical capacity; if they had a terminal illness likely to end their life within six months; and if they were competent to decide, I could provide the medication.
I examined my moral compass, talked to trusted people, and came to understand that my conscience would allow me to do this. It met my values to relieve someone’s unbearable suffering, especially if it could not be relieved in a manner that the person considered tolerable.
As a specialist GP with a strong belief in generalism and the importance of “being there” for people at every life stage, from cradle to grave, not only could I do this, but if it was not going to be people like me, then who would do this?
I took the LearnOnline courses (learnonline.health.nz), attended the training sessions with the Ministry of Health team, and was soon referred my first patient.