The Nathaniel Centre

Euthanasia in New Zealand

Over the last few years, there have been several events that have generated an active public discussion on euthanasia and assisted suicide in New Zealand. In 2012, then Labour List MP Maryan Street prepared a Private Members Bill, the "End of Life Choice Bill". It was subsequently withdrawn from the ballot box prior to the 2014 election campaign as the Labour Leadership did not want it debated during an election year.

Then, in 2015, Wellington lawyer Lecretia Seales, who was suffering from terminal brain cancer, sought a ruling from the High Court that "assisted dying" was not unlawful under the Crimes Act, and that a ban on "assisted dying" contravened her human rights under the New Zealand Bill of Rights Act 1990. The Court ruled that any assistance, whether in the form of assisted suicide or euthanasia by her doctor, would be unlawful and that the relevant provisions of the Crimes Act 1961 were consistent with the rights and freedoms contained in the Bill of Rights Act. It further suggested that changes to the law sought by Ms Seales could only be made by Parliament. Justice Collins referred specifically to the complexity and broad nature of the issues that are implicated in changing the law, stating that: "The complex legal, philosophical, moral and clinical issues raised by Ms Seales' proceedings can only be addressed by Parliament passing legislation to amend the effect of the Crimes Act.".

Following this ruling, a petition organised by the Voluntary Euthanasia Society (VES) was presented to Parliament in June 2015 by former MP and VES President Maryan Street and Matt Vickers, the husband of Lecretia Seales. It asked that the House of Representatives investigate public attitudes towards the introduction of legislation permitting "medically-assisted dying". The Select Committee investigated 1) factors that contribute to the desire to end one's life, 2) the effectiveness of services and support available to those who desire to end their own lives, 3) the attitudes of New Zealanders towards the ending of one's life and the current legal situation, and 4) international experiences.

ACT Party Leader and MP David Seymour submitted his own "End of Life Choice Bill" in October 2015. The key difference from Street's Bill was that it did not include End of Life care directives. While this Select Committee inquiry was still in process, Seymour's Bill was drawn from the private members ballot box on 8 June 2017. The Bill seeks to legalise euthanasia and assisted suicide in New Zealand for people 18 years and over with either a terminal illness or "grievous and irremediable medical condition" (effectively people with disabilities, chronic, and mental health conditions).

Meanwhile, the Health Select Committee released their report on the VES petition in August 2017. The submission process received over 21,000 unique submissions from around the country between 27 August 2015 and 1 February 2016, and heard 944 oral submissions (read the submissions here). 80% of the submissions were opposed to the legalisation of euthanasia and assisted suicide in New Zealand. The Report echoed Justice Collins' observation that the issue "is clearly very complicated, very divisive, and extremely contentious", but made no clear recommendations about legislation on euthanasia or assisted suicide in New Zealand, stating that it was a usually a matter of a conscience vote. Instead, the Report encouraged "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".

Seymour's Bill had its first reading just before Christmas on the 13 Decmeber 2017. You can read the transcript or watch the videos from the first debate here. It is currently before the Justice Select Committee, who received over 35,000 submissions from New Zealanders. The Committee are now hearing from everyone who indicated that they wanted to be heard in person by the Committee. Information about hearing times and locations can be found here. Videos from some of the hearing sessions so far can be found here. Submissions for the Bill can be found here (not all submissions have been posted yet).

 

It is  important to understand that personal choices that people make are always contextually bound. The current New Zealand context, characterised as it is by 'functionalism', increasing ageism that is manifesting itself in growing elder abuse and an increase in the social isolation of the elderly, and a deficit understanding and fear of disability means, in our view, that there has never been a more dangerous time to make suicide and/or euthanasia more easily available.

The answer to the existential suffering that many people experience, and which drives requests for euthanasia and assisted suicide in overseas jurisdictions, is not to make it easier for people to end their lives but to continue to improve access to palliative care for all New Zealanders. It is our informed view that when all of the risks are objectively assessed and weighed up, any perceived benefits for a small minority of persons would be far outweighed by far larger numbers being exposed to the very real dangers of a premature death.

