Would you like to make your voice hear?
The Ministry for Reforms has recently launched a public consultation on Voluntary Additional Contribution (VAE)
Points to explore
The points below offer prompts on what you might want to consider in your submission
Personal experiences
Personal experiences of the end-of-life suffering of loved ones who would, or might have, chosen VAE if available
Compassion
Compassion for those with no hope – VAE isn’t murder; it’s an option for those who can no longer bear continuing to live
Autonomy
People facing irreversible decline, intolerable physical suffering and loss of all quality of life should have the right to choose how and when their life ends, on their own terms
Conscience & Religion
The sanctity of life, for those who uphold it and wish to live as long as possible, is not in question. But adults of sound mind should be able to make a decision based on their own values and beliefs. A pluralistic society must respect the moral autonomy of all; laws must be for everyone. Ageneral prohibition on VAE binds all, patients and medical professionals alike, to one view. Legalisation, for those relatively few who need it, would enable everyone to act according to their own conscience. Conscientious objection by professionals must be respected, but mustn’t obstruct access to lawful end-of-life options
The safeguards
Clear safeguards and strict eligibility criteria are crucial. But suffering, not time, should guide eligibility. The six-month prognosis rule is unreliable and risks excluding those in pain. And eligibility should not exclude those with chronic but non-terminal conditions if they are experiencing enduring, intolerable suffering
Palliative care
Palliative care and VAE are complementary, not competing. One does not necessarily undermine the other, and there is no inherent reason for the introduction of VAE for the few necessarily having a negative impact on palliative care for the many. Legalising VAE often strengthens palliative care systems.Palliative care will always have its limits, and insisting on an (undefinable) improved system of palliative care before permitting VAE is unrealistic and overlooks the immediate needs of patients now
‘Medical’ Wills
Living wills stating a patient’s wishes if they become incapable of expressing themselves, should be legally-enforceable, and include, if thepatient wishes, the provision for health proxies to take decisions on their behalf.
