Euthanising oversight
Quick poll: If two-thirds of the experts monitoring the effects of a new law say they’re “extremely concerned” by its implementation, should we relax its parameters? Or slam on the brakes?
We’d expect to be hearing the squeal of tyres right about now, but instead we’re barrelling towards the expansion of a risky law while its drivers lock out dissenters.
Where’s the outcry from those affected? Well, that’s the thing. They’re dead.
Five years ago, David Seymour assured us that legalising physician-assisted suicide was not only compassionate but also safe. Most voters believed him, so now we’re one of only 10 countries that allow people to both access lethal drugs (assisted suicide) and enlist medical professionals to administer them (voluntary euthanasia).
Don’t worry, sceptics heard, the oversight will be so rigorous that only people who have no better alternative will get approved. And a review by the Ministry of Health, to be completed this November, will check it’s working as advertised.
The doctors who provided systemic oversight of the law say its implementation has been so shoddy that they “would not have known if someone had died wrongly.”
The Act Party is so confident of a positive review that it has plans to loosen the legislation’s restrictions. However the guardrails that already exist appear ineffective. The doctors who provided systemic oversight of the law say its implementation has been so shoddy that they “would not have known if someone had died wrongly.”
Here’s what the legislation promised:
Successful applicants will be “competent to make an informed decision”—absent coercion from those who might consider them a burden, poor mental health, or cognitive decline.
At least two medical professionals evaluate each applicant, and the prognosis must be 6 months or less.
Each death will be verified by a three-person committee that reviews clinicians’ reports. That committee, formed in 2021, included Dr Dana Wensley, an ethics expert, and Dr Jane Greville, a palliative care specialist.
Both doctors soon found reports that excluded prognosis, diagnosis, assessment of the patient’s capacity, or reasons to trust absence of coercion. If anything untoward occurred—say, pressure from caregivers, the death of someone who would benefit from psychiatric care, or ineffective doses that left people dying for hours—how would they know?
At least two medical professionals evaluate each applicant, and the prognosis must be 6 months or less.
When the reviewers queried these gaps, the Ministry told them to assume nothing was wrong.
They aren’t convinced. At least one person who was euthanised may have had dementia and didn’t speak English, yet no interpreter was present at their assessment.
And when Dr Greville contacted doctors personally to fill in gaps from other reports, she found “sometimes jarring inconsistencies.”
Unsurprisingly perhaps, the Ministry didn’t renew Dr Greville’s contract. Dr Wensley resigned following her two-year term after witnessing things that went “against best practice.” The committee tasked with ensuring that vulnerable people aren’t dying unjustly then went into hibernation; the deaths continued.
Compassionate? Safe?
Sure; if you’re happy “assuming” nothing has gone wrong. We need to resume our national conversation about euthanasia. If this law can’t effect the promised safeguards to support our most vulnerable at the end of their lives, it is not fit for purpose. Euthanise oversight, and trust in our institutions dies as well.
Listen to the podcast
Researcher Maryanne Spurdle explains the thinking behind her column.