Written By:
tracey - Date published:
11:00 am, June 6th, 2015 - 189 comments
Categories: uncategorized -
Tags: compassion, courage, death, humanity, life
I hesitated before writing this. I knew that nothing I could write would do justice to the courage of Ms Seales and her family and supporters.
The recent decision of Justice Collins on assisted death makes legal sense to me. I struggled to understand prior to his decision how he could legally support Ms Seales’ case. To do so really requires a law change and that must come from Parliament.
Ms Seales’ court case has clarified the law from the perspective of statutory interpretation. It has highlighted its shortcomings. As much as she would have liked a different outcome, I can’t help but suspect that with such a sharp legal mind she knew she would probably not win, and that the “win” would be if the decision could push those who represent us to show some courage by dealing with this issue, front-on, and stop running away.
So, who supports assisted death? The Right? The Left? A mix? And who opposes?
The Right speak about personal responsibility. They talk about it all the time. Some practice it, some don’t. Being able to end your life in a humane way with the help of all that humans have developed is the ultimate in taking personal responsibility. On one view of the argument.
Resolving this issue will require courageous leadership. So far it has been left to victims and victims families. Change has been slow.
What I would like to see is a discussion between the legal and medical communities (and by medical I mean in its broadest sense) about the kind of protocols, regulations and criteria that might be devised to give people the right to be assisted, in a humane way, to their deaths AND how those protocols, regulations and criteria will protect the vulnerable and to deter those who may use the “power” for evil. Bear in mind that about 47 people per year, on average, get murdered each year in NZ, so we are not a nation tending toward willfully taking each others lives (twice as many people die from workplace injury than are murdered).
Can we not move from “this is evil” or “unfettered right to assisted death” to concrete proposals for how this might work, and then debate from that point?
Visit Lecretia’s website and read her husband’s statement about the decision and the path for Parliament.
The Court decision is here. Please read it.
And then tell me, what does courage look like?
The image is from Lecretia’s website. If anyone in her family objects we will remove it.
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She was a great woman!…and she leaves a brave legacy which will be fulfilled …the terminally ill should be allowed and helped to go at a time of their own choosing
There would seem to be three elements that would need to be present to legitimise assisted dying:
* recovery is a forlorn hope
* consent is absolutely unequivocal
* medical treatment has become ambiguous or negative to the degree that
prolonging life is no longer in the patients best interests
Given that switching respirators off is now widely practised a legitimising procedure that establishes these elements – and perhaps one or two more determined by legal or medical specialists – should suffice.
and how to establish those things? At least two medical teams (note I say teams not doctors alone).
And how we balance power between medical and non-medical people in those decisions. Myself, if the person is legally considered competent, then medical opinion should be advice only and technically not part of the decision.
it needs to be informed consent surely, which requires the transmission of medical information?
yes, but that’s a different thing than doctors having control in the decision. You could compare this to our abortion law, where the decision about whether a woman is legally allowed an abortion is made by two doctors. Instead it should be the woman’s decision and just need a professional’s referral for access to the medical procedure (with informed consent processes etc).
I’d suggest three doctors could determine the first, and three JPs, Notary Publics, Doctors or Ministers of Religion (i.e. those who formally witness declarations) could ascertain the second.
The third is somewhat subjective and would require some medical input and perhaps psych or patient advocacy input, and I think the family should also be consulted.
We’d need to create a robust but not impossible process if it is to actually help people.
Interesting article here quoting a Dutch euthanasia watchdog
http://www.dailymail.co.uk/news/article-2686711/Dont-make-mistake-As-assisted-suicide-bill-goes-Lords-Dutch-regulator-backed-euthanasia-warns-Britain-leads-mass-killing.html
Sheeezus, thousands a year killing themselves in the Netherlands. (Pop. 17M)
Suicide is already so common in NZ society – 500+ deaths a year.
suicide not assisted by doctors in NZ
Maybe they should be – if people are determined to kill themselves they should be doing it in a safe and professional environment under supervision, don’t you think.
I would ant to try and help them first, if we are talking depression and other mental illness.
I’m surprised the Right doesn’t want euthanasia, it would be cheaper than treatment…
the cost/benefit anaylsis is faultless
The liberal left seems to have a penchant with the officially funded medical taking of life.
how many nations have legalised euthanasia CV?
How many nations have lefties campaigning for legalised euthanasia…
Lucky for you Russia hasn’t legalised it. Otherwise you’d be twisting yourself in knots fighting yourself.
slippery slope, slippery slop….
I agree. I worry that we keep talking about ‘Terminally’ ill. Surely in a true democracy one should be allowed to cease living if they so wish. In some cases this might be the only truly free choice that one could finally make.
“Sheeezus, thousands a year killing themselves in the Netherlands. (Pop. 17M)”
Is there something wrong with that?
Surely when you legalise euthanasia the numbers are going to spike, in part simply because of better and more formal recording practices.
I was thinking that too weka BUT it is the type of “illness” that folk are suffering from who take this option that is interesting.
What do you mean?
“‘Whereas in the first years after 2002 hardly any patients with psychiatric illnesses or dementia appear in reports, these numbers are now sharply on the rise.
‘Cases have been reported in which a large part of the suffering of those given euthanasia or assisted suicide consisted in being aged, lonely or bereaved.”
Ah, ok, thanks. I haven’t read it. So are the safeguards not working, or is something else going on?
It’s worth a read. Well, it’s hard to tell whether, as you suggested, numbers are rising because more people understand and are accessing it, or if it is being abused.
They do seem to have pretty strict protocols in place but maybe they dont inject enough resources to monitor it. That is what I would want in any legislation. Strong resourcing of the monitoring aspect.
ok, had a read. There is some interesting things in there, but it raises more questions than it answers, and there are too many people expressing opinions without clarifying what they mean. The main man being quoted is talking from belief, but not providing much in the way of evidence to understand what is going on.
agree.
FFS very very wrong and the fact you can’t see it is telling.
Tell you what weka, when climate change and economic decline and social dysfunction clearly become out of control, then everyone will be keeping an ampule of “Quietude” ready to pop, won’t they.
Personally, I think suicide in the face of catastrophic climate change is going to be a reasonable option. That’s a different debate though. What you are implying is the ‘people will be pressured into euthanasia’ argument against legalisation.