 

The current legal status quo remains the most responsible option for New Zealand at this time.

 

 

Download: Quick Facts: Euthanasia and Assisted Suicide.

 

 

 

Further articles

Articles in this section are ordered according to topic.

Disability

Dying/End of Life Experience

Euthanasia 

International

Medical/Palliative

Official Reports & Statements

Public Opinion/Discourse, Law

Suffering/Care/Compassion

Suicide/Assisted Suicide

Assisted Suicide in Oregon – Updated Facts re Safeguards

The State of Oregon (population 3.93 million) law allowing doctors to prescribe lethal overdoses for some patients’ suicides took legal effect late in 1997. Supporters often point to its safeguards operating well and having prevented abuse. In fact the data suggest that the “safeguards” are largely meaningless. The numbers of deaths under the Oregon Death with Dignity Act has greatly increased over the years.

  • In Oregon, 1545 lethal prescriptions have been written and at least 991 patients have ingested the drugs up to the end of 2015.
  • In 2015 there were 132 deaths, a 26% increase over 2014 and almost eight times the deaths in the law’s first full year.
  • All reporting about doctor-assisted deaths is self-reporting by the doctors prescribing lethal drugs.
  • Doctors cannot report reliably on the situation when patients actually ingest the lethal overdose and die, as nothing in the law requires them to be present. No one else who may be present is required to report.
  • In Oregon, the prescribing physician was present at the time of death in only 11% of cases in 2013 and 2015 and 14% in 2014, compared to an average of 16.5% in previous years.
  • From 1998 to 2012, on average only 6.2% of patients who died under the Act in Oregon were referred for counselling to check for “impaired judgment.” In 2013-2015 this declined to less than 4%.
  • Once lethal drugs have been prescribed the Act has no requirements for assessing the patient’s consent, competency, or voluntariness. No witnesses are required at the time of death.
  • In 2015, a clear majority were women (58%, compared to an average of 47% in past years).
  • Those dying under the law increasingly have no or only governmental health insurance – 56% in 2013, 60% in 2014, and 63% in 2015 (compared to an average of 35% in past years).
  • Inadequate treatment for pain or concern about it, is not among the top reasons for taking lethal drugs; in 2015, over 90% cite “losing the ability to engage in activities making life enjoyable” and “losing autonomy,” and 48% cite being a “burden” on family, friends or caregivers (compared to an average of 40% in past years).

Sources:

Oregon Death with Dignity Act: Data summaries 2013, 2014 and 2015. https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/ar-index.aspx

Secretariat of Pro-Life Activities, United States Conference of Catholic Bishops
http://www.usccb.org/issues-and-action/human-life-and-dignity/assisted-suicide/to-live-each-day/upload/Oregon-and-Washing-euthanasia-2013.pdf

 

A Timeline of the Euthanasia Debate in New Zealand

Assisted Dying, Assisted Suicide, and Euthanasia

The term ‘assisted dying’ a generic term that can refer to either assisted sucide or to euthanasia or to both. Assisted suicide occurs when lethal drugs are prescribed to a person at their request but taken by the patient themselves to end their life. Euthanasia occurs when a third party ends the life of a person by administering a lethal drug, either orally or by injection.

A Catholic Understanding – Church Teachings

“It is a common human tendency to ignore our own mortality and pretend that death is something that is “far away” that we don’t have to worry about right now. But the reality for Christians is that death is not the end, but rather the beginning of a new, resurrected life with God. The catechism teaches that our fate after death ultimately hinges on the state of our souls when we die (CCC 1021)[1].

