Health select committee agrees to euthanasia inquiry

In response to a petition presented to Parliament by the Voluntary Euthanasia  the Health Select Committee has agreed to investigate matters raised by the petition.

NZ Herald reports: Parliament to hold euthanasia inquiry following Lecretia Seales’ death

An inquiry into voluntary euthanasia is to be carried out by Parliament – a process supporters hope will be an important step towards a law change.

Today’s announcement comes after a petition from the Voluntary Euthanasia Society was presented to Parliament by supporters including Matt Vickers, the husband of the late Lecretia Seales.

The petition, signed by former Labour MP Maryan Street and 8,974 others, asked that Parliament’s health and select committee “investigate fully public attitudes towards the introduction of legislation which would permit medically-assisted dying in the event of a terminal illness or an irreversible condition which makes life unbearable”.

It will set-up an inquiry to “fully investigate the matters raised by the petition”, health committee chair Simon O’Connor said.

The terms of reference will be drafted over the next few weeks, which will form the outline of that investigation.

“This is an important subject and the committee needs to think carefully about the best way to examine it,” Mr O’Connor said.

“I would like to see a thorough investigation that covers as many aspects of this topic as possible in a responsible and robust manner.”

It’s impossible to know where this may lead, if anywhere, but i think it’s time Parliament properly and comprehensively looked at the pros and cons of voluntary euthanasia, the right to choose how we die etc.

Dunne supports discussion on end-of-life issues

Another thoughtful blog post from Peter Dunne on ‘end-of-life’ issues which although not named includes euthanasia.

The issue of end-of-life care is on the agenda again. I am not one who believes that doctors should be able to kill terminally ill patients, but then I doubt many New Zealanders do either. In any case, the issue is far more complex than that, which is why a wider inquiry is justified.

All of us who have experienced the pain of watching someone close to us suffer a lingering and often painful death have felt the anguish and powerlessness of wanting to do more to help, but being unable to do so.

We have admired the dedicated and compassionate efforts of those involved in palliative care and know of the medications now available to ease pain and make the last stages of life more comfortable, and are hugely appreciative of that.

But, at the same time, we are becoming more aware that end-of-life care is but one aspect of overall health care. Advanced care planning, where people discuss with family at earlier stages of life what their expectations are when they become old and/or frail or suffer from a terminal illness, is becoming equally important.

Similarly, understanding people’s expectations is also a significant consideration as well. At a time when the bulk of health spending occurs in the last five years of a person’s life, are we certain that is what they want, or do they simply want a dignified, managed exit?

Medicines management is another factor. For years now it has been an open secret that doctors manage the demise of terminal patients through adjustment to medication levels to ease suffering and assist gentle death.

Nor is it a new practice – King George V’s doctors reportedly managed his death nearly 80 years ago so that it could be announced in the morning papers. But doctors managing life as it ebbs away is different from actively securing its end.

Nevertheless, the moral argument about the sanctity of natural life and that no-one has the right to interfere with it begs the question somewhat. While I have sympathy with that view in an absolutist sense – hence my vehement, unwavering opposition to capital punishment – I acknowledge that in many terminal cases, it is questionable (as a consequence of medication and other life support measures) whether a patient is actually living a natural life any more. Therefore, the morally absolutist argument may no longer be relevant in all cases.

And then there is the question of free will. I was always taught that the most precious gift we possess – which defined us as human beings – is free will, the right to be able to decide for ourselves.

Any debate about the end of life cannot overlook this fundamental point. What a patient “wants” should rank ahead of what “we can do” for the patient in such circumstances, provided the patient’s decision is rational and informed, which brings us back to the advanced care planning argument. In such instances, do the rest of us have the right to override a patient’s wishes?

Providing a patient who requests it with the means to end life in such circumstances is arguably different from another person deliberately ending that life. The ultimate recognition of free will is, after all, respecting people’s exercise of it.

A public discussion about all these issues would be welcome and timely. Ideally, an independent expert panel should be established, with a wide-ranging brief to consider and advise upon all aspects of end-of-life care and how it should be managed. This inquiry should undertake widespread public consultation leading to the presentation of full and thorough recommendations to Parliament for action. For its part, Parliament needs to show its willingness to both lead and respond.

It’s good to see MPs contribute to thoughtful discussion, especially Ministers.

Binding referendum an awful option for euthanasia

Tracey Martin said on The Nation that she didn’t have a position of euthanasia and didn’t think Parliament should vote on it, and that it should go to a binding referendum.

I think euthanasia would be one of the worst things to be decided by a binding referendum.

This issue is complex and has very serious implications. It needs a very thorough investigation into all aspects of it and then MPs should do what they are elected to do, represent all of us responsibly.

It would be possible to get popular support for “euthanasia should be a personal choice in consultation with a person’s doctor” in a referendum, and it would be highly irresponsible of Parliament to allow something like that.

Referendums are fine for things like flags, but not for protecting a small vulnerable minority.

A binding referendum would be an awful option for euthanasia.

Martin is either severely misguided suggesting a public vote – or she is trying to avoid stating a position on euthanasia. Possinble both.

David Seymour on ‘end of life choice’

It was announced yesterday that the Health Select Committee will carry out an inquiry into voluntary euthanasia – see Select committee to consider euthanasia – after a petition was presented to the committee.

ACT MP David Seymour was one of a number of MPs who were present when the petition arrived at Parliament. He is drafting a Member’s Bill to try and initiate debate on euthanasia. He has also just posted his thoughts on this difficult topic.

Free Thoughts – End of life choice

The contentious issue of voluntary euthanasia is one I have been considering for some time, and I want to explain here why I am preparing a private member’s (End of Life Choice) Bill to lodge for ballot in Parliament.

The primary motivation for this Bill is compassion.

