Justice minister defends assisted dying bill from critics as Senate committee starts hearings

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National Post 24 November 2020
Family First Comment: Apparently, there is no slippery slope – or so we are told.
Better rethink that one!
“[Canada’s Justice Minister David] Lametti also said he hopes the medical assistance in dying (MAID) regime will eventually be further expanded to people who are suffering solely from mental illness”

Justice Minister David Lametti told a Senate committee on Monday that he’s heard the fierce criticism of the government’s new assisted dying bill, which expands the regime to include people who don’t have a terminal illness.

The critics include disability rights organizations, palliative care experts, and even Jody Wilson-Raybould — the former justice minister who introduced the original assisted dying bill in 2016.

But Lametti said he believes the government has found the right balance in respecting the dignity of people with disabilities, and also their right to end their life if their suffering is too great.

Lametti also said he hopes the medical assistance in dying (MAID) regime will eventually be further expanded to people who are suffering solely from mental illness, but the government doesn’t have enough time to do it before a court-ordered deadline of Dec. 18 for this bill to pass.

Bill C-7 was introduced in response to a Quebec Superior Court ruling that found the original law, passed in 2016, unconstitutionally restricted MAID to those whose death was “reasonably foreseeable” — in other words, to patients with a terminal illness.

The bill creates a new MAID eligibility requirement for people who are deeply suffering, but who are not expected to die from their illness.
READ MORE: https://nationalpost.com/news/politics/justice-minister-defends-assisted-dying-bill-from-critics-as-senate-committee-starts-hearings
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Catholic clergy say assisted dying runs against core values, Islamic leader threatens Muslims who choose it with Hell

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NewsHub 9 November 2020
Family First Comment: Significant concerns from the Muslim community
“A Facebook post by FIANZ in the lead-up to the referendum identifies nine concerns in regard to the End of Life Choice Act – including that it may disproportionately affect Kiwi Muslims, many of whom are refugees and comparatively poor. “In cases of severe illness where health care costs are high and carers are scarce, members of the community could request euthanasia out of guilt… as a way of relieving the society of their burden,” FIANZ President Ibrar Sheik writes. “Persons in our community who are in extreme pain and clouded by depression, shock and grief could make irrational decisions… not giving themselves time for possible recovery or coming to terms with their condition. “Passing this legislation will be tantamount to saying to our terminally ill and disabled that their lives are less valuable to society than the youthful.””

Many religious Kiwis oppose the End of Life Choice Act for ethical reasons, citing concerns with a perceived lack of reverence for life and its implications for our most vulnerable citizens, while others support it on the grounds it relieves suffering. For Catholics and Muslims, however, the response to the referendum result has been almost unequivocal, as both religions explicitly condemn assisted dying. The Catholic Church issued a ‘Declaration of Euthanasia’ in 1980, condemning the procedure as a crime against both life and God, while a recent letter written by the Vatican’s doctrinal watchdog and endorsed by Pope Francis describes it as “intrinsically evil”. Meanwhile Islamic literature asserts that God decides how long each person lives, and explicitly prohibits planning or knowing one’s time of death in advance.

…’They will dwell in Hell forever’: Islamic leader says Qur’an is clear on euthanasia

One of New Zealand’s most senior Islamic leaders says while Muslims accept the referendum result, they’re disappointed in the country’s decision and will continue to oppose euthanasia. Mustafa Farouk, the executive of the Federation of Islamic Associations of New Zealand (FIANZ), said Muslims have the right to choose euthanasia – but they shouldn’t expect to be honoured at death by their faith community if they do so. In Islam, there are many rituals at the time of death. The deceased is bathed and shrouded in cloth, before receiving the Ṣalāt al-Janāzah – a funeral prayer that seeks pardon for the dead. The body is then buried with the head facing Mecca. Farouk said there still remains an obligation to ensure the deceased is buried if they opt for assisted dying, but indicated they would forfeit an Islamic funeral by doing so, telling Newshub a lot of people simply “would not attend”. “The Qur’an is very clear that we cannot take life – not only take the life of someone, but we can’t even take our own life. If anybody takes their own life, they will dwell in Hell forever. There is no grey area there whatsoever,” he said.

