Frequently Asked Questions about euthanasia

What is meant by euthanasia, assisted suicide, and physician assisted dying?

Involuntary euthanasia is the practice of ending another’s life, without their consent and perhaps without their knowledge. End-of-Life Choice (EOLC) does not condone involuntary euthanasia, but advocates voluntary euthanasia, which is the practice used in countries such as the Netherlands and Belgium. In New Zealand we also use the terms End-of-Life Choice and Physician Assisted Dying.
Assisted suicide is a term we don’t use in New Zealand, preferring the term ‘physician assisted dying’. It covers the process of assistance whether or not the person is able to take the medication themselves or needs someone else to help them. Suicide is currently legal in New Zealand, but assisting in a suicide is a criminal offence.

Assisted dying, as proposed by the ‘End of Life Options Bill’ is for those who have a terminal diagnosis or suffering that cannot be alleviated. People in that category do not have a choice in how they live, but with the ‘EOL Options Bill’ they would have a choice in how they can achieve a peaceful death, surrounded by their family, and supported by the medical community.

Isn’t the End-of-Life Options Bill a path toward a slippery slope?

The Slippery Slope argument has been raised by opponents of end-of-life rights whenever and wherever the issue of assisted dying is raised. The argument states that permitting limited physician assisted dying will then lead to broadening of the acceptability of the practice and then make an opportunity for broadening the parameters of the laws to make more and more people eligible for the process. The argument claims that normalising assisted dying will legitimise involuntary euthanasia, and then lead to the unwanted deaths of the most vulnerable among us.

In jurisdictions where assisted dying is legal, such as in the U.S. states of Oregon and Washington, and in the Netherlands and Belgium, the statistics do not bear out that argument. After 15 years in Oregon and nearly 12 years in Belgium, for example, the number of patients who request assisted dying remains very low. The Dutch number is less than three percent of all deaths associated with assisted dying. In Oregon and Washington State, it is less than one-half of one percent. There is not much sliding happening in this field.

Won’t those who are vulnerable, have a disability, or are a burden to the family be encouraged to use assisted dying?

This is a common and completely false claim. New Zealanders will not support a loosely written, open-ended law. The law's multiple safeguards specifically require and guarantee direct patient involvement. In direct contrast, euthanasia is an ambiguous concept that often implies a person's involuntary death. Oregon and Washington State have two carefully written and regulated Death with Dignity laws. There have been no efforts to expand either law beyond their strict guidelines.

What is meant by 'Safeguards'?

Safeguards are points in the Bill that protect not only the patient, but also family members, friends, and the medical community. For instance, a written request for medication, signed by witnesses who will not benefit from the death, ensures that patients are not being coerced. Legalising a process and protocol for medications protects the medical community from feeling like they need to participate in illegal activities to alleviate the suffering of some patients. And setting strict parameters and rules for who qualifies for using the law takes the guess-work away from medical care providers and family members. Although assisting in a suicide is now illegal, assisting with a planned death, under the EOLOptions Bill, would not be. Patients could achieve death with family at their bedside, rather than alone. The safeguards written into the EOLOptions Bill include three points of protection:

1. The law respect and upholds the integrity of the relationships between medical practitioners and their patients.
2. The law requires that either the patient self-administer the prescribed medication, or that the patient’s medical practitioner inject the prescribed medication to hasten death, under strict medical protocols.
3. The law ensures the patient is the driving force, the ultimate and conscious decision maker in the process.

In addition, the Bill requires the formation of an interdisciplinary review panel: a collective of experts in end-of-life care, who track usage of the law to ensure it is working as it should.

Can't people just use hospice and palliative care?

Anyone with a terminal illness can--and should--access the best hospice and palliative care available to them. In Oregon, 95% of those who use the Death with Dignity Act are enrolled in hospice care, and benefit from pain and symptom management. However, about 5-10% of hospice patients around the world do not benefit from modern pain management protocols, because the drugs don’t work for them, they are allergic to the drugs, or they cannot be prescribed doses large enough to alleviate pain without leading to an unintended death. There is also the issue of intrinsic pain that can’t be addressed with drugs, such as loss of dignity, loss of control, and loss of ability to enjoy life. For the patients who fall into these categories, the death experience is tedious and painful.

Are medical practitioners required to assist their patients in this process if it conflicts with their beliefs?

Medical practitioners are allowed to opt-out of the process for any reason, or for no reason. The language of the Bill states that they must refer a patient to another medical practitioner who chooses to assist. Such requirements are currently the norm in New Zealand.

How does one qualify for using the proposed EOL Options Bill to hasten death?

Qualifications include:

• Must be a New Zealand Resident.
  
• Must be at least 18 years old , with a terminal diagnosis, or medical condition that makes life unbearable.
  
• Two medical practitioners must agree on the diagnosis, and that the patient is within 6 months of death, or has enduring unbearable suffering.
  
• Must submit two written requests for the medication. 

Can people simply stop eating and drinking to hasten death?

Yes, stopping eating and drinking will hasten a death, eventually. This is the option many New Zealanders use now. However, it is less than optimal, can take days or weeks, and often requires palliative sedation to relieve negative symptoms of the fasting process.