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The New Zealand Herald reports a 2015 study showed two-thirds of the NZ population support medically-assisted dying:

Faye Clark. Photo / Supplied

Last year, 15,270 participants in the NZAVS were asked: "Suppose a person has a painful incurable disease. Do you think that doctors should be allowed by law to end the patient's life if the patient requests it?"

On a scale ranging from 1 (definitely no) to 7 (definitely yes), roughly two thirds were in favour, and mostly at the "definitely" end of the spectrum.

"The mean response to the question was 5.6 out of 7 - this indicates that most New Zealanders were, on average, supportive of euthanasia," said Sonali Dutt, who conducted the study as part of her summer research scholarship.

About 12.3 per cent were opposed.

The lowest rates of support were among those aged 80 to 84, while the highest levels came from young people aged 18 to 19.

"In the last few years, between 60 and 90 per cent of New Zealanders have been in favour of a change," said Hamilton voluntary euthanasia advocate Faye Clark, who has been asking for the right to end her own life since she was diagnosed with myeloma, an incurable bone marrow cancer, seven years ago.

"I think our politicians need to ... reflect the wishes of the electorate."

The Canadian Parliament Committee has reported on on medical assistance in dying (aka physician-assisted dying). Their recommendations are very close to what is allowed for in the VES (Maryan Street's) End Of Life Options Bill including the end-of-life directive. It will prove immensely useful to the NZ Select Committee deliberations because it sets out clear recommendations which are very patient-orientated.

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Hello everyone,

Thank you all for sending your submissions to the Health Select Committee.

Now that you are waiting for the Health Select Committee to visit your town, or for your call-up to speak to your written submission in front of them, you might consider doing the following:

1. Keep an eye on the Parliamentary website for any posted arrangements by the Select Committee as to their itinerary or when they are hearing submissions.

2. Send a copy of your written submission to all the MPs in your area, electorate and List MPs.

3. Make an appointment with any local MPs to discuss the submission you just sent them.

4. If you or a friend are invited to present to the Select Committee, get together to rehearse what you might say and the points you want to make in 5 minutes - that may be all the time you get! Working with someone else is always helpful, especially if you have not submitted to a Select Committee before.

5. Turn up at a Select Committee hearing to support your friends - a crowd always shows the MPs that people are interested.

6. Send your submission to church leaders and community representatives in your area, as well as local MPs.

7. Continue to write letters to the editor of your local paper, quoting bits from your submission - keep the issue alive locally in the media.

Maryan

NZ Doctor - Friday 29 January 2016

Matt Vickers, husband of Lecretia Seales, urges health professionals to make submissions to the Health Select Committee inquiry into physician-assisted dying.  

Last year my wife, Lecretia Seales, took a claim to the High Court seeking the right to choose how and when she died. Her case followed similar actions in the UK, the USA, Canada, South Africa and Ireland, where patients facing terminal or severe degenerative illnesses sought more control over the ends of their lives. 

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Submissions to the Health Select Committee on End of Life Choice close on 1 February 2016 – only a week away. Making a submission doesn't need to take long, but it's important that there is an adequate number of supportive submissions to balance those that are in opposition.

Here is a simple statement to base your submission on. PLEASE ADAPT this suggestion using your own words, or add a personal statement. NB. If a number of submissions are exactly the same, they may all be discounted.

​I strongly believe that I and other people have a right of CHOICE about significant events in my life and therefore I totally support the legalisation of assisted dying for people who have terminal illnesses or whose irreversible conditions make their life unbearable.​.

​You can make your submission online using this link. Please note that there is a verification process...you have to click on a particular icon at the bottom of the webpage. Scroll down to see it.

If you prefer to send your submission by post or by email please refer to this useful guide. 

This document outlines the difference between PAD and suicide. It was part of a couple of the affidavits in the Seales case.

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Two views published online January 19 in JAMA (Journal of the American Association) illustrate the moral and ethical struggle of the medical profession when terminally ill patients want their physicians to help them die.

Prescribing self-administered medication intended to hasten death is now legal in Oregon, Vermont, Washington, Montana, and California. Prescribing lethal medication given by a clinician at patients' request is legal in Belgium, Colombia, Canada, Luxemburg, and the Netherlands.

Yes: Help Patients Keep Control

In their viewpoint article, Timothy E. Quill, MD, from the Palliative Care Division, Department of Medicine, University of Rochester Medical Center in New York, and colleagues say it should be an option in the continuum of care.

"Patients with serious illness wish to have control over their own bodies, their own lives, and concern about future physical and psychosocial distress. Some view potential access to physician-assisted death as the best option to address these concerns," they write.

Being willing to explore the options with patients is important for the physician–patient relationship. Many more patients are interested in the possibility and find comfort in the thought of a back-up than will actually use the prescription, their research finds.

The authors cite numbers from Oregon, the first state to legalize the practice. "In Oregon, where physician-assisted death has been legal for 18 years, 1 in 6 terminally ill patients talks with their families, 1 in 50 talks with their physician, and only 1 in 500 directly accesses this option," they write.

Slippery slope concerns and worries about coercion, the authors say, have not been borne out in the states where it has been legal.