…. A Facebook post by FIANZ in the lead-up to the referendum identifies nine concerns in regard to the End of Life Choice Act – including that it may disproportionately affect Kiwi Muslims, many of whom are refugees and comparatively poor. “In cases of severe illness where health care costs are high and carers are scarce, members of the community could request euthanasia out of guilt… as a way of relieving the society of their burden,” FIANZ President Ibrar Sheik writes. “Persons in our community who are in extreme pain and clouded by depression, shock and grief could make irrational decisions… not giving themselves time for possible recovery or coming to terms with their condition. “Passing this legislation will be tantamount to saying to our terminally ill and disabled that their lives are less valuable to society than the youthful.”

Other religions are split on whether euthanasia is to be avoided or embraced.
For many other Christian denominations – as well as for those who practice Hinduism, Judaism, Jainism or Shinto – there is no consensus on euthanasia.
Some Hindus believe helping end a painful life is a fulfilment of their moral obligation, while for others it’s seen as a disturbance of the natural separation of body and spirit and a threat to the cycle of reincarnation.
READ MORE: https://www.newshub.co.nz/home/new-zealand/2020/11/euthanasia-referendum-catholic-clergy-say-assisted-dying-runs-against-core-values-islamic-leader-threatens-muslims-who-choose-it-with-hell.amp.html

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Referendum results live: NZ votes yes on euthanasia

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NZ Herald 30 October 2020
ACT leader David Seymour thanked MPs for supporting the End of Life Choice Bill through Parliament.

He also thanked Dame Jenny Gibbs for “giving me the courage as a young MP to pursue this cause”, Brooke van Velden for her work in rallying support in Parliament for the bill, and National MP Chris Bishop.

He said New Zealand would be “a kinder, more compassionate, more humane society – what a great day to be a Kiwi”.

David Seymour hosted an event at Parliament from 1pm that heard from Shirley Seales and, via Skype from New York, Matt Vickers – the mother and widowed husband of euthanasia campaigner Lecretia Seales.

Shirley Seales gave an emotional speech acknowledging her daughter’s legacy.

“I’m sure [Lecretia] would never have imagined that she would still be acknowledged for the part she has played. She would be very humbled and I know she would want others acknowledged.”

She paid tribute to Matt Vickers, several lawyers who advocated for the cause, and MPs including Seymour, Maryan Street and Michael Laws.

She said it had been “particularly upsetting to hear lies about Lecretia throughout the campaign”.

“I have been tempted to respond, but my greatest reward will be a majority vote. We are extremely proud of Lecretia, and I’m sure she is smiling down on us all.”

Today’s result marks the end of the five-year journey for Seymour since he first put the End of Life Choice Bill in the ballot.

The referendum is binding and the majority “yes” vote will see it become law, with terminal patients able to request assisted dying from November 6 next year.
READ MORE: https://www.nzherald.co.nz/nz/politics/referendum-results-live-nz-votes-yes-on-euthanasia-no-on-cannabis-legalisation/LBKXYT2QB5IZLLCZJ7EVM6D4SY/

‘The devil is in the detail’: Salvation Army concerned over loopholes in euthanasia legislation
Radio NZ News 31 October 2020
Vulnerable at risk
Family First say the success of the assisted dying bill will put some vulnerable people at risk. Spokesperson Bob McCoskrie said support for the law change lowered as the debate went on.

He said many people did not realise there is an amount of choice people have in their latter days, such as turning off life support, refusing treatment, upping pain management, and do -not-resuscitate orders.

Meanwhile, a top QC said the law legalising euthanasia is shrouded in so much secrecy it will be difficult to know if anyone has been pressured into ending their life.

Auckland barrister Grant Illingworth said two doctors must sign off on someone’s request to die, but there is no requirement for them to ensure that the person has not been pressured.

“The processes under the act are shrouded in confidentiality and secrecy so nobody is ever really going to know whether people have been bullied or pressured or whether something has gone wrong in the process.

“It’s a confidential process, it’s surrounded by secrecy so how do we know?”

He said the regulations fail to require doctors to satisfy themselves there’s no coercion of a patient.

The chair of Risky Law New Zealand said the law will compromise the capacity of doctors to show undivided care and compassion to patients.

Dr Peter Thirkell said the lack of safeguards remains a big concern, particularly where patients already feel a burden to others.

The group is calling on the government to fully fund palliative and hospice services so that intentionally killing some people in vulnerable circumstances becomes unnecessary.
READ MORE: https://www.rnz.co.nz/news/national/429542/the-devil-is-in-the-detail-salvation-army-concerned-over-loopholes-in-euthanasia-legislation

Referendum results: ‘Sad and dangerous’ day, say opponents to End of Life Choice Act
Stuff co.nz 30 October 2020
Family First national director Bob McCoskrie said some would be euthanised without a definitive prognosis. Others would request “assisted suicide” as a result of coercion, or because they could not afford treatment.

