Ed

University of Otago 9 September 2020
Family First Comment: “Judging by the experience in Oregon it is likely that this may only benefit a small number of older educated white people. The health system is currently significantly stretched by the extra demands and changes required because of Covid-19… Hospices currently have to fundraise for 60% of their costs. Only one in three people dying in New Zealand are supported by a hospice. There are 33 hospice services in New Zealand but there is inevitably limited service to rural areas and smaller centres. Given this limitation of access, and the extent of fundraising required, there is a strong argument to prioritise funding to hospices as an effective and non-contentious strategy to decrease suffering at the end of life. This may also decrease the demand for euthanasia.”

At the next election voters will be asked to answer the referendum question “Do you support the End of Life Choice Act 2019¹ coming into force?” If a majority vote Yes then this Act will come into force without further amendment.

The focus of discussion has almost exclusively been around the ethical question of whether, in the circumstances described in the Act, it is ethical to proceed with medically assisted aid in dying. There has been little discussion about whether, if we accept this is ethical, introducing a regimen to enable this is a sufficient current health priority to justify the funding required to operationalise the Act.

If this level of demand is reflected in New Zealand, then it will benefit a small but increasing number of people over time likely from a group who can afford the costs and who already get significant benefit from our health system. The result of enacting this Act will be to increase health outcome disparities…we will be providing an additional service to educated white people. The opportunity cost to the State will be higher if this is State funded. If privately funded there will be a smaller opportunity cost to the State of running the accountability bureaucracy, but the service will only be available to those who can afford it.

A lot of effort has already gone into this debate. No matter what the outcome, the opposing sides are both likely to continue to be active. If it is passed, those opposed will probably lobby to try to limit the application of the Act. If it is not passed, then proponents will probably continue to lobby to re-litigate at a future date. In the meantime political parties are likely to pay more attention to issues at the end of life. Hospices currently have to fundraise for 60% of their costs.⁷ Only one in three people dying in New Zealand are supported by a hospice.⁸ There are 33 hospice services in New Zealand but there is inevitably limited service to rural areas and smaller centres. Given this limitation of access, and the extent of fundraising required, there is a strong argument to prioritise funding to hospices as an effective and non-contentious strategy to decrease suffering at the end of life. This may also decrease the demand for euthanasia.

Changing the status quo now will require focus on this issue and take attention away from the much more serious issues of responding to the Covid-19 pandemic and to the Simpson review of the health system.

The ethical debate is unlikely to reach consensus. However, this referendum is also about allocating scarce health care resources on providing an assisted dying service (assuming it has an element of state funding), which will disproportionately be used by the affluent and educated. As well as considering the ethics of euthanasia we also need to consider whether the funding needed to set up and run an assisted dying service would be better spent on other priorities such as reducing disparities in cancer screening, diagnosis and care services or supporting and improving the provision of palliative care.
READ MORE: https://blogs.otago.ac.nz/pubhealthexpert/2020/09/09/is-euthanasia-a-health-priority-for-new-zealand-at-present/

NewsRoom 11 September 2020
READ MORE: https://www.newsroom.co.nz/assisted-dyings-inequity-problem\
Emergency medicine resident medical officer Carmen Chan shares her concerns about euthanasia as an equity problem and explains how it broadens the gap in health outcomes for those already having trouble getting fair access to care

Family First notes these comments by Carmen Chan:

“If you had asked me as a medical student some years ago, I would have told you that I supported the proposed End of Life Choice Act. We put down our animals when they are suffering. Who’s to say that we can’t have the right to control how we end our own lives when we live with a terminal illness? But now as a practising clinician, I have many doubts about the proposed law on euthanasia. The conversation is much more complex and nuanced than what you’ll commonly read in the media – which is why I feel the need to speak out…

“..Euthanasia is an equity problem. It broadens the gap in health outcomes for those already having trouble getting fair access to care – for example, Māori and Pacific populations, rural communities, those impoverished and anyone already marginalised by the healthcare system. For me, it’s obvious who would be more likely to opt to end their lives early through euthanasia because they cannot access the medical care and support that they need. We need to think very carefully about what this legislation might end up doing… Rather than endorsing euthanasia, I want to call upon our government to strengthen palliative care, social services and support systems.

