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Submissions closed this week on NZNO's draft position statement that advocates for individuals have the right to the option of assisted dying.  A 'pro-life' organisation Right to Life has responded by saying it was "very concerned" that NZNO wasn't defending patients against the "threat of euthanasia and a culture of death".

In the draft position statement the New Zealand Nurses Organisation (NZNO) says it is inevitable that some law on medically assisted dying (AD) will be passed and, as an organisation that advocates for patients, it could no longer take a neutral stance.

Its draft position is to advocate for individuals to have the option or choice of AD and to ensure that nurses were involved in any legislative changes that impact on the day-to-day practices of nurses working with dying people – including members having the right to conscientiously object to taking part in AD.  The statement follows in the wake of the NZNO submission in September last year to Parliament's Health Committee public hearings on the Maryann Street petition to allow AD.

The Right to Life organisation put out a press release this month saying it was "very concerned" that NZNO had "abandoned its ethic to care for its patients" by coming out in support of AD. Right to Life describes AD as "allowing doctors to kill or assist in the suicide of patients".  It has called on NZNO members to protest the move so as to protect the nursing profession from a "culture of death".

Jane McGeorge, NZNO's nursing and professional services manager said in response to the release that NZNO had 48,000 members and therefore had a wide range of views on assisted dying.

She said the feedback on the draft position statement consultation was being looked at now and NZNO would continue to consult with members with an aim of agreeing on a principle-based position.

“Nurses have a duty to give patient care and respect and need to be sure they are involved in consultation around any draft legislation so that their rights as nurses and the rights of their patients are protected as much as possible.”

“Any future legislation will need to take into account the role and responsibility of nurse prescribers as they may be in a position to prescribe medicines to assist dying," said McGeorge.  She said legislation should also provide nurses with the right to conscientious objection like there currently was with reproductive health services.

The draft position suggest NZNO principled approach to AD could include:

• taking a progressive stance in championing the individual right to make a fully informed choice;
• ensuring that members are informed, are safe and competent in their practice and understand their professional and legal obligations;
• lobbying for law changes for those members who wish to object on the grounds of conscience to being involved in AD services; and
• developing clear guidelines to ensure that all nursing and non nursing staff involved with individuals who are dying across the care continuum have AD training, as death and dying is not be restricted to one setting.

The consultation document goes on to say that NZNO members have diverse views and backgrounds (cultural, religious and ethnic) on AD with no one clear position.

"There is however an urgent need to develop guidelines to assist nurses to understand their rights as well as the ethical and legal complications of their actions and making decision that honour health consumers’ decisions," says the document.

It also says that the Nursing Council of New Zealand's Code of Conduct provides clear principles and guidelines to ensure health consumers are treated with respect and that their dignity, culture and individuality are valued.

"Nurses are often the first health professional, trusted with ‘wish or desire to die’ conversations. At times these decisions can challenge our own values and beliefs and be highly emotional for all parties," says the consultation document. "Nurses are aware that when they are involved in these conversations, their own personal beliefs relating to AD must be put to one side. Having the right environment to make well considered decisions with sufficient information and moral/emotional support, without coercion is essential."

It adds that holistic indigenous health models, such as Te Whare Tapa Whā, have the ability to support and discuss both life and death issues such as AD.