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October 2020

Euthanasia Law Will Be A Danger To The Vulnerable

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Media Release 30 October 2020
Family First NZ says that the End of Life Choice Act – a.k.a. assisted suicide law – will be a danger to both the vulnerable and society in general.

“It is one thing to say yes to a nice sounding phrase around having ‘choice’, but assisted suicide is not a simple yes no answer,” says Bob McCoskrie, National Director of Family First NZ.

“Some people will be euthanised on account of a disease they thought they had but did not. Prognosis is an uncertain procedure. Others will request assisted suicide because of coercion either internally or from relatives, or concerns around costs of treatment, and others will be struggling because of a terminal disease prognosis and actually just need appropriate support.”

“They may come to feel euthanasia would be ‘the right thing to do’; they’ve ‘had a good innings’ and do not want to be a ‘burden’ to their nearest and dearest. This law now means that vulnerable people facing a terminal illness will be asking themselves – why should I not be accessing euthanasia?”

There is also concrete evidence from those countries which have authorised euthanasia that the availability and application of euthanasia expands to situations never initially envisaged as indications for it. Netherlands has recently backed plans for euthanasia for terminally ill children under-12, is considering euthanasia being automatically available for healthy people over 75 years old, and a champion of the Dutch euthanasia system has admitted that assisted dying is a slippery slope to ‘random killing of the defenceless’. And a kiwi pro-euthanasia campaigner is already calling for an expansion of the criteria to qualify for assisted suicide.

“Nothing in this Act guarantees the protection required for vulnerable people, including the disabled, elderly, depressed or anxious, and those who feel themselves to be a burden or who are under financial pressure,” says Mr McCoskrie.

“How many euthanasia mistakes are we willing to accept? Today is a sad and dangerous day for the vulnerable.”

Health-care costs in Canada dropped after assisted dying became legal

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Global News 20 October 2020
Family First Comment: A dangerous and flawed report from Canada where euthanasia has been legal since 2016…
“Many studies have shown that health-care costs in the last year of life, and especially the last month, are “disproportionately high,” the PBO report stated. The costs represent between 10 per cent and 20 per cent of total health-care costs despite those patients representing about one per cent of the population.” 🤢

Since Canada’s law on medical assistance in dying came into effect more than four years ago, health-care costs have dropped millions of dollars, according to a Parliamentary Budget Officer (PBO) report released Tuesday.

The report on assisted dying said since becoming legal on June 17, 2016, Canada’s health-care costs have dropped $86.9 million.

Many studies have shown that health-care costs in the last year of life, and especially the last month, are “disproportionately high,” the PBO report stated. The costs represent between 10 per cent and 20 per cent of total health-care costs despite those patients representing about one per cent of the population.

The report emphasized that the numbers should “in no way be interpreted” as suggesting assisted dying be used to reduce health-care costs.

The PBO report added that access to medically assisted dying will result in a reduction in health-care costs for provinces. But the reduction “represents a negligible portion” of the health-care budges of provinces.
READ MORE: https://globalnews.ca/news/7407627/health-care-costs-canada-assisted-dying/
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Would legal assisted dying add to our dire suicide figures?

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Stuff co.nz 15 October 2020
Family First Comment: Disturbing…
“In the early stages of the End of Life Choice debate in Parliament, I noticed something shocking: the young people I was working with were rehearsing the very-same arguments used by those supporting euthanasia – autonomy, dignity and compassion – and applying them to their own situations. Not much later, I noticed that the methods published in various End of Life Choice websites and print publications came up in a discussion with a client I was working with and who later attempted to end their own life. In my mind, I understand that assisted dying and suicide can, in principle, be distinguished from each other. That point is often made. But my real-life experience, and that of others in the field of mental health support, is that there is a huge potential for what the Canadian Association for Suicide Prevention has called “overlap cases”. Any theoretical bright line between the two disappears at the coal-face.”

OPINION: My interest in the question of assisted dying began as a hands-on mental health practitioner working to dissuade young New Zealanders from committing suicide.

In my experience, when people feel their lives are not worth living, they reach for many and varied rationalisations. The work I do to support suicidal people is not so much a work of persuasion but more about accompanying them out of their existential distress, incrementally, day by day. This requires a delicate balance of risk and trust.

