Ending of Life report leaves door open for more debate

Editorial

The decision of Parliament’s Health Select Committee, reporting on its Ending of Life in New Zealand inquiry, not to make a recommendation on introducing “assisted dying” legislation has both sides in the debate claiming victories of sorts.

Those wanting a law change have said that the select committee did not do what the majority of submitters wanted — a clear recommendation that the law stays unchanged.

Those backing the retention of current law point to the fact that the original petition by Maryan Street and 8974 others specifically mentioned legislation that would permit physician assisted dying, and this did not get a clear green light.

The ongoing debate is likely to focus on two principal arguments — personal autonomy versus public safety, and the purported support of the majority of the population for some sort of change in the law.

The first argument comes down to the autonomy of the few seeking to control their own deaths (with the assistance of others) versus the threat to a not insignificant number of vulnerable people who could lose their lives if assisted suicide and/or euthanasia becomes an accepted norm.

In this context, the issue of unbearable pain suffered by some terminally ill inevitably crops up. But the select committee reported “submitters generally agreed that, in most cases, good palliative care services are available and adequately relieve pain at the end of life”. While there are rare cases where palliative care “does not always relieve pain and suffering”, specialists told the committee that “they are always due to issues of access, delivery, and misperceptions”.

Those insisting on personal autonomy in this area often make confident noises about the efficacy of safeguards. It is disappointing that the select committee report had only one page on this subject alongside “criteria”. In its conclusion, the report stated it was difficult to consider what safeguards should be, given the wide variance in ideas for criteria for eligibility. However, concern was expressed about “protecting vulnerable people, such as individuals with dementia or reduced capacity”. Then, in a key phrase, the report stated: “Some of us remain unconvinced that the models seen overseas provide adequate protection for vulnerable people.”

The New Zealand public does not need to look overseas to see evidence of a lack of protection for the vulnerable by supposed safeguards in a “life or death” matter.

Since 1974 some half a million children have been aborted in New Zealand, largely under mental health grounds, meaning that this country effectively has abortion on demand (albeit with a few administrative hurdles to get through).

The other argument now being put forward by supporters of a change in the law is that this is what the majority of New Zealanders want. Indeed, the select committee report pointed to several polls which indicate high levels of support for legalised “assisted dying” in New Zealand (some of these were taken around the time of the Lecretia Seales court case).

But polls often ask simplistic questions and are sometimes designed to produce the outcomes their sponsors desire. And, when given more information, poll results can change. For instance, in Australia last month, a survey of 1200 voters in Victoria conducted for the anti-euthanasia group Hope showed support for legalisation of voluntary euthanasia at 70 per cent, consistent with New Zealand polls.

But The Australian reported that “once factors such as the lack of consensus among medical professionals and relying on palliative care as an alternative to assisted dying are factored in, support for the change” drops to about 50 per cent.

As the select committee’s report noted, the issue is “clearly very complicated, very divisive, and extremely contentious”. It is not amenable to analysis by the “kneejerk” reactions that simple polls can elicit.

It is to be hoped that Parliament will not be swayed by such populism in considering the Seymour bill very carefully. Lives are at stake.

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Michael Otto

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