The End of Life Choice Bill
On 9 April 2019 Parliament’s Justice Committee published their report on the Bill and the submissions process.
The Bill passed its second reading on Wednesday 26 June 2019.
The Committee of the House stage will begin on Wednesday 31 July, when the details of the Bill, including the eligibility criteria, will be debated.
What is proposed
This Bill is NOT about turning off life support, ‘do-not-resuscitate’ requests (no CPR) or stopping medical treatment. In these situations, a person would die of natural causes – from their underlying medical condition.
The Bill proposes immunity from prosecution for medical practitioners who perform ‘assisted dying’, which is a euphemism for euthanasia and assisted suicide using lethal drugs.
It is assisted suicide when the person who dies takes the final action that ends their life, e.g. swallowing a deadly dose. It is euthanasia when someone else takes the final action that ends the person’s life, e.g. give a lethal injection.
Four methods are proposed for the administration of a lethal dose: ingestion or intravenous delivery triggered by the person (assisted suicide); and ingestion through a tube or injection (euthanasia). – Clause 15(3)(a)
Who would qualify
The criteria are wide enough to include life-limiting conditions, as well as some disabilities, ageing-related and degenerative conditions, chronic (longstanding) conditions and mental illnesses.
It would be up to the individual to define ‘grievous’, ‘advanced’, ‘unbearable suffering’, ‘capability’ and ‘intolerable’.
Based on the Oregon law, “a terminal illness that is likely to end his or her life within 6 months” means that a person is likely to die within six months if the condition is allowed to take its course without medical treatment. In Oregon eligible conditions have included diabetes, heart disease, hepatitis, sclerosis, arteritis and even arthritis.
Section 4: Meaning of person who is eligible for assisted dying
In this Act, person who is eligible for assisted dying means a person who—
(a) is aged 18 years or over; and (b) is—
(i) a person who has New Zealand citizenship as provided in the Citizenship Act 1977; or
(ii) a permanent resident as defined in section 4 of the Immigration Act 2009; and
(c) suffers from—
(i) a terminal illness that is likely to end their life within 6 months; or
(ii) a grievous and irremediable medical condition; and
(d) is in an advanced state of irreversible decline in capability; and
(e) experiences unbearable suffering that cannot be relieved in a manner that the person considers tolerable; and
(f) has the ability to understand—
(i) the nature of assisted dying; and
(ii) the consequences for them of assisted dying.
The proposed process in a nutshell
After a person has made a formal request for death, two doctors would assess whether the person is eligible. The second doctor must be a member of SCENZ, a purposely-created group of medical practitioners who are willing to facilitate assisted suicide and euthanasia. If one or both doctors would doubt whether the person is able to understand what ‘assisted dying’ is and that they would die, a psychiatrist or psychologist would assess whether the person is able to understand this. Each medical practitioner would send their paperwork to a registrar who would co-sign the prescription for lethal drugs.
The Bill is available at tiny.cc/EOLCbill.
Some issues with David Seymour’s End of Life Choice Bill
David Seymour’s End of Life Choice Bill effectively proposes assisted suicide and euthanasia on demand for anyone 18 years or older due to its vague and subjective terminology:
- There is no clear definition of ‘terminal illness’. It could be interpreted to include any condition that is life-shortening or life-threatening. There is no bright line between terminal conditions and chronic conditions. Some chronic conditions can become life-threatening in a matter of minutes, for example diabetes, asthma, severe allergies and high blood pressure. There is also no bright line between terminal illness and disabilities, because many disabilities are life-limiting and involve complications that can become life-threatening. Even clinical depression could be regarded as a terminal condition by some, because it could lead to death (suicide), or to losing the will to live and fight a disease.
- It’s impossible for doctors to accurately predict how long a person is expected to live, especially as long as six months out. There have been cases of people who were expected to die within hours or days, but they recovered and lived for months or years. Diagnosis can also be wrong, despite a doctor’s best intentions. Diagnosis and prognosis are not based on certainty, but on probability (the likelihood based on other cases). There is no guarantee that an individual’s disease will progress the same way as others’ have.
- The phrase ‘irremediable medical condition’ is vague enough to include any condition that is not cured within an expected time frame. Any condition can become ‘irremediable’ if a person exercises their right to refuse further treatment. ‘Irremediable conditions’ could possibly include disabilities; chronic conditions such as arthritis, asthma, gluten intolerance or chronic pain; mental illness such as anxiety or depression; ageing-related conditions such as the deterioration of eyesight, mobility or skin elasticity; scarring; and even skin pigmentation such as age spots or birth marks… Please note: We are not claiming that a person with one of the above-mentioned conditions would be eligible for an assisted death under this Bill, as all the eligibility criteria would need to be met and applications would need be assessed on a case by case basis. The point we are making is that the phrase “irremediable medical condition” is open to wide interpretation.
- Words such as ‘grievous’, ‘unbearable suffering’ and ‘intolerable’ are entirely subjective (up to the individual to determine). If a patient would use any of these words to describe their condition, the doctor would not be able to argue.
- ‘An advanced state of irreversible decline in capability’ is just a wordy way of saying ‘disability’ or ‘ageing’. The Bill doesn’t explain what is meant by ‘capability’. Could a person qualify who has become less able to run, walk, read, or enjoy life? Could a person’s ‘decline in capability’ become ‘irreversible’ by them refusing treatment?
- The End of Life Choice Bill doesn’t mention depression. Even if it did specifically exclude depression, some depressed people could still access death instead of treatment under such legislation. Depression can be hidden, even from doctors. Depression can be misdiagnosed or dismissed as ‘understandable depression’. Even subclinical depression can still have an effect on a person’s decision making capabilities.