Many of my constituents have urged me to proceed with a Bill, particularly in light of the withdrawal last year of a similar Bill sponsored by Iain Lees-Galloway, originally introduced by former MP Maryan Street. Two previous Bills on this issue have in the past failed to gain Parliamentary support, but the clear international trend since the 1990s is towards the legalisation of medically assisted end of life choice.

The motivation for this Bill is the very real anguish faced by people with terminal illness, as they anticipate the prospect of intolerable suffering, and the indignity of the final few days and weeks of their lives. While pain can be ameliorated somewhat, the suffering and indignity of that final period of life remains a profound concern to many people.

The intention of the Bill is to allow people with a “grievous and irremediable medical condition” to obtain medical aid to die if they should so choose.

I appreciate that within our community there is a wide range of religious and philosophical views which influence attitudes to this issue. What is unthinkable for some, is considered by others the most compassionate way to address the inevitability of end of life, and the realities of terminal illness.

The Bill I intend to lodge will offer choice that is currently prohibited, for those in our community who are grievously and irremediably ill and who wish to have the option, as they near life’s end, to choose the manner and timing of their final days.

The protections designed to avoid potential abuse are crucial, and would need to be fully examined before any final Bill was to return to the House. A Select Committee process considering specific proposals will enable all these matters to be considered in detail and in public, will provide an opportunity for the full range of views in our community to be heard, and will allow us to examine the international experience.

There are several key considerations behind my intention to lodge a private members Bill.

In my view it is politically, morally, legally and, in terms of public policy, the right thing to do.

I will consider each of these in turn.

Legally this is the right thing to do.

As noted in the recent judgement on the Lecretia Seales case, the issue of end of life choice is a matter for Parliament to determine.

Likewise, earlier this year the Canadian Supreme Court determined unanimously that “The prohibition on physician-assisted dying infringes on the right to life, liberty and security of the person in a manner that is not in accordance with the principles of fundamental justice.”

But the Court suspended its judgement for 12 months, giving the Canadian Parliament a year to draft new legislation to reflect that judgement.

This reflected a view that it is a matter for Parliament to decide, not the Courts. Legislation to give effect to assisted dying will involve very many detailed ethical, legal and practical considerations.

The scrutiny of a select committee process, examining a concrete proposal, is the best and most thorough way of considering this issue.

In terms of appropriate legal process, introducing a Bill to Parliament is the right thing to do.

Morally this is the right thing to do.

The difficulty with assisted dying is that we are attempting to balance competing values, each of great importance.

The first is the sanctity of life and the need to protect the vulnerable. The second is the autonomy and dignity of a competent adult who seeks to end their life as a response to a grievous and irremediable medical condition.

The difficulty is that an absolute prohibition on assistance in dying effectively creates a “duty to live” rather than a “right to life”.

An absolute prohibition on assisted dying also calls into question the existing legality of any consent to the withdrawal or refusal of lifesaving or life-sustaining treatment. Yet already there is a degree of societal consensus that the administration of palliative sedation and the withholding or withdrawal of lifesaving or life-sustaining medical treatment, which can have the effect of hastening death, are ethically acceptable.

Protracted dying was once rare; death typically came swiftly. But medicine has advanced, and now a protracted death is common.

By acknowledging this reality, the argument can be advanced that it is also ethical for voluntary adults who are competent, informed, grievously and irremediably ill, and where the assistance is clearly consistent with the patient’s wishes and best interests, and in order to relieve suffering, for them to have the option of physician assisted end of life.

In short, an absolute ban on assisting another person to end their own life can amount to condemning a person to a life of severe and intolerable suffering.

It was for that reason the Canadian Courts concluded that the ban on assisted dying was too broad – by justifiably attempting to protect the vulnerable, it denied the rights of some individuals in a way that bore no relation to the object of the law.

As the Court said, “A person facing this prospect has two options: she can take her own life prematurely, often by violent or dangerous means, or she can suffer until she dies from natural causes. The choice is cruel.”

That is why the international trend since the 1990s has been for Parliaments to recognise that, in certain well defined circumstances, an individual’s choice about the end of their life is entitled to respect.

The international evidence was closely examined in the Canadian courts. There it was stated that an absolute prohibition on assisted dying would have been necessary if:

  • The evidence showed that physicians were unable to reliably assess competence, voluntariness, and non-ambivalence in patients;
  • That physicians fail to understand or apply the informed consent requirement for medical treatment;
  • Or if the evidence from permissive jurisdictions showed abuse of patients, carelessness, callousness, or a slippery slope leading to the casual termination of life.

But after an exhaustive examination of the evidence these possibilities were rejected. The judgement found that properly designed and administered safeguards were capable of protecting vulnerable people from abuse and error, that the elderly or people with disabilities are not at a heightened risk, and that there was no evidence of a slippery slope.

Before any changes to New Zealand law are contemplated, these issues should be considered afresh by our Parliament.

Morally, reconsidering the law on end of life choice is the right thing to do.

Politically this is the right thing to do.

My job as a Parliamentarian is to represent the voters, and that involves reflecting the will of the public, insofar as that “will” makes sense and is not inconsistent with my fundamental beliefs.

On this issue, for some MPs, there will inevitably be a clash with some profoundly important religious or philosophical beliefs.

That said, the public clearly wish this issue to be debated, so that regardless of one’s personal view on the matter, this is an issue which deserves to be placed before the House – as I will seek to do with my Bill – and which deserves also to be taken at least to select committee for the sort of thorough review that the Canadian case examined.

Advancing the consideration of End of Life Choice through a Bill to be thoroughly examined via select committee, is the best way to respond to the wishes of the NZ electorate.

I concluded therefore that, politically, introducing my Bill is the right thing to do.

In terms of public policy this is the right thing to do.

The law against assisting somebody to end their life, is of course a ‘generally sound law’. But it is also one which has an extraordinarily harmful effect on a small number of individuals.

As the Canadian judgement determined, that law is overly broad.

As a matter of public policy, we need to reconsider the situation of that small number of persons who:

  • clearly consent to the termination of their life, and
  • have a grievous and irremediable medical condition, including an illness, disease or disability, that causes enduring suffering that is intolerable to the individual.