We work together to recognise situations that trigger hopelessness and create strategies to counter these until people feel that ending one’s own life is no longer considered the best solution to their complex problems.

In the early stages of the End of Life Choice debate in Parliament, I noticed something shocking: the young people I was working with were rehearsing the very-same arguments used by those supporting euthanasia – autonomy, dignity and compassion – and applying them to their own situations.

Not much later, I noticed that the methods published in various End of Life Choice websites and print publications came up in a discussion with a client I was working with and who later attempted to end their own life.

In my mind, I understand that assisted dying and suicide can, in principle, be distinguished from each other. That point is often made. But my real-life experience, and that of others in the field of mental health support, is that there is a huge potential for what the Canadian Association for Suicide Prevention has called “overlap cases”.

Any theoretical bright line between the two disappears at the coal-face.
READ MORE: https://www.stuff.co.nz/national/health/euthanasia-debate/123070527/would-legal-assisted-dying-add-to-our-dire-suicide-figures

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Euthanasia referendum: Disabled New Zealanders concerned about assisted dying Act

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Stuff co.nz 15 October 2020
Family First Comment: “there is no ‘bright-line’ test to clearly distinguish disability and terminal illness, and states the claim disabled people are prevented from accessing the regime as it is worded is incorrect.”

Some disabled New Zealanders fear they will be at risk if assisted dying or euthanasia is legalised.

On October 17, New Zealanders will vote in a binding referendum on whether the End of Life Choice Act should come into force as law, allowing terminally ill adults to request assisted dying.

Under the Act, a person must have a terminal illness likely to end their life within six months – those with mental illness, disability or advanced age do not qualify on those grounds alone.

However, some Kiwis with disabilities say there is no clear distinction between their conditions and terminal illness, putting them at risk. Meanwhile, others say the framing of disabled people as being exposed to greater risk is “patronising”.

Proponents of the Act say excluding advanced age, mental illness and disability protects these groups, and the law is clearly for people suffering greatly at the end of life, not for those with disabilities.
READ MORE: https://www.stuff.co.nz/national/health/euthanasia-debate/300118864/euthanasia-referendum-disabled-new-zealanders-concerned-about-assisted-dying-act
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Netherlands backs euthanasia for terminally ill children under-12

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BBC News 14 October 2020
Family First Comment: When they argue that there is no slippery slope, ignore them. They’re either unaware or lying.

The Dutch government has approved plans to allow euthanasia for terminally ill children aged between one and 12.

On Tuesday, Health Minister Hugo de Jonge said the rule change would prevent some children from “suffering hopelessly and unbearably”.

Euthanasia is currently legal in the Netherlands for children older than 12, with mandatory consent from the patient and their parents.

It is also legal for babies up to a year old with parental consent.

But there is no provision for those aged between one and 12 who are terminally ill.

The issue has proven extremely controversial and has triggered months of debate in the four-party ruling coalition government. There has also been strong opposition from conservative Christian parties.

But, following the government’s approval of the plans, Mr de Jonge said he would draft new regulations for the practice. He said a study by experts had noted a need for the rule change.

In 2014, Belgium became the first country to allow for voluntary child euthanasia if they are terminally ill and in great pain and if they have parental consent. The Netherlands introduced the same rule for children over the age of 12 shortly afterwards.
READ MORE: https://www.bbc.com/news/world-europe-54538288

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Concern End of Life Choice Act created by middle class Pākehā to the detriment of Māori

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Stuff co.nz 15 October 2020
Family First Comment: Good coverage here….
“Māori, like other communities, do not have a singular view about the End of Life Choice referendum. Tikanga used to inform the actions of Māori differs between whānau, hapū and iwi. But there is consensus the referendum has a Pākehā worldview about dying and could negatively impact on Māori.

Māori, like other communities, do not have a singular view about the End of Life Choice referendum. Tikanga used to inform the actions of Māori differs between whānau, hapū and iwi. But there is consensus the referendum has a Pākehā worldview about dying and could negatively impact on Māori. Carmen Parahi reports.

“If we could go back to that period of time I would end my mum’s life,” says Manurewa Marae chairman Rangi McLean.

