End of Life Choice bill (TVNZ Breakfast Show video from today)
I am preparing a bill which I am calling “End of Life Choice”. It arose out of a meeting in Nelson last year with a group of people who all want to be able to exercise the same control over the end of their lives as they are enjoying during their lives. It is as much about human rights as it is about dignity, autonomy and compassion.
Three levels of protection are necessary:
1 – for the patient or person themselves – from family who would either exploit them or overturn their wishes in extremis, and from insurance companies or anyone else who might exploit them;
2 – for any attending physicians, and there would need to be 2 – from any coercion to breach their own ethics or criminal liability if all procedures were observed;
3 – for any family members who assist in the final moments – from criminal liability.
The first time this was voted on was 1995 (Michael Laws’ bill), it was defeated 61-29. The second time, in 2003 (Peter Brown’s bill), it was defeated 60-57 and of the three who made the difference, two did not vote (John Tamihere and Heather Roy) and one abstained (Dail Jones). It will always be a conscience vote.
I think the time has come for this question to be revisited. I think the social conversation needs to happen again. I think the numbers would be different this time.
Am I right?
Thank you for initiating this conversation. It is important that people have choices at the end of their lives that allow them to achieve a death that reflects their values and beliefs. In Oregon, people have had access to death with dignity for 14 years. There have been no abuses. No fraudulent insurance denials. Family and friends are protected from prosecution. And not one person has used aid-in-dying based solely on a disability. Vulnerable people are protected. It is time for New Zealanders to have end-of-life rights as well.
You are right. Provided good protections are in place, this is something I would welcome.
Thank you for starting the public conversation about VOLUNTARY euthanasia.
Our legislation urgently needs updating so that individual patients can receive help in their dying when their condition is terminal and demeaning. We need to show more compassion to the dying, so that individuals can choose whether to ask for help—or not.
Legislative change is also needed to protect doctors or family who are involved in helping terminal patients in their dying. At present it is illegal.
Carefully written legislation will protect our obligations and offer compassionate choices.
MAryan used the correct word – Compassion. All the recent letters and anti mateiral sent out (viz Right to Life in the Christchurch press) seem to ignore this word which is essential in any consideration of end of life choice.
Karen Armstrong got it right. The Christian and monotheistic religions have forgotten this word compassion – all they want to be is ‘right’
Funny – I thought their god was full of compassion!!
JMM
You are right!
Thank you Maryan. I have been waiting for someone prepared to take this up again and have blogged about your bill;
http://lindsaymitchell.blogspot.co.nz/2012/03/welcome-news.html
I certainly agree with this bill. I’m glad you are proposing it to Parliament again, Maryan. I always thought I was a supporter of allowing a person to choose their time of death. I remember the precise argument that convinced me: Able bodied persons can choose their time of death if they wish, but we deny that choice to the people who have the most valid reasons for exercising it.
There will always be risks, but properly managed these provisions offer people in the most dire of circumstances the chance to end their time on earth in a way that lets them depart with some dignity and self-respect intact. I know it’s a very emotive issue, but I hope we can at least have this discussion in a reasoned way.
Thanks for heading up this issue. It is very important. I believe that although protections must be present, that the arguments about vulnerable people and ‘slippery slope’ are not supported by fact in any jurisdiction where assisted death is available. There is good evidence now available to support exactly the opposite. There is a lot of misinformation about the Netherland experience but a recent 10 year review should be very reassuring for those that worry about this issue.
Thank you for being prepared to get this debate going again Maryan. You’re quite right that there needs to be a range of safeguards in place.
It seems a large percentage of the population would like to make their own choice about the end of their life. Of course, if you’re capable, you can take your own life, legally.
This is a very sad thing to contemplate from all points of view as it must be done alone to avoid making a criminal of family or friends, and the aftermath may cause great trauma to others.
And, in order to avoid a prolonged, distressing death, many take their lives well before it would be deemed ‘time’ because they are afraid of losing the ability, and therefore the control over the circumstances of their own death.
As much as the last journey must be done on one’s own, nobody wants to die alone.
Rather, let us look to making an environment where everyone can legally be entitled to a gentle end with loving supporters.
Control and choice seem to be what people want at the end of their lives. Let’s have some compassion. ‘End-of-Life Choice’ – what a good name you’ve chosen for your private member’s bill.