What is wrong with a thousand people in a state of extreme suffering, that is not going to end except by death, choosing to end their life? If you are morally opposed to euthanasia, just come out and say it, it will save us all a lot of time.
bs. I’m saying not such thing. I’m saying that the case against the status quo has not been made.
Hmmm. How so? Why do you think that I would be interested in “saving time” and cutting short a full debate?
I have no idea what you are talking about, and I’m not really interested in a drawn out proceess trying to guess or trying to pull out of you some coherent statements. I think you do have a moral objection, and that this underpins your comments and that you should try being honest about that.
Euthanasia and suicide are different things. People who suicide or attempt suicide in NZ generally do so under horrendous conditions and often with little expertise. They do it in isolation, often with shame, panic, or out of desperation to find their way out of a situation beyond their control. Some of those people survive whether they want to or not, which increases suffering, and some damage themselves in the process. Euthanasia is a medical procedure, and making it legal will reduce those sufferings by creating humane processes and giving people access to competent medical treatment instead of DIY. It’s grossly ignorant to suggest that people can already easily kill themselves. Compassionless too.
you are not debating, you are dropping in little phrases as a substitute for sharing knowledge and then denying your moral driver.
Those 6000 would have died anyway. The change to euthanasia laws didn’t change that at all and so that is not an argument against euthanasia.
Dont forget the “Silent Euthanasia”
“The figures do not include deaths by terminal sedation, where patients are rendered unconscious before they are dehydrated and starved to death, an act often referred to as ‘euthanasia by omission’.
This practice accounts for more than 12 per cent of all deaths in the country( Netherlands- According to Daily Mail
This pathway for assisted death can apply to those who dont have a terminal illness but are merely old and inform. It normally involves restrictions on fluids and food.
“Can we not move to concrete proposals … To how this might work?”
Why?
I have no doubt about her courage to take and front such a personalised case to court.
I doubt her purpose.
She always had the right to take her own life.
She resolutely and for many months chose not to.
I can certainly imagine circumstances of astonishing terminal pain one would wish to be free from. But techniques for relieving that are well practised here.
Instead, she sought to legalise someone else to assist her.
Only in the last four hours of her life was she immobilised such that she could not act to end her own life. At that point, again, palliative care is already well versed.
This was certainly a case in courage.
This was not the case to test whether a doctor should be licensed assisted to end one’s life.
And that sums it up.
what do you think her purpose was?
secondly, if we have concrete proposals for what the laws around it would look like we can debate substance not the peripheral and non specific stuff.
Knowing what we are actually deciding upon doesn’t mean we agree.
thirdly, she should have kllled herself a year ago to avoid the suffering of her death???
“She always had the right to take her own life.
She resolutely and for many months chose not to.”
How do you propose that she might have killed herself? You imply that taking one’s own life is currently relatively straightforward as long as one is not physically immobilised. Was that your intention?
Content warning on the rest of this subthread.
Over 500 Kiwis a year kill themselves. They each make their own decision as to how to do it.
Are you saying that those who get diagnosed with terminal illness need to make sure they suicide while they still can, even if they could live for another 12 months of reasonable quality before the point they actually wanted to end their life cos of the pain and suffering that lies ahead but have to go much earlier to be certain they have the capability of doing it by themselves?
Don’t know where you drew all that from. weka asked “How do you propose that she might have killed herself?”
I answered.
well, I am asking you. You keep responding to posts about assisted death with comments about suicide. So, I am trying to ascertain if you think people should suicide while they are still able, without assistance.
People take their own life all the time. That’s their personal decision.
re-read my question cos you didn’t answer it.
By “without assistance”, you actually mean:
“Without someone else taking legal responsibility for taking my life.”
No need to go all grisly on us. The point of the case was assigning legal responsibility for death to someone other than the person.
Don’t be a wanker Ad. I am not being “grisly”. I am trying to advance the conversation by trying to understand other people’s positions.
Nope. I mean without the help of those who are given exclusive access to the means to do it.
Your post was too slanted not to clarify terms.
No problem with your emotiveness, but it’s far too serious a topic to be imprecise.
Yes, people should be able to end their own lives, especially in cases where the endpoint is huge suffering and definite death-point.
Do you consider calling someone grisly is emotionally neutral?
My opening post for example suggested a legal/medical discourse…
I suggested a set of proposed processes/policies/regulations by tose advocating assisted death so we can debate actual, tangible ideas, and you said, why bother?
How do you think they should end those lives if the point at which they want their lives ended they are not capable of doing so?
I think his is the first response that makes sense. To ask for assisted suicide is asking someone else to kill….
Suicide vs assisted death
They have more in common than they have in difference.
How many suicide’s involved the consent of the suicidee to have a doctor with them administering the dosage?
That’s just technical methodology, not intent or objective.
That’s a “don’t know” or” can’t be bothered finding it cos it won’t support my line of “discussion”.
Well you and I are just going to have to disagree on this matter, then.
That you haven’t worked out that I am not on a side only makes your dogged moral stance more obvious
You stick with your moral stance and I will continue to try to understand the whole topic.
Oh I worked out that you weren’t on my side on this issue from the very start. And you can be sure that it will stay that way.
That’s just pseudo philosophy to hide the lack of courage to say simply what you mean.
My pseudo-philosophy versus your pseudo-philosophy then. You suffered watching a loved one suffer. I know a little bit about what that is like.
You need to re-read my post and you will find there what I am asking for.
I have watched 3 loved ones die and yet i am not convinced that we should legalise euthansaia or assisted death, but then you made assumptions about my position, didn’t you?
no they don’t
my mother abhorred suicide, believing that every day was different and that maybe tomorrow would be a better day. She also had two family members that died by suicide, and she forever asked herself what she could have done to prevent these suicides.
at the end of her life, after a horrendous year of bowl cancer treatment (after having her uterus and ovaries removed due to cancer), and just before they diagnosed her with the cancer having spread elsewhere, she was in so much pain that her whole body was literally covered in morphine patches.
she was afraid of eating, as it meant that she would have to go to the toilet – and that was so painful she preferred not to eat. Catch 22 if ever there was one.
She wanted euthanasia in the case that it became all just unbearable. Alas, she lived in germany and no such recourse is given. She suffered till the last minute.
So to compare suicide and euthanasia is comparing apples and oranges. Both are fruit, but they are not quite the same.
For what is worth, my mother would have never ended her life a minute before it stopped being life and started to just being pain.
