Parliamentary report on medically assisted dying

In June 2015 a petition was presented to Parliament from then MP Hon Maryan Street and 8,974 others requesting:

That the House of Representatives 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.

Parliament’s Health Committee has just released their report on this. It looks in detail into many aspects of assisted dying and euthanasia.

This is a separate process to the Private Members’ Bill of David Seymour that was drawn from the ballot earlier this year, which hasn’t had it’s First Reading in Parliament yet (unlikely before the election).


Report on the petition of Hon Maryan Street presented

During its consideration of the petition, more than 21,000 individuals and organisations submitted their views to the committee. Over 108 hours, 944 people took the opportunity to share their opinions.

The petition requests that the House of Representatives 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 that makes life unbearable.

Recommendation:

The Health Committee has considered Petition 2014/18 of Hon Maryan Street and 8,974
others and recommends that the House take note of its report.

This report gives us the opportunity to summarise, for the benefit of the House and the
public, what we heard and considered during our review of more than 21,000 submissions from the petitio extremely contentious. We therefore encourage everyone with an interest in the subject to read the report in full, and to draw their own conclusions based on the evidence presented in it.

Background

The petitioner, Hon Maryan Street, was a member of Parliament between 2005 and 2014.
While a member, she sought to introduce the End of Life Options Bill as a member’s bill.
The purpose of this bill was to provide individuals with a choice about how they end their life and allow them to receive assistance from a medical practitioner to die under certain circumstances. The petition originated with the Voluntary Euthanasia Society of New Zealand (VES) before being adopted formally by Hon Maryan Street. Since leaving
Parliament, Ms Street has become the President of VES.

There have been two first reading debates in Parliament on similar bills. Both were
unsuccessful. In 1995, members voted 61 to 29 against Michael Laws’ Death with Dignity
Bill. In 2003, members voted 60 to 58 against Peter Brown’s Death with Dignity Bill.
The petitioner’s bill was formally removed from the members’ bill ballot in December
2014.

Full report here

Conclusion

We thank the petitioner for bringing this petition before the committee and encouraging us to ascertain the views of New Zealanders on ending one’s life in this country. We appreciate that people come from a range of backgrounds and that this is a subject on which people hold strong views. We believe that the written submission and oral hearing process has provided a platform for people to share these views and discuss the issues with us. This report gives us an opportunity to summarise what we heard for the benefit of the House and the public.

Eighty percent of submitters were opposed to a change in legislation that would allow assisted dying and euthanasia. Submitters primarily argued that the public would be endangered. They cited concern for vulnerable people, such as the elderly and the disabled, those with mental illnesses, and those susceptible to coercion. Others argued that life has an innate value and that introducing assisted dying and euthanasia would explicitly undermine that idea. To do so would suggest that some lives are worth more than others. There were also concerns that, once introduced, eligibility for assisted dying would rapidly expand well beyond what was first intended.

Supporters of assisted dying feared their loss of dignity, independence, and physical and mental capacity. Submitters also spoke about the fear of pain and of having to watch loved ones suffer from a painful death. Supporters stressed their personal autonomy and that they should have the choice as to when to end their life.

Many submitters discussed their experiences of palliative care. We commend the service
given by palliative care providers and hospices. However, we were concerned to hear that there is a lack of awareness about the role of palliative care, that access to it is unequal, and that there are concerns about the sustainability of the workforce. We urge the Government to consider ways in which it can better communicate the excellent services that palliative carers provide, address the unequal access, consider how palliative care is funded, and address the workforce shortages.

The relationship between assisted dying and suicide was a common concern for submitters. Some believe that assisted dying should not be considered until New Zealand’s high suicide rate is reduced. Others believe that the lack of assisted dying legislation means that people are more likely to suicide.

We recognise that a lot of work and investment has gone into suicide prevention programmes and support services. However, we were concerned to hear that people feel that there is a lack of grief counselling. We therefore encourage the Government to investigate improving access to these services.

We have not made any recommendations about introducing assisted dying legislation. We understand that decisions on issues like this are generally a conscience vote.

