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A recommendation from the Ministry of Health’s latest review of the End of Life Choice Act is calling for the gag clause, i.e. the protective measure that restricts doctors from raising assisted dying with patients to be changed. This is one of 23 recommendations made by MOH to strengthen the current law. The ministry recommended that the law be amended so health practitioners could raise assisted dying — but only as part of discussions about a person’s treatment and end-of-life care options. Euthanasia advocates in favour of this law change argue that doctors managing a patient’s palliative care should be able to discuss assisted dying with patients as it aligns with giving patients information and is different to a doctor making recommendations. International evidence would say otherwise regarding coercion and decision at such a vulnerable time in a patient’s life.

On the contrary, groups and individuals such as the Disability Rights Commissioner and the Australia and NZ Society of Palliative Medicine want this law to remain unchanged as it addresses the power imbalance between a doctor and patient and reduces any perception of coercion.

The ministry’s statutory review, presented to Parliament last week, made 23 recommendations, citing the law was generally working well and that there had been no wrongful deaths among the 978 people who had gone ahead with the procedure. Ironically, the Herald reported last month that two former members of the committee felt the oversight process was so inadequate they would not have known if someone had died wrongly.

The MOH report also recommended more powers for the End of Life Review Committee, which is tasked with ensuring each assisted death complied with the law. It said the committee should be able to access a broader range of information and be able to raise any concerning cases with relevant authorities.

Act MP Todd Stephenson has drafted a member’s bill which focuses on one aspect of the law — a requirement that a patient have six months to live to get access to assisted dying. Stephenson said he would consider re-drafting his bill to include some of the ministry’s recommendations, including the removal of the “gag clause” – i.e. a protective measure that safeguards both doctors and patients.

Original article

New research highlights significant gaps in paediatric palliative care services in New Zealand, with children facing inequitable and inadequate support. Currently, Starship Children’s Hospital in Auckland is the only provider of a publicly funded specialist paediatric palliative care service, and the service is small and vulnerable due to workforce pressures and a lack of additional funding.

Each year, about 350 children (aged 19 and under) die of serious illness in New Zealand, and a much larger group could benefit from specialist palliative care. International research suggests that with advanced medical technology, the number of children living with life-limiting conditions is expected to triple in the next decade. However, the workforce of trained paediatric palliative care professionals is insufficient to meet the growing need. As a result, many children and families are missing out on essential care, which has serious consequences for their well-being.

A report commissioned by the Ministry of Health in 2012 recommended the establishment of a nationwide service supported by Starship, with funded clinicans in each district. A group in Wellington has started a donation-funded paediatric palliative care service, but the researchers emphasize that a nationwide, publicly funded service is needed to ensure all children, including Māori, receive quality, compassionate care. They call for more investment in training and resources to build a workforce capable of meeting the demand.

Full story found here https://www.rnz.co.nz/news/national/533164/poor-care-for-dying-children-in-most-regions-report-shows

Authorities in northern Switzerland have detained several individuals and opened a criminal investigation following a suspected assisted suicide involving a controversial device known as the “Sarco” capsule. This 3D-printed capsule is designed to allow a person to self-administer a lethal dose of nitrogen gas in a sealed chamber, leading to death by suffocation.

Exit International, the organization behind the Sarco, reported that a 64-year-old woman from the U.S. died using the device near a forest cabin in Merishausen. The group claimed her death was “peaceful, fast and dignified.” However, Swiss law stipulates that assisted suicide must be carried out without external assistance, and authorities are investigating possible incitement and accessory to suicide.

Prosecutors in Schaffhausen had previously warned the operators of the Sarco that using the device could lead to criminal charges, and regional officials indicated that its operation might violate product safety and chemicals laws.

The Swiss Interior Minister Baume-Schneider, taking questions in parliament on Monday, said:

“The Sarco suicide capsule is not legally compliant. Firstly, it does not meet the requirements of product safety law and therefore cannot be placed on the market. Secondly, the corresponding use of nitrogen is not compatible with the purpose article of the Chemicals Act,” she said.

