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Today is a FREE taste of an Insight Politics article by Olivia Pierson that was first published 15th October 2020.
The Assisted Dying Referendum – Let Us Heed Some Lessons from Europe
I have to admit to feeling entirely confounded by the choice to vote Yes, or No, on the proposed End of Life Choice Bill in our coming referendum.
I don’t think this is a simple as many folks make it out to be and some of the heated discussions I’ve been involved in, have been an exercise in frustration due to views being overly simplistic.
To bring some kind of order to the decision that is actually on the ballot, I’ve had to delve into the details of the issue of assisted dying, and one would be a fool to not take note of the lessons coming from other places, such as Oregon, Belgium and Holland, states which started their legislation on the same footing as what is now being proposed for New Zealand.
Firstly, to seek assistance from a doctor to end one’s own life voluntarily because one desires to avoid chronic, dehumanising suffering is an act of self compassion – which also extends to compassion for family members, for they suffer greatly too when another loved-one suffers in front of them.
Secondly, I do not believe that life belongs to anybody else but the person whose life it is; not God, nor other family members, tribes or whatever. I believe firmly in the sovereignty of the individual who lives that life and is, therefore, the owner of it.
So from this point of view, compassion and personal sovereignty, I do not have any objection to assisted dying on principle.
However, what we are asking of our medical profession, if this legislation becomes law, is something that doctors in other countries are now often having second thoughts about being involved with.
It creates another complex bureaucracy within medical circles because to help another person end their life with dignity requires a doctor to have to intentionally kill a patient at the patient’s request. For those doctors who still take their antiquated Hippocratic Oath seriously, this practise is at odds with it.
Why is it at odds for some European doctors?
Because “intractable and unbearable pain,” the criteria for assisted dying in their legislation, is not just interpreted as being physical, it can also now be mental: depression, mental illness, grief and exhaustion etc. In Belgium, a country that has had euthanasia legislation since 2002, the bracket creep (slippery slope) is very real. People are now requesting doctors to assist them to die when they are young and otherwise healthy, such as in the case of 24-year-old “Laura” who, in 2015, was given the go-ahead to receive a lethal injection because she asked for it due to experiencing suicidal thoughts and depression throughout her young life.
In February 2015, Belgium updated its euthanasia laws in a Bill which passed with 86 votes to 44, allowing for terminally ill children to receive an assisted death with no legal age limit set.
Tine Nys, a 37-year-old Belgian woman received a lethal injection in 2010 for psychological suffering from grieving the loss of her boyfriend after a breakup. Her family sued the doctors involved for their decision to euthanise Tine, believing that they were callous and had little interest in persuading her to live. After a retrial, the doctors were finally acquitted in January 2020.
In Holland, a country which boasts the most liberal euthanasia laws in the world, the legislation has “crept” over the last 20 years to now include children of 12 years and over to receive assisted dying if at least one of their parents gives their permission.
Before Holland enacted its euthanasia laws, Dr. Boudewijn Chabot was asked in 1994 to help end the life of a perfectly healthy 50-year old woman suffering from grief and depression after the death of both her sons. She had already attempted suicide twice and botched both attempts. Dr. Chabot, not wanting her to embark on another failed suicide attempt, gave her a potion saying, “I hope that you pour this down the toilet.” She didn’t. She took the potion and died in the arms of her friend at home.
Chabot was taken to the Supreme Council over this breach of the law, the verdict was “guilty but not punishable.” He now admits to regretting his decision in helping this woman end her life. It still haunts him.
Chabot has written books on this subject and claims that many doctors in Holland feel the same way he now feels, i.e, that they do not want the burden of what the bracket creep in the country’s euthanasia laws has now brought them. They feel that they are now being asked to take the lives of people that they originally studied medicine in order to help save.
Dementia is a thorny issue and the proposed NZ Bill does not make any provision for it. To qualify for assisted dying, people have to be in possession of a sound mind. Not even an advanced directive written earlier in the progression of their disease can qualify dementia patients for assisted dying.
Dr. Chabot talks about this also, for in Holland dementia patients can end their life through an advanced directive. But his point of view is quite telling when he says this:
“My thesis has put a new fact on the table in the euthanasia debate: except in the terminal phase of cancer or in cases of a terrible muscular disease, doctors are not indispensable for dying in a dignified manner.
That provides room to deal pleasantly with somebody who presents with early dementia and who turns up with an advanced directive. The conversation might proceed as follows:
‘Would you euthanise me when I cannot recognise my daughter anymore?’
‘When you call your daughter Sara, just as your late beloved one, but you become calm when your daughter sits next to you for an hour, in that case you still recognise her.’
‘Anyway, I mean when I start to urinate in a corner of the room, just like my old dog, then, surely, I am not human anymore!’
‘You would be a human being who has lost the way in life, but not a dog.’
‘All right, not a dog, but not the type of human anymore, which I used to be.’
‘If you are confused, you will remain a human to me and I would not kill you. But I realise that you would not like to experience the process of dementia that is ahead of you. That means that you yourself should take the difficult decision at a time of your choosing that you want to die.
‘You don’t want to help me!’
‘I would not help you by killing you, but rather by pointing out to you how you could kill yourself.’”
So Chabot is advising that rather than patients seeking the hand of a doctor to administer death, doctors could instead give advice about methods for suicide so that those with a serious death-wish can do it themselves. He calls this a “self-chosen good death.”
Holland’s parliament has been trying to get through a Bill – part of their ever-widening euthanasia legislation – to allow a freely available “poison pill” for any person over the age of 70 so that doctors no longer have to be involved in these self-chosen good deaths. But it is not hard to imagine circumstances where this could so easily be abused by family members, perhaps wanting to quicken the pace of their coming inheritance. Not all families love each other.
In considering all of the above information, I think New Zealanders need to factor in that all these complexities will eventually become ours. Some cancer patients literally lie rotting in their beds from untreatable tumours which cause family members to not want to be in the room due to the stench. I couldn’t imagine anything more revolting and dehumanising to have to bear. To allow these people a choice to end their suffering is the humane thing to do. But this legislation will creep along the same lines of other countries – each government henceforth will add to the legislation and that is something Kiwis should be very mindful of as they vote in this referendum.
I’m leaning toward Yes. But we must remain hyper-vigilant that the criteria for assisted suicide remains very tight – and truly compassionate, merciful and micro-managed. I personally would like for myself an advanced directive should I ever be unlucky enough to be diagnosed with Dementia, Parkinsons or Alzheimers. That is currently not within this legislation.
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