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Why I changed my mind on euthanasia

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NewsRoom 27 May 2019
Family First Comment: “The turning point for me came about a month ago. I saw the report of a meeting hosted by disabled people’s organisation, People First (a group run by and for people with learning/intellectual disabilities) in the Central North Island. At that meeting, access to health care was discussed, as this is a key issue – particularly for people within this segment of the disability community – for whom find it difficult accessing care for many reasons, including attitudinal issues on the part of some medical professionals. This was exemplified by the stories shared at the meeting where some people – who had gone to hospital for treatment – had discovered upon reading their files that they had ‘no resuscitation’ orders attached to them. More problematically, these orders had not been requested by any of the disabled people or their families.”
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Chris Ford explains why he’s now firmly in the ‘no’ camp on the voluntary euthanasia legislation

Last Wednesday, David Seymour’s End of Life Choice Bill (EOLC) was scheduled to come before Parliament for its second reading. However, thanks to some filibustering, it’s been delayed until the next Private Member’s Day when non-government bills are dealt with.

Whatever the reasons for the delay, it’s given opponents of the legislation more time to present good arguments to the public as to why the legislation needs to be defeated. This delay also presents me with a good opportunity to say I’ve changed my mind on it and am now firmly in the no camp.

I know that this will put me in the same column as Christian conservatives who also oppose the legislation for moral reasons. Personally, this makes me feel very uneasy given that I hold otherwise progressively social liberal views on issues such as abortion and reproductive rights, LGBTI rights, women’s issues and indigenous issues, etc. Yet, I want to outline from a socialist, progressive and disability rights perspective as to why I have swung my support to the anti-euthanasia camp.

The turning point for me came about a month ago. I saw the report of a meeting hosted by disabled people’s organisation, People First (a group run by and for people with learning/intellectual disabilities) in the Central North Island. At that meeting, access to health care was discussed, as this is a key issue – particularly for people within this segment of the disability community – for whom find it difficult accessing care for many reasons, including attitudinal issues on the part of some medical professionals. This was exemplified by the stories shared at the meeting where some people – who had gone to hospital for treatment – had discovered upon reading their files that they had ‘no resuscitation’ orders attached to them. More problematically, these orders had not been requested by any of the disabled people or their families.

Personally, this brought home to me one of the key arguments of the anti-euthanasia camp: that people who are already marginalised or devalued (such as older and disabled people) would be at high risk from euthanasia. The pro-euthanasia lobby would counter that people will have the right to exercise real legal choice and that the rights of vulnerable people would be better protected within the EOLC once it goes through the remaining stages of the parliamentary process. In stating this, I acknowledge that when the legislation returns that Seymour is preparing to remove the ‘irremediable conditions’ clause, which was one of my genuine concerns with it.

The way in which society views disabled people is still largely negative and any introduction of euthanasia laws might further diminish our standing in the eyes of wider New Zealand society.

Chris Ford is a Dunedin-based writer and researcher who focuses on disability, economic and social issues and proudly identifies as a disabled person.
READ MORE: https://www.newsroom.co.nz/2019/05/27/602948/why-i-changed-my-mind-on-euthanasia

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Euthanasia bill ‘goes against the ethics of our profession’ – Medical Association chair says

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TVNZ One News 22 May 2019
Family First Comment: “Doctors are still the ones that would be involved in assisting people to die. It goes against what a doctors role is,” Dr Baddock says. She says the reason the Medical Association is opposed to the Bill in its entirety is that it doesn’t address the social issues it needs to. “Particulary those of coersion, competence and vulnerability. It doesn’t protect the vulnerable, the weak, the lonely, those in pain and those that are suffering. It doesn’t protect them from a wrongful death.” She says elder abuse is happening and this Bill only encourages it.
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Newly proposed amendments to the End of Life Choice Bill, which is set to have its second reading in Parliament, have been strongly rejected by the New Zealand Medical Association, with its chair saying it “goes against the ethics of our profession”.

Dr Kate Baddock told TVNZ1’s Breakfast this morning under the new bill doctors would still be the ones administering the injection for those choosing to end their life through voluntary euthanasia.

“Doctors are still the ones that would be involved in assisting people to die. It goes against what a doctors role is,” Dr Baddock says.

She says the reason the Medical Association is opposed to the Bill in its entirety is that it doesn’t address the social issues it needs to.

“Particulary those of coersion, competence and vulnerability. It doesn’t protect the vulnerable, the weak, the lonely, those in pain and those that are suffering. It doesn’t protect them from a wrongful death.”