The petitioner asked us to investigate attitudes towards the introduction of legislation that would permit assisted dying in the event of a terminal illness or an irreversible condition which makes life unbearable. However, some submitters thought that the criteria would or should be broader than terminal illness or an irreversible condition. This has made it difficult for us to consider what the safeguards should be. We were particularly concerned about protecting vulnerable people, such as individuals with dementia or reduced capacity. Some of us remain unconvinced that the models seen overseas provide adequate protection for vulnerable people.

We would like to thank all of the submitters for sharing their stories with us and for the
respect submitters showed for opposing views when they appeared before the committee.

This issue is clearly very complicated, very divisive, and extremely contentious.

We therefore encourage everyone with an interest in the subject to read the report in full and to draw their own conclusions based on the evidence we have presented.

New Zealand First minority view

New Zealand First congratulates the petitioner for bringing this issue before the Select Committee. Medically-assisted dying is a serious matter and is so serious that it is not one that should be taken by temporarily empowered politicians. New Zealand First cannot support such a fundamental change without a clear sign that this is the will of most New Zealanders. That would be achieved by either a binding Citizens’ Initiated Referendum, or a Government Initiated Referendum held with a future General Election thus allowing for a period of informed debate.

Two stand aside for Huo

It has been suggested this would happen for some time but now the way has publicy been cleared for Raymond Huo to return to Parliament should Jacinda Ardern win this week’s Mt Albert by-election.

Huo lost his seat in Parliament  in 2014 because he was three short of the list cut-off.

Andrew Little just made the final cut at 11 on the list (electorate MPs are ranked lower but get in automatically).

There were two other ex-list MPs who were placed higher than Huo at 21 who missed the cut, Maryan Street (15) and (Moana Mackey (17).

It was a bit embarrassing for Labour to have no Asian MPs, particularly when they launched their infamous Chinese surname attack.

After the Mt Albert by-election was confirmed Mackey said she wasn’t interested in returning to Parliament.

Gisborne Herald: Moana Mackey rules out return to the Beehive

FORMER Gisborne-based Labour list MP Moana Mackey has countered conjecture she is contemplating a return to politics.

Ms Mackey said she wanted to pre-empt speculation she was planning a return to parliament following the decision of current list MP Jacinda Ardern to seek the party’s candidacy in the Mt Albert by-election.

Ms Mackey said she had always kept Labour leader Andrew Little informed and previously told him she had no desire to return to Parliament if a list place came up on the Labour list.

“I have to say I really appreciated him getting in touch with me earlier this week, in light of David Shearer’s decision, and I confirmed that was still my position.

That was in December. Interesting that Little contacted her as soon as the by-election was confirmed.

Street has taken a lot longer but has now also indicated she won’t return. From Street on Facebook:

I am happy to confirm that I will not be taking up a place in Parliament as a List MP after the Mt Albert by-election. This will pave the way for the return of Raymond Huo to Parliament, something I fully support.

I have thought long and hard about this choice and have decided that I can be just as effective on issues dear to me outside Parliament as inside – perhaps even more so.

Besides which, I have discovered weekends.

The campaign for a law change to allow End of Life Choice has gained a powerful momentum with the petition in my name to Parliament’s Health Select Committee, where submissions are still being heard. I am heartened that it has become an issue with wide support throughout the community and across the entire political spectrum. I look forward to advancing that campaign further.

My very best wishes go to Jacinda Ardern and Raymond Huo.

So the way is now clear for Huo. I haven’t seen any indication of his intentions but presume he is interested in returning.

Street clarifies aid money question

On Thursday Radio New Zealand reported that Maryan Street, Labour’s associate foreign affairs spokesperson, was critical of the Government campaign for a seat on the UN Security Council.

Labour criticises UN bid as Shearer lobbies for support

The Labour Party has criticised the Government’s UN Security Council campaign at the same time as its foreign affairs spokesperson David Shearer is in New York lobbying for support.

I posted on this yesterday – Labour foreign affairs disconnect.

Maryan Street has responded to that:

I didn’t criticise the SC bid. I support it. I think Shearer is doing good work in NY right now.

What I did ask, in case you are interested in the facts, was whether or not there was a firewall between our disbursement of foreign aid and the SC bid campaign. In other words, has McCully been using aid money to lubricate our SC bid. A legitimate question.

John Allen said no, he hasn’t. Good answer.

