Danielle van Dalen

By Danielle van Dalen - 28/04/2020

Danielle van Dalen

By Danielle van Dalen -

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FAQ #10 | Who is vulnerable to the risks of euthanasia and assisted suicide legislation?

People with disabilities, the elderly, the chronically ill, and people with mental illness like depression are all groups that are commonly referred to as vulnerable when we discuss assisted dying legislation. In fact, when we talk about people at the end of their life, doctors and researchers tell us that vulnerable people include:[1]

  • People who have difficulties in communicating,
  • People who have unrelieved symptoms or a distressing medical condition,
  • People who are fearful of illness and potential dependence, and/or
  • People who lack social and psychological supports.

In the 2005 United Kingdom House of Lords report on Assisted Dying for the Terminally Ill, it was suggested that “some terminally ill people might feel under pressure if the option of assisted suicide or voluntary euthanasia were available in law, to avail themselves in the interests of others (in particular, family members) rather than because they themselves positively wished to die this way.”[2]

Whether or not family members are intentionally putting pressure on someone to be assisted to die, for people who are considered eligible under the law, its very existence could create increased pressure for them to consider the possibility of ending their own lives—imposing a new question on them that never before had to be considered, because it was previously unthinkable.

Why would the End of Life Choice Act impact vulnerable New Zealanders? 

The End of Life Choice Act will result in wrongful deaths. International example shows that we will be unable to prevent the risks to, and abuse of vulnerable New Zealanders. The existence of criteria and safeguards demonstrate that even proponents of this law think that there are sufficient risks to legal euthanasia, such that they would seek to differentiate between people who should be eligible for euthanasia and assisted suicide and people who should not. These eligibility criteria require us to negotiate an acceptable boundary of those who are, and those who are not, eligible. But experience shows that wherever we place this line, it will be overstepped and there will be wrongful euthanasia and assisted suicide deaths that were not intended by the people who drafted the legislation or those who voted it into law.

What does international experience tell us about the impact of similar legislation on vulnerable people?

Oregon is held up as an exemplar of how the risks of assisted suicide can be legally contained. Their experience shows, however, that legalising assisted suicide exposes vulnerable people to being influenced, either directly or indirectly, into taking their own lives.

  • It is difficult for one’s request for assisted suicide to be completely voluntary if the state has suggested it first. In Oregon patients on the state-funded health insurance programme Medicaid have received letters telling them that their request for cancer treatments have been denied, but that the state will pay for their (more affordable) assisted suicide.[3] Moreover, the annual reports show that a small, but increasing, number of people are naming “financial implications of treatment” as an end of life concern.[4]
  • Legalising assisted suicide makes possible what was previously unthinkable. It suddenly creates a new yes/no question that every qualifying person who is dependent on others for care would then be forced to ask themselves. Am I too much of a burden? Should I end my life to make it easier on the people who care for me? In 2019, 59% of those people who received assistance in dying in Oregon cited being a “burden on family, friends/caregivers” as one reason for doing so.[5]


GO TO NEXT FAQ #11 – How do we currently care for people at the end of their life?


Authorised by J. Abernethy, 49 Cape Horn Road, Hillsborough, Auckland 1041


[1] IG Finlay and R George, “Lethal physician-assisted suicide in Oregon and the Netherlands: evidence concerning the impact on patients in vulnerable groups; another perspective on Oregon’s data,” (Journal of Medical Ethics, 2011), 37:177-174.
[2] House of Lords, Assisted Dying for the Terminally Ill Bill, 38.
[3] W Smith, “‘Right to die’ can become a ‘duty to die,’” (Telegraph, 20 February 2009), https://www.telegraph.co.uk/comment/personal-view/4736927/Right-to-die-can-become-a-duty-to-die.html, accessed 3 June 2014.
[4] Oregon Public Health Division, Oregon’s Death with Dignity Act 2019 Data Summary.
[5] Oregon Public Health Division, Oregon’s Death with Dignity Act 2019 Data Summary.

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Danielle van Dalen

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