June 2018

NewsRoom 29 June 2018
Family First Comment: Yep
www.Protect.org.nz

Ahead of a five-part series examining submissions on the End of Life Choice Bill, Jeremy Rees takes a look at a group that argues the Bill is in no shape to be made law

The law firm which handles many doctors’ legal issues in New Zealand has told a Parliamentary select committee that David Seymour’s End of Life Choice Bill is “suboptimal” and should not proceed.

DLA Piper is retained by the Medical Protection Society to handle medical protection and indemnity work for doctors and practitioners. About 80 percent of New Zealand doctors are covered by MPS.

In a submission to the Justice select committee, the law firm says it is concerned that such an important change to New Zealand law is contained in a private member’s bill which has had no formal consultation before drafting.

“While the Bill is no doubt informed by prior public debate and clearly borrows from other jurisdictions, no formal consultation or engagement with stakeholders preceded its introduction,” it says in a submission, one of 35,000 to the committee.

Although there are a number of submissions from medical practitioners and their representative bodies, many focus on issues of wording and process. The DLA Piper submission stands out by questioning the very basis of Seymour’s Bill.
READ MORE: https://www.newsroom.co.nz/2018/06/28/134171/euthanasia-bill-should-not-go-ahead-law-firm

Stuff co.nz 19 June 2018
Family First Comment: Excellent commentary…
“If we lived in a perfect world, maybe a bill like this could be considered. In this world, doctors would be infallible and their decisions and predictions would always be right. Patients would be completely rational, never making decisions out of fear, pressure, or unstable emotions. Families would be loving, compassionate and unselfish, with never a thought for their inheritance. But in the real world we live in, legalising euthanasia or assisted suicide should be a non-starter. It’s just too risky.”
www.rejectassistedsuicide.nz

OPINION: Parliament has started hearing submissions on the End of Life Choice Bill, and if the last round of submissions is anything to go by, they’ll hear a lot of opposition.

In response, MPs may be tempted to think they can fix the bill – narrowing the scope, tightening the wording, maybe limiting it to terminal illness and ditching the current provision for grievous and irremediable medical conditions. But in reality, even the safest version of this bill would be dangerous.

This is a hard thing to say and to hear, when there are many stories of suffering and pain that each of us will hope we never have to go through. Both sides of the debate are motivated by compassion and concern for the vulnerable. No-one is coming at this with the intent to harm, but good intentions are not enough.

Researching the international law and experience in places like Oregon, Washington State, Canada, Belgium, and the Netherlands, shows four main issues with even a restricted version of the bill.

First, the eligibility criteria would be broad. Even if limited to people with a terminal illness likely to end their life within six months, doctors acknowledge that prognosis is more art than science. Oregon has a provision like this, but their official reports show that in 2017, somewhere between one and 14 people who were prescribed lethal drugs went on to live longer than their six-month prognosis.

Second, other jurisdictions have failed to craft effective safeguards. For example, the bill states that a person must express a desire for euthanasia or assisted suicide free from pressure. However, pressure is very difficult to detect and requires a long-term relationship between doctor and patient. In Oregon last year, the median doctor-patient relationship before an assisted suicide prescription was just 10 weeks.

Increasing numbers of people in Washington and Oregon have named being a burden on family and friends as one of the reasons they opted for assisted suicide. In Washington last year, this was 56 per cent of the people who received a lethal prescription. Although the numbers vary each year, the trend is rising steadily. Patients may name other reasons too, like loss of autonomy, but for a bill that is based on an ideal of free choice, the rising burden statistics should be a serious concern.

Third, whatever the safeguards, legalising euthanasia and assisted suicide would divide society into two unequal groups. We’d be telling some people to hang on to life, because their suicide would be a tragedy. We’d be telling others that their suicide is an understandable, rational act, that under the circumstances we agree their lives are not worth living. This underlying logic has no natural limits.

This leads to the fourth issue. The practise of euthanasia and assisted suicide tend to expand over time. There’s no reason to think we’d be immune. For example, in 2014, Belgium made children of any age eligible to seek euthanasia, albeit with stricter criteria. We cannot always control what happens after something like this has been legalised.
READ MORE: https://www.stuff.co.nz/national/politics/104832498/end-of-life-choice-bill-contains-flaws-that-are-impossible-to-fix

NZ Herald 19 June 2018
Family First Comment: How generous. But the REAL question is – why do so many medical professionals want NOTHING to do with euthanasia / assisted suicide? www.rejectassistedsuicide.nz

Act Party leader David Seymour says he may change his euthanasia bill to allow doctors to completely remove themselves from any role in assisted dying.

The End of Life Choice Bill, which is before Parliament, allows doctors to decline a patient’s request for assisted dying, but it requires them to refer the patient on to another doctor who is willing to participate in euthanasia.

A doctor who fails to do so would commit an offence punishable by a fine of up to $10,000 or three months’ jail.

This has upset advocacy groups, who say that it undermines a doctor’s ability to make a conscientious objection to euthanasia.