“Others will be struggling because of a terminal disease prognosis and actually just need appropriate support.

“This law now means that vulnerable people facing a terminal illness will be asking themselves – why should I not be accessing euthanasia?”

Opponents to the Act said there were already calls for it to be extended from pro-euthanasia advocates.

Many New Zealanders did not understand what they were voting for, and the outcome was based on misinformation and confusion, Euthanasia-Free NZ spokesman Renee Joubert said.

Polling during the voting period showed 80 per cent of New Zealand adults misunderstood what the End of Life Choice Act would legalise.

Only 20 per cent of respondents understood the Act would not make it legal to turn off machines that were keeping people alive – that was already legal.

“It’s disappointing that the New Zealand public were generally uninformed about the details of the End of Life Choice Act.”

Joubert said the group would continue to lobby against any extension to the law.
READ MORE: https://www.stuff.co.nz/national/health/euthanasia-debate/123245906/referendum-results-sad-and-dangerous-day-say-opponents-to-end-of-life-choice-act

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Huhana Hickey: I’m pro-choice – but I oppose the End of Life Choice Act.

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Where are the safeguards for Māori and the disabled in end of life law?
Stuff co.nz 1 November 2020
Family First Comment: I am a disabled Māori woman who lives with pain 24/7. That pain will progressively increase as I live on, and so I am very aware of the disparities that exist in our health and disability system.
I am also aware of how poverty and a lack of access to good medical interventions, such as the expensive cost of accessing medicinal cannabis, thanks to an inept Pharmac, lead to choices of desperation rather than a choice of free will.

OPINION: In 12 months assisted dying will be legal as, unsurprisingly, the mainstream demographic has predictably spoken with a 65.2 per cent yes vote in the preliminary results.

Congratulations to those who have had their wish granted and commiserations to those who haven’t. Whilst I am myself pro-choice, I remain opposed to this law for two reasons – those being the risk to indigenous people and the disabled, as evidenced by international research in countries where it is legal.

I am a disabled Māori woman who lives with pain 24/7. That pain will progressively increase as I live on, and so I am very aware of the disparities that exist in our health and disability system.

I am also aware of how poverty and a lack of access to good medical interventions, such as the expensive cost of accessing medicinal cannabis, thanks to an inept Pharmac, lead to choices of desperation rather than a choice of free will.

There are also issues with defining terminal and many, it seems, wrongly assume disabled won’t be affected without realising many disabilities by their very nature are terminal.

Therefore, trying to stop the voices of our disabled has led to some incorrect assumptions and misunderstanding as to why many of us have spoken out against THIS particular act.

It is poorly drafted and lacks safety mechanisms.
READ MORE: https://www.stuff.co.nz/national/health/euthanasia-debate/300146508/where-are-the-safeguards-for-mori-and-the-disabled-in-end-of-life-law?cid=app-iPhone

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Euthanasia Law Will Be A Danger To The Vulnerable

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Euthanasia referendum: Disabled New Zealanders concerned about assisted dying Act

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 


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

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

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

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

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

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

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

“That is a real struggle,” Ensor said.

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

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

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NZ Herald 3 October 2020
Family First Comment: Well said, John…
“If we vote “yes” in this referendum, we will establish the principle that there is something people can do about it when they become a heavy burden to others. They would have an end-of-life choice. And when they consider how unpleasant caring for them must be, how many would make that choice not because they really want to die but because they think they ought to? We will never know but I think the number would exceed those who made a truly free choice.”
Protect.org.nz

A referendum is a big decision. Unlike electing a government, it is not a decision you get to make again in three years. When a question is put to a referendum it is unlikely ever to be asked again. The die is cast, the direction set.

We have two referendums with this election, one that matters, to my mind and one that does not. Let me concentrate on the important one.

A few years ago I mentioned to a long-time Herald columnist, the late Gordon McLauchlan, that I was thinking of writing on the end of life choice and he made only one comment. He said, “Anyone who thinks euthanasia is a simple question is very foolish.”

A lot of people seem to think it is a simple question, a simple issue of individual rights. If someone wants to die at a time of their own choosing, they say, it is simply nobody else’s business. Their death would not harm others, so why should we deny them the right?

There are several reasons, here is the one that most worries me.