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NZ Herald 9 September 2020
Family First Comment: Superbly written….
“I want to see this Bill spark a fire of compassion in our nation. Let us engage more with the dying. Let us create true personal dignity for the dying – not by abandoning them, not by killing them prematurely – but by simply journeying with them day after day until the end; sustaining their mana… [T]o change the law to license medical professionals to kill is a fundamental ground shift in the profession, a radical change in medical ethos that is both unnecessary and deplorable. People of New Zealand, do not place this burden on our doctors. Instead get out there and do the mahi – the hard slog of being human and extending love and human encounter to our most vulnerable in their last days. Compassion is not delivered by proxy of legislation. Compassion is personal. Compassion is up to you and me.”
Yes!

The upcoming referendum on the End of Life Choice Act 2019 is by far the most important decision we as a nation will make in the October elections. Much has been written and much stated before the select committee – more than 90 per cent of submissions in opposition to the Bill. I am one of those opponents.

The most recent contribution to this very complex issue is an opinion piece by Matt Vickers (former husband of Lucretia Seales). Not surprisingly he supports the Bill. I can understand his stance but sadly it is expressed in terms that are both simplistic and false.

It is grossly false to suggest that only supporters of the Bill are compassionate and those against are not. It is false to imply that it is only supporters of the Bill who are truthful. Indeed, in his opening sentence he states that “the End of Life Choice Act was passed into law”. That is not true. It has yet to receive Royal Assent and that remains dependent on the referendum.

Like all issues in public discourse, assisted dying is complex. There are reasons for and reasons against. Inevitably there is a distribution of opinion – let’s call it a bell-shaped curve, a so-called normal distribution. So, the first point is that viewpoints on either side are valid in principle and we are duty bound on either side to respect that. But I have been to many public meetings on this issue where attacks on opponents to the Bill have been vociferous and venomous.

It needs to be recognised that a significant part of the attack on opponents has been an odd confusion between the issue at hand and religion. And the hatred of religion in some quarters has always spilled over in these meetings. Vickers comes very close to holding hands with these anti-religionists in his sweeping generalisations about “church-backed doctors and lawyers”.

To state my position clearly, I happen to be a scientist and a Christian but I doubt any considered person would refer to me as a “church-backed scientist”. For one thing, which church? Churches, too, have a distribution of opinion.

I will float a very non-scientific guess here (but its worth undertaking a proper survey). I am thinking that more opponents to the Bill have sat through the long hours and days with a dying friend, relative or stranger than proponents. Sat there holding a hand, talking quietly and lovingly often to an unresponsive patient, perhaps singing soothingly; human contact which might seem one-way only, but inevitably is mutual; savouring the sacred moments as life fades. Who knows? But I say this with passion: “opponents of this Bill are deeply compassionate” and to claim otherwise is the grossest of falsehoods.
• Dr Jeff Tallon is a physicist. The views expressed here are personal and not to be associated in any way with his employer.
READ MORE: https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=12363459

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Stuff co.nz 8 September 2020
Family First Comment:“As a specialist geriatrician for the past 25 years I have cared for older people with a wide range of acute and chronic illnesses and I want you to understand why this Act is so dangerous.
You see this Act is not about allowing people choice to end their life, decline resuscitation or turn off life support because these are all already legal in New Zealand. No, this Act is about making it legal for someone else to take your life – and at a moment in time when you are at your most fragile.”
Protect.org.nz

OPINION: I’ve never been political but have become increasingly vocal with the End of Life Act looming. If you haven’t read this Act then I strongly urge you to do so.

As a specialist geriatrician for the past 25 years I have cared for older people with a wide range of acute and chronic illnesses and I want you to understand why this Act is so dangerous.