She says elder abuse is happening and this Bill only encourages it.

“Apparently approximately 50 per cent of those who choose euthanasia in the Netherlands do so because they feel obligated to die.  They feel their continued existence is a burden either financial or emotional to their families and to society at large. They choose euthanasia even though they don’t want to die,” Dr Baddock says.
https://www.tvnz.co.nz/one-news/new-zealand/euthanasia-bill-goes-against-ethics-our-profession-medical-association-chair-says

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OPINION: Why I’m voting “’No” to Euthanasia

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Times Online 16 May 2019
Family First Comment: Well said, Simeon
“…it is clear to me that no system of euthanasia, no matter how carefully designed, can ensure the protection of the most marginalised and vulnerable in our society. This is deeply troubling to me. International precedents show that euthanasia regimes result in the involuntary death of innocent lives, often those who are marginalised and vulnerable. I cannot support a law which allows the state to intentionally kill its citizens, particularly when innocent lives will be lost in the process. The potential for this particular Bill to go so wrong is too big to ignore.”

Shortly, Parliament will debate and vote on the second reading of the End of Life Choice Bill, which is being sponsored by David Seymour, MP for Epsom.

This is a conscience issue which many people hold strong opinions on. Since the first reading of this bill, I have received thousands of emails on this topic, met with many in Pakuranga who have wished to share their opinion on the issue, spoken with palliative care experts, disability advocates, doctors, lawyers, and I have sat on the select committee to hear submissions on this Bill, 90 per cent of which were opposed.

I want to thank and acknowledge everyone who has spent time discussing this topic with me. It is a highly emotive issue and I believe that there are many well-meaning people who hold widely differing views.

I will however be voting against this bill for the following reasons.

Firstly, it is clear to me that no system of euthanasia, no matter how carefully designed, can ensure the protection of the most marginalised and vulnerable in our society. This is deeply troubling to me. International precedents show that euthanasia regimes result in the involuntary death of innocent lives, often those who are marginalised and vulnerable. I cannot support a law which allows the state to intentionally kill its citizens, particularly when innocent lives will be lost in the process. The potential for this particular Bill to go so wrong is too big to ignore.

I have also considered this issue in the context of what our doctors are saying. I join with the overwhelming majority of healthcare professionals in New Zealand – including end-of-life specialists – who oppose euthanasia.

I find the New Zealand Medical Association’s comments on coercion particularly concerning: “An absolute guarantee that those who choose assisted dying are doing it voluntarily would be extremely difficult to establish in legislation and ensure in practice. Doctors are often not in a position to detect subtle coercion – as is also the case when trying to identify signs of emotional or financial abuse of elders more generally. Coercion also extends to assumptions of being a burden, giving rise to a sense of an ‘obligation’ to die.”

Finally, in a country with dire statistics relating to elder abuse, youth suicide and mental health, euthanasia is a major step backward and represents a threat to the vulnerable in our society.

I understand why an individual who has lived a full life and now faces a painful death would want to be allowed to choose when they will go. But I don’t believe we can allow and celebrate that without creating a terrible side effect for many others, for whom this law would not be so benign. Instead of offering a legal avenue for suicide, we need to encourage and strengthen our families and communities to support those who are lonely and suffering.

I am encouraged by the rapid developments in palliative care, which has only recently been recognised as a medical specialty. As I have engaged with this sub-sector extensively since being elected, I have only grown in my admiration for their work and belief that we must prioritise their role in enabling people to have ‘dignity in death’, not in romanticised suicide.

I appreciate this is a very difficult issue and I know people have many views on this issue, and I always welcome hearing from anyone who wishes to share theirs with me.

Simeon Brown  MP for Pakuranga
https://www.times.co.nz/news/opinion-why-im-voting-no-to-euthanasia/

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End of life choices: The Crown’s duty of protection

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Stuff co.nz 2 May 2019
Family First Comment: Grant Illingworth QC nails it….
“Parliament is presently considering enacting legislation which would significantly diminish the protection currently provided by the law relating to unlawful homicide. The measures being promoted under the End of Life Choice Bill are half-baked, poorly drafted and dangerous. Freedom of choice is an appealing doctrine, and sympathy for the terminally ill and their suffering provides a compelling context too. However, egocentricity and self-interest are irradicable aspects of human nature, and it would be a grievous mistake for MPs to overlook the larger danger of exposing weak, vulnerable and defenceless people to the depredations of those prepared to advance their own interests by influencing others to end their lives prematurely.”
#rejectassistedsuicide
www.Protect.org.nz

OPINION: In the aftermath of the Christchurch shootings, heavily armed police were urgently mobilised as soon as the threat was revealed. The Government acted to protect the lives of every individual in this country, with force if necessary.

