Ed

NewsRoom 23 July 2020
Family First Comment: Superb article from palliative care specialist Dr Sinead Donnelly…
“Every week as doctors we see cases where disabled, sick or mentally ill patients will, at their most vulnerable point, contemplate suicide. With the right care and medicine the vast majority are brought out of this vulnerable state to a place of health. Under the proposed Act, those same people could be dead within 72 hours.
As doctors caring for people who are dying every day we know the difference that this legislation will make to vulnerable people. It will expose the vulnerable to the extraordinary burden of a duty to die. We are voting no and we invite you to join us in opposing this Act.”

Arguing for assisted dying legislation on the basis NZ’s palliative care is underfunded is like saying that the car needs a clean so should be pushed off a cliff, writes Dr Sinéad Donnelly

In recent weeks there have been unsubstantiated claims in New Zealand media by pro-euthanasia, retired doctors or ‘veteran medical specialists’ around the End of Life Choice Act, which will be voted on during the upcoming referendum.

As specialist doctors trained in palliative medicine and currently practising in New Zealand, we’re extremely concerned at their argument in favour of euthanasia. It’s wrong and it’s dangerous.

First, they argue in favour of euthanasia because, in their words, palliative care has been “underfunded from the start and access and quality are patchy”. They say that aged residential staff “are overworked and often poorly trained in palliative care for the dying”. In other words, they want us to vote at the referendum in favour of euthanasia due to inadequacy and inequity of palliative care and inadequate aged residential care staffing.

This is a little like arguing that the car needs a clean so should be pushed off a cliff.

When have we, as a society, agreed to prematurely end the lives of patients due to poor funding? In any other situation that would be called callous and unacceptable. It certainly doesn’t pass the kindness test.

The second irresponsible statement is that “the End of Life Choice Act is one of the safest in the world”. It is not. The Act’s claimed protection against pressure from “another person” is poorly drafted and provides inadequate levels of protection to vulnerable New Zealanders. For example, the Act requires only one doctor (the first doctor to whom a request for euthanasia or assisted suicide is made) to only “do his or her best” to ensure that person requesting euthanasia has expressed their wish “free from pressure” by “any other person”.

The Royal New Zealand College of General Practitioners, the very doctors who are also going to be on the front line of the process, told Parliament they won’t be able to detect coercion or pressure in all cases with this test, and that there will be wrongful deaths under this law. To wit:

“The College … considers clause (h) where the medical practitioner is required to ‘do his or her best to ensure that the person expresses his or her wish free from pressure’ is problematic. As one member wrote: ‘It will prove impossible to determine if a patient is ‘free from coercion’. What criteria will doctors use to determine whether or not coercion exists? If patients request assisted death, there is no provision in the Bill as to what a doctor should do if she or he thinks that coercion is actually present. Coercion of patients will be impossible to discern in every request for assisted death. Doctors will not be 100 percent correct in their assessments of coercion. Wrongful deaths will be the result of this proposed new law.’”
READ MORE: https://www.newsroom.co.nz/underfunding-no-argument-for-assisted-dying

Dutch News 19 July 2020
Family First Comment: This is so disturbing. Apparently euthanasia is now a response to depression and mental illness…
“Govt research revealed that around 10,000 people over 55 have a serious death wish.”
#slipperyslope
Protect.org.nz

A Dutch MP has submitted a long-awaited bill to offer healthy Dutch over-75s the right to ask for euthanasia.

Pia Dijkstra, medical ethics lead for D66, promised to go forward with the controversial bill at the end of January, after government research revealed that around 10,000 people over 55 have a serious death wish.

But the bill proposal, handed in on Friday, is likely to stoke conflict in the government because the two Christian parties in the coalition are radically opposed to it.

Free vote
Although the right to choose death is supported in theory by Mark Rutte’s VVD, and a previous attempt at legislation in 2016 also had the support of the PvdA labour party and GroenLinks, it is unclear whether Dijkstra’s bill would win over the majority of MPs – which it would need, as it would be a free vote.

Her proposed law would mean healthy over-75s with a strong death wish for at least two months could have the assistance of an ‘end-of-life supervisor’ to die. But opponents of the law – including the KNMG Royal Dutch Medical Association – believe it could undermine the strict due care conditions of the existing euthanasia law, arguing that lonely and impoverished older people should have help, not the choice of an early death.

Benjamin Meijer, a spokesman for D66, told DutchNews.nl that his party had agreed with the coalition to wait for the publication of research into the group of older people who want help to die, and was then busy with the joint effort against the coronavirus.
READ MORE: https://www.dutchnews.nl/news/2020/07/euthanasia-law-proposed-for-healthy-over-75s-who-feel-their-lives-are-complete/

Media Release Euthanasia-Free NZ 20 July 2020
Family First Comment: Andrew Little (Minister of Propaganda) is up to his tricks again – this time on the euthanasia referendum. Shocking.
“The government’s summary misrepresents the End of Life Choice Act. It oversimplifies one of the eligibility criteria and overstates the protections against pressure.”

