End of Life Choice Bill
David Seymour's End of Life Choice Bill passed it’s first reading on Wed Dec 13th, 2017. In was due to debated in early 2018 but other bills got delayed and we only heard earlier that day that there was a vote in the evening. A number of people contact their Members of Parliament that day to let them know they had significant concerns about this bill.
Select Committee Submissions
The select committee process for this bill is already underway. Submissions opened on Dec 14th and closed on Tuesday, 6th March 2018 (this is 2 weeks after the original date). CMFnz completed our Justice Select Committee submission. The groundwork was been set with our position statement and previous submissions.
There are some concerns about this specific legislation. This differs from the 2016-2017 Health select committee as this is going to the Justice Select Committee and is about a specific piece of legislation rather than just a concept.
As you know there was a huge response to Health Select Committee enquiry (over 20000 submissions) with 77% against a law change. We want to make sure they know there are many doctors who oppose a law change. Although there is now a new process underway, it may still be useful to read the Health Select Committee’s report as it summaries the arguments on both sides of the issue.
Please read more information at http://www.cmf.nz/select_committee2018.
If have some capacity to assist with our ongoing work with the Care Alliance then please let us know.
Other things you can do
MPs will be considering this issue over the next couple of months.
Writing or making personal contact with an MP, particularly from someone within their electorate is likely to have an impact. Information from Care Alliance suggests that visits from health professional are particularly helpful.
CMF NZ is also emailing all MPs in regard to this issue. Speaking to MPs in person is better, so if you would like to speak to an MP in your area on behalf of CMF (we will give you material/talking points) please get in touch. Euthanasia Free NZ has a list of MPs who voted for and ones who voted against the bill if this would be helpful and other information about the process.
Talk to others
The public opinion also matters and although this is a subject that many people have strong views, some shaped by very personal experiences, there are many others who have not thought deeply about the implications and impact on those who are vulnerable to coercion, or who lives will be defined as not worth living. There is also a lack of understanding around the palliative care approach, how effective it is and what is already legal (for example refusing or discontinuing treatment).
Don’t shy away from this subject in conversation with work colleagues or friends. Maybe share an article (such as this or this) on social media which clearly articulates some of the arguments against euthanasia. Given the secular world we live in, arguing from a specifically Christian point of view generally isn’t helpful. Most of our concerns about euthanasia are understandable to those with a secular humanist worldview. Encourage others to make a submission.
Some of you may also be given (or seek) the opportunity to speak about this in front of a bigger group, perhaps to your church or another group you are involved with. I (Rosalie) was interviewed on my views as a Christian doctor on euthanasia, as part of a sermon serious on difficult topics a few weeks ago. Using pre-prepared questions that I could respond to which made it less intimidating. I got a lot of positive feedback that although it is a tough subject what I shared was helpful and made people consider many aspects they had not previously.
I (Rosalie) also have a powerpoint from another talk I did (including a lot of data from jurisdictions where euthanasia is legal) that could be adapted by others. If this is something you would like to pursue and would like some help or resources please get in touch (link to my email). Even before the bill was debated CMF was getting occasional requests from churches looking for a Christian doctor to speak on this subject. If you would like to be available to do this in your region, let us know.
Let's make sure your speech is kind and respectful but also challenge people to think deeply about this issue.
The fight is on, but it is not lost
There have been many successful defeats of similar legislation overseas (and previously in our own country) so the battle is far from lost.
Please pray and call others to pray as well. Jesus calls us to care for those who are suffering and the vulnerable. I firmly believe euthanasia will lead to increased suffering and has the potential to have the biggest negative effect on some of the most helpless in our society. Therefore I have no doubt that it is an issue close to God’s heart.
This is an important opportunity to speak out for those who are vulnerable and whose lives will be further devalued by this law change. But there is a lot to do in the coming months. If you are able to help with even a small task contact Rosalie.
Doctors Say No Campaign
There are currently more than 400 doctor signatories and a copy of the letter with the undersigned has been sent to MPs directly. A poster has been developed that can be displayed on notice boards to garner additional signatures. If you are a doctor and haven’t added your name please visit http://doctorssayno.nz
InterChurch Bioethics Council has developed a resource call "Leave Doctors Out of It".
NZMA has Remained Strongly Opposed
NZMA has historically shown strong opposition to euthanasia. They commissioned a report on the subject, which discusses the complexities of the mater but suggests the NZMA continues to align itself with the opposition to euthanasia expressed by the world medical organisation. The NZMA report to the Justice Select Committee can be read here. It is strongly opposed and contains some excellent points.
Health Select Committee Report on Euthanasia and ending one’s life in New Zealand
August 2017: The Health Select Committee has tabled a report following the receipt of nearly 22,000 unique written submissions and nearly 1,000 oral submissions around the issue of the legalisation of euthanasia. Matthew Jansen, Secretary of the Care Alliance comments that "while eighty percent of those submissions were opposed to the legalisation of euthanasia, the report is a careful and thorough summary of both sides of the issue." We encourage our CMF NZ members to read the report in full. Click here to read the Select Committee report.
This select committee was not in response to a specific bill but as a response to a petition by Hon Maryan Street and 8,974 others 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.”
This investigation sought 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 terms included: 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.
Australia: Assisted dying passed by Victoria's parliament, bill defeated in NSW
In November 2017 two states in Australia had MP's consider this issue. New South Wales (NSW) Upper House rejected a bill to allow assisted suicide and euthanasia in mid-November. A week later similar legislation passed in Victoria. The law in Victoria is set to come into effect in June 2019 and those eligible are to have a must have an advanced, progressive and incurable medical condition that will cause death within six months and be assessed by two doctors. One of the reasons the similar legislation is thought to not have gotten enough traction in NSW was the united opposition by palliative care doctors who felt there was no way to make the law safe enough to prevent abuse. Internationally more bills are defeated than passed so a law change in NZ is far from inevitable.
More Details Regarding the End of Life Choice Bill
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.
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.