Choice isn’t simple for the dying
The pro-euthanasia lobby has advanced its marketing strategy for the End of Life Choice Act referendum with its campaign slogan #Yesforcompassion. Hijacking language like ‘‘dying with dignity’’ for the purposes of emotive ‘’advertising’’ is not new to the proeuthanasia movement.
Why am I particularly troubled by this latest slogan? To conflate compassion with intentionally ending the life of another human being seems perverse. What does this say of New Zealanders past, present and future who have been, are and will continue to be recipients or providers of compassionate care at the end of life?
Isn’t choice compassionate? Choice, when it comes to healthcare, is rarely straightforward. The law may seem black and white, but in the messiness of life, choices are often determined by life circumstances and in the context of multiple relationships and medical uncertainties.
Decisions unfold in a financially strained healthcare system.
The idea that choice makes possible the kind of deaths people want is somewhat erroneous. We already see this in choices about how and where people die. In a utopian Aotearoa every New
Zealander would have access to palliative care. They would expect that wherever they lived or were cared for, their care needs would be fully met.
Unfortunately, we know that Ma¯ ori, people with dementia, people with mental illness and others are less likely to have access to palliative care. Is this real choice? Who ‘’gains’’ from the EOLC Act 2019 version of compassion?
To be eligible for the provisions of the act a person has to have a terminal illness that is likely to end their life within six months.
Twenty years ago the term ‘’terminal illness’’ was relatively clear. Today it is, in my view, largely redundant. Rather, addressing the needs and ‘‘suffering’’ of, and promoting the wellbeing of, all people with life-limiting illness is what is of most concern. Those with an unmet and growing need are older people with chronic illnesses like dementia or heart failure.
Cancer treatments have progressed such that timeframes are highly uncertain. Is compassion only for a person with six months to live? Who decides when the six months start? Doctors and nurses are notoriously bad at predicting timeframes.
If doctors err on the side of caution this will mean those who are already most sick and frail will need to ruminate over decisions about ending their life, even when they are ineligible for the act. Is this the compassion that proponents of the act talk of?
The #Yesforcompassion campaign wishes us to live in a compassionate society, one that trusts fellow Kiwis to know what’s best for them.
I agree, compassion is not simply individual; we need to consider a wholeof-society response. If we have learned anything from Covid-19 it is surely that end of life care practices and their effects on society are far from being an individual endeavour.
We have shown that our ‘‘team of 5 million’’ has had to place trust in one another and to adapt in the face of adversity.
Why don’t we harness this newfound community spirit in our approach to the one thing that will affect us all – death? Why don’t we have open conversations about normal dying, about what a compassionate Aotearoa should look like in the face of death, and why compassionate care is not available to all Kiwis?
The kind of compassion I care most about is compassion for individuals, wha¯ nau and communities, whether or not they can access the End of Life Choice Act, whatever time they have left, whatever their diagnosis or their life circumstances.
Supporting all Kiwis to live as well as possible in the face of death, not just a privileged minority who argue for individual rights – this is the kind of compassion I would vote for.