The eventual scope of any Bill which might be returned to the House from a select committee review is not to be determined here.

My case is that New Zealand needs and – as is evident from recent opinion polls – wants this debate.

Our Parliament should facilitate this discussion by considering this issue afresh through the mechanism of a Bill passing its first reading in the House and proceeding to select committee review.

All New Zealanders should have the opportunity to be heard on this matter. The discussion and review should not be rushed.

My End of Life Choice Bill, when lodged and if drawn from the private members’ bill ballot, will allow this much needed review to occur.

It is the right thing to do.

David Seymour
ACT Party Leader

This is thoughtful and politically gutsy stuff from Seymour. Some people will strongly oppose making any changes on law around euthanasia and other parties have not been prepared to promote debate on it. In fact Seymour has picked up a Labour Member’s Bill carried over from last term by Iain Lees-Galloway after Andrew Little had it withdrawn as ‘not a priority’.

Select committee to consider euthanasia

It was announced yesterday that the Health Select Committee will carry out an inquiry into voluntary euthanasia. Stuff reports:

Voluntary euthanasia to be examined by Parliamentary inquiry

Announcing an inquiry on Wednesday, chairman of the health select committee, Simon O’Connor, said members were “ready to engage” on what was an “important conversation that needs to be had”.

This follows a petition on euthanasia being presented to Parliament on Tuesday.

On Tuesday, former Labour MP Maryan Street and Matt Vickers, the husband of Lecretia Seales, who died of a brain tumour on the same day she lost a High Court bid, presented the End-of-Life Choice petition to MPs.

The petition was delivered to the health select committee on Wednesday and will now be part of a wider inquiry into voluntary euthanasia.

This is a partial posthumous victory for Seales.

It would take a couple of weeks to come up with a plan for the inquiry, O’Connor said.

The inquiry would consider how best to involve the public and what questions and terms of reference need to be included, he said.

The petition, which has 8975 signatures, garnered cross-party support with Seymour, Green MP Kevin Hague, National MP Chris Bishop and Labour MP Iain Lees-Galloway all turning up on Tuesday to receive it.

This is a difficult topic to deal with but it’s something that our Parliament should seriously look at so this is a promising announcement.

Seymour and ACT lead on euthanasia

While the large party leaders waffle and wait in the wake of Lecretia Seales raising attention on the euthanasia issue, ACT leader David Seymour continues to work on doing something about it.

Mr Seymour is the only MP currently working on such a bill and he said he had briefed Mr Key on it a few weeks ago.

He said it would be based on former Labour MP Maryan Street’s member’s bill, which her party withdrew last term because it was wary of such a controversial topic. Mr Seymour said he had been working on it for several months but needed time to consult medical experts and others.

He said the Act Party board had signed off on it and he had done polling in Epsom to ensure it would not endanger his hold on the electorate.

While the others talk empty words bout doing something Seymour has stepped up and leads on an issue that has substantial public support.

This isn’t a case of wagging the dog, in this case the mangy old National and Labour dogs play politics and do nothing.

Little: “That stuff on euthanasia, it isn’t the time for us to be talking about that”

Labour leader Andrew Little has criticised John Key ‘dodging’ the euthanasia issue. This would be fair criticism – except that Little has not just dodged the issue, he

From Act plans assisted dying bill:

Mr Little has accused Mr Key of trying to dodge the issue by refusing a Government move on it. But he has also ruled out a change in Labour’s decision not to put in a bill, saying his party’s preference was for a select committee inquiry.

Last term Labour MP Maryan Street had a Member’s bill on euthanasia, and that was taken over by Iain Lees-Galloway. But Little stomped on that.

Labour MP drops euthanasia bill

A bill which would legalise voluntary euthanasia has been dropped by Labour MP Iain Lees-Galloway at the request of his leader Andrew Little.

Mr Lees-Galloway had been canvassing support for his End of Life Choice Bill before deciding whether to return it to the private members’ bill ballot.

But Mr Little confirmed yesterday that he had told Mr Lees-Galloway not to put it in the ballot because it was not an issue Labour should be focused on when it was rebuilding.

“It comes down to priorities at the moment,” Mr Little said. “We are very much focused on … jobs and economic security.

“There are more people affected by weak labour market regulation and weak economic strategy than they are about the right to make explicit choices about how they die.”

Mr Little said Labour was still a socially progressive party under his leadership.

“It’s not about avoiding controversy but it’s about choosing the controversies that are best for us at this point in time. That stuff on euthanasia, it isn’t the time for us to be talking about that.”

So Little has already dodged dealing with euthanasia. Criticising Key for not doing anything is highly hypocritical of Little, who deliberately kept a bill out of the ballot.

Little: “That stuff on euthanasia, it isn’t the time for us to be talking about that”.

So ACT’s Seymour took over Labour’s bill. Little looks more than a little hypocritical for criticising Key for trying to dodge the issue.

Key cops out on addressing euthanasia

While John Key says he supports Parliament looking at the euthanasia issue he is not prepared to do anything about it, instead leaving it to the slight chance a bill will be drawn from the Member’s ballot.

From Act plans assisted dying bill:

The hopes of euthanasia supporters appear to rely on Act leader David Seymour and the luck of the draw after both Prime Minister John Key and Labour chief Andrew Little ruled out putting up a bill on the issue.

Mr Key said yesterday that he felt sympathy for Lecretia Seales’ case on assisted dying for the terminally ill but others in National were strongly opposed to it and the Government would not sponsor a euthanasia bill.

Mr Key said he agreed with Justice David Collins’ ruling in Lecretia Seales’ court case that it was up to Parliament to change the law on the issue. However, that should be a conscience vote for MPs and dealt with in a member’s bill.

It should be a conscience issue but it doesn’t have to be done through a Member’s bill.