Would the computer program (and associated apparatus) described in this video count as suicide, or assisted death, or somewhere in between?
https://youtu.be/g2OfteN-VXQ?t=567
Where do you draw the line as ‘assistance’ anyway – the shop clerk that sold you the gun and ammo? The checkout operator that sold you the razor blades or pain killers?
Check out those nations which have legislated and you will see where and how they have drawn the line.
My doctor is coming to my house, discusses my medical issues, ask me how i want to continue i.e. hospice care, home care, pain relieve…all the issues that need to be discussed when it comes to palliative care, and last but least …assisted suicide. Is that something you want to look at? …At this stage one can say: No, my religion (or any other thingy ) is against it. End here. One can say: Yes, I would like to know more about it.
My mother and I we discussed her passing well before she was drugged into stupor., and on more then one occasion.
Death is nothing scary, it is part of life. How we want to celebrate Death that is the question. How do we want to see our Elders and Family members pass on that is what we need to discuss.
Because one thing is for sure, at the end of our lifes we are going to die.
No you didn’t, you avoided the question with a facile non-answer.
Consider this: A person is diagnosed with a terminal disease that will end their life. At the moment and for a year or two they will continue to live a normal, fulfilling life but after that they will become bed bound and unable to do anything for themselves. This latter part could last months or even years with an increasing pain component.
Now, should this person be forced to endure right to the end or should they be able to ask their doctor to assist them in ending it after they’ve become dependent for everything on other people and machines?
“Over 500 Kiwis a year kill themselves. They each make their own decision as to how to do it.”
That’s ignorant and facile. Interesting though to see you running a personal choice/personal responsibility line.
There are distinct and important differences between suicide and euthanasia. Maybe you should educate yourself.
There is more in common than there is apart.
Life and death is indeed a matter of personal responsibility. There is none more personal.
Over 500 kiwis a year choose to end their own lives and manage to do so successfully. That fact needs to be part of this discussion, not walled off and ignored as irrelevant.
I think the difference CV is that euthanasia has at least two critical elements present that are missing from suicude; the certainty of imminent death and the active consent of those who care and love for them.
Most societies strongly condemn suicide for a variety of ethical and practical reasons. While both involve a positive choice to die, one is widely considered acceptable the other not, and for this reason it’s very important to understand why.
and that suicide has a strong mental health component whereas assisted dying and euthanasia are about avoiding the loss of dignity and excruciating pain that some encounter at their death.
The majority of people who survive suicide attempts go on to live happy and fulfilling lives, and generally say they’re glad their attempt failed.
Clearly, people choosing to suicide are under a great deal of stress and not ‘in their right mind’. Just like a contract signed when your drunk doesn’t count, suicide under great psychological stress is quite a different beast from informed euthanasia.
IF any law were drafted properly the kind of mental state that leads to suicide would not be permitted as an assisted euthansia case, so that is a major difference. I would love us to do more for suicide prevention and mental health and wellness.
What are you basing the people who survive suicide go on to be happy etc on? Not challenging just interested.
My sister and brother-in-law are both clinical psychologists. Dinner-table conversation.
“the certainty of imminent death and the active consent of those who care and love for them.”
It’s not that clear cut. In some countries e.g. Belgium there may be grounds for assisted death of non-terminal, mainly neuro-muscular patients have chosen this option.
I would rather people with irreversible disease leading to significant deterioration of health and ability have the option for assisted dying than not have that option.
“There is more in common than there is apart.”
For people like yourself for whom this is a moral issue. For people like me who have no moral problem with either form of suicide, the differences are crucial.
“Over 500 kiwis a year choose to end their own lives and manage to do so successfully. That fact needs to be part of this discussion, not walled off and ignored as irrelevant.”
No-one is walling if off. You keep stating it, but you don’t say why its important. Why are you not just explaining what you mean?
The point is surely how they killed themselves. It is perfectly possible for people wishing to end their lives to be provided with a simple tablet that they could swallow and simply go to sleep and die.
We do it every day for animals but deny the right to humans.
You quote 500 people killing themselves every year but I wonder what the number of people that attempt it and fail, and may well end up in a worse situation because of the bungled attempt.
We need to provide safe easy methods for whoever wants to end their life. Anything else is just playing with the people’s lives.
“I can certainly imagine circumstances of astonishing terminal pain one would wish to be free from. But techniques for relieving that are well practised here.”
And your implication here is that all suffering can be relieved by pharmaceuticals, but we know that this is not true.
I wonder what the point is of having people so drugged to attempt to deal with the pain, as opposed to letting them die actually is? To deal with the level of pain some suffer they get rendered incoherent or coma-like.
I am surprised that no one is linking this legal outcome to the States insistence on it’s sole right to take life, and the broader power implications of that insistence.
NZ context please.
any reason you couldn’t post a link?
That is not my personal experience, nor of hospice and gerontology staff that I know.
Then let’s get them in the discussion. Did you read the decision?
Indeed I did.
Good.
I hope all who have an opinion do. It is a useful overview of our law…
In the Netherlands the law does not remove the spectre of a doctor being charged with murder or manslaughter, it
“Euthanasia and assisted suicide are legal only if the criteria laid down in the Dutch Termination of Life on Request and Assisted Suicide (Review Procedures) Act are fully observed. Only then is the physician concerned immune from criminal prosecution. Requests for euthanasia often come from patients experiencing unbearable suffering with no prospect of improvement. Their request must be made earnestly and with full conviction. They see euthanasia as the only escape from the situation. However, patients have no absolute right to euthanasia and doctors no absolute duty to perform it.”
They only escape prosecution for, presumably, murder/manslaughter if they can prove the criteria processes have been followed
http://www.euthanasiecommissie.nl/Images/Wet%20toetsing%20levensbeeindiging%20op%20verzoek%20en%20hulp%20bij%20zelfdoding%20Engels_tcm52-36287.pdf
“I wonder what the point is of having people so drugged to attempt to deal with the pain, as opposed to letting them die actually is? To deal with the level of pain some suffer they get rendered incoherent or coma-like.”
Sanctity of life argument I guess.
Is that not about others taking life from us, without our genuine consent?
Contract to kill me is illegal on that basis yes? So even in cases where the dead person has agreed to be killed in return for money for their family, we abhor it as a legal construct and will not uphold the contract, hence such a person is (and has been) charged with murder?
