Distressing death warning for ‘unregulated’ euthanasia drugs

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Radio NZ News 20 April 2021
Family First Comment: Here comes a flawed dangerous regime with unintended adverse consequences (which the public weren’t fully informed about)…
“There have been concerns expressed internationally over … the concoction of medication that is used, that in some cases, has led to traumatic end of life experiences,” 

Patients requesting euthanasia will be given unapproved, unregulated and “off label” medicines, sparking warnings of prolonged and distressing deaths.

People who chose to swallow or ingest the fatal medicines, rather than taking them intravenously, would be given drugs that were compounded (mixed up) by a pharmacist and provided to the patient without being approved by regulator Medsafe.

The Ministry of Health said those who opted for an injection would be given drugs which had been approved by Medsafe but for a different purpose – so the medicines will be provided for an unapproved, or “off label”, use.

Hundreds of pages of documentation, much of it heavily redacted, has been released under the Official Information Act to RNZ as part of an investigation into how prepared New Zealand is to introduce assisted dying.

Among the documents is an email from Dr Bryan Betty, medical director at the Royal New Zealand College of GPs, warning that mixing concoctions of drugs had led to traumatic deaths.

Dr Betty’s warning to the Ministry of Health used the example of American states not being able to access death penalty drugs due to cost and availability.

“So they made up their own concoctions initially, with examples of prolonged processes until fine-tuned. Belgium had a standard process but (this was) not used by many doctors for some years, also resulting in prolonged, distressing deaths.”

Betty said it was important to develop strong guidelines to avoid these situations.

“There have been concerns expressed internationally over … the concoction of medication that is used, that in some cases, has led to traumatic end of life experiences,” he said.

“I think we need to mitigate those risks upfront and be very prescriptive about what could be used and an end of life situation,” he said.
READ MORE: https://www.rnz.co.nz/news/in-depth/440824/distressing-death-warning-for-unregulated-euthanasia-drugs
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Government agrees people with mental illness should have access to euthanasia (Canada)

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The Canadian Press 23 February 2021
Family First Comment: No slippery slope?
Dream on.

The Trudeau government has agreed with the Senate that Canadians suffering solely from grievous and irremediable mental illnesses should be entitled to receive medical assistance in dying — but not for another two years.

The two-year interlude is six months longer than what was proposed by senators.

It is one of a number of changes to Bill C-7 proposed by the government in response to amendments approved last week by the Senate.

The government has rejected another Senate amendment that would have allowed people who fear being diagnosed with dementia or other cognitive-impairing conditions to make advance requests for an assisted death.

It has also rejected one other amendment and modified two others in a motion that was debated Tuesday in the House of Commons.

Justice Minister David Lametti told the Commons he believes the response to the Senate amendments is “fair and realistic.”
READ MORE: https://www.msn.com/en-ca/news/canada/government-agrees-people-with-mental-illness-should-have-access-to-maid-%E2%80%94-in-2-years/ar-BB1dW37m

This is video three of a series of messages directed at jurisdictions debating the legalization of euthanasia and assisted suicide. Consider Canada’s experience.

Alex Schadenberg, Executive Director of the Euthanasia Prevention Coalition, speaks about the Truchon decision (2019) and Bill C-7 (passed into law on March 17, 2021) and how they changed the euthanasia law.

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Euthanasia: What happens if the drugs don’t work?

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Radio NZ News 30 March 2021
Family First Comment: This is the danger of putting politicians in charge of a medical issue….
Palliative care professor Rod MacLeod said ending a life was not always a simple matter. “I think the public has this idea that assisted dying is quite clear cut – you take the drugs and you’re dead. But death doesn’t necessarily follow within minutes or even hours, it can take a lot longer and well documented cases of stuff not working.”

What happens if a patient doesn’t die during a euthanasia attempt? That’s one of a number of ethical and legal questions being asked by palliative care experts who say we are woefully unprepared to introduce assisted dying.

Senior nursing leaders are also concerned New Zealand won’t be ready when the law takes effect on 7 November.

The nurses union said its request for legal advice had been ignored by the Ministry of Health and nurses fear they could face disciplinary action and be struck off if they go too far discussing euthanasia with a patient.

Palliative care professor Rod MacLeod said ending a life was not always a simple matter.

“I think the public has this idea that assisted dying is quite clear cut – you take the drugs and you’re dead,” MacLeod said.

“But death doesn’t necessarily follow within minutes or even hours, it can take a lot longer and well documented cases of stuff not working.”

It was not yet known which drugs would be used for euthanasia in New Zealand and under the law it would be an offence punishable by a fine of up to $20,000 to reveal the method by which the drugs were administered to the patient.

“You assume that it’s the same as the United States [which] uses for lethal injections for the death penalty,” MacLeod said.

“We know that doesn’t always work. It’s not always that comfortable. It’s not like flicking a switch.”
READ MORE: https://www.rnz.co.nz/news/in-depth/439441/euthanasia-what-happens-if-the-drugs-don-t-work
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Fears euthanasia training will just be online course

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Radio NZ News 29 March 2021
Family First Comment: “Palliative care specialists fear health practitioners with as little as six hours online training could end up providing euthanasia for patients who would have wanted to live if they had proper care and pain relief. And a new Ministry of Health survey reveals fewer than a third of health practitioners are prepared to participate in the assisted dying regime.”
Euthanasia. Not needed. Not safe. Not supported.