“By referring a patient, a medical practitioner may feel complicit in an act to which they are strongly ethically opposed,” said Royal NZ College of General Practitioners president Tim Malloy.

The penalties appeared to be a coercive way of getting doctors to be involved in assisted dying, he said.
READ MORE: https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=12073065

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Radio NZ News 18 June 2018
The palliative care sector is warning a crisis for New Zealand’s ageing population is imminent as not enough people are being trained in end-of-life care.

Ministry of Health data shows in the next 20 years the number of people dying will increase by 50 percent – or 45,000 each year and by 2068 that number will hit 55,000.

Palliative Medicine Specialist Rod MacLeod said students and junior doctors received a “woeful” amount of training.

“I think it’s fair to say that in New Zealand the students are only getting a few days out of their five or six year programme with direct exposure to palliative medicine specialists, and quite frankly that’s woeful.”

He said other specialities received a disproportionate amount of attention in the curriculum.

“Medical students have to learn all sorts of fascinating facts about liver or pancreas disease which they may never see in their life, but they don’t have enough exposure to death and dying which they certainly will see.”

Lis Latta oversees the palliative care module at Dunedin School of Medicine.

She said the palliative care workforce was ageing and while medical students got more training now than they did six years ago, it was still not enough to replace those who would soon retire.
READ MORE: https://www.radionz.co.nz/news/national/359843/medical-students-training-for-end-of-life-care-woeful

The Guardian 1 June 2018
Family First Comment: “Opposition to assisted suicide – also called assisted dying – is characterised as being the preserve of the religious, stuffy and outdated, like religious opposition to gay marriage and abortion. In reality, some of the loudest voices opposing it are those of people with disabilities – because we have the most to fear.”
www.Protect.org.nz

I can see no safeguards to prevent people being pressured into ending their lives. What we need is more support to live.

Opposition to assisted suicide – also called assisted dying – is characterised as being the preserve of the religious, stuffy and outdated, like religious opposition to gay marriage and abortion. In reality, some of the loudest voices opposing it are those of people with disabilities – because we have the most to fear. A poll done by Scope (a disability charity) showed that the majority of disabled people (64%) were concerned about moves to legalise assisted suicide.

Arguments around the legality of suicide and the right to refuse treatment are often conflated with assisted suicide. Suicide is legal, and there is already a right to refuse treatment. People with mental capacity can also create an advance directive to ensure their wish to refuse treatment is respected in future. This leaves people often able to die on their own terms. What assisted dying advocates are requesting is to create a system in which it is legally and morally permissible for people to engage in a deliberate action designed to end someone else’s life.

There are two main models for assisted suicide legislation: the American (Oregon), and the European (Belgium and the Netherlands). The laws in Oregon restrict assisted suicide to those who are terminally ill, with less than six months to live. The number of people dying this way has increased from 15 in 1998 to 143 in 2017. There is no obligation to establish whether the petitioner has a treatable mental health problem underlying their desire to die. Nor is there one to ensure that they are not under pressure from another person. It is difficult to even establish life expectancy. Jane Campbell – the former commissioner of the Equality and Human Rights Commission – has spoken about fluctuations in her life expectancy and when it affects eligibility for assisted suicide, the stakes would be high.

Some 5% of people in Oregon dying by assisted suicide cited financial pressures as a cause. Meanwhile, the number citing being a “burden on family/friends/caregivers” increased from 13% in 1998 to 55% in 2017. This tallies with Scope’s research that the majority of people with disabilities are concerned that legalising assisted suicide might lead to disabled people choosing it in order not to be a burden on others.

Advocates for assisted suicide argue for the existence of an advance directive so people, with dementia for example, could decide to have their life ended were they to lose mental capacity. In the Netherlands, a doctor was cleared after having the family of a woman with dementia hold her down so he could give her the lethal injection. Her refusal of euthanasia in the present day was weighed against her historical desires, and she died.

Society’s priority should be to assist us to live, not to die. Provide a free social care system funded by progressive taxation that allows us to be productive, active community members. Increase NHS funding. Cut waiting lists – there are currently 4 million people awaiting treatment. Fund wheelchairs and assistive technology. Root out the disableism that leads two-thirds of people with disabilities to think that we’re seen as a burden on society. Only then can you come back to me and tell me that assisted suicide is no risk to disabled people.

I can envisage no safeguards that would prevent people being pressured into ending their lives, by interpersonal, financial or social means. All I see is a system which divides lives, offering suicide prevention to some, and euthanasia to others. When I am low and feel I cannot go on with life as a disabled adult, those around me support me, affirm that my life has meaning, and help me continue to survive. Yes, my suffering is sometimes unbearable, but the faith my loved ones have in me makes me able to bear it. Don’t take that away, by legitimising assisted suicide as the right, and gracious choice.
READ MORE: https://www.theguardian.com/commentisfree/2018/jun/01/disabled-people-assisted-dying-safeguards-pressure

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