That is why the process/protocol/criteria are so crucial? That’s why I want to see those discussed first so we know what we are actually agreeing or objecting to.
No one is talking about relieving “all suffering.” There is no drug licensed to “relieve suffering.”
What is this fascination with terminating life at either end of the human lifespan?
The link to the piece on the UK/Netherlands debate was informative to me. Thousands upon thousands of people in the Netherlands euthanised. This is clearly not about a few people per year in such extreme medical circumstances that they have no where else to turn.
Go back and read the subthread. If Ad didn’t mean what I said, then clarify.
amen.
“What does courage look like?”
A friend died the other day after a two and a half year battle with cancer.
She died at home with her husband and children and grandchildren surrounding her with love, caring and compassion.
And above all, acceptance.
There was no fanfare, media exposure or court case. No human rights exploration or legal wranglings.
No oppositional grandstanding.
Just peace, calm, caring and acceptance.
That’s what courage looks like.
I am pleased for your friend
My mother died in incredible pain, without acceptance, and we all got to watch. For a long time. She never asked us to assist her (we were 23, 25, and 27). I don’t know if she asked a friend.
But I have never let my dogs suffer the way she did, until she went into a coma 2 days before she died. Her face contorting regularly and what sounded like moaning, but we were told it was not pain. Who knows.
That is truly appalling.
There is no excuse for palliative or cancer-specialist medical professionals to let really high levels of pain continue. The guidelines for administering it in New Zealand are very well practiced.
My understanding of the case cited in your post is that she had very good treatment for pain.
That is a separate issue from legal responsibility for assisted death.
And the benefits to them to have their pain suppressed leaving them basically in a state of comatose until their heart stops beating?
Under the CSA Act medical practitioners can withdraw from being involved in certain procedures if it is against their moral positions. I don’t see any doctor, under any proposed legislation being forced to assist someone to die against the doctor’s will.
Its a matter of what society deems allowable. it’s not an issue of doctors actions.
CV, the question was to Ad, by all means answer but there is one higher up which was to you, that you might direct your attention to.
“Its a matter of what society deems allowable. it’s not an issue of doctors actions.”
It’s both actually.
sorry tracey, didnt mean to answer here.
The one last thing you should not be allowed to do is assign the responsibility for ending your own life to someone else. It is your life, your life alone to end.
Even if there existed both the right and the capacity to abnegate that responsibility to another, why do I have the right to take that right from you? Even if it is freely offered?
I can certainly see that (whether I was a doctor or a friend) I have a duty to care for you; to do all I can to take away your pain. Any good sentient creature would want to do that.
But those last moments, when I have done all I can, those moments are yours and yours alone. Your time to die.
Is your main issue with the involvement of a third party rather than the notion itself?
The problem, I perceive, is that it’s not “moments” in many case, it is days or weeks, or in rarer cases years.
Not being rude but did you mean abrogate or abdicate, cos reject (abnegate) doesn’t make sense to me in that context?
People consent to other people doing things for them all the time? Agreeing to surgery for example?
Happy with abdicate. But I was fine with the original.
Yes, it’s the combination of a third party, plus the certain end to my life.
Surgery is an odd allegory.
I presume that my informed consent to the surgeon often includes the knowing risk that I might die from something going seriously awry. But they would hold to their Socratic oath anyway.
I presume I need to give them this consent because I cannot do this operation myself.
Whereas there is no specific skill required to end my own life. But I’m not sure if a skill argument is really useful here, so I’m not sure where your allegory is really going.
I genuinely don’t understand the use of it in your original sentence, what is being rejected?
You seem to be saying (but may not) that by giving informed consent means that an (unfair?) legal obligation/burden is passed to a doctor. But such legal obligations are passed frequently by people to others.
So, if someone has no ability to move their limbs, how would your button proposal work?
It would not work if I am completely immobilized.
Nor should there always be a solution to the final part of dying.
Now we get to it.
There isn’t a solution to dying – death still happens. What we’re looking for is a solution to the intolerable condition that some people find themselves in before death comes.
Good point Draco
You mean analogy, not allegory, and surgery is an apt comparison.
You framed the issue around pain relief, allowing you to minimise the reasons people seek to end their life at a certain point. Pain may actually be a lesser consideration compared with the loss of independence and function.
Yes, but what shit rains down upon doctors who refuse to perform abortions…on moral grounds.
This would become a real issue, eventually.
Yes it would. But why start there? Why not start with an actual proposal for how it would operate, have a debate after that, include moral and other objections and then decide. Why does morality get to win from the get-go preventing any further clarification?
and above all, why are their morals better or higher then my morals?
That question goes to those that want to ban abortion, but have no issue seeing a human being dying in abhorrent situations, and have a sad when someone wants to die on their terms.
And I don’t actually advocate for a third party help in my assisted passing to the next realm, i just want a prescription that will allow me access to the drugs that help me get there with a shred of human dignity left.
I am sorry that your mother’s passing was so painful for you all. Palliative care and pain management should work better than that.
My experience with parental death was sudden, brutal and with no warning whatsoever. I was 13.
No time for resolving issues, no time for goodbyes. No peace, ever, for those left behind.
My friend had time for the farewells, her family had time to come to terms with her no longer being physically present.
And maybe, that time for the family to come to terms with a loved one dying has a place.
This is a really difficult subject…but it is helpful to have the opportunity to discuss it.
I agree it’s difficult. My partners father died suddenly and we often discussed the pros and cons (for want of a less cold phrase) of both.
One thing that emerges, for me anyway, is the almost total blackout of death in some cultures until someone is dead or dying. On the news we get a daily reminder of our mortality with the death roll call but nothing about living with it in a healthy way. That makes it very hard to die in a healthy way, if you see what I am getting at?
You are absolutely right about the trivialization of death on our media.
I can see from your posts however that you have dealt with the close reality of it, to the force and pain of its process and consequences. I think that’s where the heart of the argument is.
I don’t think it’s fair to say the media trivializes death; I think a media that didn’t report about deaths would be one that trivialised it.
I think it’s fairer to say it is “other-ised” and sanitised; as something that happens to other people, and while it is reported it’s not dwelt on or generally considered in any depth (then again, should it be?).
I think this leads to tracey’s point that the media don’t really offer a healthy perspective on death.
I have been fortunate to have worked in palliative care. Death and dying are nothing trivial.