I am afraid I would be most unlikely to vote for your bill if I was in parliament Maryan, as I think that adequate safeguards would be impossible to maintain. Our society has a strong strain of obsession with efficiencies and costs, along with a tendency to shy away from emotionally demanding situations. These tendencies would put any safeguards under pressure from the outset. While I have sympathy for people who have chosen to go that way, and certainly do not wish punishment on them, I would not like to see euthanasia enshrined in law.
Having survived cancer myself and seen what my mother had to endure, I think euthanasia is a humane way of dealing with human suffering.
To watch people going through the agony and trauma over a long period of time is quite traumatic and physchologically disturbing for everyone involved.
I support the right to life and, along with it, the right to die. It is morally reprehensible to force a person to linger in suffering if they do not want to. I understand that the religious practices of some people require “redemptive suffering” and some may choose to undergo this at the time of their death. That is their choice and their right. The legalisation of end-of-life choice will not remove that right from them. However, my values and beliefs do not require this ultimate sacrifice of me and it is an abuse of my human rights to force it upon me. Thank you for sponsoring this bill, Maryan. It will redress a significant injustice.
I think you are absolutely right Maryan. I think it is cruel for all concerned that some people are forced to suffer immense pain and indignity at the end of their lives.
I think it is an aberration that new Zealand hasn’t got here yet, despite some fairly socially liberal parliaments during the course of the last Labour government.
As for a change in the winds of social conscience, have you done the numbers in this Parliament? I suspect they’d weigh in your favour at least up to select committee..
OLwyn, I suspect you have encapsulated most people’s reservations.
However my understanding is that the person would at some point in their lucid life have to give consent in writing.
Having waited several years in England for such legislation I am delighted that its possibility is now being considered here. Of course there are dangers but what are safeguards for in any legislation and the public will have time and the occasions to discuss these when the Bill gets to Select Committee which I hope is soon. Let’s hope Maryan succeeds where two men have failed.
To Olwyn,
the intended bill will allow assisted dying only after a mentally competent person requests assistance in a signed document witnessed by others. It is also intended that the person has a full assessment by a Medical practitioner and another medical practitioner is involved in confirming the diagnosis. It is also intended that all cases be reviewed by a review body to ensure there is compliance to the law. So there are a lot of safeguards. For instance there is no room under the intended Act, for a vulnerable person to ‘euthanased’ against their will.
Jack
Maryan, Thank you for being a true politician that listens to the majority and is prepared to act. Society is changing with the age demographics and the ‘senior” members of our society are having and will increasingly have more influence. This emotive and personal issue will dovetail in with that increasing influence. The debate is needed to ensure we ” seniors” are able to determine our life end with as much dignity as possible. I am particularly impressed to hear our Prime Minister voice his opinion that the debate is warranted.
This time last year my mother was dieing of cancer, while she was still all there, and facing a near future of terrible pain, she explicitly asked me to help her if she needed it when her time came, she had brought me into the world, how could I refuse?
Fortunately my help wasn’t needed, things went quickly and peacefully.
I was put in a potentially terrible position, one I wish on no one.
Yes we so very do need such a law, people should be able to choose the way they die and the people they choose to help them should have legal protection. Thank you for taking on this difficult issue
@Tracey and Jack: Thanks for your replies. I am confident that all effort will be made to put strong safeguards in place, but I am less confident that they will remain so strong once euthanasia has been established and accepted. The reports I have read from countries where it is permitted have been mixed. We tend to associate freedom with choice, but there are areas where choice can be a burden. One could imagine, for example, a person reluctantly accepting euthanasia, when faced with debilitating illness, to avoid being a burden on her children. Such a person will have been robbed of the default position of living without questioning her life until her natural death.
Thank you all so very much for the tone of your contributions. This is exactly the kind of debate I had hoped for – thoughtful, honest, sometimes painful but ringing with care and compassion. As for some of the reservations, can I add to my original post: my intention, as others have indicated, is to have 2 physicians attest to a person’s soundness of mind and their understanding of what they are undertaking. In one European jurisdiction, they ask the person 3 times if they understand what they are asking, what will happen to them if they proceed, and that they are sure they want to do this. There is a period of time which must elapse (1-2 weeks)between each occasion of asking. That means the person has a chance to change their mind. I am also considering including Advance Directives, whereby, like living wills, a person can lay out what they want to have happen to them in the event that they become incompetent through dementia or other illness or accident. These Advance Directives would be binding but would need to be refreshed every 5 years to ensure they were current. That would also give people a chance to note any change of instruction in the event of changed circumstances. In the end, choosing your moment to go should be a final act of dignity and free will. Let’s keep talking.