The situation has sparked debate over the legality of such devices in Switzerland, which allows assisted suicide but does not permit euthanasia. In 2020, approximately 1,300 assisted suicides were recorded in the country, highlighting its unique position in the world regarding end-of-life choices.

Original story published here

Disturbing Data In Latest “Assisted Dying” Report

Media Release: 5 September 2024

The latest review of assisted suicide / euthanasia was quietly released last month by the Ministry of Health – but it should sound significant and loud warning bells about the law, especially at a time when proponents want it to be liberalised even further.

Family First has analysed the Registrar (assisted dying) Annual Report June 2024. Key findings include:

• 5% increase in assisted deaths in the last 12 months. [2022 66 (5 mnths), 2023 328, 2024 344]
• 11% increase in applications.
• 83% NZ European/Pākehā. Pasifika <0.5%. Māori <4%. Asian 2%. Other 12%.
• 60% aged 65-84. 19% 85+. 19% 45-64.
• Virtually even split between male and female.
• 12% of applicants had a disability.
• 258 applicants died before ‘needing’ euthanasia.
• The application process averages only 16 days.
• Less than 7% of applicants are for neurological conditions (such as Huntington’s Disease).

What is most disturbing is that one in four applicants weren’t receiving palliative care. The End of Life Choice Act only provides a ‘right’ to one choice – premature death. There is no corresponding right to palliative care. Good palliative care and hospice services are resource intensive; euthanasia would be cheaper. As has also been observed overseas, notably in Canada, there is a new element of ‘financial calculation’ into decisions about end-of-life care. This is harsh reality. At an individual level, the economically disadvantaged who don’t have access to better healthcare could feel pressured to end their lives because of the cost factor or because other better choices are not available to them. Some hospitals have no specialist palliative care services at all.

The NZ Herald recently reported: “A specialist paediatric palliative care (PPC) doctor says New Zealand is falling behind other nations in its care of terminally ill children and the Government must step up to help.” And the demand for this specialist medical care will only increase significantly in the near future. Our population is ageing, and therefore the number of people requiring palliative care is forecast to increase by approximately 25% over the next 15 years and will be more than double that by 2061.

Previous Governments have made little effort to address this growing problem and to increase funding for palliative care, and essential service. Euthanasia is instead given priority and full Government funding.

The other significant red flag in the report is that just 1% of applicants had a psychiatric assessment to check for both competence to make the decision, and for any presence of coercion. 99% of applicants were not assessed for these.

That so few patients are referred raises serious questions around the competency of doctors involved in euthanasia, and also implies either key psychological signs are being ignored – or missed.

Many patients who are facing death or battling an irreversible, debilitating disease are depressed at some point. However, many people with depression who request euthanasia overseas revoke that request if their depression and pain are satisfactorily treated. If euthanasia or assisted suicide is approved, many patients who would have otherwise traversed this dark, difficult phase and gone on to find meaning in their remaining months of life will die prematurely.

The unspoken reality is also that terminally ill people are vulnerable to direct and indirect pressure from family, caregivers and medical professionals, as well as self-imposed pressure. 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. It is virtually impossible to detect subtle emotional coercion, let alone overt coercion, at the best of times.

This latest data simply confirms that nothing in the law guarantees the protection required for vulnerable people facing their death, including the disabled, elderly, depressed or anxious, and those who feel themselves to be a burden or who are under financial pressure.

Family First is also deeply concerned by comments by Associate Minister of Health David Seymour who is overseeing the review of the law. He recently stated on RNZ:

“The statutory review is being the Ministry of Health right now. I believe, without pre-empting what it will say, that it will give a lot of weight to making change.” 

It is deeply disturbing that a Minister would campaign and potentially unduly influence an independent review with this type of commentary.

It’s time we focused on and fully funded world-class palliative care – and not a lethal injection.

We can live without euthanasia.

DOWNLOAD OUR FACT SHEET ON THE LAW https://familyfirst.org.nz/wp-content/uploads/2021/06/Euthanasia-Fact-Sheet.pdf