Patients to plan 'death with dignity'

A controversial national health programme criticised as "euthanasia in disguise" is being embraced by health boards.

And for people like Jean Whitteker, 91, it is a blessing.

Advance care planning (ACP) is a new concept in New Zealand that grants patients the right to plan their death care, including choosing to decline lifesaving treatment in order to die naturally.

Primary health director of nursing Vicky Noble said Capital & Coast DHB was working closely with the national ACP Co-operative and looking at different approaches to ACP and how it could be set up throughout the DHB's healthcare system.

Hutt Valley DHB and Wairarapa DHB spokeswoman Jill Stringer said neither board had formal ACP systems in place but the issue was "something which is openly discussed at clinical meetings - it's a thing whose time has come".

For Mrs Whitteker it is a blessing.

A plan had given her confirmation that she would "die with dignity - my way", she said.

Knowing doctors will be legally bound to respect her wishes and not enforce unwanted treatments to prolong her life was a huge comfort to the widow.

She watched her mother slowly die from cancer and her late husband suffered a debilitating stroke and "lived a lot longer then he wanted to".

"I can't see the point of being kept alive just to die at some time in the short distance. I would just love to not wake up one morning and that would be it," she said.

Mrs Whitteker was one of the first Cantabrians to create an ACP.

Those involved with rolling out ACP have been tasked with first educating clinicians on how to hold sensitive conversations about the "socially taboo" subject of end of life care, CDHB clinical director of palliative care Dr Kate Grundy said.

Through ACP, patients talk with health professionals and their families about how they want to die, knowing they will likely lose the capacity to make their own decisions as they near death.

In a tick-the-box application form, patients outline their values and beliefs, choose where they want to be when the time comes, if they want family members around and whether they want feeding or breathing tubes in their final days.

Patients can choose to refuse all medical treatment which would lead to their death and this controversial measure has led to an "ignorant belief this is a kind of euthanasia in disguise", Dr Grundy said.

This was a "complete misconception" - patients could not write on their plan that they wanted to die, ACP was merely giving patients a voice about their own health care at a time when they had lost their own, she said.

Mrs Whitteker suffered a stroke last year and her quality of life is not what it used to be, but with an ACP in place she no longer fears death.

The Dominion Post