It is a fundamental obligation of the government to protect us all. In law, we are all – even visitors and those who do not have the right to live here — subjects of the Crown. This principle, concerning the responsibility of government, was established in 1608 in a famous decision known as Calvin’s case. One of the most important aspects of that case was that it identified the essential features of the relationship between the individual and the sovereign.

The individual, whether resident or visitor, owes allegiance to the sovereign; the sovereign owes a reciprocal obligation, which is to govern and protect the Crown’s subjects. The judgment in Calvin’s case says this: “But between the Sovereign and the subject there is without comparison a higher and greater connexion; for as the subject oweth to the King his true and faithful ligeance and obedience, so the Sovereign is to govern and protect his subjects.”

The Crown’s duty to protect its subjects applies to everyone, but it is naturally most relevant to the weak, the vulnerable and the defenceless, including the elderly, those suffering serious illness and those who have lost the ability to think clearly and make informed decisions for themselves.

It is extremely common for those involved in legal matters to encounter situations where weak or vulnerable people and those who can’t stand up for themselves are taken advantage of by others through acts of dishonesty, intimidation and violence. In designing a justice system to shield everyone from such behaviour, the Crown carries out its reciprocal obligation to govern and protect its subjects.

This form of protection is particularly evident in laws relating to unlawful homicide, including murder, manslaughter and provisions concerning assisted suicide. These have been carefully designed to shield the lives of individuals threatened by the wrongful conduct of others and to provide a general protection for the lives of all members of our community, particularly those most at risk.

Any attempt to diminish the protection that those laws provide must, on any rational view, be subjected to the most anxious examination and scrutiny. As the greatest jurists throughout history have consistently recognised, the safety of the people is the supreme law: Salus populi suprema lex esto.

Parliament is presently considering enacting legislation which would significantly diminish the protection currently provided by the law relating to unlawful homicide. The measures being promoted under the End of Life Choice Bill are half-baked, poorly drafted and dangerous.

* Grant Illingworth is a QC and member of Lawyers for Vulnerable New Zealanders (lvnz.org)
READ MORE: https://www.stuff.co.nz/national/health/euthanasia-debate/112248130/end-of-life-choices-the-crowns-duty-of-protection

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As a tetraplegic I once supported assisted suicide – but I was wrong

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Stuff co.nz 25 April 2019
Family First Comment: “I had been told ‘if I was in your position, with your disability, I wouldn’t want to live’ by the very health professionals who are there to help suicide survivors. No one ever asked about my toxic mindset and frantic way of living.”
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OPINION: For most of my life I’ve been pro assisted suicide. It was about choice, dignity, and compassion. I think that’s why most New Zealanders are in favour of the End of Life Choice Bill.

I’d consider myself more liberal than conservative, a girl who grew up in a secular family. Growing up, I didn’t really understand the implications of having a ‘choice’.

That all changed when I turned 17 and was in a car crash where a family member fell asleep while driving. As a result, I became a tetraplegic, requiring a wheelchair for mobility, with impaired arm movement.

I attempted suicide a few times in the years following the crash. Each time, I’d end up in a coma in hospital. In 2015, health professionals encouraged me to explore assisted suicide. I signed up to a Swiss assisted suicide group and felt all my suffering and pain would soon be over.

Before I was to leave for Switzerland, I had another operation on my broken neck. The operation was a disaster, leaving me more paralysed. I had to give up my career, I lost financial security, became more dependant and was in more pain than ever.

I spent months in bed reflecting on my life. I had managed to complete my degree, a Master’s and had even worked full time. In hindsight, I realised my biggest problem had been my mindset and a lack of proper support. Prior to the botched neck surgery, to cope with grief, I would take on more work, even volunteering at Youthline as a counsellor.
READ MORE: https://www.stuff.co.nz/national/health/112052994/as-a-tetraplegic-i-once-supported-assisted-suicide–but-i-was-wrong

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Voluntary euthanasia should be available to children: civil libertarians

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Brisbane Times 17 April 2019
Family First Comment: Disturbing comments in Australia..
“We would define such a mature minor as a child over 12 years of age who … has a sufficient understanding and intelligence to enable him or her to understand fully what is proposed,” he said.

Children as young as 12 should be able to choose to end their own lives, with civil libertarians citing European laws as a model that could be replicated in Queensland.

