Ed

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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Stuff co.nz 25 August 2020
Family First Comment: Great decision. 
“Wards is particularly concerned that the act required patients to specify the time, date, and place where they wish to die.
This wasn’t conducive to terminal illness which often had many variables. He is also opposed to the bill’s stipulation that patients can choose assisted dying independently, without input from their family.”

Assisted dying will not be carried out on Hospice Southland grounds or by its staff, no matter how Kiwis vote in the upcoming referendum.

Hospice leadership have made their opposition to the End of Life Choice Act clear in a position statement sent to Southland medical bodies, medical staff, and rest homes.

“Hospice Southland does not take any action to cause patients to die sooner than they would naturally,” the letter, signed by the organisation’s medical director Amanda Sommerfeldt and chief executive Peter Wards, said.

While they would never turn someone who supported or wanted assisted dying away, Sommerfeldt said: “It won’t be done here.”

This comes after a high court ruling on a case brought by Hospice New Zealand found that medical practitioners and institutions, like hospice, had the right to conscientious objection.

In other words: they will be allowed to refuse to carry out assisted dying if it goes against the organisation’s values.

Hospice Southland’s position was discussed with all staff members – from clinical staff, to those running the Hospice Southland shop – before being put to the board of trustees and made public, Wards said.

“You’ll never get 100 per cent agreement, but this was pretty close,” Sommerfeldt added.
READ MORE: https://www.stuff.co.nz/national/health/euthanasia-debate/122557454/hospice-southland-says-no-to-end-of-life-choice-bill

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Stuff co.nz 11 August 2020
Family First Comment: Good decision. This is why assisted suicide is never safe
“Davison admitted administering Burger a lethal concoction of drugs, “placing a bag over [Varian’s] head and administering helium with the intent of helium deoxygenation and/or asphyxiation”, and giving Holland a lethal dose of pentobarbital. He argued it was “compassionate”” 🙁
A lawyer for the Professional Conduct Committee said Davison’s role in the deaths was a “deliberate breach of the obligation of all medical practitioners” to protect the “sanctity” of life, and would be seen by the public as “unacceptable” of a person registered in New Zealand.

An Auckland-born doctor convicted of helping three people to die overseas has been struck off the register.

Euthanasia advocate Professor Sean Davison appeared before the Health Practitioners Disciplinary Tribunal on Tuesday via video link from South Africa, where he lives.

In 2019 – while holding a provisional registration with the Medical Sciences Council of New Zealand – the medical laboratory scientist pleaded guilty to three murders in South Africa and was sentenced to three years’ house arrest.

Davison previously admitted counselling and procuring the attempted suicide of his cancer-stricken elderly mother Patricia Davison, 85, who died in 2006. He was sentenced in the High Court at Dunedin to five months’ home detention in 2011.

The charges involved the 2013 death of his friend, Anrich Burger, a doctor who became a quadriplegic after a car crash; the death of Justin Varian, who had motor neurone disease, in July 2015; and the death of sportsman Richard Holland, who had suffered brain injuries and had no motor function following a bicycle accident.

Davison admitted administering Burger a lethal concoction of drugs, “placing a bag over [Varian’s] head and administering helium with the intent of helium deoxygenation and/or asphyxiation”, and giving Holland a lethal dose of pentobarbital.

The tribunal heard Davison wished to move back to New Zealand to practise pathology after completing house arrest, and was granted a provisional registration.

He disclosed his conviction linked to the death of his mother, but failed to disclose that he had been involved in the murders of Varian and Holland when he knew his involvement was “unlawful conduct”, the tribunal heard.

Assisted suicide and euthanasia are illegal in South Africa.
READ MORE: https://www.stuff.co.nz/national/health/300079176/kiwi-scientist-sean-davison-struck-off-over-role-in-assisted-deaths-in-south-africa

NewsHub 10 August 2020
Family First Comment: Thank you Vicki for your powerful and brave voice!
“Vicki Walsh was told in June 2011 her brain cancer diagnosis was terminal and she only had 12 to 14 months to live. However, now aged 53, Walsh has had NINE more years of life since. She says that might not have happened if the choice of assisted dying had been available because she would’ve taken it.”
#protect
#rejectassistedsuicide

A woman with terminal cancer she wouldn’t consider assisted dying and will vote against legalising euthanasia in the referendum.