The PM said National was open to a select committee inquiry that could result from a petition on the matter and allow public debate.

The decision to rule out a Government bill means an individual MP will have to put in a private member’s bill and rely on luck to get it into the House, because measures are selected by ballot.

Although it could go straight into Parliament if there was unanimous agreement from MPs, Mr Key doubted that would be achieved.

Polls show there is strong public support for addressing euthanasia.

Key is copping out.

It looks like he is avoiding annoying some of his caucus rather than deal with something for which there is widespread support.

Very disappointing.

National supporter and pollster David Farrar posted Collins and Goff on euthanasia at Kiwiblog and said:

What we need is a bill to be introduced. I believe it would have overwhelming public support, and so long as there were strong safeguards, would get a significant majority in Parliament to pass it.

He also posted Parliament will debate euthanasia on Saturday:

Good to see that a bill will be put forward. The challenge will be to get it drawn from the ballot, or adopted by the Government (less likely).

I believe any bill, if drafted carefully with safeguards, will pass Parliament with a substantial majority.

Public opinion is massively in favour of a law change. The last public poll saw 74% in favour and just 20% opposed.

A select committee inquiry in response to the petition is a useful thing to do, but not as a substitute to a bill. It can get the arguments on the table, but it can’t lead to a law change, a vote in the House or even a debate in the House. As it is uncertain when a bill might be drawn out of the ballot, it is a good thing to do to keep attention on the issue, and hear arguments on what safeguards there should be. But a bill should go into the ballot as soon as possible, to maximise the chance of it being considered this term.

It’s disappointing that while both John Key and Andrew Little say they support addressing euthanasia neither of them will do anything about it, despite a large majority of public support.

Good on David Seymour and Act, but democracy is poorly served if it’s left to a one MP party to put a bill forward on this.

NZ Herald:

Mr Key said that while he doubted National would block one of its MPs putting up a bill, none had approached him wanting to do so. He said he was likely to support a bill if it struck the right protections.

“Striking the right legislative balance with clear definitions and adequately strong protections is an extremely difficult task and the fact no bill has yet passed is testament to that.

“However, Lecretia has certainly succeeded in sparking a debate on the issue.”

Key is talking the talk but Lecretia has failed to prompt him to walk the walk.

Oregon Death With Dignity Act

In discussions about euthanasia (like Collins and Goff on euthanasia today on Kiwiblog) the Oregon example is often mentioned.

A summary (from Wikipedia ht SGA):

Under the law, a competent adult Oregon resident who has been diagnosed, by a physician, with a terminal illness that will kill the patient within six months may request in writing, from his or her physician, a prescription for a lethal dose of medication for the purpose of ending the patient’s life. Exercise of the option under this law is voluntary and the patient must initiate the request. Any physician, pharmacist or healthcare provider who has moral objections may refuse to participate.

The request must be confirmed by two witnesses, at least one of whom is not related to the patient, is not entitled to any portion of the patient’s estate, is not the patient’s physician, and is not employed by a health care facility caring for the patient.

After the request is made, another physician must examine the patient’s medical records and confirm the diagnosis.

The patient must be determined to be free of a mental condition impairing judgment. If the request is authorized, the patient must wait at least fifteen days and make a second oral request before the prescription may be written.

The patient has a right to rescind the request at any time.

Should either physician have concerns about the patient’s ability to make an informed decision, or feel the patient’s request may be motivated by depression or coercion, the patient must be referred for a psychological evaluation.

The law protects doctors from liability for providing a lethal prescription for a terminally ill, competent adult in compliance with the statute’s restrictions. Participation by physicians, pharmacists, and health care providers is voluntary. The law also specifies a patient’s decision to end his or her life shall not “have an effect upon a life, health, or accident insurance or annuity policy.”

From the Oregon Publ;c Health Authority:

On October 27, 1997 Oregon enacted the Death with Dignity Act which allows terminally-ill Oregonians to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose. The Oregon Death with Dignity Act requires the Oregon Health Authority to collect information about the patients and physicians who participate in the Act, and publish an annual statistical report.

A number of links are provided, including to the statute:

Oregon Revised Statute

Note: The division headings, subdivision headings and leadlines for 127.800 to 127.890, 127.895 and 127.897 were enacted as part of Ballot Measure 16 (1994) and were not provided by Legislative Counsel.
Please browse this page or PDF Documentdownload the statute for printing – (or read the statute athttps://www.oregonlegislature.gov)

127.800 s.1.01. Definitions.

The following words and phrases, whenever used in ORS 127.800 to 127.897, have the following meanings:

(1) “Adult” means an individual who is 18 years of age or older.

(2) “Attending physician” means the physician who has primary responsibility for the care of the patient and treatment of the patient’s terminal disease.

(3) “Capable” means that in the opinion of a court or in the opinion of the patient’s attending physician or consulting physician, psychiatrist or psychologist, a patient has the ability to make and communicate health care decisions to health care providers, including communication through persons familiar with the patient’s manner of communicating if those persons are available.

(4) “Consulting physician” means a physician who is qualified by specialty or experience to make a professional diagnosis and prognosis regarding the patient’s disease.

(5) “Counseling” means one or more consultations as necessary between a state licensed psychiatrist or psychologist and a patient for the purpose of determining that the patient is capable and not suffering from a psychiatric or psychological disorder or depression causing impaired judgment.

(6) “Health care provider” means a person licensed, certified or otherwise authorized or permitted by the law of this state to administer health care or dispense medication in the ordinary course of business or practice of a profession, and includes a health care facility.

(7) “Informed decision” means a decision by a qualified patient, to request and obtain a prescription to end his or her life in a humane and dignified manner, that is based on an appreciation of the relevant facts and after being fully informed by the attending physician of:

(a) His or her medical diagnosis;

(b) His or her prognosis;

(c) The potential risks associated with taking the medication to be prescribed;

(d) The probable result of taking the medication to be prescribed; and

(e) The feasible alternatives, including, but not limited to, comfort care, hospice care and pain control.

