Author

Maryanne Spurdle

Maryanne Spurdle holds a Master of Public Policy from the University of Auckland, a BA in Communications from California State University at Fullerton, and is a World Journalism Institute Fellow. She held a variety of positions before joining Maxim Institute in 2023, writing, editing and designing material for mainstream media and non-profit organisations. One of Maryanne's early roles was at a charity that supports vulnerable and homeless adults in the north of England. That experience informed and fuelled her desire to discover and communicate the best ways that families, communities, and governments can encourage human flourishing in a complex world.

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Interrogating Choice: Euthanasia and the illusion of autonomy

By Maryanne Spurdle June 12, 2025

Before New Zealand passed the End of Life Choice Act by public referendum in 2019, Maxim Institute researched the experience of euthanasia overseas and the potential risks of the Act. We recommended a “no” vote.

Following the Ministry of Health’s 2024 review of the Act’s implementation, Interrogating Choice examines the quality of end-of-life choices now on offer. Does the system support patient autonomy, or merely the illusion of it?

This paper examines how New Zealand’s End of Life Choice Act impacts the reality of patient autonomy at life’s end. It highlights significant gaps in access to palliative care, weaknesses in safeguards, and the complexities that challenge true informed choice. The report calls for improved public awareness, equitable care, and stronger protections to ensure genuine autonomy for those facing end-of-life decisions.

What’s inside Interrogating Choice

• Recommendations to strengthen safeguards and oversight

• The inequities in access to end-of-life care

• Pitfalls in errors of diagnosis and prognosis

• The varied faces of coercion

• Growing threats to freedom of conscience for doctors and care providers

Discussion paper

Interrogating Choice: Euthanasia and the illusion of autonomy

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Tags

End of Life Choice Act Euthanasia Healthcare Law & Government New Zealand Palliative Care

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Author

Maryanne Spurdle

Maryanne Spurdle holds a Master of Public Policy from the University of Auckland, a BA in Communications from California State University at Fullerton, and is a World Journalism Institute Fellow. She held a variety of positions before joining Maxim Institute in 2023, writing, editing and designing material for mainstream media and non-profit organisations. One of Maryanne's early roles was at a charity that supports vulnerable and homeless adults in the north of England. That experience informed and fuelled her desire to discover and communicate the best ways that families, communities, and governments can encourage human flourishing in a complex world.

Read their work

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