End of Life Choice Bill: A case for and against
International evidence lays fears to rest on legislation whose time has come
New Zealand has never had an assisted dying lobby. The End of Life Choice Society, five MPs with assisted dying bills, and advocates such as Lecretia Seales, have all been grassroot campaigners.
And yet, New Zealanders hold strong views on the matter. University of Otago analysis shows that, over 20 years, support has run at an average 68-15 in favour of choice ( 17 per cent undecided).
Such deep and unsolicited public conviction can only come from one place: Life experience. I have listened to Kiwis from Kerikeri to Gore talk about their experiences. In a nutshell, they say: “I have seen bad death. If my time comes and I’m not doing well, then I want choices. By the way, it’s nobody else’s business.”
A few brutally honest opponents claim suffering is good for the soul. They needn’t use the bill. However, they also needn’t inflict their worldview on others.
Most opponents take a more palatable route. They concede the bill would alleviate suffering, but question whether choice for those such as Lecretia Seales could mean coercion for those less determined and articulate.
I started out as someone open to these objections. At the time of Seales vs the Attorney General, I would have said “yes, I support choice but is it genuine choice?”
The international evidence answered my concerns. Today, 200 million people live in places where assisted dying is legal. We now have 20 years’ evidence about how assisted dying laws work.
Does assisted dying compete with, or replace, good palliative care? No. Jurisdictions with legal assisted dying rank among the best for palliative care and the most improved over the period they’ve had it. Assisted dying and palliative care work together because, as both sides in Seales admitted, even the best palliative care cannot always help.
Does legalised assisted dying encourage suicide? This question was answered with a resounding no by Parliament’s 2016 select committee inquiry into the topic. I was there when Health Ministry officials told certain MPs: “There’s just no evidence for your belief.”
Does legalised assisted dying lead to a “slippery slope” where eligibility widens incrementally? The Supreme Court of Canada “rejected the argument that the adoption of a regulatory regime would initiate a descent down a slippery slope”. The reports to the Western Australian and Victorian Parliaments recently delivered similar conclusions.
The reason why is intuitive. Only Parliament can change legislation, and parliamentarians hate legislating divisive moral issues. Even if they reluctantly revisited it, we’d hear afresh all the arguments that narrowed the present bill in parliamentary debate.
Overseas experience is also valuable for testing concerns about coercion. Do the impressionable and vulnerable get steered into the process? Again, no. Those with less access to healthcare, palliative care, less education, or minorities use these laws the least. Unsurprisingly, when you think about it, it is those wellresourced, articulate and determined individuals who navigate the substantial procedures and safeguards while very ill.
Some say Parliament has sold out by putting the bill to a referendum. But Parliament must pass the bill to make the referendum possible. Parliament has scrutinised this bill more than any in recent memory, taking 23 months to the day. The net effect of the referendum is that, if Parliament passes the bill, the public will have an additional chance to veto its work. We are getting the best of all democratic worlds.
In the course of its work, Parliament has ensured that: Medical professionals can conscientiously object from acting under the bill. Only the patient can initiate a conversation about assisted dying. Two doctors must independently sign off that the person has a terminal illness, is capable of making their own decision, and indeed is making their own decision. If improper pressure on the patient is detected, the process must stop. The person can change their mind at any time and must be told so multiple times.
The full process set out in the bill would require its own article. These and all other provisions are consistent with other countries’ laws and make the bill safe.
Perhaps the strongest evidence that these bills are safe is that none has ever been reversed. For instance, 88 per cent of Dutch people support their law after 15 years of experiencing it.
Many say we should judge ourselves by how we treat our most vulnerable. Must those suffering terribly at the end of their life suffer some more to satisfy others’ moral expectations? No. We should all be allowed compassion and choice under the law if it happens to us. That’s why I’m asking my Parliamentary colleagues to vote “yes”.