(8) “Medically confirmed” means the medical opinion of the attending physician has been confirmed by a consulting physician who has examined the patient and the patient’s relevant medical records.

(9) “Patient” means a person who is under the care of a physician.

(10) “Physician” means a doctor of medicine or osteopathy licensed to practice medicine by the Board of Medical Examiners for the State of Oregon.

(11) “Qualified patient” means a capable adult who is a resident of Oregon and has satisfied the requirements of ORS 127.800 to 127.897 in order to obtain a prescription for medication to end his or her life in a humane and dignified manner.

(12) “Terminal disease” means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months. [1995 c.3 s.1.01; 1999 c.423 s.1]

(Written Request for Medication to End One’s Life in a Humane and Dignified Manner)

(Section 2)

127.805 s.2.01. Who may initiate a written request for medication.

(1) An adult who is capable, is a resident of Oregon, and has been determined by the attending physician and consulting physician to be suffering from a terminal disease, and who has voluntarily expressed his or her wish to die, may make a written request for medication for the purpose of ending his or her life in a humane and dignified manner in accordance with ORS 127.800 to 127.897.

(2) No person shall qualify under the provisions of ORS 127.800 to 127.897 solely because of age or disability. [1995 c.3 s.2.01; 1999 c.423 s.2]

127.810 s.2.02. Form of the written request.

(1) A valid request for medication under ORS 127.800 to 127.897 shall be in substantially the form described in ORS 127.897, signed and dated by the patient and witnessed by at least two individuals who, in the presence of the patient, attest that to the best of their knowledge and belief the patient is capable, acting voluntarily, and is not being coerced to sign the request.

(2) One of the witnesses shall be a person who is not:

(a) A relative of the patient by blood, marriage or adoption;

(b) A person who at the time the request is signed would be entitled to any portion of the estate of the qualified patient upon death under any will or by operation of law; or

(c) An owner, operator or employee of a health care facility where the qualified patient is receiving medical treatment or is a resident.

(3) The patient’s attending physician at the time the request is signed shall not be a witness.

(4) If the patient is a patient in a long term care facility at the time the written request is made, one of the witnesses shall be an individual designated by the facility and having the qualifications specified by the Oregon Health Authority by rule. [1995 c.3 s.2.02]

(Safeguards)

(Section 3)

127.815 s.3.01.Attending physician responsibilities.

(1) The attending physician shall:

(a) Make the initial determination of whether a patient has a terminal disease, is capable, and has made the request voluntarily;

(b) Request that the patient demonstrate Oregon residency pursuant to ORS 127.860;

(c) To ensure that the patient is making an informed decision, inform the patient of:

(A) His or her medical diagnosis;

(B) His or her prognosis;

(C) The potential risks associated with taking the medication to be prescribed;

(D) The probable result of taking the medication to be prescribed; and

(E) The feasible alternatives, including, but not limited to, comfort care, hospice care and pain control;

(d) Refer the patient to a consulting physician for medical confirmation of the diagnosis, and for a determination that the patient is capable and acting voluntarily;

(e) Refer the patient for counseling if appropriate pursuant to ORS 127.825;

(f) Recommend that the patient notify next of kin;

(g) Counsel the patient about the importance of having another person present when the patient takes the medication prescribed pursuant to ORS 127.800 to 127.897 and of not taking the medication in a public place;

(h) Inform the patient that he or she has an opportunity to rescind the request at any time and in any manner, and offer the patient an opportunity to rescind at the end of the 15 day waiting period pursuant to ORS 127.840;

(i) Verify, immediately prior to writing the prescription for medication under ORS 127.800 to 127.897, that the patient is making an informed decision;

(j) Fulfill the medical record documentation requirements of ORS 127.855;

(k) Ensure that all appropriate steps are carried out in accordance with ORS 127.800 to 127.897 prior to writing a prescription for medication to enable a qualified patient to end his or her life in a humane and dignified manner; and

(L)(A) Dispense medications directly, including ancillary medications intended to facilitate the desired effect to minimize the patient’s discomfort, provided the attending physician is registered as a dispensing physician with the Board of Medical Examiners, has a current Drug Enforcement Administration certificate and complies with any applicable administrative rule; or

(B) With the patient’s written consent:

(i) Contact a pharmacist and inform the pharmacist of the prescription; and

(ii) Deliver the written prescription personally or by mail to the pharmacist, who will dispense the medications to either the patient, the attending physician or an expressly identified agent of the patient.

(2) Notwithstanding any other provision of law, the attending physician may sign the patient’s death certificate. [1995 c.3 s.3.01; 1999 c.423 s.3]

127.820 s.3.02. Consulting physician confirmation.

Before a patient is qualified under ORS 127.800 to 127.897, a consulting physician shall examine the patient and his or her relevant medical records and confirm, in writing, the attending physician’s diagnosis that the patient is suffering from a terminal disease, and verify that the patient is capable, is acting voluntarily and has made an informed decision. [1995 c.3 s.3.02]

127.825 s.3.03. Counseling referral.

If in the opinion of the attending physician or the consulting physician a patient may be suffering from a psychiatric or psychological disorder or depression causing impaired judgment, either physician shall refer the patient for counseling. No medication to end a patient’s life in a humane and dignified manner shall be prescribed until the person performing the counseling determines that the patient is not suffering from a psychiatric or psychological disorder or depression causing impaired judgment. [1995 c.3 s.3.03; 1999 c.423 s.4]

127.830 s.3.04. Informed decision.

No person shall receive a prescription for medication to end his or her life in a humane and dignified manner unless he or she has made an informed decision as defined in ORS 127.800 (7). Immediately prior to writing a prescription for medication under ORS 127.800 to 127.897, the attending physician shall verify that the patient is making an informed decision. [1995 c.3 s.3.04]

127.835 s.3.05. Family notification.