Radio NZ reported it as criticism and it could be seen as a dig at McCully and raises an issue that wouldn’t help the bid Street makes it clear she accepts Allen’s assurance that it isn’t happening.

Street also makes it clear that she supports what Shearer is doing and supports the Security Council bid.

Labour foreign affairs disconnect

Another example of two Labour MPs working against each other, but this time it’s the spokesperson and the associate spokesperson for foreign affairs at odds.

Labour criticises UN bid as Shearer lobbies for support

The Labour Party has criticised the Government’s UN Security Council campaign at the same time as its foreign affairs spokesperson David Shearer is in New York lobbying for support.

At a parliamentary select committee, Mr Shearer’s associate foreign affairs spokesperson, Maryan Street, raised questions about the Government’s use of foreign aid in its campaign for a seat on the Security Council in 2015-16.

Mr Shearer was, meanwhile, lobbying representatives of the Palestinian Authority and Somalia, among others, at the United Nations. He says New Zealand’s bid is based on its reputation as a small country with an independent foreign policy.

The chief executive of the Ministry of Foreign Affairs and Trade, John Allen, dismisses Ms Street’s suggestion aid is being used to win a Security Council seat.

What is the official Labour position? Who speaks for Labour on this? Or do individual MPs say whatever they like.

Should euthanasia law be decided by parliament or referendum?

Maryan Street’s  End of Life Choice bill (euthanasia) has been added to the Member’s Bill ballot and will need to be drawn to proceed. There’s been some interesting blog discussion about it.

One question that came up was whether any final decision should be made by MPs and parliament, or by people via a referendum.

Graeme Edgeler has confirmed that the final referendum option is feasible:

July 24th, 2012 at 11:21 am

Basically, you go through a whole Parliamentary process, debate the full implications of everything and come up with a fully fleshed out proposal, which is drafted as legislation. It passes all its readings, but only comes into force if a majority of people voting at a referendum answer the question: do you support the proposed system of legalised euthanasia contained in the End of Life Choice Act 2014? in the affirmative.

However I have emailed Maryan Street about this and she has responded:

No, I would never consider this issue as one to be decided by referendum. It is too complex an issue for that. It is exactly the sort of issue which requires thoughtful legislation, not the kind of reductive approach required by referenda.

This doesn’t rule it out – for example, if enough MPs are in favour then Street’s bill could be amended to make a referendum a final decision.

Graeme Edgeler responds…

MPs will be faced with the same simplistic, reductive question at the third reading. They get one vote on one question: those who think this bill should become law, say “Aye”, those opposed say “No”. Those who wanted it, but in a different form, covering more or less, or having some different scheme of safeguards will be faced with the same question:

given what the select committee and the committee of the whole house have adopted, do I support the bill in its present form becoming law?

That is no more reductive than a referendum.

…and also explains the ‘reductive approach’:

What’s a “reductive approach” when it’s at home?

A reductive approach to a matter like this is one that is reduced to a simple yes/no question:

e.g. do you support a law change to provide for voluntary euthanasia for adults with terminal illnesses?

Getting public opinion on such a question is largely meaningless in drafting a law which people may actually agree with.

So, should parliament decide on this (should the bill get drawn from the ballot) or should people make the final decision via referendum?

End of Life Choice bill (euthanasia)

Maryan Street (Labour list MP) has announced she is putting her End of Life Choice bill in the Members Bill ballot this week.

I have, after 6 months’ work, finished my End of Life Choice Bill. You can find it here.

I think the social conversation has moved on from the last time such a bill was debated in 2003 and lost 60-58. The two missing votes at that time were one abstention and one voted not lodged. So that was close.

I hope I have enough specificity and enough safeguards in place for people to support it this time. I am sure it can be improved.

I am equally sure that is time that we approached this issue with compassion and gave people the right to be as self-determining at their point of death as they have been in life. It would only apply to people who were of sound mind and suffered from a terminal illness, or an irreversible condition which made their life unbearable, in their own view.

It also provides for people to register End of Life Directives in the event that these situations occur and they are unable to communicate their wishes to receive life-ending medication.

Other features include:

  • the need for two medical practitioners to attest that the person is of sound mind, has the condition they say they have and have not been coerced into their decision;
  • the need for counselling and a period of reflection;
  • and a Review Body to examine the law after a period of time to ensure it is not being abused and is operating correctly.

