Last week the champion of New Zealand’s End of Life Choice Act, David Seymour, publicly shared an email from someone who praised him for our country’s new euthanasia statistics. The emailer correctly believed that Seymour would appreciate hearing that the death tally, as of 30 June, was 1,307. Predictable comments followed, applauding euthanasia as a human right, as compassionate, and as ending suffering. Then came this one: “I’ve often wondered whether it should be offered to whole-life prisoners too. Would need to be carefully monitored, but might free up prison space.” Despite unmasking euthanasia’s utilitarian core, positive reactions to that comment outnumbered others two to one.
Currently, Kiwis who want medical help committing suicide need two doctors to affirm that they are competent to consent, declining from a condition expected to kill them within 6 months, free from coercion, and experiencing unbearable suffering. The bar is lower than it sounds. “Unbearable suffering,” for one person who underwent euthanasia, was simply losing the ability to enjoy nature. Another did not speak English, had no interpreter, and likely had dementia; consent, apparently, was just assumed. The shortest time between application to death has been two days — hardly time for the physician to “do their best,” as vaguely expressed in the legislation’s toothless words, to detect coercion.
Oregon, the first US state to legalise assisted suicide in 1994, has not legalised voluntary euthanasia. Eligible patients are prescribed a lethal dose, but physicians cannot kill them. New Zealand has legalised both practices.
Belgium, despite loose eligibility criteria that doesn’t require assent at time of death, still requires the referral of patients to a palliative care team. Unlike euthanasia, palliative care is not fully funded in New Zealand; 22% of those euthanised haven’t received the benefits of palliative care.
Euthanasia legislation overseas typically requires a cool-down period, recognising suicidal patients often change their minds. New Zealand has no cool-down requirement.
Those driving our euthanasia legalisation admit that some safeguards were included only to get the euthanasia bill over the line, and they hope to remove some. Seymour used his post last week to plug a bill that would expand access to those without a 6-month prognosis, making many with degenerative conditions eligible. He takes his lead from Canada, where patients with non-terminal conditions can already end their lives, and where (from 2027) mental illness will also qualify.
Our Ministry of Health also resists increasing safeguards or improving oversight. Two of the original three members of the End of Life Review Committee, which reviews death reports, found missing, conflicting, and disturbing information. The Ministry brushed off their concerns; if information is missing, it said, “assume nothing is wrong.”
Predictably, the Ministry’s 2024 review of the End of Life Choice Act said it is “largely operating well.” Its recommendations for “improvements” involve limiting physicians’ conscientious objection rights, allowing doctors to proactively offer euthanasia to patients, and requiring all care homes and hospices to allow euthanasia onsite – or lose their registration.
Far from endorsing free choice, the Ministry of Health rejects outright some viewpoints. It reported that “some communities’ tikanga (customary values) are not aligned with or supportive of assisted dying,” and that “some held the view that the wairua (spirit) belongs to God, and the body should be allowed to perish naturally.” Regarding Māori whanau who consider euthanasia to be the same as suicide, it writes “that this points to a lack of awareness and acceptability of assisted dying within Māori communities and an urgent need for assisted dying to become familiar, understood, and accepted.”
A Private Member’s Bill is in the tin, which, if selected and passed, would require our health system to have a clear plan for palliative care and better funding for it. That bill will make us ask: Are we committed to helping people experience the best death, or are we satisfied with what’s most expedient? If it’s the former, let’s advocate for palliative care to be universally available so that every Kiwi has that choice.
Read Maxim Institute’s Discussion Paper: “Interrogating Choice: Euthanasia and the illusion of autonomy”
– Maryanne Spurdle
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