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Assisted dying law in New Zealand and the UK

Written By: - Date published: 6:05 am, December 9th, 2020 - 65 comments
Categories: election 2020, referendum, uk politics - Tags: , , , ,

This post was originally published on Baroness Greengross’s blog

New Zealand legalises assisted dying

This post was co-authored by Baroness Greengross and her Researcher Nick Kelly who was the former Campaign Manager to Andrew Little the current New Zealand Health Minister.

Last month New Zealand made history by joining a growing list of nations to legalise assisted dying for those with a terminal illness. The question was put to the country in a referendum held at the same time as the New Zealand General Election. In the referendum, 65.1% of voters favoured legalising Assisted Dying compared with 33.7% who were opposed.

The above graph is from the NZ Electoral Commission showing the official results of the End of Life Choice referendum: see full results here

Whilst voters in New Zealand strongly favoured this law change, a vocal minority ran a strong campaign in opposition. This opposition included advocates from the disability community, many of whom had unfounded fears that supporting the End of Life Choice legislation would be used adversely against those who are sick and disabled. The bill was in fact very clear that Assisted Dying would only be allowed to people who meet the following criteria:

  • be aged 18 years or over
  • be a citizen or permanent resident of New Zealand
  • suffer from a terminal illness that’s likely to end their life within 6 months
  • have a significant and ongoing decline in physical capability
  • experience unbearable suffering that cannot be eased
  • be able to make an informed decision about assisted dying.

New Zealand follows Canada who legalised Assisted Dying back in 2016, the Netherlands, Belgium, Luxembourg, Switzerland, Germany the Australian states of Victoria and Western Australia and 10 jurisdictions in the United States, including California, Washington and Oregon. The Republic of Ireland’s Dáil (parliament) is also currently debating a bill which aims to legalise assisted dying.

There is now growing recognition internationally that the right to a dignified death is a fundamental human right. Assisted dying is not about reducing health care costs or pressuring those who are frail, old or disabled to end their life prematurely. It is about allowing those with a terminal illness the choice to die rather than face a period of significant physical decline and suffering before the end of their life. The significant point here is that this is about choice. Those whose faith or beliefs are against assisted dying have nothing to fear from this change as it merely gives choice to those who want assisted dying while still protecting the right to life for those that do not.

In the United Kingdom, opinion polls consistently show that most people support the legalising of assisted dying. In March 2019 a poll commissioned by campaign group My Death, My Decision found that 90% of people in the UK favoured such a law change. Despite support for Assisted Dying in the UK being higher than in New Zealand, to date parliament has shown a reluctance to support assisted dying legislation. In 2014 Lord Falconer introduced an Assisted Dying Bill into the House of Lords which was unsuccessful. One year later in 2015, a similar bill was put forward in the House of Commons by Labour MP Rob Marris which was also defeated. Prior to these attempts, the late Lord Joffe tried unsuccessfully on four separate occasions to introduce bills that would have legalised physician-assisted suicide. In 1997 MP Joe Ashton’s bill to legalise Dr Assisted Dying was defeated, as were attempts in the 1960s and 70s in the House of Lords by Lord Raglan and Baroness Wootten respectively.

New Zealand has a lot in common with British society in terms of culture, politics and societal attitudes. Both are small ‘c’ conservative cultures, but also where the values of compassion and social justice are important. The New Zealand referendum came after years of debate. In 1995 MP Michael Laws introduced an Assisted Dying Bill which was defeated in the second reading. Another attempt was made in 2003 by MP Peter Brown, where the bill was once again defeated in parliament, this time by just two votes. The recent referendum was a compromise by MPs as despite strong public support, parliament remained reluctant to pass this legislation.

In 2020 Lord Falconer has once again put forward a bill to legalise Assisted Dying. The Lords should support this well-drafted bill which would allow those diagnosed with a terminal illness the choice of assisted dying, but like the New Zealand law protects those who do not. Parliament should listen to public opinion and support this law change. But if it does not have the courage to do so, then like in New Zealand, the question should be put to the public in a referendum.