Let me know your thoughts.
(Comments on Red Alert blog).

Discussion on this also on:

[This bill is an excellent example of an opposition MP putting their time to good use. Other opposition MPs could do less campaigning and more work developing bills that are important to constituents. – PG]

Odd urge to withdraw euthanasia bill

Labour MP Maryan Street has drafted a voluntary euthanasia bill and plans to put it  in the member’s ballot.

National MP Paul Hutchison is suggesting she should withdraw her bill.

Street’s euthanasia bill untimely and unclear

Media release from Paul Hutchison

It is concerning that Maryan Street said she took up the bill because ‘she could not think of a reason not to’. Though she says the Bill is ‘predominantly to do with terminal physical illness’, part of the Bill refers to ‘end of life directives’ for those that suffer from an irreversible medical or mental condition that, in their view, renders their life unbearable. Including both medical and mental conditions could well lead to confusion.

Dr Hutchison says euthanasia and assisted suicide are complex areas where there are grey zones in law and in practice.  However, modern care and knowledge, along with significant advances in technology, provide huge help.

“In April ‘Hospice New Zealand’ has published a ‘Quality Review Programme and Guide 2012’ of standards for palliative care.  It describes the unique and interwoven roles of primary care services and specialist palliative care services to provide high quality palliative care and end of life care to all people in New Zealand.

“I vividly remember Peter Brown’s private members bill which was narrowly lost in the Parliament in 2003.  Peter spoke passionately and sincerely regarding the awful time his late wife had during her terminal illness.  However, on talking to him, I couldn’t help think that if he and his wife had received the skilled services that are available today, their suffering could well be far less.”

Dr Hutchison says that deep concern has been raised regarding the euthanasia laws in the Netherlands and Belgium where required safeguards have allegedly not been adhered to, resulting in people being euthanized without proper informed consent.

“Like anything as definitive as capital punishment, it is always possible for errors to occur. At least Maryan Street admits this,” says Dr Hutchison.

Labour MP Maryan Street’s ‘End of Life Choice Bill’ is couched in terms that might be liberal and hopeful.  However, Dr Hutchison says her proposal could set New Zealand on a regressive path.  It could also deprive many New Zealanders and their families from taking advantage of the wonderful facilities, compassion and expertise that are available to them during a terminal illness, when the greatest human qualities so often shine through.

“In my view Maryan Street should withdraw her bill.” says Dr Hutchison.

This is odd. Hutchison’s statement is untimely – he presumably hasn’t seen Street’s bill yet.

And it’s unclear why she should withdraw a bill because one MP requests it. Parliament is there for all MPs to decide on issues.

Sure, there are complexities and concerns, but it’s an important issue and surely parliament is the right place to examine the whole issue.

Also covered by TV3: MP urged to withdraw euthanasia bill

Euthanasia’s number 1 question

Euthanasia keeps coming up in ducsussion and debate. There is a ‘major anti-euthanasia conference’ in Auckland this weekend. Alex Schadenberg, International Chair of the Euthanasia Prevention Coalition was interviewed on Q+A this morning alongside Labour MP Maryan Street, who’s drafting a new law to allow ‘end of life choice’.

There are many pros and cons on this complex issue of end of life issue, including euthanasia.

  • There are problems now with extending lives using modern medicine.
  • There are issues with right’s to choice.
  • There are potential problems with euthanasia.

The status quo is far from perfect. People are forced to die in situations they desperately wanted to avoid. And any change will introduce new potential dangers.

But the main argument should not be pro euthanasia versus anti euthanasia.

Generally speaking, dying is crap, and some people have to suffer very crappy deaths.

The biggest question should be whether any change would overall be better or worse than how things currently are.

More euthanasia links and information.

Euthanasia – links and news

YourNZ

Euthanasia’s number 1 question – can we do better?

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. Euthanasia debate podcasts.

Voluntary Euthanasia in New Zealand
Voluntary Euthanasia in New Zealand: An Analysis of Compassion, Autonomy, and Secularism in the Public Sphere
By: Thomas M. I. Noakes-Duncan

Personal end of life experience
It has been suggested in the recent public debate in Dunedin that all that needs to happen is for more widespread top palliative care to be available to anyone that wants it.