But it does not have to be scary.
Acceptance.
and education ( I don t mean schools), and understanding. In my experience people are not scared of being dead, but of how they will die. Therein lies an education message?
YES.
and education ( I don t mean schools), and understanding. In my experience people are not scared of being dead, but of how they will die. Therein lies an education message?
Law and medicine would be the only way to discuss this issue without coming to a dead end without any useful conclusions. Once philosophy or religion gets involved (which it must eventually) no one can assure a right/wrong answer.
“…Bear in mind that about 47 people per year, on average, get murdered each year in NZ, so we are not a nation tending toward willfully taking each others lives (twice as many people die from workplace injury than are murdered).
Can we not move from “this is evil” or “unfettered right to assisted death” to concrete proposals for how this might work, and then debate from that point?
The problem with the above comparisons is that Governments (and employers) are willfully taking the lives of the vulnerable right now – as slowly as possible to avoid detection and culpability – it is the natural extension of an amoral/immoral economic philosophy. Is it murder? Not in a legal sense. Is it murderous? Absolutely, because it is a reflection of a simple baseless either/or choice.
Though many believe the contrary, no economic or legal system is a reflection of natural law. All this “I earned it”, “work hard you’ll get ahead”, “education will set you free”, “money is the reason for human life”, “make the right choices and nothing goes wrong”, “I own this property” is all either/or propositions that people choose to believe one way or the other (motivated by experience, culture or empathy), but so is “I am my own creator”, “I am god”, “pain is wrong”, “my dignity at all costs” etc etc. To believe nothing is totally “unwestern” – not to mention extremely uncomfortable.
Until our culture, attitudes to one another and perspective change, or perhaps just widen, it is potentially very dangerous to give opportunity to the State to interfere, influence, or co-opt the individual decisions to assist one’s own or someone else’s death. Our country has a history of taking individual good intent, allowing it to be co-opted into the heavy-handedness of State, and then bludgeoning people with a distorted “good moral intent” a few years or decades later. The State is not a thinking reasoning, context-reflecting individual, it is a clumsy mob creature.
Tracey touches on that very fact himself at 3.1.1.1.1
And that’s the problem with going further than Law and medicine. Logic and Western style thinking can’t go further, but Humanity demands that we do. Perhaps there is a legal term for “always turning a blind eye” to self-assisted death that would do. Don’t legislate it, just trust culture and people to not do something dumb – once the time is right.
Personally, a few years ago if you’d asked me whether I support it or not (as if it was ever solely up to me…) I’d have said no. Now I’m not so sure.
We’re all dying. Yes. you might accuse the state of taking action to shorten someone’s expected life span by a few years. Which is different again to the state reducing someone’s lifespan to the next 20 minutes.
Morality, ethics and for some, religious or spiritual belief, have everything to do with this discussion.
“Morality, ethics and for some, religious or spiritual belief, have everything to do with this discussion.”
But let’s not resort to any evidence-based discussion whatever you do.
OK fair enough, you’ve got me there.
Where is your evidence base that our society will become healthier and happier with legalised euthanasia on the books.
If we hit the same number per capita as the Netherlands, we will have around 1,000 people choosing to end their lives in this way per annum.
Let’s see your evidence of the cost savings and overall impact on our health system. And will the overall number of suicides rise or fall, according to the evidence, once this legislation is on the books?
Re-read the opening post. I am suggesting medical/legal folks get together and frame a proposal with processes/protocols/criteria that meet the notion of a right to assisted death. THEN we debate that, with people with knowledge and expertise offering up their voices. THEN we decide if that s something this society wants. It is clear that you have already made up your mind, which is fine but so far you are not contributing to the education side of the discussion, just the mallet over the head to those who don’t agree with your view.
But why not start with YOUR evidence that a large number of suicides are committed with the assistance and presence of a medical professional (up there).
As Weka pointed out (above) the rise could also be attributed to greater knowledge and awareness and access to the opportunity.
I don’t know if I want it on the books either but I would love to know what I would be agreeing to and at he moment it’s still in the ethereal realms of people’s emotions/beliefs (which have a place but not the WHOLE space).
I won’t engage further with you on this.
Spot on Tracey.
You really think that you can skip straight to the formulation of proposals for detailed euthanasia procedures without a full and broad societal debate of the morals, ethics and desirability of doing so? And to let the technocrats frame the discussion in the first instance?
Sorry, I don’t think so.
How many people every year die in NZ due to smoke related illness?
How many people every year die in NZ due to the influence of alcohol?
How many people every year die in NZ due to driving to fast?
I guess you are
a. lobbying the government to ban cigarettes once and for all….no raising taxes, but outright banning them.
b. lobbying the government to ban alcohol, no raising taxes and increasing prices but outright banning all alcohols.
c. lobbying the government to block all cars/motorbikes/quads etc to drive no faster then a 100 km.
as a – c every year in NZ causes needless death well before their time, and in the case of smoking could very well be argued are assisted long term suicides.
Another question, these thousand people that die in the Netherlands, are they all from the Netherlands, or have some moved their precisely of their euthanasia programe. Remember this is Europe, and anyone with a European Passport can live and die anywhere within the European Union.
About FOUR THOUSAND people died in the Netherlands in one year under this legislation. In other words, this is nothing like ending the life of a few suffering people who end up in medically extreme situations.
sorry i misread the number.
but in saying that i was curious to your number anyways and it seems that this number has been fairly steady over the years, and just might reflect the amount of people that would use it. It is also interesting to note, that in the case of every single one of these death, a doctor had to report that death to the euthanasia commitee. Every single time.
To have that right and privilege one has to go through some very tight assesment, so that no one can just be ‘offed’, as that seems to be the fear of many.
However, to shine a bit of light on it here we have a bit of wikipedia
http://en.wikipedia.org/wiki/Euthanasia_in_the_Netherlands
and here we have the annual report by the euthanasia commitee
http://www.euthanasiecommissie.nl/overdetoetsingscommissies/jaarverslag/
and here we have another little write up about euthanasia in the netherlands
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2733179/
I have lived and worked in the Netherlands for a few years, and frankly i have not come across a more pragmatic people than the Dutchies, and I am german. The idea, that doctors in this country just willy nilly go around killing old people and others is outlandish and pig headed.