The attending physician shall recommend that the patient notify the next of kin of his or her request for medication pursuant to ORS 127.800 to 127.897. A patient who declines or is unable to notify next of kin shall not have his or her request denied for that reason. [1995 c.3 s.3.05; 1999 c.423 s.6]

127.840 s.3.06. Written and oral requests.

In order to receive a prescription for medication to end his or her life in a humane and dignified manner, a qualified patient shall have made an oral request and a written request, and reiterate the oral request to his or her attending physician no less than fifteen (15) days after making the initial oral request. At the time the qualified patient makes his or her second oral request, the attending physician shall offer the patient an opportunity to rescind the request. [1995 c.3 s.3.06]

127.845 s.3.07. Right to rescind request.

A patient may rescind his or her request at any time and in any manner without regard to his or her mental state. No prescription for medication under ORS 127.800 to 127.897 may be written without the attending physician offering the qualified patient an opportunity to rescind the request. [1995 c.3 s.3.07]

127.850 s.3.08. Waiting periods.

No less than fifteen (15) days shall elapse between the patient’s initial oral request and the writing of a prescription under ORS 127.800 to 127.897. No less than 48 hours shall elapse between the patient’s written request and the writing of a prescription under ORS 127.800 to 127.897. [1995 c.3 s.3.08]

127.855 s.3.09. Medical record documentation requirements.

The following shall be documented or filed in the patient’s medical record:

(1) All oral requests by a patient for medication to end his or her life in a humane and dignified manner;

(2) All written requests by a patient for medication to end his or her life in a humane and dignified manner;

(3) The attending physician’s diagnosis and prognosis, determination that the patient is capable, acting voluntarily and has made an informed decision;

(4) The consulting physician’s diagnosis and prognosis, and verification that the patient is capable, acting voluntarily and has made an informed decision;

(5) A report of the outcome and determinations made during counseling, if performed;

(6) The attending physician’s offer to the patient to rescind his or her request at the time of the patient’s second oral request pursuant to ORS 127.840; and

(7) A note by the attending physician indicating that all requirements under ORS 127.800 to 127.897 have been met and indicating the steps taken to carry out the request, including a notation of the medication prescribed. [1995 c.3 s.3.09]

127.860 s.3.10. Residency requirement.

Only requests made by Oregon residents under ORS 127.800 to 127.897 shall be granted. Factors demonstrating Oregon residency include but are not limited to:

(1) Possession of an Oregon driver license;

(2) Registration to vote in Oregon;

(3) Evidence that the person owns or leases property in Oregon; or

(4) Filing of an Oregon tax return for the most recent tax year. [1995 c.3 s.3.10; 1999 c.423 s.8]

127.865 s.3.11. Reporting requirements.

(1)(a) The Health Services shall annually review a sample of records maintained pursuant to ORS 127.800 to 127.897.

(b) The division shall require any health care provider upon dispensing medication pursuant to ORS 127.800 to 127.897 to file a copy of the dispensing record with the division.

(2) The Health Services shall make rules to facilitate the collection of information regarding compliance with ORS 127.800 to 127.897. Except as otherwise required by law, the information collected shall not be a public record and may not be made available for inspection by the public.

(3) The division shall generate and make available to the public an annual statistical report of information collected under subsection (2) of this section. [1995 c.3 s.3.11; 1999 c.423 s.9]

127.870 s.3.12. Effect on construction of wills, contracts and statutes.

(1) No provision in a contract, will or other agreement, whether written or oral, to the extent the provision would affect whether a person may make or rescind a request for medication to end his or her life in a humane and dignified manner, shall be valid.

(2) No obligation owing under any currently existing contract shall be conditioned or affected by the making or rescinding of a request, by a person, for medication to end his or her life in a humane and dignified manner. [1995 c.3 s.3.12]

127.875 s.3.13. Insurance or annuity policies.

The sale, procurement, or issuance of any life, health, or accident insurance or annuity policy or the rate charged for any policy shall not be conditioned upon or affected by the making or rescinding of a request, by a person, for medication to end his or her life in a humane and dignified manner. Neither shall a qualified patient’s act of ingesting medication to end his or her life in a humane and dignified manner have an effect upon a life, health, or accident insurance or annuity policy. [1995 c.3 s.3.13]

127.880 s.3.14. Construction of Act.

Nothing in ORS 127.800 to 127.897 shall be construed to authorize a physician or any other person to end a patient’s life by lethal injection, mercy killing or active euthanasia. Actions taken in accordance with ORS 127.800 to 127.897 shall not, for any purpose, constitute suicide, assisted suicide, mercy killing or homicide, under the law. [1995 c.3 s.3.14]

(Immunities and Liabilities)

(Section 4)

127.885 s.4.01. Immunities; basis for prohibiting health care provider from participation; notification; permissible sanctions.

Except as provided in ORS 127.890:

(1) No person shall be subject to civil or criminal liability or professional disciplinary action for participating in good faith compliance with ORS 127.800 to 127.897. This includes being present when a qualified patient takes the prescribed medication to end his or her life in a humane and dignified manner.

(2) No professional organization or association, or health care provider, may subject a person to censure, discipline, suspension, loss of license, loss of privileges, loss of membership or other penalty for participating or refusing to participate in good faith compliance with ORS 127.800 to 127.897.

(3) No request by a patient for or provision by an attending physician of medication in good faith compliance with the provisions of ORS 127.800 to 127.897 shall constitute neglect for any purpose of law or provide the sole basis for the appointment of a guardian or conservator.

(4) No health care provider shall be under any duty, whether by contract, by statute or by any other legal requirement to participate in the provision to a qualified patient of medication to end his or her life in a humane and dignified manner. If a health care provider is unable or unwilling to carry out a patient’s request under ORS 127.800 to 127.897, and the patient transfers his or her care to a new health care provider, the prior health care provider shall transfer, upon request, a copy of the patient’s relevant medical records to the new health care provider.