This view of death affects how we as Catholics make decisions regarding care at the end-of-life. For some people, end-of-life care involves the blessings and struggles that accompany old age. For others, it involves medical decisions that must be made without warning as a result of a sudden illness or accident that can afflict people of any age. In these situations, patients and their loved ones must decide which course of action, if any, upholds the dignity of the person nearing the end of life. While the Church recognizes, and encourages compassionate care that alleviates the suffering of those who are near death, the Church also vigorously teaches that immoral means (such as euthanasia or direct killing) may never be used to reduce suffering even if they are used with apparently good intention[2]”.

Palliative care is a relatively new and specialised branch of medicine that provides relief for physical pain and also addresses psychological, spiritual and emotional suffering. Recent advances make it highly effective in dealing with extreme pain. Euthanasia is not required to ensure people experience a dignified, comfortable, compassionate death, provided that quality palliative care can be accessed by those needing it. Quality care needs to be available to all, not just the privileged.

The Assisted Death / Euthanasia Debate in New Zealand – A Timeline of Key Events

1961. The Crimes Act is passed, which stipulates that “No one has a right to consent to the infliction of death upon himself or herself; and, if any person is killed, the fact that he or she gave any such consent shall not affect the criminal responsibility of any person who is a party to the killing.” Further information is available here – http://www.legislation.govt.nz/act/public/1961/0043/latest/DLM327382.html.

1995. MP Michael Laws introduces his Member’s bill “Death with Dignity Bill”, which would allow a patient to request a medical practitioner to assist them in ending their life. The bill was voted down, 61 to 29. Further information is available here – https://www.parliament.nz/en/pb/library-research-papers/research-papers/assisted-dying-new-zealand/ .

2003. MP Peter Brown introduces his Member’s bill, also called “Death with Dignity Bill”. It is almost identical to the bill proposed by Michael Law and is also voted down, 60 to 58 with one abstention. Further information is available here – https://www.parliament.nz/en/pb/library-research-papers/research-papers/assisted-dying-new-zealand/ .

2012. Labour List MP Maryan Street prepares a Private Members Bill, the "End of Life Choice Bill". The Bill was subsequently withdrawn from the ballot box prior to the 2014 election campaign, as the Labour leadership did not want it debated during an election year.

March – May 2015. Lecretia Seales, a Wellington lawyer suffering from terminal brain cancer, seeks a ruling from the High Court that “assisted dying” is not unlawful under the Crimes Act, and that a ban on assisted dying contravenes her human rights under the New Zealand Bill of Rights Act 1990.

June 2015. The High Court returns its verdict on Lecretia Seales’ case, ruling that any assistance, whether in the form of assisted suicide or euthanasia by her doctor, would be unlawful and that the relevant provisions of the Crimes Act 1961 are consistent with the rights and freedoms contained in the Bill of Rights Act 1990. The High Court further suggests that the changes to the law sought by Ms Seales could only be made by Parliament. Justice Collins refers specifically to the complexity and broad nature of the issues that are implicated in changing the law, stating that "the legal, philosophical, moral and clinical issues raised by Ms Seales' proceedings can only be addressed by Parliament passing legislation to amend the effect of the Crimes Act." Further information is available here - https://forms.justice.govt.nz/.

June 2015. Following this ruling, a petition is organised by the Voluntary Euthanasia Society (VES) and is presented to Parliament by former MP and VES President Maryan Street and Matt Vickers, the husband of Lecretia Seales. It asks that the House of Representatives investigate public attitudes towards the introduction of legislation permitting "medically-assisted dying in the event of a terminal illness or an irreversible condition which makes life unbearable." The petition contains 8,974 names. A Health Select Committee is formed in response to this petition. Further information is available here – https://www.parliament.nz/

August 2015. The Health Select Committee process begins. The Committee’s task is to receive submissions from the electorate to investigate: 1) factors that contribute to the desire to end one's life; 2) the effectiveness of services and support available to those who desire to end their own lives; 3) the attitudes of New Zealanders towards the ending of one's life and the current legal situation; 4) international experiences. Further information is available here – https://www.parliament.nz/en/pb/sc/make-a-submission/document/0SCHE_SCF_51DBHOH_PET63268_1/petition-of-hon-maryan-street-and-8-974-others.

