Legalisation of assisted dying does not harm palliative care

Legalisation of assisted dying does not harm palliative care

Report  from the European Association of Palliative Care. 24 Oct 2011

A recent study compared  six European countries and concluded that  palliative care is as well developed in countries that have legalised assisted suicide or euthanasia as in those that have not. The six countries were: the Netherlands, Belgium, and Switzerland (where assisted suicide is legal) and three that outlaw it (Germany, France, and Spain).
 
Critics of assisted suicide claim that good palliative care should make the legalisation of assisted suicide unnecessary and, further, that allowing assisted suicide would undermine efforts to improve care at the end of life. 

 
The issues examined in the study included

• a comparative analysis of indicators of national palliative care development; and
• an assessment as to whether the standard of palliative care had changed for the better or worse since legalisation in countries where assisted dying is legal

The report concludes:

“Palliative care is well developed  in countries with legalised euthanasia/assisted suicide, or at least no less well developed than in other European countries. There is evidence of advancement of palliative care in countries with legalised euthanasia, also after the legalisation of euthanasia and/or assisted suicide. The idea that legalisation of euthanasia and/or assisted suicide might obstruct or halt palliative care development thus seems unwarranted and is only expressed in commentaries rather than demonstrated by empirical evidence.

The report states that when Belgium passed its euthanasia law in 2002 it also brought in a Palliative Care Act setting out the right of every patient to such care, nationwide coverage of the care, and a doubling of public funds for it. The report notes that in the Netherlands and Belgium euthanasia or assisted suicide is chosen particularly by patients with cancer, who also receive the most palliative care. In Belgium, it says, euthanasia or assisted suicide and palliative care seem to reinforce each other rather than compete. In Belgium all palliative care options must be disclosed to the patient, and many institutions there demand a mandatory consultation with a palliative
care team when euthanasia is requested, and the highest prevalence of euthanasia or assisted suicide is found in palliative care units. 

European Association of Palliative Care report is available online:
http://www.commissiononassisteddying.co.uk/wp-content/uploads/2011/10/EAPC-Briefing-Paper-Palliative-Care-in-Countries-with-a-Euthanasia-Law.pdf