Like with many other things in life, morals are something very personal, as are religious believes. If I want to end my life in the case of terminal illness that comes with great suffering, it is not up to someone who is not me to tell me about their sensitivities or their morals. My shoes, my life, my decision.
This may appeal to a sense of procedural thoroughness, but it doesn’t reassure me in the slightest. And as far as I can see, the number of people killed under this law in Holland is increasing significantly year on year.
Also, there are reports that dozens of people with dementia or serious psychiatric issues have died under the euthanasia legislation.
http://www.dailymail.co.uk/news/article-2779624/Number-mentally-ill-patients-killed-euthanasia-Holland-trebles-year-doctors-warn-assisted-suicide-control.html
If we hit the same number per capita as the Netherlands, we will have around 1,000 people choosing to end their lives in this way per annum.
Yes, imo very few.
But I’m unsure as to why you introduce this figure.
Is it merely as a basis for cost saving sums or for some other reason?
Regrettably, as soon as you mention the state’s role, you are getting close to opening up the full spectrum of state-sanctioned death, from abortion to executions to euthanasia. Not sure i’m ready for a full utilitarian argument this afternoon 😉
I’m definitely not…
how can abortion be state sanctioned death when in most countries it is merely de-criminalised with many many hurdles to overcome should one need or want an abortion?
the only state sanctioned death occurs in War (and alot of people seem to have no issues with these needless death of very young and very healthy people), or in the death penalty, again many people seem to have no issues here either.
Euthanasia however is a demand by many people to be an option when making their end of life decisions. The state in fact has no role in it other then assuring Doctors that may assist to not be charged and judged with a crime.
Well not really in USA several states still have the death penalty on the books and several states south of the Mason-Dixon line regularly use it.
yes, and few people there have an issue with it, dispite them killing and having killed innocent people.
so whats your point? That in the US state sanctioned death by police or other law enforcment agents is ok? We know that, heck the citizens of Ferguson and other places know that just to well.
However euthanasia is not the state deciding who dies, but an individual making a request to be assisted to die in a human and decent manner.
Not quite the same ey?
I was replying to your statement below pointing out that war is not the only state sanctioned death
Re: state sanctioned killing of human beings. You mean the state would not be paying for or regulating any of the services associated with euthanasia, including the training of medical professionals in the procedures? If the state did those things, it would appear to be “state sanctioned” would it not?
And if someone wanted to commit suicide, why would they also not be able to make a request to die in a humane, safe, private and decent manner?
“I can certainly imagine circumstances of astonishing terminal pain one would wish to be free from. But techniques for relieving that are well practised here.”
But the techniques don’t always work.
A close member of my family had metastatic cancer and did keep the pain at a tolerable level with Sister Morphine until the last week. By that time the level of pain from the cancer that had spread to his bones left him shrieking with the pain. Sister Morphine wasn’t doing her work any more.
He couldn’t drink or eat during that week of hell and died in agony. A simple lethal injection at the start of that last week would have been the humane end to his life however the law ensured that he died tortured with no dignity left leaving behind a traumatized family.
So what do we do if we are unfortunate enough to find that we have a terminal probably painful disease?
Gamble that you will be kept pain free until the end or while you are still in control of your functions you go and top yourself dying many months earlier than you would have needed to if there was legalized euthanasia.
Our current law is an ass and needs to be reviewed.
Again appalling.
But was your friend in a position himself to press a button and end his own life, if that were his will?
so, you are proposing such a system which would involved people installing the button, the medication triggered by the button, yes?
How would you ensure that no one else pressed the button? Family members for example?
Indeed!. The paranoia of even falling asleep!
Hardly an argument for your case.
Regrettably I would trust the medical profession even less.
But I would trust my finger on the button more than any other.
And I would also trust my finger to press that button so often that I knew I was going into a coma from which I would not awake.
My action alone, not anyone else’s.
My “case” is that the legal/medical communities should draw up protocols/processes/criteria within which assisted death might occur, so that I and every other NZer can see what we are discussing, receive information, from all sides, and make some determinations about it. You have assumed I am for assisted death. I am not. I am very undecided.
Clearly I misunderstood what you meant by “concrete proposals for how this might work”.
Do you have some?
Just to argue against my own mood for a moment, it has been a massive honour to hold someone as they died and talk them through the hours of their dying, right to the finish.
Then wail, be with the family, bury them and celebrate their lives.
It was the most human thing I think I’ve done.
I’ve been with 3 people as they died, none were conscious. We did play music for them, and remain with them. But all three had stopped being able to communicate within 4 days or more of their death. I do think that this debate/discussion has a lot to do with how some people have no learning in how to die or be with those who are dying or to see death as part of life. It is more seen as a dark shadow to be ignored (but not by all by any means)
I have been looking at some of the laws in Belgium and Netherlands to see how they “manage” it and also the CSA Act here has some light to shed in that regard.
I have been hoping for some to come in here (who have far more knowledge than me – ) with ideas for protocols/processes.
You clearly have experience with folks at the end of their lives and an understanding of the end of life care.I only have my own personal experiences and they didnt extend to deeper medical knowledge
i posted a link to Netherland’s legislation (up there). You will also have seen the link tot he former advocate turned opponent (up there).
Are you concerned that a doctor or other person would misuse the delegated power to assist?
Hell yes.
But I think I have stronger problems with it than the professional trust line of argument.
that Family member should be done for Murder.
I don’t really see all the issues.
If I want to die, and take appropriate steps it is my decision. I might take the appropriate steps well before I get sick. I might appoint a person of my trust to exucute my will, i.e. call in the meds to set me up with my pump etc etc.
but the moment someone else touches that pump, then it is not my decision anymore, and someone should be charged.
How hard can that be?
Also, if one looks at the Netherlands again, it seems that that scenario has not happened yet.
Also, I think if people are afraid that their family or friends does them away, but pressing the button to many times, they might want to reconsider their friends and family.
before you get sick or do you mean before the sickness renders you unable to take your own life?
before one gets sick. or at the time one is diagnosed as terminall ill.
I operate on the assumption that all but a few (who sadly will try to take their lifes) enjoy living, and want to live for as long as it gets.
take my case, we have a high rate of cancer in my family. A very high rate. I have had cancer treatment some 17 years ago, and expect to be diagnosed again at some stage in my life due to genetics simply.
so my chances of dying of a heart attack or passing away in my sleep are small. my chances of dying of bowl cancer, of breast cancer, of uterine cancer however are larger then average.