65 comments on “Assisted dying law in New Zealand and the UK ”

  1. Ad 1

    If only the left could muster as much energy to fighting for the NHS, rather than the most utterly marginal issue of giving the health system the right to kill one or two a year.

    • Chris 1.1

      Perhaps it's about getting the order of things sorted out first? Less people around means less need for health care. If it were the other way around we'd have a health care surplus, and we can't have that.

    • Lettuce 1.2

      That's not unlike saying, "If only the Catholic Church had put as much energy into fighting paedophilia as it has fighting abortion, there would have been a lot less child sexual abuse."

  2. Rosemary McDonald 2

    This opposition included advocates from the disability community, many of whom had unfounded fears …

    See. Right there. Calling the concerns of those who have a well documented history of being abused and neglected unto death by State Agencies "unfounded" demonstrates the complete lack of respect and understanding the mainstream has for the lived reality of these communities.

    Sort out the inequities and gross failings in our health and disability system…make access to health and disability care a Human Right… then your celebrations will be justified.

    Until then…

    • gsays 2.1

      Well said.

      The piece reads like he is preaching to the choir. I am left wondering what the purpose of the OP is.

      While taking pot shots at vulnerable members of society and their unfounded fears, he leaves out coercion. According to Seymour, GPs are going to be able to discern that.

      How long till any of the criteria get 'liberalised'?

      Lower the age, extend the pain to mental or emotional? The Dutch are down to 12 years and are moving to lower that threshold.

      • McFlock 2.1.1

        I give it 5 to 10 years before some poor sod is in the paper sad that they don't qualify for euthenasia and asking for the law to be extended.

      • Chris T 2.1.2

        The govt have to pass the bill alterations to do it, so if it happens blame the Nat, Labour, Green and ACT Partys who voted for the bill in the first place.

        • gsays 2.1.2.1

          I don't see it as a blame thing. Rather a sign of the individual becoming paramount over society or community. Not a healthy trajectory IMO.

          • Drowsy M. Kram 2.1.2.1.1

            Three days ago while chatting to the anaesthetist we got onto the topic of variation of pain thresholds – seemed fascinating but the discussion was cut short when I 'drifted off'.

            Human pain and genetics: some basics
            Pain is one of the commonest reasons patients seek medical attention. There is a high degree of individual variation in pain, very likely due to complex environmental and multiple genetic factors. There is growing evidence that a number of genes play a critical role in determining pain sensitivity, pain reporting and susceptibility to developing chronic pain and their response to surgical outcomes primarily, pain. The study of pain in humans is very challenging, as pain is a very complex trait influenced by race, ethnicity, gender and the social context and interpretation of the pain experience.

            If I fufilled the listed criteria (including "experience unbearable suffering that cannot be eased") that would permit me to request assistance to die, then if for some reason that request was denied I'd hope 'society' would at least have the decency to keep me in a medically induced coma until I passed away. That too would be my choice, for me (the individual). Prolonging unbearable suffering towards the end of a long and happy life seems pointless (heartless even), but I recognise that it's a personal choice.

            • gsays 2.1.2.1.1.1

              Pain is inevitable, suffering is an option.

              The health of the 'top two inches' greatly informs the level of suffering. Learning to accept circumstances as they are, helps to diminish suffering.

              • Drowsy M. Kram

                Good advice, however individuals can experience pain ("on a scale of 1 to 10") and suffering, very differently, and the ability to learn to accept circumstances varies too. I can only guestimate the true extent of pain (and related suffering) in others, but thanks to my 'top two inches' I know how I feel, and would prefer that knowledge be respected.

                Otoh, since my choices haven't always turned out for the best, maybe the tough ones should be left up to others. No easy answers, eh.

                • gsays

                  In terms of making choices for ourselves, it often seems like asking a 6 yr old if they want chocolate for dinner.

                  • Drowsy M. Kram

                    Maybe some terminally ill adults with conditions causing "significant and ongoing decline in physical capability", and who "experience unbearable suffering that cannot be eased", might (like 6-yr olds) be considered too immature/selfish to be trusted with any choices about their own future.

                    I like chocolate, and I still prefer to have the opportunity to make the case that it’s my (selfish) choice to make.