He still remembers the pain his mum Roka suffered when she was terminally ill with breast cancer 40 years ago. She wanted to die, says McLean, but his father listened to the advice of the doctor to prolong her life.

“It got to a point where I said to my father, let’s let her go,” says McLean. “When I saw her suffer and cry out she wanted to go, tears welled up in my eyes.”

Roka eventually passed away from the cancer. Her screams of pain when the morphine wore off still haunt McLean today. He’s watched his mum, six aunties and older sister all die from breast cancer.

McLean has already voted yes to the End of Life Choice Act referendum.

McLean is the Māori Party’s Vice President Tāne and his “Yes” tick goes against his party’s stance to vote no to euthanasia. McLean is unapologetic, saying he is Ngāi Tūhoe and has his own mana motuhake or authority to decide.

The Māori Party signalled it would not support the referendum and has actively campaigned against it. Co-leader John Tamihere called it a “kill the Māori bill” during a live online debate on The Hui last month. Tamihere says there needs to be greater protections around the Act for Māori and their whānau.
READ MORE: https://www.stuff.co.nz/pou-tiaki/300131423/euthanasia-referendum-concern-end-of-life-choice-act-created-by-middle-class-pkeh-to-the-detriment-of-mori

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Euthanasia referendum – End of Life Choice Act is ‘unsafe, uncaring, unkind’

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Pacific Media Network 12 October 2020
Family First Comment: Ahdar believes over time this act could get broadened with input from organisations such as the human rights movement or whoever sees fit. “The elderly are very much in the gun. And the most vulnerable are the poor, the handicapped and people with disabilities, the mentally ill and depressed,” he says.

Pacific community and faith based leaders who condemn the End of Life Choice Act say it sets a dangerous precedent.

The contentious act, gives people with a terminal illness the option of assisted dying.

To be able to ask for assisted dying, a person must meet all the following criteria. They must:

  • be aged 18 years or over
  • be a citizen or permanent resident of New Zealand
  • suffer from a terminal illness that’s likely to end their life within 6 months
  • have significant and ongoing decline in physical capability
  • experience unbearable suffering that cannot be eased
  • be able to make an informed decision about assisted dying.

But University of Otago Law Faculty professor Rex Tauati Ahdar describes the act as “therapeutic killing”.

He says it is not well drafted and the slippery side of the act is the psychological side.

“Once we become accustomed to the idea of voluntarily ending life, it becomes easier for society to take further steps to end the lives of those who feel life is not worth living or deserve dignity.”

Professor Ahdar says the intention of assisting someone to commit suicide is a serious offence that can lead to a penalty of up to 14 years imprisonment.

“That section of the law is going to be repealed or nullified when this act comes into effect.

“The coercion around people, and the pressure they put on themselves, what can remove a patient’s thought from subjecting to it? There’s no part there to protect patients from feeling pressured.”
READ MORE: https://pacificmedianetwork.com/articles/euthanasia-referendum-end-of-life-choice-act-is-unsafe-uncaring-unkind?fbclid=IwAR3pqifHCFckFsSDi2xQfVF4y2u2xCr3frchRslNyeH88tATJXQsTEYl3xI
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Euthanasia campaigner already wants criteria expanded

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Kiwi convicted of mother’s death hopes for pardon if euthanasia referendum passes
TVNZ One News 13 October 2020
Family First Comment: Lawyer Grant Illingworth said there was nothing to protect vulnerable people being bullied. “The referendum is not about compassion and not about choice. It’s about a set of rules that have been enacted by Parliament and the public of New Zealand are being asked to vote on that set of rules.” He said he had never been part of any campaign before and did not plan on being involved in future ones. “This is an important issue because it raises questions of life and death for very, very vulnerable people,” 

Davison’s support for change comes as many lawyers continue to have issues with the act and urge a “no” vote.

Under the act, anyone asking for assisted dying has to fulfil several criteria.

But Davison says those conditions should be expanded to include others who are not terminally ill.

“To me it is very good, it’s a very good start,” he said.

“But not included in this, people with irrecoverable illnesses like motor neuron disease and quadriplegics.”

He said they too should be given an option of assisted death “should they want it”.