Imagine you have become a “burden” to other people, either because you are very old, very ill or permanently disabled. You don’t want to be a burden, nobody does. You hate having to rely on another person for your most intimate bodily care and you know how unpleasant it must be for the person giving you that care.
READ MORE: https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=12369645

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The price of the euthanasia law is too high

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Stuff co.nz 27 September 2020
Family First Comment: Well said, Maggie Barry
“As the Minister for Seniors for three years, I was horrified at the extent of the scourge of physical, psychological and financial elder abuse.”

OPINION: If people want different choices at the end of their lives, the End of Life Choice Act is not the law change to provide it.

The risks and lack of safeguards to protect the vulnerable is too high a price to pay.

Before New Zealand pushes the nuclear button to legalise euthanasia and assisted suicide, we need to ensure that everyone who needs gold-standard palliative care can access it.

Tragically, too many people have suffered through inadequate pain relief and have experienced difficult deaths.

We need to do better.

Legally, right now, dying people and their families already have the choice to turn off life-support, to refuse any treatment, to have a ‘do not resuscitate’ order and to be given palliative pain medication, such as morphine, that may hasten death.

Under this legislation, if a patient asks a doctor about assisted dying, the GP is explicitly prohibited, at risk of prosecution, to offer counselling and treatments. They are required instead to advise the patient they are not obliged to talk to anyone in their family and to refer them to a list of 12 Doctors – appointed by the Ministry of Health – who are supporters of euthanasia, and ‘willing to act’.

The vast majority of medical practitioners who came before the select committee don’t want to be part of administering lethal drugs; they want to care for their patients, not kill them.
* Maggie Barry was deputy chair of the Justice Committee which considered the End of Life Choice bill in 2018
READ MORE: https://www.stuff.co.nz/opinion/300117427/the-price-of-the-euthanasia-law-is-too-high

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Euthanasia referendum: Anti-euthanasia doctor slams David Seymour’s ‘disgraceful’ questioning of her motives

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NewsHub 26 September 2020
Family First Comment: “That’s a disgraceful, sectarian comment. I have 25 years of experience in palliative medicine, I speak from a professional point of view, I’m an associate professor of palliative medicine, research and education, I’ve worked in four different countries – so I speak from that platform and that experience. I deeply care for people – that’s all I care about. Four generations of doctors in my family… I know we can relieve their suffering through palliative care. Palliative care works.” She said Seymour’s comments were “bigotry at its utmost”. 
Yep

A televised debate on the upcoming euthanasia referendum turned nasty, when one participant accused the other of basing her objections on religion, not facts.

Voters next month will decide whether to make ACT leader David Seymour’s End of Life Choice Act the law in a binding referendum.

Seymour appeared on Newshub Nation on Saturday morning with Sinead Donnelly, a palliative care doctor and strong advocate against making assisted dying legal.

Dr Donnelly says the End of Life Choice Act is a “dangerous law” that will put the lives of 25,000 vulnerable people at risk, whilst Seymour says it will give people a choice to die with dignity, and there are numerous checks and balances to prevent it being abused.

“I’ve travelled literally from Kerikeri to Gore campaigning for this law,” Seymour explained.”I’ve heard the stories of New Zealanders who have seen bad death. No matter how much people try to say ‘just a bit more palliative care, it’s going to be okay’ they know what they’ve seen. They want to have that choice of dignity and control.

“It’s their life – it should be their choice. It’s not up to others to tell them that they should stick around a bit more to fit someone else’s morality.”

Dr Donnelly went over some of the common objections to the proposed law, including fears people will be coerced into ending their own lives and that some people make miraculous recoveries after being close to death.

“Prognostication is an estimate… we get it wrong most of the time. Even within a few days of death. Families often ask ‘how long have they got to live?’ We generally say we’re not sure, we don’t know… It’s not as if we plug in the patients details into a computer and out pops a date of death.”

Seymour fired back with the usual defences of his Act – it has checks and balances, is a long process that gives people time to get better or change their minds, for example – before accusing Dr Donnelly of being dishonest about the real motive for her objections.

“I think that it would be a lot more respectable if instead of making up these kinds of what I call ‘false objections’ if Dr Donnelly came here and said ‘this choice is against my religion, and I don’t want other people to be able to make that choice’. It would be a lot more respectable if she would say that.”

Dr Donnelly was visibly shocked.

“That’s a disgraceful, sectarian comment. I have 25 years of experience in palliative medicine, I speak from a professional point of view, I’m an associate professor of palliative medicine, research and education, I’ve worked in four different countries – so I speak from that platform and that experience.

