With a final amended version of the End of Life Choice Bill expected to be voted on next month, potentially followed by a referendum next year, it’s time to decide whether this is a law that we actually want. It’s important we learn from the example of the United States which has found that, among other risks, no safeguard can sufficiently protect people with disabilities.

Oregon is widely recognised for having particularly restrictive assisted dying legislation, and yet dangers to people with disabilities remain. Only a few weeks ago, for example, the US National Council on Disability presented a report to the President on “The Danger of Assisted Suicide Laws,” outlining their concerns based on the experience of the nine US states, including Oregon, where this is legal. The National Council is particularly concerned that “safeguard provisions in US assisted suicide laws are inadequate, can be readily circumvented, or fail to protect patients from pressure to end their lives.”

People with disabilities are frequently pointed to as a population vulnerable to the risks of euthanasia legislation. The National Council have seen the risks turn into reality in places like Oregon, where assisted suicide has been legal for 25 years. Despite safeguards that attempt to limit the law to those who have terminal illnesses with six months to live, euthanasia and assisted suicide legislation doesn’t deal with the potential for misdiagnosis and the indirect pressure for people with disabilities to make this choice.

Determining a patient’s prognosis is always difficult. This is especially true for patients with disabilities, where the boundaries between disability and terminal illness can become blurred. As the report points out, “faulty prognoses pose considerable danger to people with new or progressive disabilities or diseases, who may often be misdiagnosed as terminally ill, but who [have and] could potentially outlive these prognoses by years or even decades.” Blurred lines don’t make for good legislation.

Whether or not someone feels pressure to die is also incredibly difficult to determine. Sometimes this is direct, but often it’s indirect. For someone with disabilities, pressure can lead to concerns about the impact their life and care is having on others. When euthanasia is an option this can result in indirect pressure to make that choice. In Oregon’s most recent annual report, for example, 54 percent of people who were assisted to die named being a burden on family, friends, or caregivers as one reason for doing so. No safeguard has been able to protect against this.

Unlike Oregon, however, assisted dying isn’t law here yet. We have the opportunity to prevent introducing these risks to New Zealanders with disabilities, but we need to listen to the experience of the United States where no safeguard has been able to provide proper protection. Our politicians, and all New Zealanders, need to recognise their responsibility to protect and value New Zealanders with disabilities by voting against the Bill at third reading, as well as in a potential referendum next year.