                    • gsays

                      The child having chocolate for tea analogy is as much about all the choices we make through life. Not just nearer the end of our earthly existence.

                      I have known three reasonably enlightened people. All of them faced a very grim end of life. Their state of being during the final weeks and days of their life was a profound example to me. The courage and dignity they demonstrated has been very formative.

                      I hear your point, about your choices for your life. I have a similar view to cannabis. I just feel that as a society we are taking big steps in the wrong direction.

                      You are right, no easy answers. I have wrestled with euthanasia for years. It is a good sign, IMO. To be certain about it implies a fundamentalism, which I am highly wary of.

                  • Drowsy M. Kram

                    It must have been uplifting to witness the courage and dignity demonstrated by the three people in your example. I'd like to think that society won't judge people who avail themselves of the new choice to be cowards, but rather see that they too have demonstrated courage (and dignity), each in their own way.

                    I just feel that as a society we are taking big steps in the wrong direction.

                    Absolutely – but when has it ever been possible to get (complete) agreement/acceptance about what the wrong direction is? For example, IMHO Sue Bradford's anti-smacking bill was progressive and appropriate – not everyone agreed.

                    Some steps in both the wrong and right directions (depending on your PoV) carry more risk, and this is such a step. I hope the effect(s) of this particular change in NZ law will be closely scrutinised, and expect that any proven misuse/abuse will get the response it deserves, but yes, it's risky. My main concern is how it might impact on those who believe and/or are told that they are ‘a burden’ to others.

      • Chris 2.1.3

        "The piece reads like he is preaching to the choir."

        Yes, so does a lot of what he writes.

        • Incognito 2.1.3.1

          Yes, so does a lot of what he writes.

          What do you mean by that? As opposed to what?

          Authors write here to express their personal opinions and this obviously means that some clearly nail their colours to the mast.

          About

          If you disagree here, you provide a counter argument and debate the issue(s) that you disagree with.

          You don’t have to like it but if you don’t provide a rebuttal, e.g. as constructive criticism or even just a witty riposte, you have to be careful that you don’t express your ‘dissatisfaction’ as an ad hominem. It’s ok agreeing to disagree.

  3. weka 3

    This opposition included advocates from the disability community, many of whom had unfounded fears that supporting the End of Life Choice legislation would be used adversely against those who are sick and disabled.

    Like Rosemary I find this positioning to be hugely problematic and it's a damning indictment of democractic process in NZ that such a thing was written after the vote and the supposed debate. Disabled people are the experts in our own politics, and that comment comes across as patronising and demeaning and quite frankly ignorant.

    The bill was in fact very clear that Assisted Dying would only be allowed to people who meet the following criteria:

    • be aged 18 years or over
    • be a citizen or permanent resident of New Zealand
    • suffer from a terminal illness that’s likely to end their life within 6 months
    • have a significant and ongoing decline in physical capability
    • experience unbearable suffering that cannot be eased
    • be able to make an informed decision about assisted dying.

    Let me spell it out:

    1. disabled people have end of life issues too and are part of the cohort the law was aimed at. How specifically are disabled people who fit the criteria going to be protected from discriminatory practice and systemic ableism that is specific to their disability?
    2. anyone that fits the criteria for assisted suicide in NZ is by definition disabled. You literally cannot be assisted to suicide unless you have a disability. Again, where is the protection around protecting people who are vulnerable because of disability?
    3. As Rosemary points out, the state and society in NZ treats disabled people very badly, often from ignorance, often from bigotry or prejudice. The argument against this Bill was basically saying, sort your shit out first NZ on disability rights. Imo the reason the Yes vote won is because most people simply either don't know about the issues or don't care
    4. it's a clear conflict of rights issue (care for dying people and care for disabled people). We need to get way better at navigating rights when there is such a conflict and a good place to start would be not assuming that we can only solve one side.
  4. Whispering Kate 4

    In an ideal world the law would be set in stone, never to be tampered with, no matter what government was in power then it could possibly be tolerated. But of course that will never happen and it will be meddled with, the criteria widened and it will end up a free for all. Disabled, elderly will be terrified of getting treatment or being admitted to a care home or hospital and from venal relatives who are impatient for your demise. Believe me these sort of relatives exist in God's Own Country. We have elder abuse here alive and flourishing.