It’s good that you are having this debate
http://www.kiwiblog.co.nz/2003/08/rodney_made_me_cry.html
Good time to remember this post from Kiwiblog.
Thank you Maryan; I hope that the media will support such a positive initiative and that it will lead to enlightened legislation
I would urge opponents of this serious issue to come to understand and respect that the wish to die is not a fly-by-night decision.
Olwyn
Very fair comment. I agree with the slippery slope position too. Once something is in law, watering it down is easier than getting it in the first place. On a less important subject, this govt brought in a 90 day trial (with no notice/reason) on the basis it was just for the recession and just for small businesses. It’s now law across the board.
I also have a concern that people, when well, have one view of how to end their lives, but when face to face with the impending end may feel differently.
I nursed my mother at home while she was dying. She was 52. I am lucky that she never asked me to slip her extra morphine. It may have been for a couple of reasons;
I was only 22 and I dont beilive she would have placed that burden on me
I’m not sure she felt ready to die
Maybe she asked a friend or her brother?
That was probably Rodney’s best work. Sadly for too many they need personal experience to be able to do the “right” thing.
In the end it’s not about us, its about the others.
Sorry Maryan – I don’t agree the time is right for this sort of Bill. All Labour MPs should be concentrating on re-building the Party and getting out to those potential Labour voters who did not vote in 2011, or 2008. A euthanasia type of Bill – however carefully it is worded – will just create huge controversy and reaction which – even tho it is a conscience vote – will be labelled a Labour Bill. Witness the effect of Sue Bradford’s amendment to the Criminal Act re parental smacking. This Bill would have a similar, maybe even larger, dis-affect and will distract voters from Labour’s rebuild and policies – and will destroy the Labour vote, yet again.
Tracey: I was at my own mother’s bedside when she died. She emerged from a coma to take one final, penetrating look at each of her three children, and I am very glad we didn’t deprive either her or ourselves of that moment, even though we could not have known of it in advance.
The personal, intimate, “slipping someone extra morphine” that you suggest may have happened with your mother, is not the thing I am concerned about. That kind of thing, furthermore, has always happened, and I think that even Aquinas, back in the day, allowed the refusal of burdensome treatments intended to prolong the lives of the dying. It is, as you have said, the slippery slope that comes with its being enshrined in law, and the ninety day bill is an excellent example.
It seems important to grasp that liberal law changes that are welcomed by middle class people with free an independent lives, can in some cases prove oppressive to people whose lives are not so free and independent. It is easy to dismiss such people as reactionary and uneducated, but a level of conservatism on certain issues seems to offer them a level of protection against exploitation by others. I fear that legally endorsed euthanasia would remove one of those levels of protection, especially if it were watered down, or assumed as a background condition of other policies, such as care for the elderly.
Olwyn,
I’m glad you accept the “slipping extra morphine” as the gesture of mercy that it undoubtedly is. Unfortunately, not all diseases and conditions warrant the use of increasing doses of morphine because not all are painful. Some diseases leave the patient to die of suffocation or dry drowning (like waterboarding – not painful, but terrifying). Then again, many people dread being trapped immobile forever inside their own bodies, thinking cogently but unable to move a muscle, groan or even shed a tear to communicate as sometimes happens after a stroke. I know for absolute certain that I would not want that for myself. Not out of fear of being a burden to my family, but out of absolute horror at the thought of years, perhaps decades of a “living death” that makes me less than human by my own evaluation. These cases are rare, but they exist. The Medical Association and the hospice movement acknowledge that they do. Those who wish to live through such possibilities or to have others decide for them when/if the time comes must be allowed to do so, as they do now. But those of us who do not, need a mechanism to avoid it. The mechanism is to legalise voluntary euthanasia.
@jenny Kirk
Is it concern for labour’s party vote or something else that has you worried? I would not worry about the former because Sue Bradford’s so-called ‘anti-smacking’ bill happened when labour was in power. Because labour had flirted with so much socially-progressive (Tory pundits call this ‘social engineering’) legislation, they were hit with the backlash of the Nanny State Labour meme.