“I deeply care for people – that’s all I care about. Four generations of doctors in my family… I know we can relieve their suffering through palliative care. Palliative care works.”

She said Seymour’s comments were “bigotry at its utmost”.
READ MORE: https://www.newshub.co.nz/home/politics/2020/09/euthanasia-referendum-anti-euthanasia-doctor-slams-david-seymour-s-disgraceful-questioning-of-her-motives.html
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Euthanasia’s clash with Pacific worldview

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NewsRoom 25 September 2020
READ MORE: https://www.newsroom.co.nz/ideasroom/euthanasias-clash-with-pacific-worldview

For Pacific people, the End of Life Choice Act 2019 is a direct challenge to their basic beliefs about life and death. The Act seeks to balance the need to avoid pain and suffering by people with terminal illness while safe guarding them against unscrupulous individuals and practices taking advantage of vulnerable people.

Pacific people in particular will be dismayed and disappointed by this seemingly callous and casual approach to the end of human life. The majority of the Pacific people are Christians and believe human life is sacred, a gift from God to be respected and protected at all costs. This is called the sanctity of life. The Bible teaches that human beings are created in the image of God, that murder is forbidden and only God can make decisions about life and death.

Family First Comment: “For Pacific people, the End of Life Choice Act 2019 is a direct challenge to their basic beliefs about life and death. The Act seeks to balance the need to avoid pain and suffering by people with terminal illness while safe guarding them against unscrupulous individuals and practices taking advantage of vulnerable people.”

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Legalising assisted dying can actually increase suicides

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MercatorNet 17 September 2020
Family First Comment: “I used to believe that it was possible to regulate and restrict killing to terminally ill mentally competent adults with less than six months to live. I also thought that regulating suicide and death in this way would curtail those tragic cases where someone ends their own life. I was wrong. If there is one thing I learnt in my country, it is that legalising assisted dying will not constrain the numbers. Deep down, many campaigners consider the legalisation of assisted dying for terminal patients merely as a stepping stone towards further liberalisation.”

Recently I addressed a group of Parliamentarians in London about assisted suicide and euthanasia. My talk, which coincided with World Suicide Prevention day, sought to address the unintended consequences of legalising assisted suicide and euthanasia in the Netherlands.

One of the arguments we hear is that assisted dying will bring down the number of violent suicides. It will provide a more peaceful death to patients in unbearable suffering who would otherwise have violently killed themselves. For other patients, the mere option of assisted dying (even if it will never be effectuated) is said to be a reassuring thought that will keep them from killing themselves.

I admit that these arguments may hold in individual cases. However, on the whole, the argument is mistaken.

In the Netherlands, assisted dying gradually became available for patients commonly considered to be at risk of committing suicide: psychiatric patients, people with chronic illnesses, dementia patients, and elderly people without a terminal disease.

But instead, the suicide numbers went up: from 1,353 in 2007, they went up to 1,811 in 2019, a rise of 33.8 percent. In surrounding countries, most of which have no assisted dying practice, the suicide numbers went down. Germany, with a population much like the Dutch in terms of age, economy, and religion, saw its suicide numbers decrease by 10 percent in the same period.

One hypothesis I increasingly accept as an academic and as someone who worked for almost ten years in monitoring and reviewing assisted dying cases for the Dutch authorities is the normalising effect that legalising assisted dying has had on the general population.

We already know from the literature that when one person takes their own life, it can be a catalyst for others. Indeed, there are over 50 peer-reviewed studies reaching the same conclusion in what has been dubbed suicide contagion, copycat suicides or the Werther Effect. Not without reason, and based on advice from the World Health Organisation, the media go to great lengths to censor details that could trigger further suicides. Unfortunately, the same can’t be said about their carefulness when reporting assisted suicide stories, the great majority of which express an ill-informed and naïve sympathy for assisted dying.

The Netherlands should act as a cautionary tale to those in power in the UK. Like many of the current supporters of assisted dying, I used to believe that it was possible to regulate and restrict killing to terminally ill mentally competent adults with less than six months to live. I also thought that regulating suicide and death in this way would curtail those tragic cases where someone ends their own life.

Theo Boer is Professor of Health Care Ethics, Protestant Theological University, Groningen, the Netherlands, and visiting Professor of History of Ethics, University of Sunderland
READ MORE: https://mercatornet.com/legalising-assisted-dying-can-actually-increase-suicides/66597/
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