Euthanasia interest and support growing
It seems that the euthanasia debate (and support) is building up steam.

Choices about euthanasia
I had a close encounter with the pros and cons of euthanasia recently as I watched my mother die. She had expert care and assistance in her home and at the hospice. The hospice uses care plans that emphasise comfort for the patient within current laws.

In the news

Time to talk about dying

(Sean Davison in a letter to the ODT) One of the main reasons to publish was to open the public’s eyes to the issues surrounding the deaths of our loved ones and encourage debate on a change in the law. Society is now embracing issues that have previously been uncomfortable to deal with such as sexuality, homosexuality, contraception, Aids, abortion and drug abuse.

Legal euthanasia kills justice for all

John Kleinsman Stuff OPINION: As the spokesperson of a Catholic bioethics centre, there are some who discount my message because of my religious affiliation, rather than on the basis of its merits. It’s a classic case of “playing the man instead of the ball”. As two commentators noted in response to comments I recently made about the dangers of legalising euthanasia: “I am sick of the religious trying to force their narrow views on society.

While I think Christians have as much right to express their views as any other New Zealander, I am, in all honesty, not interested in imposing my religious views on anyone. Actually, with respect to euthanasia, my own personal view is irrelevant.

This is not free choice – but a lack of choice. Legalising euthanasia will end up being an illusory choice for far greater numbers of persons than the few who will ever choose to exercise a legal right to be killed.

It is the role of the law in a democratic society to ensure the interests of the majority are not prejudiced by choices granted to a few.

Man admits assisting wife in suicide

An Auckland man has admitted assisting the suicide of his wife, who suffered from multiple sclerosis.

Rosemary Mott died at her home in Paritai Dr, Orakei, on December 28 last year. Her husband was accused of aiding and abetting her suicide by allegedly helping her to research euthanasia and acquiring equipment and material for her.

Sunday Star Times: Strong public support for euthanasia
The Sunday Star-Times reader poll of more than 1000 people also found almost three-quarters of people would help a terminally-ill loved one commit suicide.

Euthanasia, assisted suicide or assisted death is being discussed a lot. Maryan Street is going to put a End of Life Choice Bill into the Members Bill ballot to try and get another vote on it. This is a collection of relevant links and information.

Discussions

Kiwiblog: The euthanasia debate

If the debate is about how do we make euthanasia safe, rather than does a person have a right to end their own life, then that is a step forward. We should firstly recognise that we already have unregulated passive euthanasia in New Zealand, where people are allowed to die, even though they could be kept alive. I think there is far greater risk in the status quo, than in legislating the circumstances under which someone’s wishes to die can be implemented with assistance.

The Standard: Euthanasia Bill
Maryan Street’s “End of Life Choice Bill” has triggered another round of debate. A recent poll shows public support for legalising voluntary euthanasia at an all time high. It’s a question of “when” not “if”.

Kiwiblog: Support for Euthanasia?
I think the current law is quite cruel when people like Sean Davison are made into criminals for doing what his mother begged him to do.”

Links

Euthanasia interest and support growing

It seems that the euthanasia debate (and support) is building up steam.

Euthanasia debate on the rise (TV3 video)

Strong public support for euthanasia

The MP campaigning for the right to die has been buoyed by a poll that shows more than 85 per cent of respondents to a survey supported voluntary euthanasia.

The Sunday Star-Times reader poll of more than 1000 people also found almost three-quarters of people would help a terminally-ill loved one commit suicide, and that support for a law change is highest among men, and those over 60. Labour MP Maryan Street has been working with the Voluntary Euthanasia Society on her End of Life Choice Bill, which would give people the right to “choose how and when they exit this life”.

The private members bill will have to be drawn from the ballot to get a hearing, but Street says the reader poll had the highest support she had seen, with most polls getting 75 per cent backing for a law change.

“There is more support out in the community for this than people imagine,” Street said. She had seen a change since a 1995 euthanasia vote was lost 61-29, to 60-57 when it was revisited in 2003. “And, nine years on, attitudes have changed again.”

See also:  The Euthanasia discussion begins

Of course for anything to change Street’s bill will need to be drawn from the ballot. It’s ironic that such an important issue is at the whim of chance.