I would like to go to my physisian now and discuss my end of life events. Now when i am sober, surrounded by my family and still cabable of making these decisions.
Years ago on TV3 i think they showed a segment of an 80 year old going to Illicit on K-road to have a Tatoo on her chest. It stated : Do Not Resusitate.
She wanted to make sure that when she drops she drops.
Death is part of us. We need to come and embrace this part as much as we embrace living.
I have seen someone do just that. We, her carers, knew she was in palliative care and expected her to last another week or so. She looked good…seriously…we got her settled in bed with her nice nightie on. We came back 15 minutes later and she was well into a coma and cheyne stoking. She passed, peacefully, within minutes. She did have a self controlled pain relief pump.
We let our beloved pets have a peaceful end when they are old and sick, why not our equally beloved family members? This should not be a legal issue although oversight is always going to be important and that is as it should be.
Because people aren’t pets.
Owners have complete agency and responsibility over their pets. But what if the pet knows what is going on, and might have second thoughts? Or doesn’t want to be a burden on the family? Or is an inconvenience for the family.
Euthenasia by a second party seems reasonable to me in situations of irrecoverable pain or distress, the decision is made solely by the patient who is 100% guaranteed to be completely informed and capable of making the decision without any external pressures.
I just can’t envision a situation where that would be the case. I can imagine a lot of situations where there is no good option to choose, but I don’t think it should be legal – recognised with mercy like infanticide maybe, but not legal.
So you are saying you oppose euthanasia? I found your comment a bit confusing (it’s probably just me).
In particular I don’t understand the last para – ‘recognised with mercy like infanticide’.
In what circumstances would you afford mercy to those who commit infanticide, and how is it comparable to euthanasia?
I oppose formal legal entitlement for a second party to commit euthanasia.
I’m open to the concept of a lesser crime than murder to recognise the intense situation that might be faced by a second party, just as infanticide is a distinct crime. I.e. the second party goes to court, and the case is examined in detail, and upon a guilty verdict the judge has the option of sentencing supervision etc and/or jail up to a specific term.
nowhere in the world, to my knowledge, is it legal for a third party to decide to euthanize another unless the person authorised it AND a number of criteria and protocols are followed. to do so remains murder even in those nations with assisted death and euthanasia provisions.
this is why i believe we have to identify the process/protocols/criteria first and then move to the decision making. morality involved but not first…
I don’t believe there should be an “unless”. As I’ve said, I do think that the law should explicitly recognise the pressures that some situations can put on the second party, as it does for infanticide, but every decision a person makes to end another person’s life should be subject to automatic review in a criminal court.
Well, I believe there should be an ”unless”. Other jurisdictions have developed a reasonable legal framework around this issue, and NZ should be leading on it.
It’s already happening covertly, and should not be contingent on a doctor’s discretion or conscience.
On a personal level, I am uncomfortable about abortion. That doesn’t mean I get to dictate to others. There are cogent reasons why it has be provided which don’t disappear just because I don’t like it.
I support reforming the law to make the process faster. I hope to lessen its incidence by supporting good social/family policies.
I am at a loss to understand why people who oppose assisted euthanasia don’t see the issue in similar terms.
They will lose the argument, but I fear the coming debate will result in yet another delay before it is accepted.
Your post reflects much of how I feel about this, including your discomfort around abortion.
As I noted below under the C,S, A Act the doctor being involved in the process is contingent on their conscience but that is by withdrawing their services NOT preventing the procedure per se. Assisted dying would run into the same problem (but heightened, imo) as abortion legislation in rural areas currently. A woman requiring an abortion can travel to another area to get the procedure (once approved) and not rely on the single doctor in their community (if they withdraw for belief reasons). Someone wanting to be assisted with dying will most likely want that “service” in their own home. IF the local doctor conscientiously objects, the patient would need to be moved from their home to an area allowing the “treatment”.
“should not be contingent on a doctor’s discretion or conscience.”
True I should have made that clearer. It would always be a conscience issue for medical practitioners.
It would be nice if NZMA would at least shift its stance to neutral to allow a more open debate.
I’ve been impressed with the way you’ve addressed this. The thread could have been a melt-down but it’s been a good discussion for the most part.
Thanks Ergo.
Abortion is different to euthanasia because the foetus is inside the mother, and for the first 20-25 weeks (can’t remember the current 50/50 prem survival threshold) needs to stay there to live. They are inseparable. And that’s without getting into the entire argument about the sentience (or lack thereof) of an organism without a brain, or even a 36-week foetus.
2nd-party euthanasia involves, at best, an empathetic decision by a disinterested second party (i.e. a physician who’s not in the will or financially burdened or medically affected by the patient’s continued survival).
The main thing that I don’t trust is that a best-case euthanasia framework requires, as you alluded to, an environment of good social and family policies. So that rules out any NACT government, ever. The risk is of elderly (for example) patients choosing, or being pressured to choose, death over being a financial burden to their family.
I can see the textbook case of a patient in irrecoverable pain who makes a rational decision to end that pain but is unable to end their pain themselves. I can see why the doctor would be performing the last act of mercy possible. But it’s the other cases I can also visualise that give me concern, and make me think that the default position for every act should be an automatic referral to an open court.
So abortion is different as the foetus is part of their mother, giving her the right to remove it, but the same person doesn’t get to exercise the same right in respect of their own life? That doesn’t make sense.
The good social and family policies I alluded to were in respect of the abortion issue; i.e I support a society in which abortion and a whole lot of other outcomes are less likely.
The point I’m trying to make is that I don’t get to ban something just because I don’t like it, but I can help push in a certain direction to make the outcome less likely.
You’ve raised elder abuse (financial pressure), but that’s a wider issue that needs to be faced by the community.
It doesn’t make sense because that’s not what I said.
Suicide is one thing. Having someone else do or enable it is another thing entirely.
You don’t get to ban stuff, I don’t get to ban stuff. But the best direction to push to avoid euthanasia-by-convenience is not in the direction of legalisation.
Euthanasia happens in a wider social and political context, so you can’t avoid problems with it just because elder abuse is “a wider issue”. It’s the lay of the land right now – avoiding wider social issues in discussions about euthanasia is like discussing house plans whilst avoiding any mention of climate, foundations or cost.
I understand a blanket moral objection, even if I disagree, but arguing that the potential for abuse rules out significant change to the status quo is completely unreasonable.