Assessing the patient's emotional state and determining personal history and values with the patient and family are essential when considering the request, and the authors include guides in the paper for questions physicians can ask.

Still, the authors recognize the boundaries physicians wrestle with and note that those who cannot morally participate should help patients find an alternative approach that may include finding another physician.

No: It Goes Against Basic Oath

In their viewpoint article, Y. Tony Yang, ScD, LLM, MPH, from the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, and Farr A. Curlin, MD, from the Trent Center for Bioethics, Humanities & History of Medicine, Duke University, Durham, North Carolina, say it should never be an option.

Arguments that physicians should follow patients' wishes with respect to hastening death undercut the essential role of the physician, they say.

"If the medical profession accepts physician-assisted suicide, it will be declaring decisively that 'physicians' are mere providers of services, to be guided only by the desires of the individual patient, the will of the state or other third parties, and what the law allows."

They argue that patients already have the right to refuse life-sustaining treatment and the liberty to end their lives in ways that do not involve physicians.

It is also an issue of trust, they say, because since the time of Hippocrates, physicians are sworn only to heal, not to harm.

"That is why Doctors Without Borders treats injured Taliban soldiers. It is why physicians have refused to participate in capital punishment, or to be active combatants, or to cooperate with torture," Dr Yang and Dr Curlin write.

They urge physicians to fight legalization of the practice and refuse to participate in it.

Terminology Fuels Conflict

Some of the controversy comes in referring to the practice as suicide, some say, as calling it suicide suggests mental illness and a self-destructive action.

Arthur Caplan, PhD, director, Division of Medical Ethics, New York University Langone Medical Center in New York City, agrees, saying "hastening death" is better terminology. "I think hastening inevitable death has little to do with suicide. Using that language is spin and not accurate," he told Medscape Medical News.

One strength of the argument from Dr Quill and colleagues, he said, is that it notes the lack of evidence that abuses or coercion have happened in states where it is legal.

"Almost no one in these states wishes to overturn their laws. This is not a theoretical debating point: the facts and experience bolster the pro–assisted dying side."

In the argument by Dr Yang and Dr Curlin, he said, "The notion that doctors should not kill is wrong. Doctors must allow patients to die. If patients who are terminal wish to die without hospice, etc, then they should have the ability to get and take medicine that hastens their death. But [if] they choose to take pills not given by doctor, that is only providing the means, not killing. The argument about killing does not hold."

Dr Quill reports receiving honoraria from various institutions for speaking about end-of-life decision-making and the topic of physician-assisted death. Dr Caplan has served as a director, officer, partner, employee, adviser, consultant, or trustee for Johnson & Johnson's Panel for Compassionate Drug Use (unpaid position) and is a contributing author and adviser for Medscape.

If you haven't already, please remember that we have just 24 days left until the 1 February deadline to send submissions to the Health Select Committee on medically-assisted dying. It would probably be wise to set yourself a target date of well before that deadline.

The press has been fairly quiet over the holiday but we need to be prepared for arguments like these now:

John Roughan is being true to form. and the Care Alliance has attacked Matt Vickers' attendance at an international conference.

Meanwhile, an unexpected view — could this be the first glimmer of Catholic pragmatism?

Here's our previous post on making a submission.

Right to Life, a group opposed to PAD, published this item yesterday.

Dr Jack Havill, our President and David Barber, our media adviser, sent this press release: 

Press release from the Voluntary Euthanasia Society of New Zealand

It is a pity that as a Parliamentary committee is holding the first public inquiry into the issue of medically-assisted dying to end intolerable suffering of the terminally ill, opponents have resorted to a campaign of blatant lies, Dr Jack Havill, president of the Voluntary Euthanasia Society of New Zealand (VESNZ), said on Tuesday.

Dr Havill, a retired specialist with 30 years’ experience in intensive care of the seriously ill, said a statement by the Right to Life organisation claiming that VESNZ supported giving a suicide pill to all 70-year-olds was “full of lies and distorted thinking” designed to confuse when opinion polls show that nearly three-quarters of New Zealanders favour a law change.

He said VESNZ had never supported giving a suicide pill to 70-year-olds in New Zealand, as claimed by Right to Life spokesman Ken Orr, and nor did Dutch euthanasia expert Dr Rob Jonquiere, who toured New Zealand earlier this year, advocate it.

Dr Havill, of Hamilton, said Mr Orr “loves talking about killing” but preferred “people to have drawn out deaths with great suffering, should palliative care be unable to meet their needs”.

Dr Havill said: “Physician assisted dying (PAD) is hugely different ethically and practically from murder and suicide. But it is obvious that Ken Orr and his ilk do not have either the intelligence or honesty to see the difference.

“For the most part, the only individuals and organisations continuing to use the words ‘suicide’ and ‘killing’ in relation to PAD, are those who for political, religious or philosophical reasons advocate against it.  This is the reason that Right to Life loves using these words.”

Dr Havill said VESNZ had no need to resort to lies to convince the public that no more people would die, but fewer would suffer if the law was changed allowing doctors to respond to requests by the terminally ill to end their lives peacefully.

He said VESNZ’s position was spelled out in its submission to the health select committee’s inquiry on voluntary euthanasia which can be viewed on the Parliamentary website (Select Committee Assisted Dying Enquiry).

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