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Breaking the silence… and David Seymour

By Bethany Reitsma

In June 2017, ACT Party leader David Seymour’s End of Life Choice Bill was drawn from the ballot, asking for euthanasia, or assisted suicide, to be legalised in New Zealand. Since Parliament will close for the election before the bill’s scheduled reading, it’s unlikely to be passed anytime soon. The issue will come up again, however, and New Zealanders appear to be pretty divided over whether legalised euthanasia would be good for the country. This has some implications for our suicide rate, especially among our young people.

Let’s get some definitions out of the way first:

Euthanasia: The patient requests a lethal injection, given to them by a medical professional.

Assisted suicide: The patient is prescribed lethal drugs by their health professional, and they take the drugs in their own time.

What euthanasia is not: Refusing food/water, asking not to be resuscitated if your heart or breathing stops, refusing treatment such as chemotherapy, or refusing to be kept on life support. These things are within your rights as a patient.

What the bill says:

That any New Zealand citizen or permanent resident 18 or older can request euthanasia or assisted dying if:

  • They have a terminal illness or other medical condition that is likely to end their life within six months; or
  • They have a grievous and irremediable medical condition; and
  • They are in an advanced state of irreversible decline in capability;
  • They are experiencing unbearable suffering that cannot be relieved in a manner that they consider tolerable; and
  • They have the ability to understand the nature of assisted dying; and the consequences for them of assisted dying.

So what are the positives?

Seymour says that the bill takes a compassionate approach to people who suffer from incurable conditions. In my own conversations with friends and family about this, people say to me that they don’t want to deteriorate slowly or suffer through an incurable disease. I’ve watched my grandparents gradually lose their physical strength, and their immune systems go downhill. More than once my oma (grandmother) has told me she’s ready to die and go to heaven. People get tired of living, and it’s heart-breaking to watch. Wouldn’t it be better to end it quickly and painlessly?

The other positive about euthanasia is that it provides a sense of control and of dignity in death. You decide when and how you die and when you get to say goodbye. The ideal way to die is on your own terms, isn’t it? That’s the best-case scenario.

But…

The wording used in the bill raises some questions right off the bat.

How do we define “unbearable suffering”? It’s up to the individual to decide how bad their pain is, but there are so many kinds of pain relief we have available. A maximum of 4 per cent of patients experience pain that isn’t able to be relieved by medication, in which case they can ask to be sedated.

What is an irremediable medical condition? This definition is pretty general. But think about the wording. Diabetes is an irremediable medical condition, and so are severe asthma and anaphylactic allergies. Most medical conditions are treatable even if they’re irremediable.

What does it mean to be in “an advanced state of irreversible decline in capability”? Sounds like the natural ageing process could come under this definition. So could disability.

The phrase “likely to end their life in six months” is problematic because as any doctor will tell you, it’s impossible to accurately predict when someone’s life will end. All they can do is guess at the best. And often their estimates turn out to be inaccurate. I’ve known so many people with cancer who were given a few months to live, but then ended up living past that limit. It would be pretty risky to offer someone euthanasia when you could be cutting short their life and opportunities.

It’s unlikely someone could make the choice to end their life free of outside influences. As an example – in the state of Oregon, America, 40 per cent of those who asked for euthanasia in 2014 said that feeling like they were a burden influenced their decision.

A Stuff headline I saw earlier this month sums up how I feel about the issue: Motivated by compassion for those suffering but raises concerns for the vulnerable. These concerns can’t be ignored. So there’s other scenarios that we risk seeing as well as the positive cases.

Why does this matter for us as students?

I used to think euthanasia was really just an issue for the elderly. I also thought euthanasia was a merciful option for someone deteriorating mentally and physically. I still understand that position, and I have compassion for those people, but I’ve since realised it’s a bit more complicated than that. I started thinking about what this all means for our suicide rate in New Zealand, and more specifically, our youth suicide rate, which we all acknowledge as a huge problem.

New Zealand has the highest teen suicide rate in the developed world, and the second highest rate among those 25 and younger. The New Zealand Herald recently ran a fantastic series of articles entitled Break the Silence, with the goal of starting a conversation about youth suicide and what we can do about it. We need to start suicide prevention early with the kids in our schools.

I can’t be the only one who sees a double standard here. We’re determined to lower the suicide rate for our young people, but we want to help people who are ageing or sick end their lives sooner? By making efforts to prevent suicide on one hand and on the other encouraging it, we’re sending a mixed message to our young people. The bill says that euthanasia would be an option for those 18 and over. It’s possible that the age restriction would fall away, if New Zealand follows the pattern in other countries such as the Netherlands, where parents can decide if they want their sick child euthanised. Arguably, the euthanasia bill isn’t going to help our suicide rates, it’s only going to legitimise suicide.

We’ve all known someone, either personally or through someone else, who has reached that rock bottom stage where they feel suicide is the only option. Each one of these cases is a tragedy, often completely preventable. But it’s about choice and autonomy, right? Why should we refer to a teen girl’s suicide as a tragedy or a waste, and to our grandma’s decision to end her life because she feels like a burden on the family as a wise and dignified choice? Is any individual’s choice legitimate when it comes to suicide, or only some of them?

We value our youth. We should value our aging population too. The New Zealand Medical Association, Hospice New Zealand, the Australian and New Zealand Society of Palliative Medicine, and Palliative Care Nurses New Zealand and others have all spoken against a law change, saying that the option of euthanasia complicates their motives and goals as healthcare professionals and undermines the important relationship of trust between patient and doctor. Euthanasia is cheaper than palliative care, and legalizing it could mean we put fewer resources into making sure palliative care is good quality. I’ve spoken to nurses, doctors and even a couple of local MPs who all affirm that euthanasia isn’t the answer to suffering; rather, we should keep focusing on caring for patients.

We don’t have the death penalty in New Zealand because the possibility of a mistake means someone might lose their life unjustly. That whole method got scratched out because of how costly a simple mistake could be. I would argue that with euthanasia, there’s a high risk of error as well. Say the doctor doesn’t interpret the patient’s wishes correctly. Say the patient asks for euthanasia when they’re in a depressed state, and changes their mind after the form has been signed. What if someone won’t admit they’ve been pressured into it by their friends and family? What if a young person asks for euthanasia without notifying anyone else? The risks trump the benefits.

It can be argued that requesting euthanasia doesn’t really give you autonomy. Rather, you’re giving a doctor power to bring about your death at a specific time. Other people become implicated in your death. That’s what the euthanasia debate is really about: whether someone else should be given the power to help you end your life.

Finally, choosing death doesn’t just have consequences for the person who makes that choice. These things affect everyone around us. It starts by breaking the silence. We need to be talking about how making suicide a legitimate option affects us all, both young and old. Something to be thinking about as we head into the election this year…

For more info on both sides of the issue head to:

http://euthanasiadebate.org.nz/

http://www.hospice.org.nz/about-hospice-nz/euthanasia-our-opinion

https://eolc.org.nz/

http://www.worldrtd.net/information

To read the bill: http://www.legislation.govt.nz/bill/member/2017/0269/latest/DLM7285905.html

 

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