September 2015. The New Zealand Catholic Bishops Conference issue a statement in response to the Health Select Committee process. The Bishops state that “The present attempt to make euthanasia and assisted-suicide legal in New Zealand is a matter of extremely serious concern.” They argue that “The legalisation of euthanasia would send a message that the lives of some people are not worth living” and that “the sick, elderly, disabled and dying would too easily see themselves as a financial and/or emotional burden on their families and communities”, especially in a societal context of elder abuse. A call to action to encourage Catholics to share their thoughts and views, and to participate in the democratic process, is issued. Further information is available here – http://www.nathaniel.org.nz/euthanasia/23-bioethical-issues/bioethics-at-the-end-of-life/euthanasia/modal-windows/262-summary

October 2015. ACT Party Leader and MP David Seymour submits his own End of Life Choice Bill. The key difference between Maryan Street's Bill and David Seymour’s Bill is that Maryan Street’s Bill did not include end of life care directives. Further information is available here – https://d3n8a8pro7vhmx.cloudfront.net/

January 2016. The Nathaniel Centre and the New Zealand Catholic Bishops Conference prepare a written submission on euthanasia to the Health Select Committee. In this submission, they argue that “Euthanasia and/or assisted suicide are unnecessary” because “good palliative care, when available, can and does address the physical and psychological suffering of patients and their families.” They note that “in cases of extreme pain or extreme existential distress, health professionals already have the option of using palliative sedation.” Their submission goes on to note that “At the heart of the debate about ‘medically-assisted dying’ are two questions: Firstly whether suicide or euthanasia, understood as the premature ending of life, should ever be recognised as a socially acceptable means of dealing with suffering and secondly, the pragmatic question of whether these practices can be safely regulated in the real world.” Further information is available here – http://www.nathaniel.org.nz/euthanasia/health-select-committee.

November 2016. The Nathaniel Centre and the New Zealand Catholic Bishops Conference are invited to give an oral submission to the Health Select Committee. In this submission, they argue that in our current societal context, marred as it is by inequitable access to palliative care, distressing and growing rates of elder abuse, rising rates of mental illness, and discriminatory attitudes towards living with any sort of disability or dependence, that “there has never been a more dangerous time in our country’s history to think about implementing an assisted suicide or euthanasia regime.” Further information is available here – http://www.nathaniel.org.nz/euthanasia/health-select-committee.

June 2017. While the Health Select Committee investigation is in process, ACT Party leader and MP David Seymour's End of Life Choice Bill is drawn from the private members’ ballot box. The Bill seeks to legalise euthanasia and assisted suicide in New Zealand for people 18 years and over with either a terminal illness or a "grievous and irremediable medical condition", a phrase which effectively encompasses people with disabilities, chronic conditions, and mental health conditions. Further information is available here – https://www.parliament.nz/resource/en-NZ/51PLLaw25081/0f09371cd3e54b891816bdef4e30d1f61e1c975a.

August 2017. The Health Select Committee release their report on their investigation into New Zealander’s attitudes towards end of life care and assisted dying. The submission process has received over 21,000 unique submissions from around the country between 27 August 2015 and 1 February 2016, and the Committee has heard 944 oral submissions. Eighty per cent of these submissions are opposed to the legalisation of euthanasia and assisted suicide in New Zealand. The Health Select Committee’s report echoes Justice Collins' observation at the close of Lucretia Seale’s hearing in 2015 that the issue "is clearly very complicated, very divisive, and extremely contentious." However, the report makes no clear recommendations about legislation on euthanasia or assisted suicide in New Zealand, stating that it is a matter of a conscience vote. Instead of offering a clear directive, the Committee encourages "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." Further information is available here https://www.parliament.nz/resource/en-NZ/SCR_74759/4d68a2f2e98ef91d75c1a179fe6dd1ec1b66cd24 and https://www.parliament.nz/en/pb/sc/submissions-and-advice/.