“The Government’s official information on the End of Life Choice Act referendum is misleading and biased,” says Renée Joubert, Executive Officer of Euthanasia-Free NZ.

“The government’s summary misrepresents the End of Life Choice Act. It oversimplifies one of the eligibility criteria and overstates the protections against pressure.”

Euthanasia doesn’t need to be a last resort

The flyer identifies one of the eligibility criteria as, “experience unbearable suffering that cannot be eased”.

“This statement is misleading, because it implies that a person would be eligible only if no treatment exists”, says Ms Joubert.

In reality, the Act states that an eligible person needs to “experience unbearable suffering that cannot be relieved in a manner that the person considers tolerable”.

“The Act would allow an eligible person to receive a lethal dose if they refused treatment. A person can refuse treatment that would relieve their suffering. The person would not even need to try the treatment. They would only need to say that they don’t consider it tolerable,” says Ms Joubert.

“Under the End of Life Choice Act, euthanasia doesn’t need to be a last resort.”

Weak protections against pressure

“The government flyer overstates the protections against pressure and does not use the wording from the Act”, remarks Ms Joubert.

“The flyer uses the heading, ‘Making sure the choice is freely made’. This phrase is not impartial nor factual, because the Act does not use this phrase and makes no such guarantee.

“Whether the Act’s clauses are sufficient to ‘make sure the choice is freely made’ is a matter of personal opinion, not fact,” she says.

The flyer goes on to state, “The doctor must do their best to make sure that a person’s choice to ask for assisted dying is their own.” This is an overstatement of what the Act actually requires.

The Act requires only one doctor to only “do their best to ensure the person expresses their wish free from pressure from another person”.

“What might ‘do their best’ mean to a busy doctor? It’s a subjective requirement that cannot be measured or enforced,” she says.

“The doctor doesn’t need to have met the person before and doesn’t need to speak to the person face-to-face. During an online consultation the person’s abuser could be sitting in the same room and pressuring them to request assisted dying without the doctor being aware of it.”

“The word ‘decision’ has a wider meaning than ‘express their wish’. A person could ‘express their wish’ free from pressure, even if their ‘decision’ to request assisted dying was influenced by pressure or abuse that occurred earlier. As many victims of psychological abuse know, a skilled manipulator can make a victim mistakenly believe that something is their own choice.”

Unlike the Australian, US and Canadian laws, the End of Life Choice Act does not require any independent witnesses.

No independent witnesses are required when the person expresses their wish; when they confirm their wish by signing a form; or when they receive the lethal dose.

“If a health professional put pressure on the person, their guilt could be impossible to prove. The only witness may be dead”, warns Ms Joubert.

The doctor is required to check for pressure by speaking to “health professionals who are in regular contact with the person” and to family members who are “approved by the person”.

“This is a very weak safeguard, considering the fact that many adults do not have regular contact with health professionals and do not live with family members.  Pressure from a boyfriend, girlfriend, caregiver, employer, friend, flatmate or neighbour could easily remain unreported.”

Only if the doctor or nurse practitioner suspects that a person is not “expressing their wish free from pressure from any other person”, do they need to stop the process.

“The only pressure acknowledged in the Act is pressure from another person. Nobody would be required to check for pressure coming from a group; or pressure due to poverty, homelessness, loneliness, depression; or pressure due to a lack of timely access to medical care or assisted living support.”

Ms Joubert laments, “A person who lacks the support they need will not be making a free choice.”

Conclusion

“The government’s summary does not represent the End of Life Choice Act accurately”, warns Ms Joubert. “We encourage the public to also read the Act for themselves.”

“This referendum is not about our personal views on whether euthanasia or ‘assisted dying’ should be legal in principle. We are not voting on a concept.

“We are voting on the details of a specific piece of legislation. Regardless of our personal views, each one of us needs to decide whether we support the finer details of this particular Act.”
ENDS

NewsHub 12 July 2020
Family First Comment: There are so many crucial points made in this piece that it’s difficult to know which bit to highlight. So take the time to read it all!
As Rhona Winnington – a registered nurse, sociologist and lecturer at the Auckland University of Technology (AUT) – concludes:
“We need to safeguard our families and communities from these social consequences of assisted dying legislation. Vulnerable populations have to remain safe from persuasion to die and there has to be a supportive framework for those left behind after an assisted death, so they can grieve without feeling stigmatised.”