The effect of this is now all but spent. The penguin and the whale, who do so much for establishing the MSM zeitgeist, will probably support this bill.
I think it is just as likely that Smile and Wave will table some meaningless amendments to reflect his ‘common sense’ concerns, will then support the bill himself, and then he will bank the political capital from its passage. So your comparison to the anti-child abuse bill may not be so far off.
All our concerns for others are still at root self interested concerns of ourselves….life allows no opting out of that fact.
Thank you Maryan for having the courage to take this bill to Parliament.
Few other members would have the intestinal fortitude to do so..
In 1994, when the first bill was introduced, I took issue with my local M P(a member of the National Party)for voting on the bill (negatively) without ever consulting with his constituents.
Therefore,I encourage all those who favour an “End-of-life choice”to talk with their M P ‘s.
All of my life I have voted National,but in the future it will be Labour!! .
@ Carol Sweeney
Actually it is an offence to try to take one’s own life, which is a bizarre aspect in itself. Perhaps to dissuade attention seekers, I don’t know.
I believe however that as an advanced creature the right to choose whether we live, or don’t live, should be in our own hands.
But it raises too many issues for society to deal with. I heard about a friend of a friend who chose not to live, his note was read at his funeral basically outlining the mental torment and circumstances which led him to that decision, and apparently this was a great relief to those who loved him.
Bloody sad anyway.
Statistics show that the most likely victims of their own hand are men who are unable to deal with the Family Court sanctioned estrangement of their children, loss of their home, and ritual allegations of abuse (encouraged by Lawyers)to facilitate this.
So we have a few issues to address in our society around right to life, right to decide, rights of fathers.
This is an excellent idea, and I am so glad to see someone having the courage to spark this debate. I recently watched my father die in a most horrible fashion from cancer, and listened to him on several occasions ask either myself or my mother if we could help him end it, that he couldn’t do this any more. Hospice care he received was inadequate, pain relief was totally inadequate, and unfortunately, he died in a great deal of pain and no peace at all. It would have been much easier on the family if we’d had the option of discussing this sensibly, instead of having god awful moments where we all looked at each other, wondering if any of us had the courage to do the thing my father was asking. To this day, I regret not doing as he asked, and I find it deeply offensive that those who have not seen this level of pain, both physical and mental, would try to tell me that decision is not my father’s or our family’s to make. Please do take this to parliament, you will have my and my families support all the way.
Thank you for this, I agree that it is uncivilized to prevent people from taking control of their end-of-life choices.
You will come under fire from those whose beliefs compel them to impose their own values on the entire population, in the process denying others their own choice.
The hospice movement is also fond of assuring us that they can control terminal pain and discomfort in almost all cases – they can’t and dont.
Please stick to your guns on this one. I’ve seen too many appalling deaths, both in and out of hospital, and would like to see terminally ill people allowed a decent, peaceful and timely death if they wish it.
Kia kaha.
I am thrilled Maryan Street has raised this again. I sincerely hope this will pass through all the stages and succeed where previously it had failed to.
Freedom of choice has been granted by God. It is wrong for people to deny that right to fellow mortals.
Hueline and I are very glad you are bringing this up again Maryan,in a thoughtful way as we would expect from you,that hopefully will be able this time round to prompt some action through a conscience vote. It is a subject we must have all thought about at some times – and needs attention in law.
Again – thank you all for your heartfelt and closely lived stories. I am hearing more of them everywhere I go.
@Jenny Kirk – The Section 59 bill promoted by Sue Bradford was not a conscience issue. The House voted in a party vote on the third reading after compromises had been reached. This bill will without doubt be a conscience vote to the end. I do not believe rebuilding the Party and pursuing progressive legislation are mutually exclusive activities.
@Waiheke Mark – it is not an offence actually to take your own life. But it is an offence to get anyone to help you do so.
And to Warwick and Hueline – nice to hear from you.
A second message to pick up on your suggestion of including Advance Directives as part of the Bill. I think that’s an excellent idea, so I hope it’s included; yes with regular updates. When we (as individuals) are in sound mind–and well ahead of time–we are in a position to consider future end-of-life scenarios, and how we would like to be treated, including being allowed to die with dignity at the time of our choosing. This is another useful way of expressing our individual preferences at a non-stressful time, or when we have a condition (e.g. stroke) that means we are unable to communicate our wishes.