    If you think this will never happen then you have gone down the rabbit hole. I don't trust this bill for one minute, its dark territory we are entering. Life is cheap enough as it is without making our demise a one stop shop.

    • Phillip ure 4.1

      @kate..

      I totally agree with everything you say..

      I share all of those concerns..

      and after thinking about it…I opposed from day one..

      and I am so ‘left’ I sometimes scare myself..

    • weka 4.2

      That it came from David Seymour at a time when he is openly doing Trumpian politics and wanting to cut benefits to disabled people tells me all I need to know about the naivety of the NZ public.

      • Chris T 4.2.1

        And all the MPs who voted it in for the referendum?

        • McFlock 4.2.1.1

          Most of them would probably be a mix of "it can't happen here" and viewing the referendum as an opportunity to wash their hands of it.

          They are wrong for voting for it. But without ringleaders, mobs are ineffectual.

          • Chris T 4.2.1.1.1

            Maybe. But I voted for it and agree with it, so probably not the best demographic to agree they were wrong.

            • McFlock 4.2.1.1.1.1

              lol you and something like two thirds of the country.

              I sure ain't going to rail against democracy because I think it got this one wrong. Sometimes all one can do is just suck it up and hope the less-than-optimal outcomes don't happen.

              • Chris T

                Lol

                True

                I guess at the end of the day, I am one of those people who try in some vain hope to think our countries MPs in all partys are doing it for the good of the country, for the right reasons, even if I disagree with some of them and wont be swayed into changing a bill that big willy nilly, if they happen to have the numbers to at the time.

                • McFlock

                  Worst case: it won't be willy nilly. It'll be a largely new generation of MPs, who haven't seen anything go wrong with the current lot, and some sob stories shape the narrative for a teeny tiny tweak to the law.

                  Like the big change done recently, a decision will have to be made between actual hardship now and hypothetical consequences. Anyone who talks about the consequences will be unfeeling bastards who are exagerrating a slippery slope.

                  Best case: it works as advertised for decades. How often does that happen?

        • weka 4.2.1.2

          they should have known better, but we already know that most aren't vested in the wellbeing of disabled people.

          • Chris T 4.2.1.2.1

            TBH I am struggling to see how the bill affects 99% of people with a disability, unless the disability is judged by doctors to result in only 6 months likely to live and the person with it, is judged by multiple specialist, mentally compos mentis enough to ask for the option.

            As much as people on this thread seem to be trying to merge unbearable terminal illness, with disability.

            • weka 4.2.1.2.1.1

              Do you think that people with unbearable terminal illness aren't disabled?

              Do you think that disabled people never meet the criteria for assisted suicide?

              Did you read my first comment in this thread?

              • Chris T

                Yes I did. And as I said people are trying to equate disability with in-sufferable terminal illness, with 6 months to live.

                Obviously a terminally ill patient with 6 months to live would in most cases be disabled leading up till the end of 6 months, maybe in the last 2, but this in only my opinion is twisting definitions, to suit a theory normally coping diabled people are some how going to be hooked into it.

                • weka

                  That doesn't make sense. If you accept that people that fit the criteria are disabled, then what are you saying? That because they're terminally ill issues related to disability and vulnerability disappear or don't matter?

                  What about people already disabled who end up meeting the criteria?

                  What does normally coping mean here?

                  • Chris T

                    You

                    “If you accept that people that fit the criteria are disabled, ”

                    That is not what I said at all.

                    I said.

                    “Obviously a terminally ill patient with 6 months to live would in most cases be disabled leading up till the end of 6 months, maybe in the last 2,”

                    If I knew in four months time I am going to be basically skin and bone, unable to feed myself, have a piss or shit without someone cleaning it up, lying there in-sufferable agony , I accept that is disabled.

                    But if I find out while it hasn't kicked in yet that is going to happen, I want the choice not to go through that shit for someone elses warm fuzzies.