(5)(a) Notwithstanding any other provision of law, a health care provider may prohibit another health care provider from participating in ORS 127.800 to 127.897 on the premises of the prohibiting provider if the prohibiting provider has notified the health care provider of the prohibiting provider’s policy regarding participating in ORS 127.800 to 127.897. Nothing in this paragraph prevents a health care provider from providing health care services to a patient that do not constitute participation in ORS 127.800 to 127.897.

(b) Notwithstanding the provisions of subsections (1) to (4) of this section, a health care provider may subject another health care provider to the sanctions stated in this paragraph if the sanctioning health care provider has notified the sanctioned provider prior to participation in ORS 127.800 to 127.897 that it prohibits participation in ORS 127.800 to 127.897:

(A) Loss of privileges, loss of membership or other sanction provided pursuant to the medical staff bylaws, policies and procedures of the sanctioning health care provider if the sanctioned provider is a member of the sanctioning provider’s medical staff and participates in ORS 127.800 to 127.897 while on the health care facility premises, as defined in ORS 442.015, of the sanctioning health care provider, but not including the private medical office of a physician or other provider;

(B) Termination of lease or other property contract or other nonmonetary remedies provided by lease contract, not including loss or restriction of medical staff privileges or exclusion from a provider panel, if the sanctioned provider participates in ORS 127.800 to 127.897 while on the premises of the sanctioning health care provider or on property that is owned by or under the direct control of the sanctioning health care provider; or

(C) Termination of contract or other nonmonetary remedies provided by contract if the sanctioned provider participates in ORS 127.800 to 127.897 while acting in the course and scope of the sanctioned provider’s capacity as an employee or independent contractor of the sanctioning health care provider. Nothing in this subparagraph shall be construed to prevent:

(i) A health care provider from participating in ORS 127.800 to 127.897 while acting outside the course and scope of the provider’s capacity as an employee or independent contractor; or

(ii) A patient from contracting with his or her attending physician and consulting physician to act outside the course and scope of the provider’s capacity as an employee or independent contractor of the sanctioning health care provider.

(c) A health care provider that imposes sanctions pursuant to paragraph (b) of this subsection must follow all due process and other procedures the sanctioning health care provider may have that are related to the imposition of sanctions on another health care provider.

(d) For purposes of this subsection:

(A) “Notify” means a separate statement in writing to the health care provider specifically informing the health care provider prior to the provider’s participation in ORS 127.800 to 127.897 of the sanctioning health care provider’s policy about participation in activities covered by ORS 127.800 to 127.897.

(B) “Participate in ORS 127.800 to 127.897″ means to perform the duties of an attending physician pursuant to ORS 127.815, the consulting physician function pursuant to ORS 127.820 or the counseling function pursuant to ORS 127.825. “Participate in ORS 127.800 to 127.897″ does not include:

(i) Making an initial determination that a patient has a terminal disease and informing the patient of the medical prognosis;

(ii) Providing information about the Oregon Death with Dignity Act to a patient upon the request of the patient;

(iii) Providing a patient, upon the request of the patient, with a referral to another physician; or

(iv) A patient contracting with his or her attending physician and consulting physician to act outside of the course and scope of the provider’s capacity as an employee or independent contractor of the sanctioning health care provider.

(6) Suspension or termination of staff membership or privileges under subsection (5) of this section is not reportable under ORS 441.820. Action taken pursuant to ORS 127.810, 127.815, 127.820 or 127.825 shall not be the sole basis for a report of unprofessional or dishonorable conduct under ORS 677.415 (2) or (3).

(7) No provision of ORS 127.800 to 127.897 shall be construed to allow a lower standard of care for patients in the community where the patient is treated or a similar community. [1995 c.3 s.4.01; 1999 c.423 s.10]

Note: As originally enacted by the people, the leadline to section 4.01 read “Immunities.” The remainder of the leadline was added by editorial action.

127.890 s.4.02. Liabilities.

(1) A person who without authorization of the patient willfully alters or forges a request for medication or conceals or destroys a rescission of that request with the intent or effect of causing the patient’s death shall be guilty of a Class A felony.

(2) A person who coerces or exerts undue influence on a patient to request medication for the purpose of ending the patient’s life, or to destroy a rescission of such a request, shall be guilty of a Class A felony.

(3) Nothing in ORS 127.800 to 127.897 limits further liability for civil damages resulting from other negligent conduct or intentional misconduct by any person.

(4) The penalties in ORS 127.800 to 127.897 do not preclude criminal penalties applicable under other law for conduct which is inconsistent with the provisions of ORS 127.800 to 127.897. [1995 c.3 s.4.02]

127.892 Claims by governmental entity for costs incurred.

Any governmental entity that incurs costs resulting from a person terminating his or her life pursuant to the provisions of ORS 127.800 to 127.897 in a public place shall have a claim against the estate of the person to recover such costs and reasonable attorney fees related to enforcing the claim. [1999 c.423 s.5a]

(Severability)

(Section 5)

127.895 s.5.01. Severability.

Any section of ORS 127.800 to 127.897 being held invalid as to any person or circumstance shall not affect the application of any other section of ORS 127.800 to 127.897 which can be given full effect without the invalid section or application. [1995 c.3 s.5.01]

(Form of the Request)

(Section 6)

127.897 s.6.01. Form of the request.

A request for a medication as authorized by ORS 127.800 to 127.897 shall be in substantially the following form:

REQUEST FOR MEDICATION

TO END MY LIFE IN A HUMANE

AND DIGNIFIED MANNER

I, ________________, am an adult of sound mind.

I am suffering from _______, which my attending physician has determined is a terminal disease and which has been medically confirmed by a consulting physician.

I have been fully informed of my diagnosis, prognosis, the nature of medication to be prescribed and potential associated risks, the expected result, and the feasible alternatives, including comfort care, hospice care and pain control.

I request that my attending physician prescribe medication that will end my life in a humane and dignified manner.

