On Wednesday 26 June 2019 the End of Life Choices Bill passed its second reading in the New Zealand Parliament by 70 votes to 50. This does not guarantee its ultimate passage into law as several of those who voted for the Bill at this stage nonetheless expressed grave reservations, especially about the dangers of coercion and elder abuse.
The key concerns with the Bill, which would permit assisted suicide and euthanasia for any New Zealander with a “grievous and irremediable medical condition”, are the risks for people with disability, elder abuse and coercion, unavoidable medical errors in prognosis, diagnosis and identifying mental illness, and undermining suicide prevention, including for young people.
The much vaunted mandatory training for doctors before they are licensed by the State of Victoria to prescribe a deadly poison to people for the purpose of suicide or administer a lethal injection to them is supposed, among other things, to ensure these doctors are competent to assess decision making capacity and voluntariness in those requesting assisted suicide or euthanasia.
However, a comparison of the total of 10 minutes training provided on these topics in the Victorian mandatory training with the thoughtful proposals presented in an article published in the Internal Medicine Journal in January 2019 entitled "Biggest decision of them all – death and assisted dying: capacity assessments and undue influence screening” leads to the conclusion that the bar has been set very low indeed in Victoria and that there will be wrongful deaths in Victoria due to this failure.
The answer to bad deaths is not euthanasia. The answer is a better understanding of basic medical ethics, of palliative medicine, of what happens to the body when it is dying, and how to care for someone at the end of life.
Dr Amanda Landers, community palliative care physician and senior clinical lecturer at the University of Otago, Christchurch
By having, as its destination, the planned, premature death of a person, [Victoria's euthanasia and physician assisted suicide] law ventures into an uncertain medical terrain, the vagaries of human nature and the extraordinarily complex nature of interpersonal relationships. No law can perfectly capture this reality. Of minds made up and then changed. Of the ebb and flow of the human spirit, despairing now, content a day later. Of a selfless impulse, in some, to ease the burden on one’s family. Of a lifetime habit, in others, of acquiescing to the suggestion, even unspoken, of a dominant relative.
A Canadian man with quadriplegia has explained how he feels pressure towards euthanasia from those providing him with nursing care as they favourably recount stories of other people who have chosen euthanasia without him soliciting information or raising the issue at all.
In an email to Alex Schadenburg of the Euthanasia Prevention Coalition he said:
I am living in the advanced stages of quadriplegia, now 33 years along. I am feeling the suggestive influence from my nursing care, regarding euthanasia. They use indirect pressure by speaking about other patients who have chosen the path of assisted death, unsolicited from me. I am worried about Canadian laws, so anti-life, and I don't ever want to end my life. I didn't choose when I was born, and I won't choose when I die. Another thing that concerns me is as these evil laws progress against the vulnerable like myself, when will this new found right to die become the duty or obligation to die? I can see it coming...
The final report of the Ministerial Expert Panel appointed by the Western Australian Labor Government includes 33 recommendations for yet another fatally flawed experiment with assisted suicide and euthanasia that would put vulnerable Western Australians at risk of wrongful deaths.
The proposed scheme would allow for broader access than in Victoria with the key eligibility criteria to include that "death is reasonably foreseeable for the person within a period of 12 months". This recommendation borrows the language of the Canadian law where it has been given a very broad interpretation in the courts. This is significantly broader than the Victorian law which requires that death be expected within six months (or 12 months for neurodegenerative conditions).
The proposed WA scheme would also allow euthanasia - where a doctor or nurse practitioner injects the person with a lethal substance - more readily than in Victoria, where this is limited to those persons who are assessed as "physically incapable of self-administering". In Western Australia, it is proposed that it be a matter of "clinical determination" between the doctor or nurse practitioner and the person as to whether assisted suicide or euthanasia is more "suitable for the person". the factors to be considered include any matter the clinician or person sees as "necessary to the decision making".
Evidence from other jurisdictions such as the Netherlands and Canada shows that where both options are available the overwhelming majority of people prefer euthanasia and that the per capita rate of euthanasia and assisted suicide is significantly higher than in jurisdictions, such as Oregon, where only assisted suicide is lawful.