Vicki Walsh was told in June 2011 her brain cancer diagnosis was terminal and she only had 12 to 14 months to live.

However, now aged 53, Walsh has had nine more years of life since. She says that might not have happened if the choice of assisted dying had been available because she would’ve taken it.

“Obviously euthanasia wasn’t an option, but I had a go at killing myself. So had euthanasia been an option then, it is probably one I would have taken, not realising I was actually depressed,” she told Newshub.

Up until then, she had always believed people should have the choice of assisted dying, saying it was, “My body, my choice”. But after her suicide attempt, her views changed.

“Do you know what, I woke up the next day and I had the best day. I kept thinking, ‘What if you’d done it?'”

Walsh now believes in what she calls a journey to completion, no matter how painful the end.

“Why would I take away the fun parts? And people say to me, ‘What happens if there aren’t any fun parts?’ I say I don’t know. But I am prepared to see that journey through because I don’t believe in anybody deliberately ending someone else’s life.”

She’s now against giving people the choice for assisted dying because there is so much room to get it wrong.
READ MORE: https://www.newshub.co.nz/home/politics/2020/08/euthanasia-referendum-terminal-cancer-patient-reveals-why-she-s-against-legalising-assisted-dying.html

Stuff co.nz 6 August 2020
Family First Comment: An excellent commentary – from someone who is intimately involved in this issue….
“The other day I phoned a patient to discuss the options for treatment of her cancer and she pleaded with me not to deny her treatment. “I know I may have terminal cancer and I am older but I have so much to live for; please allow me to have treatment,” she said. I reassured her that she would be given any treatment that was suitable for her. It got me thinking that it is easy for patients to feel that somehow, they are not as worthy as others to receive treatment.“

OPINION: I am a doctor and I have worked with cancer patients for over 20 years. I love to just “roll my sleeves up” and do my job.

I do not often speak in public forums or give my opinions on issues, but I am so concerned with the implications of the End of Life Choice Act that I feel the need to speak out and share my story.

The other day I phoned a patient to discuss the options for treatment of her cancer and she pleaded with me not to deny her treatment. “I know I may have terminal cancer and I am older but I have so much to live for; please allow me to have treatment,” she said. I reassured her that she would be given any treatment that was suitable for her.

It got me thinking that it is easy for patients to feel that somehow, they are not as worthy as others to receive treatment.

One of the great privileges of my job is that I can care for those who in society’s eyes may be considered vulnerable. In my practice I care for patients with brain damage, elderly folk (96 is my record so far), prisoners, people with extreme learning difficulties, with severe mental illness and with hearing or visual impairment.

Each of these patients is in addition receiving care for terminal conditions. Should the End of Life Choice Act become law, each of these patients may become open to subtle coercion to feel that requesting medically assisted dying would be ‘the right thing to do’ to avoid being a financial or physical burden to those who care for them.

The Oregon Health Authority reports that 59 per cent of patients who requested assisted suicide in 2019 gave being a burden to their family as one of their reasons.

Dr Melissa James is a radiation oncologist affiliated with the organisation Doctors say no.
READ MORE: https://www.stuff.co.nz/national/health/euthanasia-debate/122351691/euthanasia-referendum-an-oncologists-perspective

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Stuff co.nz 5 August 2020
A year ago, Olivia Clark didn’t think she would get to celebrate another Christmas or birthday with her young daughter.

Four-year-old Luna was born with hypoplastic left heart syndrome, meaning the left side of her heart is missing.

After four open-heart surgeries, the first of which Luna had at just two days old, fluid in her body refused to drain and doctors said they weren’t confident she would survive another surgery.

In August 2019, the Clark family took Luna home after about five months in Auckland’s Starship Children’s Hospital.

They had decided her quality of life was more important, and they wanted to give her all the experiences she wanted.

Luna’s team of doctors said her family may have just four weeks with her if the fluid continued at the rate it was filling up.

But a year later, her mum says Luna is “absolutely thriving”.

