Tomorrow, 13 November 2019, David Seymour’s End of Life Choice bill is to have its third and final reading in New Zealand’s Parliament. The bill seeks to legalise euthanasia as an option for the terminally ill. The originally-poorly-drafted bill has been modified and may go to the nation for a referendum.
In my experience, many people cannot distinguish between and confuse (a) euthanasia [which is what this bill is about], (b) the decision to cease extraordinary means of being kept alive (including the decision to cease extraordinary means of prolonging the suffering of a dying person), and (c) controlling severe pain with the consequence that it hastens death (the Principal of Double Effect). (b) and (c) are already legal, and generally acknowledged to be ethical. Harrowing as individual stories may be, and important as human experience is, hard cases make bad laws.
Secondly, we are a country with a tragically high suicide rate. David Seymour is misguided if he thinks that those contemplating suicide will be unaffected in their thinking by the passing of such a bill. David Seymour responded to a recent letter from leaders of a wide variety of faith communities who, as one of their points, expressed this concern. I read the 2016 Health Committee report on medically-assisted dying that David Seymour pointed to in his response. He quoted that the Ministry of Health had advised that “there does not appear to be any connection between assisted dying or euthanasia and rates of suicide”. As a mathematician, I found the article he pointed to unconvincing. I am more persuaded by the experts’ letter to parliamentarians that showed evidence connecting legalising assisted suicide with the raising of the unassisted suicide rate.
Thirdly, in New Zealand we have wonderful palliative care available. How will the availability of euthanasia affect the financing of research, improvements, and availability of palliative care in this country?
Fourthly, what process can assure that the euthanising is not inflicting even more suffering?
Debating euthanasia requires agility with differing ethical theories: deontological (an action is right or wrong in and of itself); consequentialism (an action is right or wrong depending on its imagined consequences); proportionalism (the morality of an action cannot be defined without reference to the circumstances and intentions behind the act);…
Here is a letter signed by over 1500 New Zealand doctors holding to the World Medical Association that represents 114 countries and nine million physicians who say it’s not the role of a doctor to end someone’s life:
We endorse the views of the World Medical Association and the New Zealand Medical Association that physician assisted suicide and euthanasia are unethical, even if they were made legal.
We are committed to the concept of death with dignity and comfort, including the provision of effective pain relief and excellence in palliative care.
We uphold the right of patients to decline treatment, as set out in the NZ Code of Health and Disability Services Consumers’ Rights.
We know that the proper provision of pain relief, even if it may unintentionally hasten the death of the patient, is ethical and legal. Equally the withdrawal or withholding of futile treatment in favour of palliative care is ethical and legal.
We believe that crossing the line to intentionally assist a person to die would fundamentally weaken the doctor-patient relationship which is based on trust and respect.
We are especially concerned with protecting vulnerable people who can feel they have become a burden to others, and we are committed to supporting those who find their own life situations a heavy burden.
Doctors are not necessary in the regulation or practice of assisted suicide. They are included only to provide a cloak of medical legitimacy. Leave doctors to focus on saving lives and providing real care to the dying.
Doctors want NO part in assisted suicide
Here is the full letter of the religious leaders:
Religious Leaders Write to … by Stuff Newsroom on Scribd
I have a very ‘liberal’ or ‘progressive’ position on most ethical and moral issues. But I am very uncomfortable about the prospect of euthanasia being legalised. Now before anybody accuses me of having no compassion for those in intractable pain, I have no issue with people being given whatever care is needed to alleviate their suffering, even if it does shorten their lives. That is already legal and is considered ethical. But I am gravely concerned about the consequences of legitamising suicide. And the likelihood that the elderly, the disabled, and others who are vulnerable, could be coerced into being euthanised because they are considered a burden. There is no closing this Pandora’s Box once it has opened. And for these reasons, I will be voting ‘no’ if there is a referendum.
Thanks, Darryl. I struggle with boxes such as “liberal”, “progressive”, “conservative” as an overarching category for individuals. I would hope that, as far as ethics is concerned, people engage with individual ethical discussions conscious of their approach (deontological, consequentialist,…) If I were the boss, I would have ethics taught at schools, and agility in ethical theories a requirement for ordination… Blessings.
I don’t like to label myself. But labels such as I used can add context. On this occasion, I used them to show even though I am no ‘moral conservative’, I still have serious concerns about euthanasia.