Palliative care specialists fear health practitioners with as little as six hours online training could end up providing euthanasia for patients who would have wanted to live if they had proper care and pain relief.

Their concerns come as a new Ministry of Health survey reveals fewer than a third of health practitioners are prepared to participate in the assisted dying regime.

Palliative care specialists say that might mean euthanasia is unavailable in some areas and a small band of itinerant doctors with no connection to their patients may do the bulk of the cases.

Palliative Care professor Rod MacLeod said nearly every week that he spent working in hospice care he was approached by someone who wanted to end their life – but during his 32-year career all but one of those people changed their minds.

“I’ve had lots and lots of people ask me for assisted dying. But with palliative care provided those requests melt away.”

He said that meant that under the euthanasia regime people who would have changed their minds could be put to death.

Palliative care specialists say most people skilled in end of life care don’t want to be involved in euthanasia.

But a Ministry of Health survey of nearly 2000 health practitioners shows that, while almost half supported assisted dying in principle, fewer than 30 percent were “possibly or definitely” willing to provide the service.
READ MORE: https://www.rnz.co.nz/news/national/439361/fears-euthanasia-training-will-just-be-online-course

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Med students become more opposed to euthanasia while at uni

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Stuff co.nz 15 March 2021
Family First Comment: No surprises in this trend…
Support for euthanasia fell over each year of medical training: 64% in support in second year plummeting to 39% in fifth year.
“Ending a life was “contrary” to what med students were trying to become… Their whole orientation is to try and make things better, and ending a person’s life doesn’t feel that way.”
Exactly.

Medical students become more opposed to euthanasia as they progress through medical school, a new study has found.

Almost 65 per cent of second year medical students at Otago University supported euthanasia or assisted dying, compared with 39 per cent in fifth year, the researchers found.

Support for the practice fell over each year of training: 64.8 per cent in support in second year, 62.6 per cent in third year, 51.5 per cent in fourth year and 39.1 per cent in fifth year.

“We suggest that this difference is most likely due to their time in medical education,” concluded Luke Nie​ and Simon Walker​, along with two other Otago researchers.

First and second year students see few patients and their views mirrored the results of the End of Life Choice referendum held last November – 65 per cent in favour of legalisation, 34 per cent opposed.

By fifth year, however, med students are seeing lots of patients and are “confronted… by the complexities” that can come up in end-of-life situations, he said.

Otago med students are taught palliative medicine and end-of-life care as a “vertical module” throughout most of their education. They also get bioethics courses, although those are mostly identifying issues and enabling students to think for themselves, Walker said. He is a bioethicist and teaches some of these neutral classes.

Professors, doctors and nurses with strong views on euthanasia also probably made impressions on the students, he said.
READ MORE: https://www.stuff.co.nz/science/124506016/med-students-become-more-opposed-to-euthanasia-while-at-uni

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Belgian euthanasia study – Legal requirements are undermined or ignored

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Euthanasia Prevention Coalition –  5 February 2021 – Alex Schadenberg
Family First Comment: Belgium’s experience warns us of what is likely to happen here:
“The study points out that there is a yearly increase in the number of euthanasia deaths, but the number of actual euthanasia deaths is unknown due to high percentage of unreported euthanasia deaths… Euthanasia has become more common for people over the age of 80 who live in nursing homes.… All people should be concerned about how the legal requirements of the euthanasia law that are intended to operate as safeguards and procedural guarantees in reality often fail to operate.”
Disturbing.

A study by Belgian researchers and published in the Journal of Medicine and Philosophy on January 25, 2021, examines the practise of euthanasia in Belgium and concludes that legal requirements are being undermined and safeguards ignored. The study concludes that:

there are shortcomings in the Belgian euthanasia law, the application of that law, and the monitoring of euthanasia practice. This leads us to conclude that several of these shortcomings are structural and thus require more than simply increased oversight.

The study was conducted by Kasper Raus, Bert Vanderhaegen and Sigrid Sterckx from Ghent University and examines the official Belgian euthanasia data within the context of other studies that examine the application of the Belgian euthanasia law. This study is done by Belgian researchers who have been examining the Belgian euthanasia data for many years. One may disagree with the conclusion of the study but the data is impeccable.

Looking at key issues.
The study points out that since euthanasia was legalized in 2002 in Belgium, the debate on the issue has continued. There has been several legislative proposals to change the law since 2002. The study states:

All but two proposed amendments were voted down. The Euthanasia Law was first amended in 2005 to provide legal protection for pharmacists dispensing the lethal medication for the performance of euthanasia (Law of 10 November 2005). In 2014, the Euthanasia Law was amended again, this time to allow euthanasia for minors who are judged to have “capacity for discernment,” without setting an age limit (Law of 28 February 2014).

The study points out that there is a yearly increase in the number of euthanasia deaths, but the number of actual euthanasia deaths is unknown due to high percentage of unreported euthanasia deaths.
READ MORE: http://alexschadenberg.blogspot.com/2021/02/study-belgian-euthanasia-law-is-out-of.html
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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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