Dr Megan Best gets Belgian study wrong


Dr Megan Best at 'The Palliative Care Bridge'

The Australian Medical Association (AMA) has just published an article about the Belgian assisted dying law experience, which it says “splits Aussie experts.” But the AMA report indicates that at least one, Dr Megan Best, gets her facts fundamentally wrong.

AMA writer Sarah Colyer reports on Belgian assisted dying practice in the latest edition of MJA InSight, “Belgian euthanasia model splits Aussie experts.”

In the article, Colyer writes (and let’s assume she’s quoting Dr Best accurately and fairly):

Dr Megan Best, a bioethicist and palliative care practitioner at Greenwich Hospital in Sydney, told MJA InSight:

“I am concerned by the reduction in referral to palliative care doctors and specialists in the euthanasia approval process, as GPs are less likely to know whether or not the suffering can be alleviated – the keystone of the act,” she said.

“This is a weakening of the due process of the act and suggests that the ‘safeguards’ are seen more as a barrier to be overcome than an opportunity to improve life to the extent that euthanasia is no longer necessary.”

Colyer was reporting, and Best was providing commentary on a study of assisted dying practice in Belgium recently published in the Canadian Medical Association Journal.

Dr Best selects one factoid (the increase in second-opinions from GPs)—and claims there’s been a reduction in palliative care referrals—to argue a case that Belgium’s is a risky model.

And she’s absolutely wrong.

In the detail of the report (where you have to look to find the mention of GP second-opinions which she reports correctly), is also the clear statement that:

“…the proportion of cases in which at least one palliative care team was consulted about the request increased [with high statistical significance].”

But you don’t even have to read the whole report from cover to cover to find that out, even assuming that you had access to the full report—it’s behind a subscription paywall. Right there on ‘the cover of the tin’ (the publicly-available Abstract), it says in plain English that:

“Palliative care teams were increasingly often consulted about euthanasia requests, beyond the legal requirements to do so [with high statistical significance]” and “palliative care teams were increasingly consulted about the euthanasia request” [at least in respect of Flemish cases]

So, while Dr Best claims the study reported a “reduction in referral to palliative care doctors” the study itself says the exact opposite in multiple places: “palliative care teams were increasingly often consulted.” While Dr Best claims “a weakening of the due process of the Act”, the evidence in regard to palliative consults demonstrates the opposite: “a strengthening of the due process of the Act.”

Is this another example of the religiously opposed noticing ‘evidence’ that apparently supports their stance while failing to notice solid evidence (and in this case in a sentence immediately adjacent to the selected one) that contradicts that stance?

I have no doubt that Dr Best is an excellent palliative care practitioner, but in this matter she is utterly and evidentially wrong—and the evidence was anything but 'buried' in the report on which she chose to provide 'expert' commentary.

I ask the AMA to add an addendum to the article on their website, correcting the erroneous statement that there was a "reduction in referral to palliative care doctors."

Who is Dr Megan Best?

Dr Megan Best is an experienced palliative care physician and Chief Medical Officer for Community Palliative Care at Greenwich Hospital in NSW. The hospital is a Christian charity which believes all people are made in the image of God, and which operates according to the Gospel of Jesus Christ. Dr Best is a Fellow of the Centre for Public Christianity in Sydney, a media company offering “high-quality and well-researched” material to the public via the mainstream media, and is its spokesperson for palliative care.

She is author of Fearfully and Wonderfully Made, a “biblically-based ethical handbook” which holds “the Christian Bible as authoritative” and in which she concludes “may the God of all comfort hold you in the palm of his hand.” She is also author of A Life Already Started, giving advice to women faced with unwanted pregnancy that “God has not left you to manage on your own.” She is also a regular contributing writer to the Centre for Christian Apologetics, Scholarship and Education.

Dr Best completed her Master of Arts in Applied Ethics in Health Care at the Australian Catholic University in 2001.

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