Oct. 16, 2020—New Zealand voters will vote on October 17th whether to approve the End of Life Choice Bill. The Bill, which passed in parliament last year, includes in its provisions a requirement that voters approve the law in a referendum. Results are expected at the end of the month.
Similar to other laws, the New Zealand bill presents itself as a matter of autonomy, suggesting that the ability to end one’s life is simply one more option for end of life care. Under its provisions, adult New Zealanders who have received a diagnosis expected to result in death within six months may request assistance in ending their lives (Part 1, cl. 4). Two practitioners must attest to the prognosis and may not approve requests where they think there is coercion involved or that the patient lacks competence (Part 2, cls. 10(2), 11(3)). If they suspect the person is under “pressure,” they must stop the process (Part 3, cl. 18B). If they suspect a lack of competence to decide, they must arrange for a psychiatrist to evaluate the patient (Part 2, cl. 12).
Patients who meet the criteria must set a date to receive the lethal medication (Part 2, cl. 14A), which they can self-administer or have administered to them (Part 2, cls.15-16); they can change their mind before it is administered, or request to change the date (Part 2, cl. 16(2)). The law requires a healthcare provider to be present at the death (Part 2, cl. 16(5)). It does not require healthcare providers to participate; conscientious objectors must inform patients of their objection and of their right to contact the assisted suicide oversight board for assistance in finding a practitioner willing to help them end their lives (Part 2, cls. 5A(1), 6(2)).
By providing more direct bureaucratic oversight, its proponents attempt to address concerns regarding risks to the vulnerable. However, these protections are dubious; for one, as in other countries, cases are retroactively examined (Part 3, cl. 20(2)), which cannot return a patient to life. Additionally, terms such as “terminal illness” can be interpreted broadly. Fabian Stahle, an independent Swedish researcher contacted public health authorities in the U.S. state of Oregon about their interpretation. Public health authorities there told him that patients with highly manageable chronic conditions, such as diabetes, which would be fatal without treatment, could qualify under their interpretation of the law’s requirement for a terminal diagnosis.
Local disability rights activists have voiced opposition to the bill for several years. In 2018, Wendi Wicks of Not Dead Yet Aotearoa, a network of New Zealanders with disabilities, testified before Parliament that the bill put disabled people, already marginalized, at risk, criticizing the idea that safeguards could make a difference “in a bill that starts with the implicit proposition that it is better to be dead than disabled.” Many of the terms used to describe conditions which “qualify” a patient to access assisted suicide can also describe living with a disability. The Not Dead Yet Aotearoa continues to raise these concerns in press appearances and via social media. Disability rights commissioner Paula Tesoriero noted “overwhelming” opposition among submissions from those in disability-connected work during debate on the bill.
Palliative care providers have also come out against the bill. Aileen Collier, a palliative care doctor raised the incomplete picture of coercion in the bill’s provisions, which she stated ignores the reality of internal pressure felt by the vulnerable, and noted that many patients do not currently receive the care they have a right to under law. The Australia & New Zealand Society of Palliative Medicine, Inc. (ANZSPM), which issued a plea against the bill shortly before its adoption, recently released a statement (download at bottom of page) that debate around the referendum is causing the spread of “dangerous” misinformation about end-of-life care. ANZSPM criticized reports suggesting that pain relief, palliative sedation, and the right to refuse treatment constitute euthanasia already for creating fear about death and dying.
World Youth Alliance shares these concerns, and others as outlined in the white paper on assisted suicide and euthanasia. As WYA’s Declaration on Human Dignity and Bioethics states, “Permitting such practices violates the dignity of those most vulnerable, due to age, disability, or other conditions or characteristics, by equating it with personal utility and ability.” Unfortunately, polling suggest that a majority of New Zealanders support the law. WYA urges those voting in the referendum to vote against a bill that legalizes practices which put the vulnerable at risk and are fundamentally at odds with human dignity.
This article has been updated to include information about the expected announcement date.