Euthanasia discussion – comments

Here are some of the comments from Euthanasia and Assisted Suicide — A Discussion We Need To Have held in Dunedin on Thursday.

Thomas Noakes-Duncan (postgraduate student, Department of Theology & Religion) started with a presentation of a short research paper on attitudes towards euthanasia in NZ society

What is at stake?
1. Compassion
Ethical issues, humane, crime of compassion
The nature of our dying has changed.
Can we talk of a natural death any more?
God is not dominant any more, doctors are.
2. Dignity
My body, my choice.
Is death on demand a commodity?
God gives each of us the choice to decide to live, or to end our life.
3. Secularism
Secularisation has radically altered our world view.
Ethics, liberty and human rights.
Exit at a time and means of our own choosing.
Three questions:
1. Emotion over moral reason?
2. Compassionate solidarity? Note social loneliness.
3. Naive?
Power of the media.
Right to die versus duty to die?

Professor Sean Davison (author of Before We Say Goodbye)

His mother was a medical doctor who got cancer. She stopped eating, and after five weeks of wasting away she asked for help to die.
Ask anyone else what they would have done?
– Any humane peerson would have done it.
Not a crime to help someone to die when theyb have made a choice.
(meaning it shouldn’t be, he was convicted of helping)
A right to say “no thank you, I’ve had enough”.

Professor Grant Gillett (University of Otago Centre for Bioethics), has been working on end of life issues since 1995.

Euthanasia isnpersuasive.
Patient shouldn be able to ask doctor to hasten death.
Doctors have a fundamental hangup.
Value of life.
It can be hard to make decisions in the middle of your own tragedy.
Hard not to feel some depression when facingb terminal illness.
Medical profession says they should not hasten death.
Doctors can just hasten death but should be told to do so.
A doctor must stop treatment if requested by the patient.

Hon Maryan Street, MP (sponsor of a Private Member’s Bill to legalize some end-of-life options)

If drawn from the ballot this would be the third attempt to pass legislation in parliament on legislation, and would be a conscience vote.
1995 – 29 for, 61 against.
2003 – 57 for, 60 against.
Cannot have end of life discussion without ann involvement from faith.
It’s about dignity and choice.
Levels of protection:
1. Wishes must be made when of “sound mind” (this was argued against later).
2. Competent to make decision.
3. Protected from coercion – no family or doctor coercion.
4. Protection for family members from criminal liability.
Palliative care is very good quality but doesn’t provide choices.
Social conversation needs to be had.
Lobby every member of parliament to tell them how you want them to vote.

John Kleinsman (Director, Nathaniel Centre, the NZ Catholic Bioethics Centre, Wellington)

Implacably opposed to euthanasia.
Implacably opposed to legislation on euthanasia.
Personal position isn irrelevant.
Can it be safely be implemented? No.
Not satisfied with the status quo.
Currently there isn’t equal access to palliative care, once we have that we can have this debate.
We are in one of the most dangerous times.
New pathways for elder abuse.
Burden of proof may lead to duty to die.
Cannot be limited to a small group.
There would be a progression to non-volunteers.
What about mental suffering without imminent death?
Abuses will continuie to occur?
All or nothing, it’s a farce to talk about voluntary.
It wouldn ultimjately empower the state.

Associate Professor Colin Gavaghan (specialist in medical law and ethics, Faculty of Law)

Quite limited case law.
There’s no such law as euthanasia, it comes under the general law of homicide.
Time isn’t important in law – whether the imminence of death is hours or months.
Does an action actually have an effect on shortening life.
Could prove an attempt to shorten life, but difficult to prove it actually shortens the life.
Must be proven to be intentional.
Assisted suicide – who takes the final step? Swallowing, or giving?
Inciting – if initiated by another person.
Aiding and abetting – degree of uncertainty on this.
Is gathering information aiding and abetting?
Assisting sonmeone to travel to a place they can be assisted in suicide?
Doctors can knowingly shorten life with analgesics, or by withdrawing treatment (which is legal).
Coercion and competence are issues.
Concerns already with us under current law.
Doubt now about where the line is drawn.
The current legal situation is not black and white.

Questions and responses.

Need to carefully define words and underlying assumptions, eg dignity of death.

Q. compare it to sending many people to war knowing it will kill some of them.
(the debate was the day after ANZAC Day)
Davusin: Have to draw the line at “terminally ill”.
Calling it “assistance in dying”.

Q. What can we do to encourage MPs to look at it?
Street: Calling her bill “end of life choice bill”.
Making decisions to hasten death.

Q. Are we at an unfortunate patch in history?
Davison: decades agowe didn’t talk about Aids, abortion. Similarly it’s no longer taboo to talk about euthanasia.
Davison: To get a law passed it has to be very clear – someone who is terminally ill should have a right to choose.

Q. If it’s limited to people “of sound mind” does that rule out being depressed about dying, which will oiften be the case?
Street: People with clinical depression must be excluded.
Street: Two doctors must make a clinical judgement of soundness of mind.
Gavaghan: a degree of depression is likely, but does that mean a lack of “sound mind”? Depression may not be incompatible with making a competent decision.

Q. an 82 year old man has since forty repeatedly made written statements about his wish to choose his own manner of death. If he becomes “gaga” will that be taken into account?
Street: Advance directions would not able to be overturned, but it must be refreshed. Every 2, 3, 5 years?

Q. Asked to compare mercenaries – professional killers – versus voluntary euthanasia.

Q. If doctors assessments are confidential who do you guarantee there’s no coercion?
How to check if two doctors are not just selected to “tick the boxes”?
A. There should be a health and disability advocate?
Doctors are tremendously trustworthy people, ethical.
Kleinsman: could specialists who are not doctors be used? He said in Oregon the two doctor test is not working as people go doctor shopping to fin onse that will agree.

Q. Concern over abortion law parallel where in practice “choice” is available on a threat to mental health basis.
Kleinsman: the intention of law doesn’t always work in practice.
Street: legislation would erequire a review after say 5 years.

Q. What happens if the elderly are deemed to have become a burden?
Gavaghan: there’s no way to make the law 100% safe. No other part of healthcare is.
Davison: stastistics show that when choice is available the rates of suicide decrease.

Q. Is it all or nothing? (if allowing choice in some cases will it open floodgates?)
Street: Could not disagree more. It’s possible to have legally assisted suicide without it morphing into legal murder.

NOTE: these comments are in my words as noted in attendance at the discussion.

My conclusion = a complex issue with no simple answers.
I agreed mostly with most points made, with several interesting quandaries and questions raised.
We can’t stop everyone making their own choices because it may be abused by a few.

Euthanasia and Assisted Suicide — A Discussion We Need To Have.

- was held in the Colquhoun Lecture Theatre, Dunedin Public Hospital, 26th April 2012.

It was organised by the Centre for Theology and Public Issues. The Centre is based in the Department of Theology and Religion at the University of Otago. It was founded in January 2009, and is New Zealand’s first.

4 Comments

  1. Rachael Ford

     /  April 28, 2012

    As a nurse I can say I don’t agree it is complex. It is very simple – people who rationally elect death because they do not want to suffer physical pain should have an absolute right to do so. The only strong objections come from religious twits and don’t hold water. The same religious twits who wholeheartedly support continuation of the death penalty in America very often – go figure. Humans deserve the same rights dogs have in this situation. Euthanasia happens all the time, it’s just swept under the carpet, but it would and should happen more and with better support and processes to ensure against mistakes eg relatives acting under stress when actually changes to the medical regime could have restored ample quality of life. Not in support =’s wet behind the ears imo.

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