Editorial Euthanasia: A case of ‘selective listening’?

Maryan Street, author of a bill which seeks to legalise euthanasia and physician-assisted suicide in New Zealand, has repeatedly made the point that "the social conversation has moved" since 2003 when the last Bill was put forward. I agree with her.

But, whereas Street means to infer (without real evidence) that there has been a shift in opinion towards favouring change, I mean something quite different. I mean that in the last 10 years the social context has changed and is now characterised by a range of different concerns. These concerns, articulated in various social conversations, lead me to a very different conclusion about the desirability of euthanasia.

Firstly, there has arisen a new conversation about the dangers of growing old in New Zealand. Elder abuse is now a significant issue confirmed, sadly, by recent reports of family members in Christchurch standing over elderly relatives and intimidating them to hand over earthquake compensation pay-outs. The reported case of the woman who died a horrific death from scabies, allegedly attributed to carer neglect, is yet another example. Age Concern (NZ) notes that 1 in 40 of all elderly people experience some form of abuse or neglect, equivalent to two people being abused every hour of the day. Given that the reported cases represent approximately 16% of the total abuse cases, that would amount to a total of 6,250 cases per year or 17 per day. Shamefully, 80% of abuse is committed by family members even when that person is in residential care.

Then there is the conversation that has followed from the reporting of the (Auckland) results of the New Zealand Longitudinal Study of Ageing. Over half of those questioned were lonely and nine per cent described themselves as "severely" or "very severely" lonely. Depression is also a significant factor for more than 20%, and 40% report experiencing everyday discrimination, mostly because of age. The study further notes that elderly people are facing a future of less housing and income security. These figures are of huge concern when considering research which shows that persistent requests for euthanasia or assisted-suicide are related to loss of control, social isolation or being a burden rather than a desire to avoid a painful death.

There has also been a lot of talk about the rising number of suicides amongst elderly New Zealanders. Dave Armstrong (The Dominion Post, 24 September) has challenged us to get the issue of suicide into the open and to recognise the "complex factors" which contribute to the problem including "relationship breakdowns, depression and old people feeling they are a burden." Making suicide easier to access is not what Armstrong and others have in mind; it is hardly a caring, let alone ethical, solution to this problem and it will send a mixed message to our young people at a time when youth suicide remains a growing problem in areas such as Northland. To those who say this is not what Street's Bill is aiming to do, it should be noted that her proposed bill is not just for people who are dying and, moreover, it includes persons, young and old, with irrecoverable mental illnesses.

These conversations point to powerful, deep cultural and societal forces at work. Personal choice is not something we exercise in splendid isolation; our choices are always constrained by the pressures and influences around us and they impact on others. What a person believes he or she should do is not necessarily the same as what an individual really wants. No amount of safeguards can protect people from being caught up in these powerful currents.

While a law change may well benefit a very small number of strong-minded individuals, in reality very few people are like that. As Baroness Ilora Finlay notes, in the face of illness and increasing dependency most are "ambivalent, oscillating between hopelessness and hope, worrying about being a personal or financial burden on those they love or that their own care costs will erode their descendants' inheritance." The end result of what one commentator has called the "continual apology for your own existence" would be significant numbers of people being steered towards euthanasia. This is neither free choice nor what Street has called "vigorous self-determination".

We should be very afraid of the consequences that would follow the legalisation of euthanasia, in particular the way it would undermine many people's will to live. While supporters of Street's Bill argue that a change in the law is about 'choice', the real fear is that we will realise all too late that its effect will be to steer people down a one-way-dead-end street.

Maryan Street and I have obviously been listening to very different conversations. If as a society we are going to properly discuss euthanasia, it must occur as part of a fully informed social conversation rather than one based on selective listening.

If our politicians decided that euthanasia was too dangerous in 1995 and 2003, then it is even more so now given the way "the social conversation has moved."

John Kleinsman is director of The Nathaniel Centre