Senior lawyer Grant Illingworth QC told 1 NEWS those comments are “a red flag” and the act is already not fit for purpose.

“The set of rules that have been prepared for this issue are shoddy. They have not been drafted to the required standard and they do not do the job that we need them to do,” he told 1 NEWS.

Illingworth said a group of almost 200 other lawyers is opposed.

“The biggest mistake that’s being made at the moment is that people are voting on the question of compassion and choice instead of voting on the particular set of rules that we’re being asked to vote about.”

There was nothing to protect vulnerable people being bullied, he said
READ MORE: https://www.tvnz.co.nz/one-news/new-zealand/kiwi-convicted-mothers-death-hopes-pardon-if-euthanasia-referendum-passes
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Grant Avery: The Slippery Slope of Euthanasia

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Grant Avery was New Zealand’s ‘Risk Management Professional of the Year’ 2017, and is the author of ‘Project Management, Denial, and the Death Zone’ (foreword by Sir Ranulph Fiennes), an award-winning book on the causes and reduction of risk in high-risk projects. Avery is Principle Consultant for Outcome Insights, a company advising private and public sector organisations on reducing risk and failure in projects, and on strengthening project governance. Prior to starting his own consulting practice Avery was Director Project Advisory for KPMG in Wellington. Avery has an MBA with Distinction from VUW and lives with his wife Melanie and their two children north of Wellington city.

 

The claim by some in the Euthanasia debate that there is no Slippery Slope – i.e. no need to worry about society widening the criteria for euthanasia in future years –  is strongly contradicted by an area of academic and applied risk management called Risk Homeostasis Theory.

Risk Homeostasis Theory states that when a person becomes comfortable with the risks of the status-quo (for example a recent law change…) they will engage in more risky activities to compensate for their new found comfort. ‘Comfort’ is the key word. In corporate risk management it is called ‘Risk Appetite’. What level of risk are you comfortable taking? That is your Risk Appetite.

Risk Homeostasis (also known as Risk Compensation) was widely researched by the late Professor Gerald J.S. Wilde, Ph.D., Professor Emeritus of Psychology[1], and is summarised in his book “Target Risk 3; Risk Homeostasis in Everyday Life[2].

Examples of Risk Homeostasis include people driving faster once they have become comfortable driving at a lower speed, and climbers climbing ever more-challenging mountains. Mount Everest is littered with the bodies of the victims of personal Risk Homeostasis.

Risk Homeostasis also under-pinned NASA becoming more and more comfortable with perceived ‘minor-issues’ occurring during shuttle launches[3] (resulting in the loss of two shuttles (1986, 2003) and 14 astronauts.)

The Netherlands is a good example of Risk Homeostasis and the Slippery Slope at work in euthanasia law. First introduced there in 2001[4], the Netherlands allowed euthanasia for children as young as 12 years old. In 2005 the Netherlands moved to change the law to include euthanasia for infants. Recently an MP in the Netherlands has submitted a bill for a law to offer state help to die for healthy over-75s who are simply ‘tired of life’[5].

Within the Netherlands concerns are growing about euthanasia and the slippery slope. The Australian Daily Mail recently reported “A champion of the Dutch euthanasia system has admitted that British critics are right to warn that assisted dying is a slippery slope to ‘random killing of the defenceless’.”[6]

In a recent article[7] New Zealand Lawyers Catherine Marks and Colin Gavaghan suggested that the Slippery Slope cannot happen in euthanasia law in New Zealand because law goes through ‘a parliamentary process’. Parliamentary processes do not prevent risk homeostasis though – they are the very vehicle by which risk homeostasis occurs. One law-change at a time.

As well as time spent in the status quo, the comfort which enables risk homeostasis is also created by silencing the voices of people who have concerns.

A significant development here for the EOLC Act is the removal of the final decision on the Act from the hands of Parliament (who were briefed about the concerns (and to a lesser extent the hopes) of the over 38,000 people who made submissions to the Select Committee) and the passing of that decision to a general public who have little awareness of what the 38,000 said.

The Government has made no effort to actively promote the report of the Select Committee hearings – the summary of the views of the 38,000 – to New Zealand’s general public.