Every human system carries that risk and as a country we tolerate abuse of many types and inequalities that have stark consequences.
It’s not about fear that bad things might happen to people (I don’t mean you specifically, but broadly speaking), it’s about control.
And political cowardice of course.
Again, I’m not arguing “that the potential for abuse rules out significant change to the status quo”.
I’m arguing that the known tendencies to abuse in the past and the known wider social issues we have in the present both combine to make the pre-emptive authorisation of euthanasia by a second party a legalisation that has a far greater potential for wrong than the potential it has to legitimately relieve the suffering of a minority of cases that could be better handled by lessening the medical emphasis on life at any cost and ensuring patients have control over care when cure and treatment are less realistic as options.
And let’s not forget the issue of moral cowardice. Because being politically brave in doing the wrong thing, still makes it the wrong thing to do.
With over 4,800 deaths under the euthanasia law in the Netherlands, and children between the ages of 12 to 16 being euthanised as well, it’s very clear that this is about many more cases than just the most medically extreme ones undergoing assisted suicide.
CR
There must be a break down of those figures into illness types?
What is the population of the Netherlands? 17 million?
I haven’t seen anyone on this thread support a blanket/unfettered euthanasia law. I think no one has said a doctor should be compelled to assist or have a legal obligation punishable in some way if they don’t.
What morality is it you think is wrong?
The right to autonomy?
beneficence?
mal-beneficience?
Justice?
Some other tenet of morality?
The notion that there is one-kind of morality which is right is misguided.
The Contraception, Sterilization and Abortion Act allows practitioners to explicitly opt out if the act of assisting the procedure goes against their beliefs.
In Netherlands there is a review panel. I suggested (somewhere up there) that for me to be even close to satisfied by this there would have to be guaranteed, ongoing, adequate resourcing/funding of this part of the process for me to feel ok about the whole thing.
For example, the recent tragedy at Whanganui hospital.
Sure. I don’t think infanticide is a useful comparison though; for instance in that case there was no intention to end a life, so it does not seem relevant to the euthanasia debate.
Assisting suicide is a crime (in law). Judicial mercy is very relevant to the debate.
nope.
178 Infanticide:
Thanks McFlock. This too.
Whilst I agree that some people should be shot like a wounded horse, it is almost Kafkaesque to make such comparison between killing animals or humans. I belief anybody advocating assisted suicide should consider that not everybody has noble intentions, not always are higher motives are at play. And seriously, before making the step into this direction, major issues should be considered, such as political means of ending lives that are no longer “productive”, or so disabled that society feels in charge of those peoples feeling and implying they are “better off” when being “put down”. History has shown that humans cannot be trusted to have such power in their hands.
^ This.
Any legislation in support of assisted suicide needs an anti-fascist clause. Entrench the UDoHR in such a way as to criminalise politicians who propose to weaken it?
Or accept that the National Party will amend the legislation as their owner/donors see fit?
Or some third thing that hasn’t occurred to me?
Yes, you can legislate but by opening the door, you have made the issue “negotiable”. Allowing the “assisted death” in what ever circumstance will lead to abuse of that privilege. Unfortunately, people are far from being enlighten to help for humanitarian ends only. I appreciate that there will be people citing examples and personal experiences. They are not the ones deciding on every case that will occur or voice any mitigation veto if the motive is “don’t want to be the carer anymore”, “need the inheritance”, ” have to move on to a new live” etc etc…
assisted death.
an interesting read this one is
http://www.smh.com.au/comment/full-text-of-dr-rodney-symes-speech-on-the-right-to-physicianassisted-death-20150526-gh9vh0.html
thanks for this Sabine. This is why i suggest we start with lawyers and doctors… frame up something for us all to consider and debate. sadly much of the discussion starts and ends with belief systems and personal values both of which an change with facts. I am not suggesting we remove morality that would be impossible and undesirable but i am suggesting starting from a moral standpoint has meant the discussion doesnt move on
I wouldn’t trust any government- red, blue or green- with the power to kill sick people. nor would I trust nz society in general with that power. I remember whenthe government lowered the drinking age to 18. there were all these promises about how alcohol would be more tightly managed with a suite of new measures, and all that counted for shit. same with prostitution law reform. it was gonna be great for the hookers.
I suspect that people who support more “liberty” are making the same fuckup that neoclassical economics is based on: that individual human beings are above all else rational decision-making machines, wanting only.for the right informational input.
+∞
Mit der dummheit kämpfen götter selbst vergebens.
Mmmm Schiller or Asimov? just currious
Schiller – Die Jungfrau von Orleans
we already do…
what drugs pharmac funds
how much funding pharmac gets
turning off life support systems
Those decisions are designed to save the most lives possible, to create the best health possible or to stop human interference with natures processes.
what drugs pharmac fuud is a cost/benefit analysis CV and you would normally be the first to point that out. Undoubtedly lives end prematurely because of those decisions.
the aim of Pharmac is to help the most people possible. It is a kind of medical and economic triage. Some people will end up not getting help and being worse off, but the entire government organisation is about saving lives, not taking lives.
and, that’s not really a textbook example of engagement with the substantive issues raised.
there are probably better uses of your time than making a bunch of cheap shots, in the hope that they’ll coagulate into one big expensive shot.
Like the post that leads the discussion you mean?
Or the repeated calls to ascertain exactly what process is being objected to before the moral or apocalyptic discussion takes place?
“I remember when the government lowered the drinking age to 18. there were all these promises about how alcohol would be more tightly managed with a suite of new measures, and all that counted for shit. same with prostitution law reform. it was gonna be great for the hookers.”
Pharmac chooses not to fund drugs that could save or extend lives. That is a decision to shorten or end lives. How that isn’t relevant, but alcohol laws and prostitution laws are is beyond me.
IF you have read the entire thread you would have seen that one thing that is a not negotiable for me is that resourcing/funding MUST be available at the review of decision part of the process or, for me, the rest of the protocol is irrelevant, and no assisted death can legally take place.
ich mit deinem gnomic Ausserung kampfe auch
Do you mean Äußerung?
I don’t get the sense that you would fight to the death for my right to say something
http://www.theguardian.com/society/2014/jul/17/euthanasia-assisted-suicide-laws-world
http://www.life.org.nz/euthanasia/euthanasialegalkeyissues/global-euthanasia-laws/