When New Zealanders go to the polls in September, they will also be asked to vote in a referendum on assisted dying.

Parliament already passed the End of Life Choice Act in 2019, but the referendum will decide whether it comes into force.

We will be asked if we accept or decline the right of people to seek an assisted death, without the need for consultation with family and with no stand-down period other than a requirement of 48 hours to prepare the medication. The act would allow people to choose when they die and by what means, whether the medication is self-administered or given by suitably qualified clinicians.

This appears an ideal scenario, affirming the right to choose, but it is a deeply profound decision for the public to make. Many may be unaware of issues beyond the goal of ending suffering for people with life-limiting conditions.

My research shows an assisted death can have repercussions for many people – those left behind or others struggling with a chronic disease. Experiences from countries where assisted dying has been legal for some time have highlighted these challenges.

Social consequences of assisted dying

In the Netherlands, assisted dying has been legal for 18 years. Over time, there have been notable slips in the criteria that have to be met. This includes the level of physical suffering, which is a subjective experience, and the requirement that people must be competent to agree to an assisted death at the point of administration. This may not be possible for people with dementia who have previously given written consent but can no longer consent at the point of death.

While the law hasn’t changed, its interpretation has, and people with mental illness can now also request an assisted death. Data from the Netherlands show one in 30 people now die by euthanasia, compared to one in 90 when the law was introduced in 2002.

In the US, some medical insurance companies pay for an assisted death but not for palliative care. This removes any notion of choice and autonomy from the person.

In Canada, where assisted dying has been legal for four years, the number of people seeking medical help to die has risen significantly, with figures more than doubling year on year. This has exposed unexpected consequences, such as fear of judgement for leaving family members unsupported after an assisted death and stigmatisation of clinicians, whether or not they support people choosing the time of their death.
READ MORE: https://www.newshub.co.nz/home/politics/2020/07/euthanasia-referendum-why-new-zealand-s-law-lacks-necessary-detail-to-make-a-fully-informed-decision.html

NewsRoom 10 July 2020
Family First Comment: An important commentary….
“I read headlines stating the majority of public (63%) support legalising euthanasia, according to the poll. To the untrained eye, that looks like some strong evidence that the End of Life Choice Act (EOLC Act) is a done deal. But to me it just smacks of the same shallow approach to this vote that many are tempted into making. Hold that poll up against other polls that show 74% of Kiwis don’t know we can already turn off life support, 70% incorrectly think the EOLC Act will legalise the choice not to be resuscitated (which is already legal), and 75% thought it would only be available when all other treatments have been tried… so I wonder what information we are basing our poll voting on?

Most Kiwis aren’t aware that the end of life choice act is not a concept they’ll be voting for, but specific, unmovable legislation. And if we make a mistake, death is a heavy penalty, writes Caralise Trayes. 

A new Colmar Brunton poll revealed last weekend doesn’t do any favours in helping people recognise the binding referendum question they will actually be asked at this year’s election. It only reinforces the point that Kiwis aren’t being equipped to make an informed vote.

I read headlines stating the majority of public (63 percent) support legalising euthanasia, according to the poll. To the untrained eye, that looks like some strong evidence that the End of Life Choice Act (EOLC Act) is a done deal. But to me it just smacks of the same shallow approach to this vote that many are tempted into making.

Hold that poll up against other polls that show 74 percent of Kiwis don’t know we can already turn off life support, 70 percent incorrectly think the EOLC Act will legalise the choice not to be resuscitated (which is already legal), and 75 percent thought it would only be available when all other treatments have been tried… so I wonder what information we are basing our poll voting on?

Us Kiwis need to know we will in fact be voting on a very specific piece of legislation; not the concept of euthanasia. If we vote ‘yes’ in the binding referendum, the law is passed and active. No changes or adjustments can be made to this Act. So we should be examining the piece of law in front of us. However hard it is, we must put aside our view on the topic of assisted dying, and check this is the right law for the job.

We need to carefully assess and analyse this law to ensure it allows the autonomy to choose – something that many of us seek, while protecting those who shouldn’t have access, for one reason or another. And there’s no space for error – if we get it wrong, death is a big penalty.
READ MORE: https://www.newsroom.co.nz/no-room-for-error-on-assisted-dying

Radio NZ News 28 June 2020
Family First Comment: This new book is worth checking out…
“[This bill] is intended for very few, the extreme cases probably. I assumed that the people we would be offering this to would be in extreme pain. But internationally, where assisted suicide is legal the motivational reasons for people using this isn’t actually pain. In Oregon, 2019 research shows that the primary motivational factor for people choosing this: 90 percent of people use this because their life is no longer enjoyable, 59 percent are saying they’re worried about being a burden on other people, and only 33 percent are actually in pain, or they’re afraid of the pain.”