You see this Act is not about allowing people choice to end their life, decline resuscitation or turn off life support because these are all already legal in New Zealand.

No, this Act is about making it legal for someone else to take your life – and at a moment in time when you are at your most fragile.

And that someone just happens to be your doctor – just a quick rewrite of the Hippocratic Oath (just that bit about never harming you). Talk about mixed messages for our patients!

For doctors like me, it’s a quantum leap from caring for someone as they die … to actively killing someone who may not be dying at all. You see this Act talks about the state of being terminal. But doctors have never been able to predict death accurately. Who doesn’t know someone, given six months to live, proudly re-telling the story years later down at the local pub.

The reasons promoting euthanasia are sometimes because of distressing cases. And yes, I’ve lost family and friends to cancer and neurological disease and one day it will be me.  But, no matter how much insurance and control we may want over our deaths, how can this Act be supported when it takes away the legal protection when we are at our most vulnerable. Having control and choice is all very appealing but not when it places our most vulnerable at risk, and bullies doctors into the bargain.

In Aotearoa, we already score poorly with many of our social indices for both young and old compared to other countries. Elder abuse currently affects 10 per cent of older people in New Zealand although this figure is thought to be much higher in reality due to underreporting.
Dr John Thwaites is a consultant physician and geriatrician and a member of the Vote No to the End of Life Act group.
READ MORE: https://www.stuff.co.nz/national/health/euthanasia-debate/300102192/euthanasia-referendum-the-right-to-die-or-a-licence-to-kill

Radio NZ News 7 September 2020
Family First Comment: Thank you Vicki for your bravery and your conviction!
“Vicki’s greatest fear is that people will feel pressured to end their lives earlier than they need to. “The coercion thing is one of biggest concerns for me about this bill, people say it wouldn’t happen – well we already have an elderly abuse problem in this country. So I already know what I feel like, like my family don’t make me feel like a burden, but I also feel like a burden sometimes and I’m not getting that pressure.”
Protect.org.nz

A woman dying of cancer is urging New Zealanders to ‘pull the plug’ on the proposed euthanasia law, saying people could be coerced into an early death.

The public will be asked to vote yes or no to the End of Life Choice Act, in a referendum on election day.

The Act would allow terminally ill people who are given six months or less to live and who are experiencing unbearable suffering, the option of medically assisted dying.

Vicki Walsh, who is now 53, was diagnosed with Glioblastoma Multiforme in June 2011.

The aggressive brain cancer is nicknamed ‘The Terminator’ and those who have it typically die within 14 months of diagnosis.

But nine years later, Vicki is still around, living near Palmerston North with her husband and two adult children.

She has been taking the drug Avastin – which has cost her $24,000 – and the mass in her brain has halved.

“I was always told there was nothing more that could be done,” she said. “So in eight years, nine years, things have changed, so I got another surgery, I got radiation and now we’re having this drug that we’re paying for.”

But there was a moment after her diagnosis where she felt helpless and depressed.

She said she watched people, who were battling the same illness overseas, choose euthanasia and felt she should take her own life.

“I actually felt kind of gutless, I was looking at my husband and we were trying to keep life normal and I had a bit of a stroke and it ended up really, really big and I just felt that this is it for me,” she said.

“It had been several weeks, it wasn’t just an overnight thing, and I just thought, if this is how it’s going to be, I don’t want to live like this anymore.”

But Vicki changed her mind in the last moment.

Had she gone through with it, she said she would have missed out on watching her grandchildren grow up.

“If you’d asked me if I want to live like I am now, I would have viewed my life 15 years ago as not having much of a quality of life now” she said. “I love my life, you know, I love my life.”

Vicki said she didn’t want to see people suffer, but felt the End of Life Choice Act was not watertight.
READ MORE: https://www.rnz.co.nz/national/programmes/checkpoint/audio/2018762966/i-feel-like-a-burden-sometimes-dying-woman-urges-public-to-say-no-to-euthanasia

NZ Herald 9 September 2020
A Catholic school that has given parents “vote no” literature on cannabis and euthanasia has sparked a moral and legal row over whether schools should get involved in politics.

