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Experts discuss arguments for and against assisted dying ahead of election referendum

Two euthanasia experts spoke to TVNZ1’s Breakfast about their views on assisted dying ahead of the End of Life Choice Act referendum in this year’s election.

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Breakfast talked to PhD candidate Jessica Young and palliative care practitioner Dr Sinead Donnelly on their views on assisted dying. Source: Breakfast

The argument for

Researcher Jessica Young, who explored the views of terminally ill Kiwis who would consider dying in her PhD, outlined the arguments for the act as the executive director of the Yes for Compassion campaign.

Young said her PhD aimed to highlight the views of people who were dying from illnesses to contribute to the debate about the proposed law.  

“They were suffering unbearably at the end of life and this option, even if they didn’t take it, was going to bring them great comfort,” she said.

“Why would we deny other people that choice even if you don’t agree with this? This is a safe bill, and voting yes is the compassionate thing to do.”

She said her study showed coercion to choose assisted dying was very uncommon.

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“This act has more safeguards to detect pressure than any other legislation around the world.

“It states clearly that if the doctor or nurse practitioner suspects at any point in the process that there is pressure, they must stop that process and refer it to the Registrar.”

Young said people were asked repeatedly if they wanted to proceed and choose assisted dying, and doctors would be “extremely cautious” because they would want to comply with the law. 

She said her research showed people considered euthanasia as the “option of last resort”.

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“They’d like to live and make as many memories with their family as possible. So this isn’t something they’re going to rush into.”

International evidence suggests people only shortened their life by about 10 days, she said.

Under existing laws, people have the right to refuse medical treatment. But Young said it could lead to a “slow, long death for people”.

“Why not give people a choice about how and when that death happens for them, rather than making them wait?”

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Jacqui Maguire says the polarised views people hold about life being sacred or the importance of autonomy doesn’t work when discussing euthanasia. Source: Breakfast

The argument against 

Care Alliance’s Dr Sinead Donnelly, a palliative care doctor and senior lecturer at the University of Otago, outlined the arguments against the act. Care Alliance is made up of a range of organisations, including providers of end-of-life palliative care in New Zealand. 

Donnelly said she was opposing the act as it was written. 

“We’re concerned about the risk and we don’t believe that it’s safe,” she said.

When asked why she believed the act was unsafe, despite the High Court and lawyers saying there were more than 45 safeguards, Donnelly said the Care Alliance was looking at it from a practical view. 

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“We [at Care Alliance] care for people who are facing their death every day. … We live in the real world. 

“When we read this act as it’s written and apply it to the real world, it leaks. It’s not waterproof or safe in any way. There are multiple reasons and multiple risks we’ve identified.”

She said it could be difficult to judge whether a person was being coerced into assisted dying because coersion can be subtle. 

There are also challenges to making a prognosis that someone only has six months left to live, Donnelly said. 

“Prognosis is an estimate. International literature and our own daily experience shows we’re often wrong about prognosis.

“How can you create a safe law when the consequences are the death of a person with such imprecise so-called safeguards?”

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Donnelly said, in her experience, it was common for people to feel as if they were a burden.

“I feel they’re actually going to feel a greater burden. They now have to choose, ‘Do I ask for this or not?’”

She said it was already legal for people to ask for treatment to be stopped. 

She said the palliative care system is rapidly developing but it is “chronically underfunded” in New Zealand, and there are inequities to accessing quality care. 

This means people may not have a true choice between palliative care and euthanasia, Donnelly said.

Who would qualify for assisted dying?

The proposed law puts restrictions on who could qualify for euthanasia if it is voted into law. The person would have to be a New Zealand citizen or permanent resident over the age of 18 suffering from a terminal illness likely to end their life within six months. 

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1 NEWS online’s political reporter Anna Whyte explains what the proposed law means and what both sides of the issue are saying. Source: 1 NEWS

The person would also have to be able to make an informed decision about euthanasia and be undergoing a significant decline in physical capability and experience unbearable suffering that can’t be eased. 

A person would not be eligible to ask for assisted dying if the only reason they give is that they are suffering from a mental disorder or mental illness, have a disability of any kind or are of advanced age.

Read both sides of the argument here.

For more information on the referendum, go to https://www.referendums.govt.nz/endoflifechoice/index.html