This delegation of such an important decision to the general public is unprecedented.  The Hon Justice Mallon in her June 2020 decision[8] for Hospice NZ described it as ‘…a unique constitutional situation in this country, if not the Commonwealth, in Parliament having assigned the final step in the law-making function to the electorate via a binding, binary, referendum’.

Some claim that Parliament heard the findings of the Select Committee – i.e. heard the voices of the 38,000 – debated the Act, passed it, and have now simply forwarded the Act to the public for endorsement.

But that’s not what happened. A number of Parliamentarians voted to support the Act in exchange for the public being allowed to decide it, not as a final endorsement. The Parliamentary vote on the Act consequently did not benefit from the quality of debate or consideration it normally would have.

This explains, at least in part, why New Zealand’s EOLC Act contains few of the safeguards we see in the euthanasia laws of other countries (for example proactive or independent tests for depression and coercion.)

To take the final decision on the EOLC Act from the informed hands of Parliament, and pass it to the uninformed hands of the public, is analogous to taking a court decision from the hands of an attentive jury and passing it to the hands of a sleepy public gallery. How should we expect a sleepy public gallery to respond to the question ‘Do you support choice?’  when they have neither heard, not had promoted to them, a summary of the evidence for and against that question?

It is not just a risk that New Zealand may slip down euthanasia’s Slippery Slope if this law is passed, it is a scientific given. And who knows where 30 years of euthanasia law reform, one step at a time, might take us.

 


[1] Queen’s University, Ontario, Canada. See https://www.queensu.ca/gazette/stories/queen-s-remembers-gerrit-gerry-wilde
[2] https://www.amazon.com/Target-Risk-Psychology-Safety-Health/dp/0969912439
[3] See article “Blowup” by Malcolm Gladwell for The New Yorker:   http://summer350.wdfiles.com/local–files/readings/blowup.pdf
[4] http://news.bbc.co.uk/2/hi/europe/1269682.stm
[5] https://www.thetimes.co.uk/article/dutch-mp-backs-euthanasia-for-over-75s-who-are-tired-of-life-z8bdp6685
[6] https://www.dailymail.co.uk/news/article-8729235/Dutch-euthanasia-supporter-warns-UK-wary-slippery-slope.html
[7] https://www.stuff.co.nz/national/health/euthanasia-debate/300107918/euthanasia-referendum-there-is-no-slippery-slope-to-the-end-of-life-choice-act-say-senior-legal-professionals
[8] HOSPICE NEW ZEALAND (applicant), ATTORNEY-GENERAL (respondent) Judgement 16 June 2020;  CIV 2020-485-176,[2020] NZHC 1356 see: https://forms.justice.govt.nz/search/Documents/pdf/jdo/8b/alfresco/service/api/node/content/workspace/SpacesStore/bab8773d-b3eb-4caf-8e09-cf7a84cef0fc/bab8773d-b3eb-4caf-8e09-cf7a84cef0fc.pdf

Palliative care can’t just survive on ‘cakes and op-shops’ – leaders

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NewsHub 7 October 2020
Family First Comment: “According to leaders in the palliative care field, the sector can no longer survive on “cakes and op shops”.”
Exactly.
And that’s the danger with legalising euthanasia – a cheaper option. 
Scary.

According to leaders in the palliative care field, the sector can no longer survive on “cakes and op shops”.

Dr Aileen Collier, Chair of Palliative Care Nurses New Zealand, said nurses’ pay was just the start of major problems facing a sector that is caring for an increasing number of patients as the population continues to age.

“It’s urgent, if we don’t do something now, we’re going to be in real trouble.”

Collier said hospice and aged care nurses are paid around 20 percent less than their DHB peers, and that was backed up by Dr Brian Ensor, the Medical Director at Hospice Waikato.

“That is a real struggle,” Ensor said.

“The funding of nursing staff and allied health staff, trying to keep them within cooee of the DHB, which is a major competitor for experienced staff, is a real problem.”

And the concerns are shared by the aged care sector – which now cares for the greater portion of people in their final months and days.
READ MORE: https://www.newshub.co.nz/home/new-zealand/2020/10/palliative-care-can-t-just-survive-on-cakes-and-op-shops-leaders.html
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