INITIAL ONE:

_____ I have informed my family of my decision and taken their opinions into consideration.

_____ I have decided not to inform my family of my decision.

_____ I have no family to inform of my decision.

I understand that I have the right to rescind this request at any time.

I understand the full import of this request and I expect to die when I take the medication to be prescribed. I further understand that although most deaths occur within three hours, my death may take longer and my physician has counseled me about this possibility.

I make this request voluntarily and without reservation, and I accept full moral responsibility for my actions.

Signed: ___________

Dated: ___________

DECLARATION OF WITNESSES

We declare that the person signing this request:

(a) Is personally known to us or has provided proof of identity;

(b) Signed this request in our presence;

(c) Appears to be of sound mind and not under duress, fraud or undue influence;

(d) Is not a patient for whom either of us is attending physician.

__________ Witness 1/Date

__________ Witness 2/Date

NOTE: One witness shall not be a relative (by blood, marriage or adoption) of the person signing this request, shall not be entitled to any portion of the person’s estate upon death and shall not own, operate or be employed at a health care facility where the person is a patient or resident. If the patient is an inpatient at a health care facility, one of the witnesses shall be an individual designated by the facility.

[1995 c.3 s.6.01; 1999 c.423 s.11]

PENALTIES

127.990

[Formerly part of 97.990; repealed by 1993 c.767 s.29]

127.995 Penalties.

(1) It shall be a Class A felony for a person without authorization of the principal to willfully alter, forge, conceal or destroy an instrument, the reinstatement or revocation of an instrument or any other evidence or document reflecting the principal’s desires and interests, with the intent and effect of causing a withholding or withdrawal of life-sustaining procedures or of artificially administered nutrition and hydration which hastens the death of the principal.

(2) Except as provided in subsection (1) of this section, it shall be a Class A misdemeanor for a person without authorization of the principal to willfully alter, forge, conceal or destroy an instrument, the reinstatement or revocation of an instrument, or any other evidence or document reflecting the principal’s desires and interests with the intent or effect of affecting a health care decision. [Formerly 127.585]

Slater versus English and family

Cameron Slater has posted an attack on Bill English ate Whale Oil: SCUM LIST MP SAYS HE WILL VOTE FOR PAIN AND SUFFERING

Bill English has declared he will vote against any euthanasia bill put before the parliament. no debate, no reading the legislation, he is just going to let his Catholic dogma dictate how he will vote.

This is a typical Slater-type attack – Slater has been very critical of English in the past so this is not out of the ordinary. So far.

And now we see one of the problems with MMP and scum list MPs. They don’t have an electorate to listen to or canvas.

They are representative of no one but themselves and the party.Electorate MPs like Nick Smith always survey their electorate and debate the issues with voters.

Much and all as I dislike Nick Smith’s politics, in person he is a top bloke, he keeps getting elected with massive majorities because he listens to his constituents.

Slater also campaigned against MMP so it’s no surprise to see him slamming list MPs.

Until English retired from his Clutha-Southland electorate and went onto the list only last year he kept getting elected with massive majorities. In 2011 with a majority of 16,168 he got 21,375 votes,  over twice as many as all other candidates combined.

Bill English has to listen to no one but his stroppy missus.

This is a low blow from Slater, Bringing English’s wife into is a low blow. Again this isn’t out of the ordinary for Slater, he was particularly nasty during National’s Northland candidate selection slinging dirt involving the family of one candidate.

Some comments supported Slater but there more supporting English and criticising Slater managed to survive the censor’s filter and getting significant support. For example:

That’s a bit harsh. Bill is entitled to his opinion as you are of your opinion.

24 upticks

Yes he is but I don’t want his personal religious beliefs to dictate what I wish to happen if the occasion arises. I would like to make my own decision and have it written down for when I am too ill to fight for that right.

1 uptick

And:

Right, you’ve now lost me. When you call Bill English a”scum list MP”, that shows you to be in the same loony class as those you keep referring to as the Green Taliban and I have laughed with you at their silly antics. I happen to think, also that the Greens are loony. But I also think that there are some areas where people are entitled to exercise their consciences, and the sanctity of life is one such area.

26 upticks

And:

Would you prefer him to say one thing and do another (as so many people do)? At least we know where he stands. While I might not agree with his views, I respect his right to have them.

34 upticks

Compared to:

Catholic or not, this is the sort of arrogance we saw from Cullen. Please remind me who got National down to the miraculous 20% threshold?

English’s expertise lies within financial management. I for one am happy he is no where near social policy. He doesn’t have a clue and doesn’t gauge with the public very well.

2 upticks

I disagree with English on euthanasia but respect his right to have his own stance on what would be a conscience issue if this was voted on in Parliament. This is the report Slater was criticising:

His deputy, Mr English, a Catholic, said today he would vote against any law change.

“The law says that if the doctor helps them die that would be breaking the law and that’s what the judgment said pretty clearly,” Mr English said on TVNZ‘s Q&A programme.

Mr English, whose wife is a GP, said he personally did not believe the law needed to change.

“My personal view is that the law is where it should be,” he said.

3 News

While polls show a sizeable majority of people support euthanasia there are still many who oppose it, and they have as much right to be represented in Parliament as anyone.

This was also raised on Kiwiblog, and Slater is criticised by several including someone who has been a fairly loyal supporter of Slater:

Nookin

Mr Slater seems intent on re-creating himself as a man of unlovely disposition. I used to enjoy some of his more outrageous observations but, really, he has descended to a level of almost perpetual ad hominism ( if that is a word). The site very rarely contains anything of any interest other than his own insatiable desire to be heard.

16 upticks, 2 down

Keeping Stock

@ Nookin – WO makes his distaste of English pretty obvious. But to attack English’s wife, who to the best of my knowledge has never tried to impose her personal views on the electorate is poor form indeed.

Slater is entitled to his own view, and calling MPs ‘scum’ is typical of his critical approach, but using family members in political criticism crosses a line for most people.

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