St Joseph’s School in Stratford, Taranaki, has emailed all its parents attaching Family First literature listing 20 reasons to vote no to the upcoming referendums on both issues, and giving a link to the VoteSafe website opposing the proposed euthanasia law.

The email appears to breach Ministry of Education advice that state and state-integrated schools are state entities and “can’t encourage electors to vote or not vote for specific parties, policies or candidates”.

But Catholic Education Office chief executive Paul Ferris said school boards of trustees were “independent legal entities” and he had not provided any advice on how they should handle the referendums.

“A secondary school even has the legal power to make bylaws. That’s how it can enforce uniform policies and things,” he said.

Family First director Bob McCoskrie said the documents attached to the email came from a pamphlet that has been distributed to 300,000 people but has not been sent directly to any schools.

“We haven’t targeted schools. It will just be coming on site through either parents or staff,” he said.

He said Family First was spending more on the “trifecta” of this year’s two referendums and general election than it has on any previous issue including the 2009 anti-smacking law and the 2013 same-sex marriage law.

He said spending by groups involved in the anti-smacking referendum was limited to $110,000, but the cap on spending for “third-party groups” this year was $338,000.
READ MORE: https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=12363285

Taranaki Catholic school’s email to parents included documents to ‘vote no’ in cannabis and euthanasia referendums
Stuff co.nz 9 September 2020
The Ministry of Education plans to remind educators of the “appropriate approach” during election season after a Stratford Catholic school upset parents by sending an email with reasons to ‘vote no’ in the euthanasia and cannabis referendums.

The email, which was sent to the parents of pupils at St Joseph’s Catholic School Stratford on Tuesday, came from principal Chris Linders through the school’s office manager.

“Please find attached information to help you make an informed decision about the upcoming referendum. The www.votesafe.nz/quiz is also worth a go. It contains 10 questions and just takes a few minutes,” it read. “God bless, Chris.”

Each attachment contained a document from valueyourvote.org.nz, which is run by social conservative group Family First New Zealand.

The documents were 20 reason to vote no to cannabis, and 20 reasons to vote no to euthanasia.
READ MORE: https://www.stuff.co.nz/taranaki-daily-news/news/122707416/taranaki-catholic-schools-email-to-parents-included-documents-to-vote-no-in-cannabis-and-euthanasia-referendums

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Stuff co.nz 5 September 2020
Family First Comment: Great decision, and a ‘clear conscience’:
“As experts in providing palliative care, with a long-established philosophy of neither delaying nor hastening death, Nelson Tasman Hospice conscientiously objects to assisted death.”
Protect.org.nz

New Zealand will soon vote on whether terminally-ill people should be able to ask for help to end their life. Nelson Tasman Hospice chief executive Frans Dellebeke explains why the Nelson Tasman Hospice conscientiously objects to the End of Life Choice Act 2019.

This October, New Zealand will go to the polls to choose our next Government. At the same time, two referendums will be held: A non-binding referendum on cannabis legalisation and control, and a binding referendum on whether to allow someone who is terminally ill to legally request assisted dying to end their life.

This Act is called the End of Life Choice Act 2019. The process is also known as voluntary euthanasia and assisted dying.

The Nelson Tasman Hospice accepts that all people have freedom of choice and should they wish to choose assisted dying, we will continue to provide support and palliative care to the patient and their family/whānau, which includes bereavement support and counselling.

This is what Hospice has always done. We will continue our commitment to providing excellent palliative care to everyone, regardless of the outcome of the referendum this October.

The referendum is a big decision for every voter, and we each have a responsibility to fully understand what we are voting on. More information on these choices is available at www.nelsonhospice.org.nz and www.hospice.org.nz.