“They can’t really explain it, we can’t explain it, it’s just … she’s just not ready to go.”
READ MORE: https://www.stuff.co.nz/national/health/122341930/auckland-4yearold-thriving-a-year-after-being-given-just-weeks-to-live

Euthanasia Prevention Coalition 28 July 2020
Family First Comment: We are told that euthanasia is “compassion.” But how compassionate is it when last year in Canada, hundreds of sick people were euthanized because of loneliness? The country’s 2019 MAID [medical assistance in dying] Annual Report found that 13.7% of the 5,631 Canadians killed by doctors asked to be lethally injected because of “isolation or loneliness.” If my math is right, that’s about 771 people, or 64 a month, or two per day.

The country’s 2019 MAID [medical assistance in dying] Annual Report found that 13.7 percent of the 5,631 Canadians killed by doctors asked to be lethally injected because of “isolation or loneliness.” If my math is right, that’s about 771 people, or 64 a month, or two per day. Good grief!

Some of the other reasons people gave for asking to be killed:

• Loss of ability to engage in enjoyable activities, 82.1 percent. That’s a serious concern, but with proper interventions, it can be overcome.
• Loss of ability to perform activities of daily living, 78.1 percent. Ditto.
• “Inadequate control of pain (or concern about it),” 53.9 percent. That’s a scandalously high percentage. Palliative and hospice pain-control experts will tell you that most serious pain in terminal illnesses can be successfully alleviated.
• Loss of dignity, 53.3 percent. Again, this is a serious concern but can be overcome with appropriate care.
• Perceived burden on family, friends, and caregivers, 34 percent. In other words, people put themselves out of their loved one’s misery.
• Emotional distress/anxiety/fear/existential suffering, 4.7 percent.

These statistics are scandalous and should make Canada deeply ashamed.

Alas, most Canadians are proud that their doctors can legally kill sick people whose deaths are “reasonably foreseeable.” Not only that, but the country is now engaged in the process that will expand the conditions qualifying for lethal injection, including incompetent people with dementia if they asked to be put down in an advance directive.
READ MORE: https://alexschadenberg.blogspot.com/2020/07/hundreds-of-sick-canadians-euthanized.html

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TVNZ One News 29 July 2020
A new framework to improve the services for Māori whānau in hospice care has been launched.

This week’s talanoa we are joined by Dr Ate Moala, who is against it and social work student, Togi To’o who strongly supports the bill. The End of Life Choice Bill gives people with a terminal illness or a grievous and irremediable medical condition the option to request assistance to die.
Dr Ate Moala is also a board member of Family First NZ.

NZ Herald 25 July 2020
Family First Comment: The NZ Herald is working hard to allay the concerns around the flawed euthanasia bill.
• Apparently it’s not a ‘slippery slope’ – it’s ‘deliberate and considered reform’
• It concedes that pinpointing whether someone has 6 months to live is very difficult – yet it’s the key component of the bill!
• The Ministry of Justice agrees that somebody could be killed within 3-4 days – but apparently it’s likely to take months to do the paperwork. (We know it’s a government department – but pull the other one!)
• They question concerns around ‘duty to die’ & ‘abuse of the vulnerable’ (apparently there’s also other reasons – wow, that feels better then), and ‘increased suicide rates’ (we’re assured that “experts stress New Zealand has unique social, cultural, political and other factors”.
Sheesh. They don’t do a very good job at allaying the legitimate concerns around a flawed law.
Protect.org.nz

Euthanasia could soon be legal in New Zealand, but what exactly would that mean?

Could a patient tell their GP they want to die on a Wednesday and be dead by the weekend?

Is it inevitable that the proposed euthanasia law would be expanded from the terminally ill to those with depression? Or to children? And how secure are the safeguards?

These are some of the debates taking place in public meetings, on social media and over family dinner tables.

As part of the Herald’s ongoing coverage of the euthanasia and cannabis referendums, we take a look at some of the most headline-grabbing arguments around voluntary euthanasia and whether they stack up.

The ‘slippery slope’
It is one the most common arguments against voluntary euthanasia – that making it available for a small group of people, such as terminally ill adult patients who are in decline, will inevitably lead to it being broadened to more people, such as those with mental illness or young people.

Opponents usually point to the examples of the Netherlands and Belgium, where people can get access to euthanasia on the grounds of psychiatric illness, and where there is no minimum age for eligibility.

But there is no evidence that broadening the law is inevitable wherever euthanasia is legalised.
READ MORE: https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=12350755

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