Ed

NZ Herald 7 August 2018
Family First Comment: The 11y/o had cystic fibrosis – but treatment enables people to live to their 30’s and longer.
“Everywhere else in the world, the law reflects powerful human intuitions, moral and practical: that it is wrong to abandon hope for a person so early in life, no matter the illness; that it is absurd to grant ultimate medical autonomy to someone too young to vote or legally consent to sex; and that even the best-intentioned fallible human beings should not be entrusted with such life-and-death power.”
www.rejectassistedsuicide.nz

Deliberately taking a small child’s life is unlawful everywhere in the world, even when the child is terminally ill and asks a doctor to end his or her suffering once and for all.

There is an exception to this rule: Belgium. In 2014, that country amended its law on euthanasia, already one of the most permissive in the world, authorising doctors to terminate the life of a child, at any age, who makes the request.

For a year after the law passed, no one acted on it. Now, however, euthanasia for children in Belgium is no longer just a theoretical possibility.

Between Jan. 1, 2016, and Dec. 31, 2017, Belgian physicians gave lethal injections to three children under 18, according to a July 17 report from the commission that regulates euthanasia in Belgium.

The oldest of the three was 17; in that respect, Belgium was not unique, since the Netherlands permits euthanasia for children over 12.

Belgian doctors, however, also ended the lives of a 9-year-old and an 11-year-old. These were the first under-12 cases anywhere, Luc Proot, a member of the Belgian commission, told me in an interview.
READ MORE: https://www.nzherald.co.nz/world/news/article.cfm?c_id=2&objectid=12102737

During our oral submission against David Seymour’s euthanasia bill, we referenced JJ Hanson.

J.J. Hanson, 35, is a former Marine from New York’s Hudson Valley who did a tour in Iraq. In 2014 doctors discovered he had stage 4 glioblastoma (GBM), one of the deadliest forms of brain cancer—and the same kind of cancer that assisted suicide advocate Brittany Maynard had when she ended her life in late 2014. Three different doctors told Hanson his case was terminal and said he had four months to live. But he was determined to do aggressive treatment anyway. He joined a clinical trial. Hanson who worked in New York state government before turning to the private sector once supported the New York bill to allow physician assisted suicide – until he had a terminal disease. He campaigned against it and it was eventually defeated, like many around the world. He then led efforts against physician-assisted suicide legislation around the USA with the organization Patients’ Rights Action Fund. Why the change in opinion? At month 5 of his treatment, Hanson became depressed. He says he lay in his bed and asked himself if he should give up, if it would make things easier for everyone if he were gone. He decided to continue—but then he imagined what others in his position might do.
Hanson asked. “When you were the sickest in your life, how well were you thinking at that time? Not good, right? Now multiply that exponentially. … Put [the drugs] in a glass of beer, done. In that moment of weakness and difficulty and stress, done. … I don’t think I would have done that, but there’s many people who could’ve or would’ve in that situation.” … Hanson spoke to legislators, emphasising how legalising assisted suicide will change social norms, legitimising the general practice of suicide. Sadly, JJ Hanson died on 31 December 2017 – living 3 years longer than original prognosis of 4 months.

Three weeks before his death, JJ and his wife, Kristen, reflect on their life together and how choosing to live and to fight brought them more joy and love then they could have ever imagined.
www.protect.org.nz
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Bruce Logan 25 July 2018
Bruce Logan warns us that contrary to the libertarian credentials of ACT’s David Seymour, euthanasia will encourage the old, disadvantaged & disabled to undervalue themselves, and will actually decrease individual freedom.
David Seymour, the ACT member for Parliament and sponsor of the Euthanasia Bill claims libertarian credentials (Herald, July 3). Excellent. One could say a number of good things about libertarianism. Not least, its grasp on the notion of citizenship freedom and its suspicion of over-reaching state power.

However, like many libertarians Mr Seymour finds himself advocating something other than what his philosophy advocates. His demand for euthanasia might look like increasing individual freedom, but it doesn’t. It’s quite the opposite.

The confusion lies in a misplaced faith in the law to control our lives and make us better. Unfortunately, the law is not a nurse; it’s a schoolmaster who would discipline us everywhere. There are, however, good laws and bad laws. Good laws encourage conscience while bad laws negate it. The End of Life Choice Bill is bad law because it will compromise first the individual conscience and ultimately public morality.

Implicit in Mr Seymour’s bill is the assumption that law should be used to create new personal freedoms, the right to kill under certain circumstances, when it should be preserving the self-evident freedom of the right to life. It fails to comprehend the transcendent foundation of human dignity. It  is an ideology that presumes universality when its vision is limited by contemporary human rights theory. It is presumptuous in its claim to understand the mystery of human suffering.

Euthanasia might first appear to be an enhancement of freedom by widening the contemporary fixation with choice, but it is not possible in this context, or any context, to distribute choice justly. It will, in fact limit the choice for a great deal more people than for those very few people who might appear to benefit. The very nature of Mr Seymour’s bill undervalues the complexity of human decision making because it will undermine sensitive family dynamics. It creates too great an opportunity for relatives to coerce family members to hasten their own death.