The End of Life Choice Act will be put to the vote in a referendum alongside the national election, and has already been a hot subject of debate as it made its way through parliament.

The difficult topic has been explored in a book by journalist Caralise Trayes: The Final Choice, which includes interviews with medical and legal experts, religious leaders, ethicists, and experts on the practice of voluntary euthanasia in other countries.

Trayes’ interest in the debate was pricked when she took a freelance job focused on a meeting where assisted dying was discussed.

“I came away thinking I know very little about this, but what I do know is I’m going to have to vote on this binding referendum and make a really difficult choice. We all come into this discussion and decision with our own personal experiences, what we’ve seen and how other people have died – and that’s a really hard thing to look through.

“So I did some research and the further I got into the issue the more I realised how intricate it is and how many levels there are to it. I came away with questions … and there’s so much misinformation and so much emotion out there, I think it’s hard to find good information to make sure you can make a good choice – it’s really to equip people to make good choices.”

Trays says she can’t call which direction the referendum will fall in September.

“I know that right now, somewhere between 58 and 74 percent of Kiwis sit very on the side of voting for it, but what I’ve also seen is that same proportion of people don’t know much about this.

“Seventy-four percent of people think that this assisted dying law will mean they can turn off life support – that’s already legal. We need to get equipped and educated to make a really informed decision – this is a big decision, this is life and death. It’s worthy of that time and commitment.”
READ MORE: https://www.rnz.co.nz/national/programmes/sunday/audio/2018752582/new-book-examines-assisted-dying-ahead-of-2020-referendum

Stuff co.nz 17 June 2020
Family First Comment: Significant concern for groups like Hospice NZ…
“The judge said hospices and other organisations could refuse to provide assisted dying services. But there also had to be a way for health practitioners to meet their obligations if asked by someone in the care of the hospice or organisation. It was not for the court to suggest ways those two positions could work together, the judge said. 
One of the questions was whether Crown funding for hospices could be declined if they were not offering assisted dying because of conscientious objection. The judge said questions about funding would have to await a case where the funding process was in issue.” 
And Hospice will pay the cost! Lose lose.

A judge says it’s too early to clarify how conscientious objection rights for assisted dying might work in hospices.

Hospice New Zealand, an umbrella organisation for all hospice services, wanted answers about how conscientious objection would operate if the End of Life Choice Act was accepted in the referendum in September.

It hoped the answers would help inform debate on the referendum, and it wanted voters to be clear what they were being asked to decide.

Hospice NZ was opposed to euthanasia or assisted suicide and a cornerstone of its care was to neither hasten nor postpone death.

It took a case to the High Court in Wellington asking for declarations on the legal position but Justice Jill Mallon said in general the questions could not be decided until the issues arose against particular facts.

A referendum on whether to put into force the End of Life Choice Act is to be run alongside the general election, and if the vote was “yes” the act would take effect a year after the result was declared.
READ MORE: https://www.stuff.co.nz/national/health/121860950/assisted-dying-conscientious-objection-questions-too-early–court

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TVNZ One News 15 June 2020
Family First Comment: Legalising euthanasia would simply exacerbate the potential threat to vulnerable people..
“most cases are psychological, with elderly socially isolated, bullied and humiliated…. the majority of abuse comes from family members”

Up to 10 per cent of people aged 65 and over experience some form of abuse in New Zealand.

Ki he kau poupou, kaunga maheni mo e kainga Tonga kotoa pe:
Malo e lelei! Koe’uhi ko e teuteu fakaha loto mahu’inga (referendum) ‘a e fonua ‘i Sepitema ‘o e ta’u ni fekau’aki mo e maliuana mo e ‘iufanesia, kuo mau teuteu’i ai ‘a e ngaahi tohi fakamatala mahino mo lelei ma’a hotau ngaahi famili, maheni mo e siasi fekau’aki mo e ongo kaveinga ni. Pea ‘oku ta’etotongi fokii!! ‘Oku ma’u atu ‘eni ‘i he WWW.REJECTASSISTEDSUICIDE.ORG.NZ/translations/ ke mou lau mo vahevahe atu!
“‘Uhinga ‘e 20 ke tali NO ki he ‘iufanesia”
Fakapapau’i ‘oku ke mahino’i ‘a e ongo kaveinga pea ke toki fili!
‘Ofa atu,

To our Tongan supporters and friends:
Malo e lelei. In preparation for the upcoming referendum on euthanasia, we’ve prepared the perfect resource for your families, friends and church groups.
And they’re free! Download them today – and share.
“20 Reasons to Vote No to Euthanasia”.