                    • weka

                      Oh, you are saying that you want to have state sanctioned assisted suicide before you become disabled? In other words you want the current EoLC Bill changed so the criteria is widened?

                      ie you want to change these two criteria?

                      • They must be in an advanced state of irreversible decline in physical capability.
                      • They must experience unbearable suffering that cannot be relieved in a manner that they consider tolerable.

                      https://en.wikipedia.org/wiki/End_of_Life_Choice_Act_2019#Eligibility_for_assisted_dying

                    • Chris T

                      The first meets my criteria

                      The second you admittedly have a point.

                      But no. I wouldn't change it

                    • weka

                      If you wouldn't change it then we're back to where we were. The criteria are by definition only for disabled people. Not people with a diagnosis that will one day be a disability, but for people who are disabled at the point that euthanasia is being considered.

                      And there are still the issues for people with a pre-existing disability who end up meeting the criteria.

                      So what's your point exactly?

                  • Chris T

                    No

                    It is for terminally ill people in-sufferable pain you pendantically insist as grouping with people who happen to live their lives as happily as poss with a disability.

                    Do me a favour. Define disabled

                    Which disabilities would be categorised as only having 6 months and being in unbearable pain?

                    • weka

                      "Which disabilities would be categorised as only having 6 months and being in unbearable pain?"

                      late stage cancer.

                  • Chris T

                    Sorry. That is a terminal illness

                  • Chris T

                    None of which have a 6 month till you die after suffering like a beaten pet dog

                  • weka

                    I thought vulnerable people were going to be protected from covid /massivesarc

                    (that's a bloody sad story. Imagine being told that your husband has no quality of life so we're going to let him die).

                    • Pat

                      To be fair that example is the US….though it cannot be denied 'rationing' occurs in the NZ health system.

                    • Chris T

                      If someone loses both big toes and has trouble walking it is a disability.

                      You are equating lung cancer, and suffering from it to losing big toes.

                      That is fine. But I disagree it is the same

                    • weka

                      Someone who is blind has a disability. Someone who is in a wheelchair has a disability. They're not the same. They both still disabilities.

                    • weka

                      @Pat, yep, but I heard the same arguments from Americans, that they should let covid run through the community and 'protect' the vulnerabl people.

                  • Chris T

                    You are twisting illness to disability again.

                    They are different things.

                    I tried to be open to arguments and say at the end terminally ill people may count as disabled, but I am beginning to think this was stupid as you seem to not be able to see any circumstances the other way

                    • McFlock

                      Covid just brought a lot of these issues to the fore – not just disability, age, too. Read a stat somewhere about people in rest homes getting covid in one european country had a single-digi-percent chance of seeing a doctor face-to-face. Whereas non-retired people get seen (and directly treated) by doctors, not a nurse on zoom.

                      So the NZ equivalent would be someone with cancer. Would they get offered a more expensive or hard to get treatment with a slim but non-trivial chance of success? Would they meet the points if they were viewed as having a lower quality of life? Or would they not even be offered it, be declared "terminal", and not want to be a "burden" to their family?

                      That's the sort of shit people are worried might happen to them under the current legislation. And it's not unrealistic.

                    • weka

                      Chronic illness is a kind of disability.

                      Disabled people have the same rights and legal entitlements as other New Zealanders. The Human Rights Act 1993 (HRA) and the New Zealand Bill of Rights Act 1990 (BoRA) protect the right of people with disabilities to freedom from discrimination.[6]

                      Both rely on the HRA definition of disability:

                      • physical disability or impairment
                      • physical illness
                      • psychiatric illness
                      • intellectual or psychological disability or impairment
                      • any other loss or abnormality of psychological or anatomical structure of function
                      • reliance on a guide dog, wheelchair or other remedial means
                      • the presence in the body of organisms capable of causing illness.

                      https://www.hrc.co.nz/files/5614/2388/0537/HRNZ_10_DisabilityCh5.html

                    • weka

                      Read a stat somewhere about people in rest homes getting covid in one european country had a single-digi-percent chance of seeing a doctor face-to-face. Whereas non-retired people get seen (and directly treated) by doctors, not a nurse on zoom.

                      Is that because of the pandemic, or was that true before covid as well?