December 2017. David Seymour's End of Life Choice Bill receives its first parliamentary reading just before Christmas. The draft Bill passes this and is referred to the Justice Select Committee for the next stage of the parliamentary process. Further information is available here – https://www.parliament.nz/en/pb/hansard-debates/rhr/combined/HansDeb_20171213_20171213_52.

January 2018. The New Zealand Catholic Bishops Conference issue another call to action to encourage Catholics to continue to share their thoughts and views with the Justice Select Committee on the End of Life Choice Bill, and to continue to participate in the democratic process. Further information is available here – https://www.catholic.org.nz/news/media-releases/your-voice-counts-calling-for-submissions-on-the-end-of-life-choice-bill/.

February 2018. The New Zealand Catholic Bishops Conference and The Nathaniel Centre prepare a written submission to the Justice Select Committee. In their submission, the Bishops acknowledge that “The factors that contribute to the desire to end one’s life are complex, and include grief, different forms of depression, social isolation, neglect, fear, loss of hope, and a sense of being trapped.” However, they note that “we know from our experience of walking with the dying that a fearful, vulnerable, powerless person – religious or not – can be bought, with good holistic care, into a peaceful place where pain is controlled, their circumstances are dignified, and family and whānau relationships can be healed, if necessary, and enjoyed prior to death.” In response to the argument that “those opposed to the legalisation of euthanasia and assisted suicide do not have to use it”, they respond that this rationale “narrows the issue down to a matter of individual choice, and ignores the societal effects of the legalisation which will be experienced by everyone, particularly vulnerable groups.” With regards to the vulnerable, they argue that the End of Life Choice Bill “is an abnegation of the responsibility of the kaumātua (including politicians) of a nation to protect its citizens and their well-being” and that it “undermines one of the prime functions of law which is to uphold the moral and ethical standards of a community in the interests of the most vulnerable.” The Nathaniel Centre’s submission echoes these thoughts, arguing that the End of Life Choice Bill “i) does not and cannot provide adequate safeguards against coercion; (ii) that in giving the choice of euthanasia or assisted suicide to a few, the Bill will severely constrain the choice and/or ability for many others to continue to live; (iii) that the practices of euthanasia and assisted suicide contradict medical ethics and are the antithesis of ethical healthcare.” Further information is available here – https://www.catholic.org.nz/resources/submission-to-the-justice-select-committee-from-the-new-zealand-catholic-bishops-conference/ and http://www.nathaniel.org.nz/component/content/article/16-bioethical-issues/bioethics-at-the-end-of-life/451-submission-to-the-justice-select-committee-end-of-life-choice-bill

March 2018. The deadline for submissions to the Justice Select Committee closes. The Committee has received 39,159 written submissions and it has heard 1,350 oral submissions. Of these submissions, approximately 90% are opposed to the Bill and approximately 8.5% are in support of Bill. Further information is available here - https://www.parliament.nz/en/pb/bills-and-laws/bills-proposed-laws/document/BILL_74307/end-of-life-choice-bill.

June 2018. The New Zealand Catholic Bishops Conference and The Nathaniel Centre are invited to give an oral submission to the Justice Select Committee. In their submission, the Bishops argue that if passed, the Bill would “be a regressive move.” They note that “New Zealand prides itself on being a progressive nation” and that to be truly progressive, as a society we must “challenge ageist attitudes and eliminate the sense that being sick or old or dependent equates to being a burden” – a message that the End of Life Choice Bill implicitly conveys. In its submission, The Nathaniel Centre speaks to the Bill’s problems, specifically: “i) its imprecise terminology; its vague and subjective language around eligibility; iii) its failure to consider broader social implications and the ethical contradiction of involving doctors in ending the lives of their patients; iv) the impossibility of ensuring people were not coerced into ‘assisted dying’; v) the growing rates of elder abuse as well as growing social isolation amongst older people along with an increased sense amongst our elders that they are a burden.” Further information is available here – https://www.catholic.org.nz/news/media-releases/catholic/ and http://www.nathaniel.org.nz/component/content/article/16-bioethical-issues/bioethics-at-the-end-of-life/461-oral-submission-to-the-justice-select-committee-on-the-end-of-life-choice-bill.

