Euthanasia – the devil is in the detail

By June 10, 2015 Recent News

Editorial: NZ Herald 11 June 2015
Nobody in Parliament except Act’s David Seymour is anxious to take up the euthanasia cause in the wake of the Lecretia Seales case, and no wonder. More experienced MPs have seen previous private member’s bills on this subject and know that inexpertly drafted bills cannot deal with all the practical difficulties the subject poses.
Labour and the Greens are urging the Government to put properly prepared legislation into the House but the Prime Minister is unwilling. He thinks a select committee inquiry as a response to a public petition would be a better way to proceed.
The reluctance of all parties is perfectly understandable because the practicalities of voluntary euthanasia are as difficult as the principles it raises. Putting principle to one side, it is easy to say a doctor should be able to accede to a dying person’s request, but at what point exactly can that request be made? Advocates of voluntary euthanasia agree the request would have to be made when the person is clearly mentally capable of making it and the doctor is confident no external pressure is being brought to bear.
That would require the arrangement to be made well ahead of the patient’s need, which is indeed what Ms Seales was seeking. But is it then to be up to the doctor to carry out the request, like an organ donation, at the time the doctor decides? Almost certainly no doctor would do so without a subsequent request or some form of consent from a conscious patient to act immediately. Doctors do not even act on the previously expressed will of organ donors without the consent of the nearest relatives at the time of death.
Can immediate family be consulted if a person who has previously requested euthanasia is no longer able to communicate? The need to protect the vulnerable from undue pressure says relatives should have no part in the decision to act. But that is placing a terrible responsibility on the doctor and denying the patient the ability of someone nearest and dearest to know what the patient most wants.
These and other details are difficult enough for medical and legal ethicists to resolve and lawmakers to express in subtle and precise language. They cannot all be decided by referendums, nor by courts hearing cases that would vary in their circumstances and take a long time to build a body of reliable law. That is the reason Justice David Collins in the Seales case ruled that any change was properly left to Parliament.
Even the Supreme Court of Canada, whose unanimous ruling in February inspired the Seales case here, has done no more than uphold a right to euthanasia in principle. The judges suspended the effect of their decision for a year, in which Canada’s federal and provincial Governments and its medical profession are supposed to resolve the practical details. For example, they will need to reach a working definition of the court’s “grievous and irremediable medical condition” and decide whether it extends to people who are not terminally or even physically ill but chronically depressed.
The devil really is in the detail.