Hospice care is about managing/easing pain and allowing a person to live the last weeks, months, or years of their life with dignity and respect.
READ MORE: https://www.stuff.co.nz/nelson-mail/opinion/300096874/why-hospice-objects-to-proposed-end-of-life-law

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Stuff co.nz 7 September 2020
Of the nearly 40,000 submissions made on the End of Life Choice Bill, most were in opposition – some citing religious reasons. Last year, leaders from across the religious divide penned a letter to MPs in a desperate final bid to prevent the bill being passed.

Ahead of the final parliamentary vote last November, leaders from the Catholic, Baptist, Presbyterian, Anglican and Lutheran churches, as well as the Federation of Islamic Associations and the Salvation Army, expressed “grave concerns” about the bill. Among them was the risk people would choose assisted death because of a “lack of other meaningful choices” – pointing to “inequitable” access to high-quality palliative care across the country. They stated they “firmly believe” allowing assisted dying would “open the gateway to many foreseen and unforeseen consequences” including the “real risk that people in lower socio-economic groups will find themselves being challenged unnecessarily and unjustly towards a premature death”.

John Kleinsman, director of The Nathaniel Centre for Bioethics – an agency of the New Zealand Catholic Bishops Conference, says while the conference believes it is dangerous to implement any euthanasia law, it also specifically takes issue with this particular piece of legislation.

He says that in a context where elder abuse is rife and “rising” despite a “very clear, robust law” prohibiting such abuse, the question: “if we can’t keep [them] safe now, how do we think we could keep them safe” has to be asked if such a law was to pass.

Kleinsman says as Catholics they are not interested in “imposing” their beliefs on others, and they understand there is a case to be made for euthanasia.

However, he pointed to “a number of issues” within the Act of concern to the Catholic bishops, including the absence of a ‘cooling-off period’, which he believes makes it a “dangerous” piece of legislation.

The Christian church promotes the idea of autonomy and self-choice, but “we are not individuals in isolation”, and assisted dying is “not the only way to have a dignified death”, he says.

Kleinsman says the organisation takes the stance – as Catholics – of looking at how this will impact the community and society, particularly those who are vulnerable.

Christianity remains New Zealand’s largest overall religious grouping, despite decreasing as a proportion since 2013. The top five denominations in order, as of the last Census, were Anglican, Christian with no denomination specified, Roman Catholic, Presbyterian and Catholicism (not further defined).

Kleinsman states any “euthanasia regime” relies on the idea that some lives are worth living while others are not: “if anything, those most vulnerable deserve the greatest protection and care”.

He says compassion and mercy are at the core of what it is to be Christian, but says it is compassion towards those who will be “sucked in unwittingly” and experience “wrongful death” that form the basis of his opposition to the Act.

“I think it will change the way we are as a society … how we think about old people, how we think about people with disability.”

It is important to note that under the Act, a person would not be eligible if the only reason they give is that they are suffering from a mental disorder or mental illness; have a disability of any kind; or because of their advanced age.

The Catholic Bishops and Nathaniel Centre both made submissions to the select committee about the bill as it was going through Parliament.

Kleinsman, who has been involved with the Nathaniel Centre for 20 years and director for 10 years, says priests and chaplins have significant experience with the dying, and know how difficult the process can be even with effective palliative care.

However, in a country where palliative care is “not equitable”, assisted dying legislation could see “people choosing [assisted dying] … because they don’t have any other option”, he states.

In Hinduism and Buddhism there are several points of view, both for and against euthanasia, however for those of Sikh or Muslim faith, the position is more steadfast.

Sikhism is the fastest growing religion in New Zealand, with those identifying with the religion at the 2018 Census more than quadrupling since 2006. About 41,000 Sikhs lived in New Zealand at last count.

Daljit Singh, spokesman for Supreme Sikh Society, the largest Sikh body in New Zealand, says Sikhism is a religion for the “whole humanity”.

“Under the guiding light of our Guru Sahib, Sikh religion does not agree with the End of Life Choice Act,” Singh told Stuff.

The sacred scripture of Sikhism, the Granth Sahib – states those who “self-destruct”, who take their own lives, are “not only finishing oneself but also destroying the whole world and humanity”, Singh says.