Thanks, Darryl. Yes, I understand your point. If this becomes a decision for the general population, I hope people become agile with the decision making theories in ethics. I also notice a general ignorance that assumes that the different possible euthanasia laws are all essentially the same. Here is Bill English arguing that even those who support euthanasia should not vote for this particular bill. Blessings.
Before working in this field, I did feel, yes, we should have the choice.
But, now I say no. After speaking with a young man who was a top sports person in motorcross bike riding,, was third in the world for body building, a trained butcher and a volunteer firefighter, was at 35 Years old diagnosed with MS. This disease attacks the amune system and you slowly lose the control of your body muscles , affecting your ability in physical movement etc. This disease is a death sentence! At the time he was married with 2 children and his wife couldn’t cope with his disability and left him. ( this effects the whole family!). If he had; had,the choose to end his life legally at that time he would have and nearly did take his own life as you can only imagine the grief and pain he was experiencing. Fast forward, he is 45years old now, remarried , with a beautiful wife and young daughter , in a wheelchair now, running the household, So his wife can work fulltime, with a bit of help from me! In his wildest dreams he could never have imagined this future, but kept his faith on this journey. He still experiences pain, but has the opportunity to take medication to relief this.
The whole persons wellbeing needs to be addressed, not just the physical body wellbeing. I believe we are much more than the physical? Blessings Bosco, Ruth
‘The whole persons wellbeing needs to be addressed, not just the physical body wellbeing. ‘ ( Ruth )
Amen Ruth.
The whole concept of palliative care forms around meeting spiritual and psychological needs, and where these are met people in extraordinarily challenging circumstances go on to have what end-of-life caregivers term ‘a good death’ in the case of terminal illness, or, as in the case of Ruth’s client, a good life adapted to difficulty and change.
‘Recent reports from Canada and the United States make it clear that numerous patients
are choosing assisted death for reasons related to unmet service needs. High quality palliative care is not yet equitably accessible throughout Aotearoa New Zealand and, until it is, there is a strong likelihood that New Zealanders will also choose assisted death becauseof a lack of other meaningful choices. In such a context, there is the real risk that people inlower socio-economic groups will find themselves being channelled unnecessarily…’ ( letter of the religious leaders cited above )
I resigned a position I loved as a protest that terminally ill patients were not taken seriously or treated appropriately, there is a lack of training in this field despite a now extensive body of knowledge. Sometimes what determines quality of life is not necessarily complex or expensive but down to organisational attitudes, and ignorance or unwillingness to accept and address death or suffering as a natural part of life. Not everything can be ‘fixed’ in the way we want it to be.
Palliative care needs to begin sooner, especially where people are living a long time with pain, loss or other distress. Compassion is everything.
‘We count as blessed those who have persevered’ ( James 5 11 )
Hi Father B, long time no see!
This is a difficult topic. I live in WA State, USA and this state has had its Death With Dignity law since NOV 2008 when it was passed by a vote of the people and became effective in MAR 2009.
It is very comprehensive in who, what, where, when, why and how the Act may be used. It may only be requested by the patient who is a legal resident of WA State under the care of a licensed Medical Doctor or Doctor of Osteopathy in WA State. The patient must have a terminal disease with only a 6-month life expectancy. The lethal Rx must be requested a total of three times; 1st orally, second written and 3rd orally again with specified waiting periods between. The opportunity to rescind the request must be offered. The MD or OD may request the patient have a psychological evaluation before they will continue to participate in the process. Only an MD or a DO, licensed in WA may write the Rx. Only a pharmacist, licensed in WA State may fill the Rx. Witnesses to the patient’s request for the lethal Rx can not be a relative in any legal capacity and cannot stand to benefit from the patient’s death. The lethal Rx has to be self-administered. Any MD, DO or RPh may refuse to participate in writing or filling the lethal RX and are not required by the law to refer the patient to someone who will assist them.
Personally, at this point in my life, I’m not predisposed to participate in this process for myself. I believe that if confronted with the situation, I would be supportive of someone else in their choice to use the Act to end their life. As one who is of indigenous ancestry, I know that many North American tribes had a custom where elders & others who were terminally ill would quietly, voluntarily slip away from the community to die on their own terms facing the elements. As their descendant, I respect that choice in life even today.
Thanks, David. There are similarities and differences with the proposed NZ law – highlighting my point that comparison is not as simple as some/many say. Blessings.