NZ MPs warn of risks to the disabled, elderly and suicidal youth

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.

Pasifika MP, Agnes Loheni enunciated the proper test for the Bill:

It has been said that a nation's greatness can be measured by how it treats its most vulnerable, its weakest members. We cannot risk one wrongful death. This bill will not guarantee that that will not happen.

She explained how contrary the Bill was to Pasifika values and culture:

This bill is in conflict with those values and our Pacific culture of care. In Pacific families, it is our duty to look after and care for our elders, be it our parents, our grandparents, aunties and uncles. They are treasured and respected in our culture. We care for them out of love and deep respect for the hard work and the sacrifices they have given to their families. This bill opens the door to the vulnerable being coerced and to feelings of being a burden on their families. This bill erodes the sanctity of life and aspects of the social relations that are important for strong, healthy, resilient families and communities. This bill focuses on the individual—my life, my choice—that is in conflict to Pacific values and culture, which sees and interacts with society through a lens of families and communities.

Ms Loheni spoke about the double standard on suicide prevention the Bill would create:

We have a suicide problem in New Zealand. Pacific peoples have one of the second-highest suicide rates overall and one of the highest suicide rates amongst our Pacific youth. We cannot hide from that. At a time when we should be rallying to address suicide, at a time when our message should remain ‘Suicide is never the answer’, we are backing off.

Labour MP Michael Wood highlighted the threat to people with disability recounting the story of Raymond Mok, who has Duchenne muscular dystrophy:

an incurable and progressive disease that means that Raymond is unable to move about by himself. He requires assistance with his breathing and is not able to lead a life in the same way that many of us do. He is a person who has told me that at points in his life he would have, if the option was available to him, taken up the option of ending his life, but with help and support, with mental health assistance he is a person who has been able to live a meaningful life.

Raymond tells me, when he meets with me, that his concern with this bill is that it creates a situation where people who have, as he does, a grievous and irredeemable medical condition—would be people who would be placed in a category in which the end of their life is legally permissible. And that is not a category that many other New Zealanders are put into. This is a concern that I share.

Mr Wood also drew attention to the subtle pressure those “approaching an end of life situation” could feel.

They feel the burden on their families, they worry about the pain that the final months may put them through, and they may see it simply as a better choice for other people to access the end of life provisions that are included within this bill.

National MP, Dan Bidois explained why he had shifted from supporting to opposing the Bill:

I am concerned about the lack of safeguards with respect to protecting our most vulnerable in New Zealand. I especially worry about its impact on the elderly. I've had several cases  of elderly people saying ‘Dan, I need your help. I need your help because my son or daughter has complete control of my financial affairs and I'm worried about my safety.’ It's brought me almost to tears. So I have very grave concerns about how this bill protects our most vulnerable elderly from coercion. We heard from the select committee that it's very difficult from doctors or lawyers to actually detect coercion. It takes many, many months.

The Hon Maggie Barry compared the debate on the Bill to the 1961 debate in New Zealand on abolishing the death penalty:

Public safety and protection of the most vulnerable, rather than an individual's personal choice, must be the overriding concern of any Parliament. Our role as lawmakers must be to ensure the greatest good for the greatest number, and we have a duty to ensure that the degree of safety built into legislation matches the gravity of the risk. The stakes are very high, and we each have to ask ourselves the question, and then be able to live with the answer: how many unintended deaths are too many? Can anyone here put a number on it? As with voting down the death penalty 60 years ago, we have to ask ourselves whether one innocent life lost is OK and can be treated as collateral damage and something we can live with. I know I can't, and that's why I am opposed to this bill and that is why here tonight in this Chamber I am voting against this fatally flawed ‘End of Life as we Know It Bill’.

She also highlighted the likelihood of mistakenly assessing a person as having decision making capacity:

Who would have to decide on whether someone with dementia has the capacity to understand the decision they're being asked to make? It would be the doctors. One 10-to-15-minute consultation with a doctor a patient may not even know. The second consultation doesn't even have to be face to face.

Ms Barry pointed out how the Bill would introduce a profound inequality into the law:

Our current laws are straightforward the way they are. They protect all human life equally. No one person's life is treated differently from anyone else's, not based on wealth, ethnicity, or any other points of difference. As so many submitters have told us, the lives of the sick, the disabled, and the elderly will be defined by their medical conditions. As the Disability Rights Commissioner Paula Tesoriero told the committee, this bill undermines the position of the disabled and the vulnerable. It devalues their lives and poses significant risks. The so-called right to die for some would all too easily become a duty to die for others.

The Minister for Health, the Hon Dr David Clark, reiterated the concerns around coercion and pressure:

My most fundamental concern with this legislation is that sanctioning euthanasia makes it easier for vulnerable people to feel that the most appropriate option is to take their own life, and that it is very difficult to ensure protection sufficient to preclude this ever happening.

Labour MP, Dr Deborah Russell, said

I value autonomy and I value agency, and I think we must respect those individuals. But for me, it is precisely the individuals whose autonomy is compromised, the individuals whose agency is compromised, that we need to have concern for. Ultimately, that is why I am changing my vote from a yes to a no. I thought in particular of people with disabilities and I felt, in particular on older people and on young people.

She cited evidence from school councils about the likely impact on youth suicide:

School councils say that in their experience of dealing with young people, young people would see euthanasia as permission to commit suicide. Yes, the two things are different, but on the one hand with euthanasia we would be saying that it was permissible to end a life, and the young people would see that as permission themselves. And we know that we have a problem with youth suicide in this country. I have to say that this one is particularly personal to me. It worries me intensely with respect to youth suicide.

Detailed debate on the clauses of the Bill could begin on Wednesday 31 July.

The full debate can be read or viewed here

Read more about the risk of wrongful deaths from any law permitting assisted suicide or euthanasia here