Thank you so much for the opportunity of expressing our views, and for your courage to start discussing this sometimes difficult topic.
I’m not sure if you’re familiar with TED.com, but Peter Saul gives a really, really excellent free talk that you can watch on the issue, that is available here:
http://www.ted.com/talks/peter_saul_let_s_talk_about_dying.html
13 minutes of your time that you won’t regret spending.
Thank you for being brave enough to raise this issue again. I agree with you the numbers will be different this time.
I watched both my parents die from cancer and it was horrible, they were both ‘around’ for about 2 weeks longer than they needed to be. We all knew the end was nigh and there was no quality of life.
My Dad died when he was 53 years old; about 4 1/2 mths after diagnosis and he complained often about the lack of dignity he was experiencing.
For myself I do not want to go that way. Most particularly because I do not want my family to suffer.
So besides terminal cancer I would like to be able to have an advance directive that states that if I am ever diagnosed with Dementia or similar and become unfit to live in my own home then I want to be able to exert my right to voluntary euthanasia that I specified when I was of sound mind and body.
This is an interesting point because we may decide this early on and yet when we reach that point are not cognisant enough to exert that wish and it is unfair to expect of your spouse or children when they risk criminal prosecution.
For those people who don’t agree that’s fine – they can CHOOSE not to have anything to do with Voluntary Euthanasia but I want the right to be able to CHOOSE it.
By the way, comparing this subject with the anti-smacking bill is not comparing apples with apples.
Kia kaha Maryan
In the New Zealand Herald of today, 10th April 2012, there is yet another tragic case that describes an alleged assisted suicide. Once again, the illness was irreversibly progressive and once again, palliative measures failed to give relief. The victim (Mrs Mott, aged 55) tried to protect her husband by sending him out of the house before committing suicide alone, but he has been arrested and charged with assisting her to research suicide methods. Their story was never going to have a happy ending, but it could have been happier if voluntary euthanasia had been legally available to this lady. Instead of dying alone and undoubtedly afraid, she could have died peacefully and swiftly with her husband and family around her. Bring on that good day!
Maryan – thank you for having the compassion and political guts to initiate a new Bill to try to make some sense of the law. The right to End-of-Life choice must come soon. The opinion polls for the last 20 years have shown 70% of people interviewed want change. I am sorry for the judges and the police having to act on antiquated legislation but mostly for those family members who are convicted for “crimes” of compassion. Now is the time for Parliament to act for the people – maybe a 70% vote in favour of your Bill, Maryan?
Congratulations to Maryan Street on proposing to introduce her End of Life Choice bill.
I see that unlike her two predecessors in this field she has the good sense to consult with the Voluntary Euthanasia Society beforehand.
I assume that the wording of her bill has not yet been finalised so I would stress the need to ensure that the bill includes the incurably chronically sick as well as the terminally ill within its ambit.
Frank Dungey
Congratulations Maryan on both your Breakfast T V interview and more recently on the T V 3 “Think tank”
You shone like a star !!–so articulate concise and clear in your statements.
I am sure you impressed many T V watchers.
Thank you for your courage in taking this bill forward.
Thank you Maryan for all your hard work in preparing the new bill” end of life choices” and working together with people who have thought about these issues for decades: the representatives of the VES New Zealand .
Sounds like New Zealand might soon be a leader in the Pacific on important moral issues , excellent timing, thrid time absolutely unmistakenly right!
1. Life and health care insurance companies plus ACC and the government.
The former may try and avoid pay out, even if the illness was fatal (valid if the illness was not fatal, not otherwise). The latter could benefit from intransigence over coverage and drive a person to termination of their life to spare the family (and or their inheritance estate) the cost of their care.
Olwyn is right to be wary about consequences – the general paranoia of the right about welfare cost is extending its reach into care of the aged and tax paid super (also some affordability test for the right to bear children and raise them up).
We would probably need to look at human rights legislation in relation to this issue if/as we proceed – be fully aware of the risk of placing a cost on preserving human life. Government austerity cannot be allowed to compromise “human” values.
It’s bad enough we rationalise the cost of economic failure to accept Pharmac being left unable to afford the best medicine – undermine the quality of life of others.