                    • McFlock

                      Totally pandemic-related. One of the scandi countries prioritising healthcare.

                  • Rosemary McDonald

                    Thank you, McFlock.

                    This is exactly what has happened already here in Godzone.

                    Can very much depend on the clinician making the 'quality of life' assessment. (We have encountered some absolutely brilliant doctors…but also have had to fight off arseholes. ) One stood over my partner in A&E in the wee hours demanding that he sign a DNR form. The Good Doctor described the horrific outcomes of such interventions an the high possibility that neither ICU or HDU would accept someone with a high spinal injury, choosing to prioritise patients with odds of recovery.

                    It is a lottery, and the source of massive anxiety when we are forced to engage with the public health system.

                    Get the wrong medico and what would be a treatable condition for most becomes 'terminal' for a disabled patient.

                    • weka

                      that's so fucking appalling.

                      Is there generally a shortage of ICU/HDU places or is he being a manipulative fuck as well?

                    • Rosemary McDonald

                      @weka

                      Definitely a shortage of beds and staff. Also cost is a factor. All the talk at the start of Te Virus about the 'hard decisions being necessary' in order to accommodate patients certainly gave us serious pause for thought. What was already a lottery that was largely individual doctor dependent was now being promoted by MOH and Uncle Ashley.

                      Have developed a somewhat fatalistic/philosophical outlook about the whole thing. Peter tends towards optimism despite having been on the discard list…a glass half full kinda guy…but I'm more cynical and suspicious. I now assume they are all like Dr DNR unless they prove otherwise. Delighted to have been proved wrong by the doctor at Whangarei Hospital clinic the other week who treated Himself like an actual person.

      • Lettuce 4.2.2

        Did you feel the same way when Maryan Street was proposing similar legislation? (serious question)

        • Phillip ure 4.2.2.1

          yes..

        • weka 4.2.2.2

          Not sure what you are asking me exactly. Do I think Maryan Street has the same politics as Seymour? No. I guess we can be grateful that Labour aren't doing Trumpian politics. But I must have missed Labour's apology for their leader giving a major speech that promoted bigotry against disabled people. So while there are obvious differences between the two parties, Labour can't stop a right wing government from making the EoLC Bill worse for disabled people and Labour's general position on disability is wanting enough to not seem them as a cultural brake either.

          • Lettuce 4.2.2.2.1

            IMO Maryan Street and David Seymour could be considered polar opposites in their political views. I probably share 90% of Maryan Street's political values and none of Seymour's. 'End of Life Choice' is the sole issue they agree on. It is as unfair to presume that supporters of the legislation are of like mind with Seymour, as it would be to assert that disagreement with the law equates to an endorsement of Bob McCroskie or Maggie Barry.

            • weka 4.2.2.2.1.1

              I think you might have missed my point. Despite Street and Seymour being polar opposites in political beliefs, on this issue they both ignore the issues of disability and euthanasia. Act are dangerous to disabled people, Labour are neglectful (some say willfully). There are differences but this doesn't mean that Labour somehow do good euthanasia. And, always, there's the point that lefties can't stop righties from messing with the law once they are in power.

              Of course, the Key years also demonstrated that you often don't need to mess with the law, or it's easier to mess with the law, when you have neolib centre left governments holding the door open for you.

              When viewed through a disability lens, Labour don't come out looking so good, despite them being obviously better than NACT.

  5. Chris T 5

    At the end of the day Saint Jacinda voted for it, so it must be great, inclusive and have massive "kindness"

    • Lettuce 5.1

      As did Amy Adams, Chris Bishop, Paula Bennett & Judith Collins, along with all eight Green Party MPs. It could be said that this is an issue that transcends traditional left vs. right politics.

  6. DS 6

    There is now growing recognition internationally that the right to a dignified death is a fundamental human right.

    There is something insidious about calling something like this a "fundamental human right" – by doing so, you basically shut down the entire conversation, since the opposing viewpoint then implicitly becomes anti-human rights…in other words, monsters.

    I personally am opposed to Euthanasia (and voted against it), but I recognise that a lot of very decent people disagree with me. Fine. That's different from shutting down the conversation.

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