A Queensland inquiry, led by a parliamentary committee, is examining aged care, palliative care and voluntary euthanasia.

Queensland Council for Civil Liberties president Michael Cope said the views of mature minors about voluntary assisted dying (VAD) should be respected.

“We would define such a mature minor as a child over 12 years of age who … has a sufficient understanding and intelligence to enable him or her to understand fully what is proposed,” he said.

“However, we do recognise that children are entitled to extra protection when making their decision.”

Mr Cope said children should be assessed by an independent psychiatrist before their request to die was authorised.

“Secondly, at least one of the independent medical practitioners should have specific qualifications and experience in dealing with children,” he said.

“Thirdly, in the case of children a request for VAD should not be based solely on an underlying psychiatric condition.”

Mr Cope said the suggestion was based on laws in Europe, where 13 minors had accessed voluntary euthanasia in the Netherlands since 2002 and three in Belgium since 2014.
READ MORE: https://www.brisbanetimes.com.au/politics/queensland/voluntary-euthanasia-should-be-available-to-children-civil-libertarians-20190417-p51ex1.html

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As a doctor who swore to first do no harm, the End of Life Bill really bothers me

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Stuff co.nz 21 April 2019
Family First Comment: “How we die says a lot about our society. Having held a few hands of the dying, I know that those moments are sacred. I didn’t swear the oath of first doing no harm, to then participate in an activity with multiple harmful effects to both the living and the dying.”
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OPINION: First, do no harm. This is our medical creed.

When our class graduated I was the student who read out our version of the Hippocratic​ Oath, “a declaration of professional dedication”, in te reo Māori.

All brand new baby doctors in the old Maidment Theatre, 20 years ago. The kids were there holding my hands. Te Kaanga Skipper, our med school mother hen, gave us all a pounamu heart to wear around our necks. Merimeri Penfold lent me a korowai. Pineaha Murray and Selwyn Muru put the cloak on me. Karakia were spoken, and an ancient oath was made new.

The End of Life bill has brought it all back in vivid, living colour. Reading the legislation – not everyone’s cup of tea – has been exacting my little grey cells this week. I find it fascinating. And with a new bill like this one the preamble and description of the process to date is insightful stuff.

In essence, the judicial committee who reviewed it were “unable to agree that the Bill be passed”. They concluded members of Parliament needed to resolve the matter.

There are a few things that really bother me.

One is that the law is written as if we are all living completely independently of each other, as if we make decisions alone. This is not true. That there is no compulsion to discuss “assisted dying” with any whānau at all strikes me as fundamentally wrong. This is not reflective of how we – Māori and Pākehā – live, or how we may die.

Many aspects of the law that I deal with regularly provide salutary lessons that are relevant here if we don’t want to make the same mistakes.

* Child and adolescent psychiatrist Hinemoa Elder PhD is a Fellow of the Royal Australia NZ College of Psychiatrists, and Māori strategic leader at Brain Research NZ.
READ MORE: https://www.stuff.co.nz/national/health/112099470/as-a-health-professional-the-end-of-life-bill-really-bothers-me

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End of Life Choice Bill report offers only ambiguity for MPs before second reading

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Stuff co.nz 16 April 2019
Family First Comment: “Whatever form the law took, creating legal assisted suicide would confront every eligible person with an entirely new question: is my life worth living? Should I hang on, or end my life now? It’s a question that becomes an undercurrent in conversations with doctors and family members.”

OPINION: After months of thought and argument, the justice select committee has thrown the End of Life Choice Bill back in Parliament’s lap.

We’re in the strange situation where no-one, not even sponsor David Seymour, is supporting the bill as it is. The select committee couldn’t agree that the bill should pass and made only technical changes to it, deliberately leaving major questions hanging. Supporters are trying to invest the procedure with the illusion of certainty, but the bill is now overshadowed by ambiguity.

Seymour has stated that, if the bill passes its second reading, he will propose an amendment limiting eligibility under it to patients with terminal illnesses. But he has also said his amendment would introduce eligibility for neurodegenerative conditions that are likely to cause death within 12 months, alongside the current provision that has a six-month limit.

This example shows that amending the bill would be messy, with MPs voting on a patchwork of proposals that are unlikely to add up to a coherent, watertight law. Not only would each MP vote based on their individual conscience, but party agendas would be at play too. In particular, NZ First has stated that the issue should be subject to a binding referendum and may refuse to support any bill without it.

