Short Cuts Info – The risk of wrongful death in the End of Life Choice Bill
How many people would this Bill make eligible for euthanasia and assisted suicide?
First, the Bill seems to ignore the fact that determining a patient’s prognosis is more art than science. It would legalise euthanasia and assisted suicide for people with a terminal illness that is predicted to end their life within 6 months, but medical professionals readily accept that their estimations are often wrong and some patients outlive their prognosis in even the last days and weeks of life.1
Second, the Bill makes no clear, safe distinction between who would or would not be eligible. It would legalise euthanasia and assisted suicide for someone with a “grievous and irremediable medical condition.” This could include, for example:
– A person with disabilities, including someone who is deaf,
– Someone struggling with chronic depression,
– Someone with severe arthritis, and
– Someone with insulin dependent diabetes.
The Bill tries to claw back the broad eligibility but uses vague language, providing no real protection
The Bill has other criteria to limit eligibility but they are vague and subjective. It says a person is eligible for euthanasia or assisted suicide if they are in an “advanced state of irreversible decline in capability,” and experiencing “unbearable suffering that cannot be relieved in a manner he or she considers tolerable.” These phrases fail to draw a clear boundary.
For a safeguard to be effective, it must have objective criteria. The safeguards in this Bill are subjective, relying on the individual’s perception of their own experience, and permitting a wide range of interpretation—allowing the meaning to shift easily to include people we want to protect from harm.
Over time, even more vulnerable people could be put at risk, because international evidence shows that law, practice, and interpretation can all expand
Currently, the proposed Bill limits eligibility to New Zealand citizens and permanent residents who are 18 years and over.
The Belgian law was also initially limited to those aged 18 and over, with a clause for children aged 15 and over who were emancipated from their parents. The law was changed in 2014 so that there is now no reference to age as criteria.2
The Dutch law restricts access to those aged over 18, but also offers euthanasia and assisted suicide to 16-19-year-olds whose parent or guardian has been consulted and 12-16-year-olds whose parent or guardian has given consent. The 2005 Groningen protocol, moreover, ensures doctors and parents are not prosecuted when euthanising a baby whose life they determine is not worth living.3
Review committees come too late to help and haven’t worked overseas
The proposed end of life review committee and SCENZ (Support and Consultation for End of Life New Zealand) Group are supposed to detect abuses of the law through annual reports, provide advice on medical and legal procedures, and suggest replacement independent medical practitioners. International example has shown that these groups are unable to prevent abuse of the vulnerable.
– At least 23 percent of Dutch euthanasia deaths are not reported each year, while in the Flanders region of Belgium this number increases to about 50 percent.4
1 A D MacLeod, “Euthanasia and physician-assisted death,” The New Zealand Medical Journal, (125:1367) 2012, p.128
2 RT News, “Children’s euthanasia bill signed by Belgium King,” (5 March 2014), available at: https://www.rt.com/news/belgium-king-sign-euthanasia-bill-566/ accessed 11 July 2017
3 G van Loenen, Do you call this a life? Blurred Boundaries in the Netherlands’ Right-to-Die laws (London, Ontario: Ross Lattner Educational Consultants, 2015), 26-28
4 B Onwuteaka-Phililpsen, et al., “Trends in end-of-life practices before and after the enactment of the euthanasia law in the Netherlands from 1990 to 2010: a repeated cross-sectional survey,” The Lancet (2012), 908-915; T Smets, et al., “Reporting of euthanasia in medical practice in Flanders, Belgium: cross sectional analysis of reported and unreported cases,” British Medical Journal (2010), 341:5174