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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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Experts discuss arguments for and against assisted dying ahead of election referendum

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TVNZ One News 18 September 2020
Family First Comment: One is a ‘researcher’. The other is a real doctor – a palliative care specialist with real world experience and dealing daily with the care of actual people.
WATCH as she DESTROYS the argument of the pro-euthanasia academic!

“We care for people who are facing their death every day. … We live in the real world. When we read this act as it’s written and apply it to the real world, it leaks. It’s not waterproof or safe in any way. There are multiple reasons and multiple risks we’ve identified.” She said it could be difficult to judge whether a person was being coerced into assisted dying because coercion can be subtle.

“We care for people who are facing their death every day. … We live in the real world. When we read this act as it’s written and apply it to the real world, it leaks. It’s not waterproof or safe in any way. There are multiple reasons and multiple risks we’ve identified.” She said it could be difficult to judge whether a person was being coerced into assisted dying because coercion can be subtle.

Two euthanasia experts spoke to TVNZ1’s Breakfast about their views on assisted dying ahead of the End of Life Choice Act referendum in this year’s election.

Care Alliance’s Dr Sinead Donnelly, a palliative care doctor and senior lecturer at the University of Otago, outlined the arguments against the act. Care Alliance is made up of a range of organisations, including providers of end-of-life palliative care in New Zealand.

Donnelly said she was opposing the act as it was written.

“We’re concerned about the risk and we don’t believe that it’s safe,” she said.

When asked why she believed the act was unsafe, despite the High Court and lawyers saying there were more than 45 safeguards, Donnelly said the Care Alliance was looking at it from a practical view.

“We [at Care Alliance] care for people who are facing their death every day. … We live in the real world.

“When we read this act as it’s written and apply it to the real world, it leaks. It’s not waterproof or safe in any way. There are multiple reasons and multiple risks we’ve identified.”

She said it could be difficult to judge whether a person was being coerced into assisted dying because coersion can be subtle.

There are also challenges to making a prognosis that someone only has six months left to live, Donnelly said.

“Prognosis is an estimate. International literature and our own daily experience shows we’re often wrong about prognosis.

“How can you create a safe law when the consequences are the death of a person with such imprecise so-called safeguards?”

Donnelly said, in her experience, it was common for people to feel as if they were a burden.

“I feel they’re actually going to feel a greater burden. They now have to choose, ‘Do I ask for this or not?’”

She said it was already legal for people to ask for treatment to be stopped.

She said the palliative care system is rapidly developing but it is “chronically underfunded” in New Zealand, and there are inequities to accessing quality care.

This means people may not have a true choice between palliative care and euthanasia, Donnelly said.
READ MORE: https://www.tvnz.co.nz/one-news/new-zealand/experts-discuss-arguments-and-against-assisted-dying-ahead-election-referendum

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