Other holy verses explain that pain and pleasure are bestowed upon humans at the will of the Almighty, Singh says.

If a person does not agree with [their pain], they should “return back to Almighty itself and make prayers to Him” to have such suffering relieved, and “not that a human become a boss of its own suffering or pleasure,” Singh said of the scriptures.

Singh says Guru Sahib also teaches it is not a human’s will when and how their lives shall come to an end: “We cannot go against his will,” they are told.

Similarly, one of the core tenets of Islam, of which more than 57,000 New Zealanders identified with at the last Census, is the consideration that all human life is sacred.

Muslims believe life is to be protected and promoted, and not “terminated prematurely” – with the Quran stating it is neither permissible to kill another or one’s self.

In a statement published by Federation of Islamic Associations of New Zealand last year, opposing euthanasia and the End of Life Choice Bill, its president Dr Mustafa Farouk, said it was “not for us or doctors to kill or aid others in destroying themselves”.

In it, Farouk said New Zealand Muslims were worried the “vulnerability of our community members could be exploited if euthanasia is legalised”.

Most of New Zealand’s Islam community migrated from countries where authorities are “hardly questioned”, prompting concern from FIANZ that people could be “suggested, pressured or coerced by authoritative figures like doctors to end their lives if they had terminal illness or disabilities”.

It said it was also concerned legalising euthanasia would “normalise it for future generations” and “erode our cultural identity”.

The Association worried members of its community who experience severe illness – particularly refugees, who were often poorer than the general population – could request assisted dying “out of guilt”, faced with high healthcare costs and “scarce” carers.

Perhaps most importantly, Farouk said FIANZ believe legalising euthanasia may provide “societal acceptance” needed by those with suicide tendencies in Muslim communities to “rationalise” suicide.

FIANZ was approached for comment.
READ MORE: https://www.stuff.co.nz/national/health/euthanasia-debate/300066732/euthanasia-referendum-kiwis-of-faith-split-on-end-of-life-choice-act

The Age 1 September 2020
Family First Comment: “State government-sanctioned lethal medication was used to end the lives of 124 terminally ill Victorians in the 12 months since the state’s landmark euthanasia laws came into effect in June last year, far surpassing initial estimates of just 12 people in the first year… [Daniel Andrews predicted a dozen in the first year.] Loss of autonomy was the most profound reason applicants gave for requesting assisted dying, the report found. Other reasons cited included loss of joy, losing control of body functions and loss of dignity.”
But not pain (which, we are told, is the reason we need euthanasia).
Protect.org.nz

State government-sanctioned lethal medication was used to end the lives of 124 terminally ill Victorians in the 12 months since the state’s landmark euthanasia laws came into effect in June last year, far surpassing initial estimates of just 12 people in the first year.

Stuff co.nz 31 August 2020
Family First Comment: Superb commentary from Grant Illingworth QC – on David Seymour’s “shoddy” euthanasia law.
“While superficially attractive, it contains serious shortcomings that create unacceptable risks for vulnerable people. The most glaring example is the lack of any meaningful safeguard against coercion in the Act. Every law student learns about situations in which vulnerable people are pressured into making decisions against their will or their better judgment.”
Protect.org.nz
#rejectassistedsuicide

OPINION: The New Zealand public will shortly be asked to decide whether to give health workers the authority to assist terminally ill people to die. Many people, including now Sir Michael Cullen, think it’s a good idea to give people who are terminally ill a choice about how to end their lives.

As New Zealanders, we like the idea of having a choice. We also like the idea of showing compassion towards those who are suffering.

Rightly so; but the assisted dying referendum does not involve voting about an idea; it concerns a set of rules that have already been drafted and enacted by Parliament.

Those rules will come into force automatically if a majority vote in favour of them.

One of the basic requirements of a good statute is that it should build up a sequence of concepts that make logical sense and which, in combination, constitute a sound, consistent and coherent statutory scheme.