In New Zealand the law says that one citizen must not kill another. Mr Seymour’s Bill would claim that it is permissible, under certain conditions, for some people to kill others. Immediately that compromises the freedom of those citizens the law says we may assist to bring about their death.

Government power, the use of positive law, to influence human behaviour is a very blunt instrument. At best, with some obvious practical exceptions, it can only say what must not be done not what should be done. Every law passed that presumes a utilitarian understanding of human dignity is one more subtle movement towards increasing state power over the lives of its citizens.

At the outset euthanasia might look like an action of mercy, one of compassion when in fact it is probably motivated by pity; an emotion that wants to get rid of pain and discomfort as quickly as possible. Compassion one the other hand will share in the anguish and suffering of the patient. Any law that permits assisted suicide threatens the outworking of that compassion.

The vexatious conflict surrounding Mr Seymour’s bill is that he casts the intimacy of human relationships within a human rights framework. He says, “the end of life choice is the last great human rights issue.”

The language or rights prevails. But as influential French philosopher Simone Weil said decades ago, the language of rights ultimately cannot build or sustain a common life.

“If you say to someone who has ears to hear: ‘What you are doing to me is not just’, you touch and awaken at its source the spirit of attention and love. But it is not the same with words like ‘I have the right . . .’ or ‘you have no right to . . .’ They invoke a latent war and awaken the spirit of contention. To place the notion of rights at the centre of social conflicts is to inhibit any possible impulse of charity on both sides.”

Consequently, it becomes inevitable that a human life will be valued by its usefulness. Mr Seymour’s bill is thoroughly utilitarian. Its internal logic would have us devalue the old, the disadvantaged and the disabled. Indeed, it will encourage the old, the disadvantaged and the disabled to undervalue themselves.

Bruce Logan is a Board member of Family First New Zealand.

NewsRoom 9 July 2018
Family First Comment: “As euthanasia and physician-assisted suicide are against the ethos of palliative care, we believe this will have a detrimental impact on the workforce.” www.protect.org.nz

The group which represents the 35 hospices in New Zealand says a new bill could require it to host physician-assisted deaths even if it philosophically opposes them.

Hospice New Zealand says it strongly opposes David Seymour’s End of Life Choice Bill, which sets out a process by which people suffering a terminal illness or enduring “unbearable suffering” can apply to their doctor to die using a fatal medication.

It questions a clause in the Bill which allows a medical practitioner to have a conscientious objection to carrying out a death but then sets up a body which administers the law and which would provide a second medical practitioner.

Hospice NZ says that seems to prevent it from having a policy of not providing physician-assisted suicide. Even if its staff objected to assisted deaths then a patient could ask the administering body, the Support and Consultation for End of Life in New Zealand, for other practitioners.

“Could physician-assisted suicide take place in a hospice inpatient unit – provided by a SCENZ member if as an organisation we are unable to conscientiously object?”

The submission is one of a record 35,000 submissions made on the Bill, which are being slowly made public by Parliament’s Justice Select Committee.
READ MORE: https://www.newsroom.co.nz/2018/07/08/140506/hospices-say-no-to-euthanasia#

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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NZ Herald 27 May 2018
Family First Comment: “I do not want New Zealand to become a country where vulnerable dementia sufferers or disabled people are not valued and become even more susceptible to pressure from society to end their lives prematurely. I share in the concerns of Disability Rights Commissioner Paula Tesoriero, who said the bill “undermines the position of disabled and vulnerable members of our community. It devalues their lives and poses significant risk to them.””
www.protect.org.nz

As deputy chairwoman of the justice select committee, I’ve been listening to some very well considered submissions on the controversial euthanasia and assisted suicide bill before Parliament.

There were 36,000 individuals and groups who wrote to Parliament with their views on the End of Life Choice Bill. Ten per cent have indicated that they would like to be heard in person, which the committee has promised to do.

So we have extended the reporting deadline from September to next March. While I will listen attentively and respectfully to everyone’s viewpoint, I remain concerned at the lack of adequate safeguards to protect our most vulnerable.

A troubling aspect emerging from the public discussions is the large number of people who say they are in favour of the bill but who admit that they have not actually read it, claiming they don’t care about the detail, they just want to have the option.

Have you ever heard of anyone who did not want to die with dignity or be treated with compassion? Rather than being lulled by the wording around this poorly drafted bill, I’ve been urging people to delve deeper – it’s vital to know the details when stakes are so high and protections for the vulnerable so low.

Many incorrectly assume the law only applies to the terminally ill, but it would actually licence doctors to end the life of anyone with a “grievous, irremediable condition”.

That vague phrase is not an accepted medical or legal one and leaves the door open for coercion and abuse, and could potentially extend to include people with long-term conditions such as arthritis, dementia and diabetes as it has in other countries that have opened the door to euthanasia.
READ MORE: https://www.nzherald.co.nz/health/news/article.cfm?c_id=204&objectid=12059324

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