End of Life Choice Bill
On Thursday 8 June 2017, David Seymour's End of Life Choice Bill was drawn from the ballot. The parliamentary debate on this important issue is now imminent.
You can read the bill for yourself online. This bill is very similar to Maryann Street’s proposed End of Life Bill, which was withdrawn just prior to the last general election.
Some of the specific concerns we have regarding this bill:
The Bill defines a person eligible for assisted dying as someone who:
is aged 18 years or over
has New Zealand citizenship or is a permanent resident
suffers from a terminal illness likely to end their life within 6 months or has a grievous and irremediable medical condition
is in an advanced state of irreversible decline in capability
experiences unbearable suffering that cannot be relieved in a manner that he or she considers tolerable
has the ability to understand the nature and consequences of assisted dying.
Euthanasia Free NZ has summarised some of the specific concerns they have regarding the bill:
- There is no clear definition of “terminal illness”. It can be interpreted to include any condition that is life-shortening or life-threatening. There is no bright line between terminal conditions and chronic conditions. Some chronic conditions can become life-threatening in a matter of minutes, for example diabetes, asthma, allergies and high blood pressure. There is also no bright line between terminal illness and disabilities, because many disabilities are life-shortening and involve complications that can become life-threatening.
- It’s impossible for doctors to accurately predict how long a person is expected to live, especially six months out. There have been cases of people who were expected to die within hours or days, but they recovered and lived for months or years. Diagnosis can also be wrong, despite a doctor’s best intentions. Diagnosis and prognosis are not based on certainty, but on probability (likelihood based on other cases). There is no guarantee that an individual’s disease will progress the same way as others’ have.
- Depression can also be regarded as a terminal condition, because it could lead to death (suicide), or to losing the will to live and fight a disease.
- Any condition can become “irremediable” if a person exercises their right to refuse further treatment. A depressed person would not have to ask for assisted suicide based on their depression. He or she would only need to refuse treatment for another condition in order to qualify.
- The phrase “irremediable medical condition” is vague enough to cause almost anyone to be eligible. These could include disabilities; chronic conditions such as arthritis, asthma or gluten intolerance; mental illness such as anxiety or depression; ageing-related conditions such as wrinkles, or the deterioration of eyesight or mobility; scarring; and even skin pigmentation such as liver spots or birth marks…
- Words such as “grievous”, “unbearable suffering” and “intolerable” are entirely subjective (up to the individual to decide). If a patient would use any of these words to describe their condition, the doctor would not be able to argue.
- “An advanced state of irreversible decline in capability” is just a wordy way of saying “disability” or “ageing”. The Bill doesn’t explain what is meant by “capability”. Could a person qualify who has become less able to run, walk, read, or enjoy life?
- The End of Life Choice Bill doesn’t mention depression. Even if it did specifically exclude depression, depressed people could still access death instead of treatment under such legislation. Depression can be hidden easily, even from doctors. Depression is often misdiagnosed or dismissed. Even subclinical depression (not severe enough to be diagnosed) can still have an effect on people’s decision making capabilities.
In addition we are also concerned about the other aspects of the implementation and regulation of the proposed law:
- Those who do not comply with the law but in "good faith" intended to provide assistance in dying are immune for any consequences (section 26):
- Although there is an supposed allowance for conscientious objection this involves the doctor making a referral to another doctor who will comply with the request. If someone does not comply with the Act they can be imprisoned for up to 3 months and / or fined up to $10,000.
- A small number of doctors, who often will not know the patient or their circumstances well, will mainly be involved in making these decisions. Doctors associated with the Support and Consultation for End of Life in New Zealand (SCENZ) Group will be those who patient are referred to if their own doctor has a conscientious objection, and will act as the independent medical practitioner for the 2nd opinion.
Petition of Hon Maryan Street and 8,974 others & Subsequent Health Select Committee Enquiry
Hon Maryan Street and 8,974 others submitted a petition requesting “That the House of Representatives investigate fully public attitudes towards the introduction of legislation which would permit medically-assisted dying in the event of a terminal illness or an irreversible condition which makes life unbearable.”
In response the committee is undertaking an investigation into ending one’s life in New Zealand. In order to fully understand public attitudes the committee will consider all the various aspects of the issue, including the social, legal, medical, cultural, financial, ethical, and philosophical implications. The Committee will investigate: 1. The factors that contribute to the desire to end one’s life. 2. The effectiveness of services and support available to those who desire to end their own lives. 3. The attitudes of New Zealanders towards the ending of one's life and the current legal situation. 4. International experiences. The committee will seek to hear from all interested groups and individuals.
Written submission closed Feb 1st, 2016. The committee is currently going through the many submissions they heard both in favour of and opposed to a change in the law. They are currently hearing oral submissions.
Lecretia Seales Court Case (2015)
Lecretia Seales was diagnosed with a brain tumour in 2011. On 21 March 2015 her lawyers lodged an application in the High Court for a declaratory judgment that would allow Ms Seales’ GP to assist her to die without being prosecuted under the Crimes Act 1961.
Justice Collins provided his judgment declining all the orders sought by Ms Seales on 4 June 2015 and commented "The changes to the law sought by Ms Seales can only be made by Parliament. I would be trespassing on the role of Parliament and departing from the constitutional role of Judges in New Zealand if I were to issue the criminal law declarations sought by Ms Seales."
Lecretia passed away at home in the presence of her family on the 5 June, 2015, aged 42.
The Care Alliance, as well as the Voluntary Euthanasia Society and the Human Rights Commission, applied for and were granted “intervener” status. This allowed the three groups to present limited evidence and submissions to assist the Court.
Affidavits by Witnesses for the Care Alliance can be found here.