As with a good recipe, the instructions should all contribute harmoniously to a satisfactory outcome. But if the instructions are not clear, the chef will have only a recipe for confusion.

Before endorsing any set of legal rules, we should all be convinced that the proposal is watertight, especially in matters involving life and death.

Unfortunately, in this case the proposed law is not watertight.

While superficially attractive, it contains serious shortcomings that create unacceptable risks for vulnerable people.

The most glaring example is the lack of any meaningful safeguard against coercion in the Act. Every law student learns about situations in which vulnerable people are pressured into making decisions against their will or their better judgment.

Pressure of this kind has various legal labels including terms like “undue influence” and “economic duress.” In more colloquial language, we routinely talk about people being “bullied” into doing things they don’t really want to do.

Under the proposed law, doctors are required to encourage a person who seeks assisted dying to discuss their wish with others, such as family, friends, and counsellors.

But doctors must also ensure the person knows they are not obliged to discuss their wish with anyone.

Doctors must “do their best” to ensure that the person is expressing their wish free from pressure by conferring with other health practitioners who are in regular contact with the person and by conferring with members of the person’s family “approved” by the person.

But there may be no other health practitioners who are in regular contact with the person and, even if there are, they may know nothing about the family situation.

And the duty to confer with members of the family is expressly limited to people who are “approved” by the person.

If the person has been bullied into seeking assisted dying, the person is unlikely give their approval. These provisions provide no more than the illusion of safety.

An independent medical practitioner must read the person’s medical files, examine the person and reach an opinion about whether the person is eligible for assisted dying. But that practitioner is not required to make any form of assessment concerning possible coercion.

There is no requirement for any health professional, at any stage of the process, to ask the person who seeks assisted dying whether someone else has suggested that they make an assisted dying request and, if so, whether that other person has anything to gain from the outcome.

No-one has to ask the person whether he or she has been pressured to make the request or whether assisted dying is being sought in order to relieve or help family members.

These are questions that must be answered before it could be concluded that the decision to seek assisted dying has been made voluntarily, but no-one has been given the responsibility of asking those questions.

The proposed law provides that the assisted dying process must be stopped if, at any time, the health practitioners suspect, on reasonable grounds, that the person is not expressing their wish to receive assisted dying free from pressure from any other person.

But this does not amount to a requirement to exclude possible coercion in any proactive way. Importantly, the independent medical practitioner has been given no role to play in the assessment of voluntariness. Put simply, the proposed law does not require any meaningful form of coercion assessment.

Another serious problem will be created, too, if the proposed law comes into force. The Crimes Act provides that homicide is the killing of one human being by another.

Homicide may be either culpable or not culpable. Culpable homicide is either murder or manslaughter.

Homicide is culpable when it consists in the killing of any person by an unlawful act, but it may also be culpable where the offender causes the victim to take their own life as a result of threats, fear of violence, or deception.

If a bully only puts emotional pressure on a vulnerable person to commit suicide, the bully can’t be charged with murder or manslaughter, but the bully could be charged with aiding and abetting suicide. It’s a serious crime to counsel or procure any person to commit suicide, or to aid or abet any person in the commission of suicide.

It is also a crime to encourage another person to commit suicide, even if they don’t do it.

But what if the proposed law is voted into effect and a person accesses assisted dying as a result of being bullied? If the victim is wrongfully pressured into killing himself or herself, even with medical assistance, the bully could be prosecuted and imprisoned for up to 14 years, because the result would still be a form of suicide.

But if the bully were careful enough to pressure the victim into being killed by a doctor administering a lethal poison, it seems that no offence would be committed because the result would not be suicide, so no-one could be punished for the wrongful death.

This is an unacceptable outcome which has been overlooked in a piece of very shoddy legal drafting.

Grant Illingworth QC is a barrister-at-law based in Auckland and is taking part in the #DefendNZ movement to try to block the End of Life Bill from passing into law.
https://www.stuff.co.nz/national/health/euthanasia-debate/300095438/euthanasia-referendum-the-proposed-law-isnt-watertight

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