But let’s imagine that, somehow, the stars align and a cut-back, workable law is passed. Even a narrow version of the bill creates a risk of wrongful death: deaths that would fall outside the bill’s own criteria. For example, the bill is based on the ideal of free and informed consent, but the select committee noted submissions from doctors that “determining whether a person is competent [to consent] is complex, challenging, and subject to error … a person’s competence can vary daily, particularly if they are suffering from a terminal illness”.

There’s also a risk that some people would choose euthanasia because they felt pressure from others, and fear of being a burden was a reasonfor choosing assisted suicide for 63 per cent of patients in Oregon last year – a trend that has been rising steadily.

There’s also no reason to think the law would be set in stone. For example, Belgium introduced a euthanasia law in 2002, then expanded it to terminally ill children in 2014; and after just over two years, the Canadian Government is considering whether to expand its euthanasia law to “mature minors“. Our attorney-general, in his report on the bill, said that limiting eligibility to over-18s was inconsistent with the New Zealand Bill of Rights Act and that consistency would require lowering the age limit to 16 or removing it altogether.

* Alex Penk is chief executive of the Maxim Institute, an independent think tank.
READ MORE: https://www.stuff.co.nz/national/health/euthanasia-debate/111943234/end-of-life-choice-bill-report-offers-only-ambiguity-for-mps-before-second-reading

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Youth worker worried about euthanasia bill’s impact on suicide

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Radio NZ News 15 April 2019
Family First Comment: Exactly what we warned about in our Submission….
“Mr Howard said the conversation around dying as a way out remained. He said many of the young people he worked with were intelligent and articulate, and followed discussions around the bill. Some were using the justifications of euthanasia advocates to inform their own situations.”

A therapist who specialises in youth suicide is concerned not enough is known about how assisted dying may affect vulnerable youth.

The End of Life Choice Bill allows for people in unbearable suffering or with an incurable, grievous condition to ask a doctor to help end their life.

Dion Howard, a nurse and therapist who has spent 20 years working with young people and has expertise in adolescent mental health, wrote a submission to MPs considering the bill.

In his submission, he argued the ripple effects on youth had not been adequately explored.

“Really, my question to the select committee is, ‘Can you be certain this would not impact the suicide rates of young people?’ To which the answer I’m certain is, ‘We don’t know that’.

“So, the next question should be, ‘Well, shouldn’t we know or shouldn’t you be certain before supporting a change?’ ”

He said overseas jurisdictions had grappled with the same issue.

“It was quite remarkable that the Scottish Parliament rejected their similar bill on the basis that they didn’t think they could reasonably prevent and educate on the prevention of suicide and present it as a solution at the same time.

“We need to be cautious about this and we have good grounds to be cautious.”
READ MORE: https://www.radionz.co.nz/news/political/387102/youth-worker-worried-about-euthanasia-bill-s-impact-on-suicide
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Euthanasia bill could threaten vulnerable Māori if it becomes law – advocacy group

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TVNZ One News 10 April 2019
Family First Comment: Dr Hickey says the bill is not fit for purpose. “We’ve just done a massive fundraising campaign for Mike King’s campaign and here we are willing to bring in legal suicide basically…” Dr Hickey says the bill threatens vulnerable Māori already being failed by the health system. “In Oregon 63% of those that were euthanised were from poor backgrounds who were on state insurance and who refused treatments to have kept their lives going well. We do have a public health system that is rationing certain things like dialysis and who are the biggest recipients of dialysis? Māori and Pacific peoples.”

The group of lawyers who specialise in protecting vulnerable New Zealanders say the controversial euthanasia bill is fatally flawed.

Former legal academic Dr Huhana Hickey says the bill is a threat for Māori who are already have high rates of suicide, terminal illness, mental health issues and disabilities.

Speaking to Te Karere, Dr Hickey says the bill is not fit for purpose.

“We’ve just done a massive fundraising campaign for Mike King’s campaign and here we are willing to bring in legal suicide basically,” she says.

In its current form, according to Lawyers for Vulnerable New Zealanders, the End of Life Choice Bill has 35 flaws.

“There is a danger in this legislation and it comes with irreversible, irremediable and terminal. You cannot determine what irreversible, irremediable is,” says Dr Hickey.

“I qualify under that and I still got a lot of life left in me. Many of us will quality for that. Depression after your husband, wife dies will quality under that.”

But the bill’s advocate Act Party leader David Seymour doesn’t agree.
READ MORE: https://www.tvnz.co.nz/one-news/new-zealand/euthanasia-bill-could-threaten-vulnerable-m-ori-if-becomes-law-advocacy-group

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