Apr 2019. The Justice Select Committee issues its report based on the submissions it has received. In this report, the Committee state that they are “unable to agree that the Bill be passed” because the Committee “hold diverse views”. Because of this, the Committee state that they “decided to report the bill back with minor, technical, and consequential amendments only” and that they “leave it to the full membership of the House to resolve the broader policy matters.” The Committee members further state that the Bill “is expected to result in conscience votes by members in the House”, noting that “in previous situations where a bill was expected to result in conscience votes, committees have recommended amendments that left the policy content of the bill largely intact, while trying to ensure that the bill was a coherent and workable piece of legislation— particularly regarding consequential amendments and amendments to related legislation.” Further information is available here – https://www.parliament.nz/resource/en-NZ/SCR_86640/c5b7adfc7598b85747ff94855bc46bfb40470db0.

Jun 2019. The End of Life Choice Bill receives itssecond reading in parliament. The Bill passes this reading. Further information is available here – https://www.parliament.nz/en/pb/hansard-debates/rhr/combined/HansDeb_20190626_20190626_28.

13 Nov 2019. The End of Life Choice Bill receives itsthird reading in parliament. The Bill passes this reading, meaning that the Bill has been approved by parliament to pass into law. However, it is decided that the final decision as to whether the Bill becomes law rests with the New Zealand electorate and should be subject to a binding referendum. October 2020 is set as the date for this referendum. In the meantime, however, the Bill receives its royal assent. Further information is available here – https://www.parliament.nz/en/pb/hansard-debates/rhr/combined/HansDeb_20191113_20191113_16 and https://www.parliament.nz/en/pb/bills-and-laws/bills-proposed-laws/document/BILL_74307/tab/hansard.

October 2020. The NZ public will vote in binding referendum on the question “Do you Support the End of Life Choice Act 2019 coming into force?”.

 

Resources

http://www.nathaniel.org.nz/the-dangers-of-euthanasia-a-statement-from-the-new-zealand-catholic-bishops

http://www.nathaniel.org.nz/component/content/article/16-bioethical-issues/bioethics-at-the-end-of-life/467-making-death-easier-makes-life-harder

https://corpus.nz/euthanasia-and-the-common-good/

http://www.nathaniel.org.nz/component/content/article/16-bioethical-issues/bioethics-at-the-end-of-life/451-submission-to-the-justice-select-committee-end-of-life-choice-bill

http://www.nathaniel.org.nz/component/content/article/16-bioethical-issues/bioethics-at-the-end-of-life/431-euthanasia-assisted-suicide-and-the-medical-profession-keep-doctors-out-of-it

https://carealliance.org.nz/

https://carealliance.org.nz/icare/

https://www.riskylaw.nz/

 

[1]https://dphx.org/respect-life/know-the-issues/euthanasia-and-assisted-suicide/

[2]https://dphx.org/respect-life/know-the-issues/euthanasia-and-assisted-suicide/

If euthanasia is a ‘right’ then it must be universal … and if it is universal then we can’t deny it to anyone. Once we allow it for some circumstances then, over time, we will have to allow it for many.

Legalisation of euthanasia results in normalisation.

Twenty to 40 percent of medical diagnoses prove wrong when confronted with the ultimate criterion of truth, the autopsy. This means that the license to cause deaths on the grounds of medical diagnoses can lead to tragic mistakes. - Dr. Richard Fenigsen

The Dutch experience has shown that the acceptance of death as a medical solution is suppressing the performance of doctors and nurses in critical situations when life is threatened but can still be saved. - Dr. Richard Fenigsen

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