(End Of Life Choice Bill, private bill lodged by MP David Seymour.)

The organisation NZ Young Nats (National Party) recently sent out an email to all of its members with a survey on what students think of this Bill. Having signed up at clubs day, I received this email. Feeling compelled to respond to it, after having attended various events and presentations in France and New Zealand on End-of-Life, Palliative Care and Euthanasia, I responded to this survey with this long opinion piece:

What do you think?

I can’t say that I am very informed on the exact content of the Bill, however I am strongly opposed to any measure that legally recognises an individual’s right to end their life, or to shorten their life. Here are my personal views on the matter:

Legislating to allow medically assisted suicide has major implications on the medical profession. By giving doctors the right (and potentially the obligation) to prescribe medication to end a person’s life – whether in comfort or not, to ease suffering or not and whether they are expected to live long or not – the lifesaving function of a doctor would be undermined. The law would tell them that they may prescribe a pathway to end their life, going against the basic principles of a doctor’s duty to protect that person’s life at any cost. In any other case, the doctor may face Negligence or Criminal charges for increasing the peril to a person’s already threatened life. The idea that medical aid is designed to uphold the value of that person’s life is thrown into disarray by a legal pathway to shorten or end the life of that person (regardless of their consent). This is different to palliative medicine, which does all it can to assuage the emotional and physical suffering of a dying person up to the point that their life is immediately put at risk. For example, morphine can be prescribed in very small doses to help a dying person feel less pain and anguish, but not to the extent that the dose will be the cause of their death (instead of their illness or old age). The law’s principle, which establishes the “right” for someone to reduce or end their life also undermines the principles of human dignity and rights. On a moral level, a person’s life is of great value and must be upheld as much as possible. On a legal level, the NZBORA recognises a person’s right not to be deprived of life except in accordance with fundamental justice (fair administration of justice by legitimate authority). These principles suggest that a doctor cannot deprive the person of their right to life as this is not in accordance with fundamental justice.

Here are some of the justifications for such a law, and my response to them:

“A person’s consent to end their life, in the right circumstances, is sufficient to merit their right to do so”

Firstly, the law is implicating a third party, the doctor, in the person’s choice to end their life. The issue here is giving the power for another person to lawfully participate in killing another person. Consent does not apply to that person no more than a person can consent “on behalf of” the other in a sexual relation. The issue of allowing doctors to prescribe an ultimately lethal medical plan is that they are participating in ending that person’s life and have a responsibility in it. It is wrong to say that the doctor is outside of any responsibility because that person could have ended their life anyway, since the doctor is carrying out an action which gives the person the ability to harm themselves. Would we be willing to legislate to allow corrections facility personnel to supply devices to let prisoners commit suicide? The issue is a moral one, however it also undermines principles such as Negligence, which relies on a person’s obligation to act in a way that does not harm another.

Secondly, the notion of consent is limited to certain fields. For example, a person cannot consent to be tortured. Consent is also limited by ability, such as mental soundness or state (such as age in Statutory Rape). Consent should not be sufficient to allow a person to legally request assistance to suicide. The Universal Declaration of Human Rights declares that “All are … entitled without any discrimination to equal protection of the law.” This law sees the potential for abuses against people with mental instability or social vulnerability. In countries such as the Netherlands where more extensive shortening-of-life laws have been implemented, social pressures have begun to build on vulnerable individuals in situations which place them as a financial or human “burden” on others, to request the end of their life (for the benefit of third parties). In these end-of-life situations a person’s emotional distress may limit their ability to freely consent to such measures. Furthermore, consent generally applies to things which do not threaten their well-being, such as sexual relations or contracts. This is at odds with a pathway to medical suicide. If a doctor give consent to end the life of another, then a person cannot give consent to end their own life.

“The person is suffering terribly (and so may be their families). We have the duty to help ease their pain”

There are already pathways that exist to ease the pain of people with terminal illnesses. This is known as palliative care and is unfortunately not well known or understood by many people. This bill is completely different, with the key issue being the ultimate goal of terminating a person’s life. Palliative care recognises the very high likelihood of a person’s death and responds to their emotional and physical needs by prescribing medicines and care to reduce distress and pain. It does not however permit the use of these treatments in such a way as to shorten the person’s life. The nurse can for example tend to the ill person to relieve them of physical pain but cannot, out of so called “pity”, stifle them with a pillow. The same goes for the painkillers or relaxing agents administered.

Yes we do have the duty to ease their pain, but not at the expense of their life. A person’s life is a greater right and of greater value than their comfort. International law recognises the right to life not the right to comfort. Helping these individuals in suffering is a duty for the citizens, especially family and friends as well as psychologists, religious leaders and doctors. The law must not give a cheap, quick solution to their pain by proposing to shorten their lives. This is a measure that seeks to reduce the obligations of those around the individual, not a law that upholds their rights or dignities.

Is it enough to justify such a law on the basis of personal suffering? There is another issue that lurks behind this justification.

“They are going to die anyway. They are a burden to their family who need to move on in their life”

As above, the right to life is universally declared, and in the NZBORA may only be reduced in exercise of fundamental justice (such as army personnel killing armed combatants or police officers incapacitating armed aggressors). The measure of the person’s right to life is not time nor the cost of palliative care (regardless of the opinions of family members or “friends”). It is a basic principle which underpins the entire justice system and more broadly New Zealand society. Every living person has the duty to uphold the right to life of every other person and cannot justify the removal of that right for personal gain, no matter how noble that gain may seem.

Another argument is that in cases more common than is suggested, certain terminal illnesses are cured or the person’s life expectancy extended. We cannot allow a law which provides for a person to end their life out of despair when in fact there are still opportunities to continue living.

“Everyone has the right to a dignified death”

As above, nowhere in our laws is this true. A person has the right to life and to dignity. No legal or illegal pathway exists to end the life of another person or oneself with dignity – the end of life can only be dignified if occurring naturally and with the respect and care of those surrounding the dying individual.

Some other miscellaneous reasons not to allow such a law:

Why do we grieve at the idea of adolescents harming or killing themselves, and socially rebuke suicide as a woe and a plague among certain categories of youths, and yet we would be willing to legally recognise suicide when it is carried out in a less graphic way? The outcome of violent suicide is the same as medically assisted suicide, and can often be just as violent – such as the person’s violent reactions to the lethal medicine, such as seizures. The violence can also be psychological, for children for example as they watch their dying parent intentionally administering themselves with lethal substances. Not only is the individual outcome the same, but the impact of medical suicide is the same, despite the myth of a “comfortable death”.

Conclusion:

The motivations for this law are certainly founded on conscience and moral principles, as any argument surrounding the right to life and the dignity of the person lie in moral and religious views on the nature and dignity of the person. As such, it is understandable that it be voted on as a conscience vote. However, even in this it, private interests and ideological positions play a very important role in influencing public opinion. In my opinion, the increased media attention on this topic is lead by strong private interests, including Exit International and other international Pro-Euthanasia groups. As such, the public should not be fooled that this is a purely conscience-oriented topic and that this bill and the limits it imposes would be the final change to New Zealand laws.

Therefore I strongly support Young Nats taking a firm position AGAINST this bill, upholding the values of many categories of New Zealanders, including many Christian churches and other religious groups too often marginalised from these discussions (for the sake of “Church and State”), while still recognising the value of a conscience vote in removing the party pressures on MP’s.

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