Viewpoint - Death with dignity

By: Marja Lubeck

Mahurangi-based MPs were asked to comment on The End of Life Choice Bill in light of the views of Warkworth GP and chair of the New Zealand Medical Association (NZMA) Kate Baddock (MM July 3). My views only got a brief hearing in the original article and it is impossible to do the subject justice with just a small quote.

As MPs, we receive daily feedback with a range of views on this challenging and emotive topic of euthanasia. And I respect that everyone has the right to their opinion. While I am not a member of the Justice Select Committee that dealt with this Bill, I met with many individuals and organisations on this topic, read through written submissions and attended several oral submission hearings. It was disappointing to see politics getting in the way of substantive changes being made to the Bill. As a result, it came back to the House without the amendments that would have made it a better Bill.

In my view, removing the eligibility criteria of “a grievous and irremediable medical condition”, and limiting assisted dying to those “with a terminal illness likely to end the person’s life within six months”, would go some way toward addressing fears that the Bill may harm vulnerable people.

I agree with Dr Baddock that any law must safeguard the vulnerable. Amendments are necessary to ensure protection against coercion: explicitly stating a person is not eligible for assisted dying only because of disability, or mental illness. Coercion needs to be able to be detected through a process which has safeguards to ensure the patient expresses their wish free from the pressure of others. Several other jurisdictions have such processes in their legislation. The Bill requires a medical practitioner to halt the assisted dying process if they have reasonable grounds to suspect that a person was subject to coercion.

Some have said that there are ways already for people to end their own life. But this often means people die alone. A terminally ill person may decide to end their life earlier than they would if assisted dying were available, while they are still physically able to do so. I don’t believe this is consistent with NZMA’s concept of “death with dignity and comfort”.

The knowledge of having access to assisted dying provides comfort and thereby lessens suffering, but as research shows, it doesn’t necessarily mean the person will choose the option of assisted dying.

A comment about the law in the Netherlands and Belgium – humanism is a great influencer in these countries, making comparisons with New Zealand problematic.

Additionally, the social structure of Dutch society, the legal system and the cultural climate, the system of health care and insurance are all different. These countries are able to report on assisted dying cases, providing for a more accurate picture of the situation.

As NZMA states, palliative sedation treatment and pain relief already occurs but these practices lack legal guidance. This Bill would require for the actions of doctors to be accountable and transparent. This would result in more accurate reporting of assisted dying by medical doctors.

Marja Lubeck, Rodney-based MP


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