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Ending one’s life in New Zealand

August 31, 2017
New Zealand Catholic Bishops

This is an excerpt from the New Zealand Catholic bishops’ submission to a government inquiry on public attitudes toward the introduction of legislation to permit medically assisted dying in the event of a terminal illness or irreversible condition. The inquiry published its report Aug. 2 with no formal recommendation. More than 75 percent of submissions to the inquiry opposed legalized euthanasia.

 

Normalization of euthanasia
In countries and states which have legalized either euthanasia or assisted suicide, or just assisted suicide, there have been startling increases in the number of people choosing to die in this way. The increase in numbers is out of all proportion to population increase and can only be properly accounted for in terms of an ongoing expansion of the parameters surrounding eligibility – a phenomenon referred to as “bracket creep.”

As noted in a 2010 Report on Euthanasia in Belgium by the European Institute of Bioethics:

“Initially legalized under very strict conditions, euthanasia has become a very normal and even ordinary act to which patients are deemed to ‘have a right.’ In the face of certain high-profile cases, the evident relaxation of very strict conditions has caused many reactions but also a total absence of any sanctions on the part of the commission, and a very conciliatory silence from the political establishment has given rise to a feeling of impunity on the part of some concerned medical practitioners and a feeling of powerlessness in those worried about where things are leading.”

The increase in numbers indicates that assisted suicide and/or euthanasia have been normalized and are now even expected in some circumstances.

 

Effect on the medical profession
When assisted suicide and euthanasia are considered to be rights, they cease to be the exceptions most laws originally envisaged. The normalization of assisted suicide and euthanasia and their definition as rights has imposed obligations on doctors to take part in assisting people to die, which are in direct opposition to the nature and ethos of the profession.

The elderly and sick have reason to fear doctors who can propose and even subtly persuade vulnerable people to consider ending their lives. The status of a doctor can easily make a suggestion into an obligation, given the power imbalance between a vulnerable person and their doctor.

The original safeguards built into the Belgian and Dutch legislation have in practice over the years become ineffective. The narrow target group of the terminally ill has expanded to include those suffering from psychiatric conditions, dementia and those who are simply old, lonely or have been bereaved. The expansion to include teenagers, children and babies is particularly horrifying.

In theory in Oregon those eligible for assisted suicide must have less than six months to live. A footnote in the Oregon annual report for 2014 relating to the category “other illnesses” (16.9 percent of lethal prescriptions) describes these other illnesses as “benign and uncertain neoplasms, other respiratory diseases, diseases of the nervous system (including multiple sclerosis, Parkinson’s disease and Huntington’s disease), musculoskeletal and connective tissue diseases, viral hepatitis, diabetes mellitus, cerebrovascular disease and alcoholic liver disease.” These may be illnesses which shorten life, but it is hard to believe that the people concerned were all terminally ill.

Support for euthanasia or assisted suicide among the general population is often contingent upon strict controls being in place, and controls which are seen as being strong may be the swing factor for some politicians in voting upon this issue. Belgium and the Netherlands began with what were thought to be strict controls, but over the years there has been a progressive widening of eligibility through changes to the legislation. In Oregon the controls remain in place in the legislation, but there has been a widening in the interpretation of the legislation and in the practice of physicians which has effectively undermined the strict controls on eligibility.

 

Climate of fear
The normalization of euthanasia and assisted suicide in places where it has been legalized change the societal perception of those who are ill, disabled or elderly. Rather than being valued members of the community, they are more likely to be seen and to see themselves as a burden. The fear of being a burden is well documented as a reason for people choosing assisted suicide or euthanasia.

In Belgium and the Netherlands these vulnerable people rightly fear euthanasia itself, and there is documented evidence of persons being killed without their consent. Family and societal pressures are exercised subtly rather than overtly, which compounds the fear of those whom others might view as a burden. The question becomes who a vulnerable person can trust to act in their best interests if family and doctors cannot be trusted. That is a point of utter loneliness which no elderly, ill or disabled person should have to experience.

 

Potential increase in suicides
In the Oct. 10, 2015, edition of the Southern Medical Journal, research titled “How Does Legalization of Physician-Assisted Suicide Affect Rates of Suicide?” was published. The aim of this study was to examine the association between the legalization of physician-assisted suicide and state-level suicide rates in the United States between 1990 and 2013. In particular it aimed to test claims that legalization of physician-assisted suicide could lead to a reduction in total suicides and to a delay in those suicides that do occur. The conclusion from the study was:

“Legalizing physician-assisted suicide has been associated with an increased rate of total suicides relative to other states and no decrease in non-assisted suicides. This suggests either that physician-assisted suicides does not inhibit (nor acts as an alternative to) non-assisted suicide or that it acts in this way in some individuals but is associated with an increased inclination to suicide in other individuals.”

In our experience suicide creates deep emotional wounds and does huge relationship damage in families. We lose more than 500 people to suicide every year, leaving behind networks of friends and family who can take years to recover. Apart from the real loss of so many of our people to suicide, there is a loss to the community in the very real devastation suffered by those close to the person who committed suicide.

Research such as that outlined above indicates a need for great caution in doing anything which might give those contemplating suicide a greater impetus to act.

 

Conclusion
The precautionary principle is widely used by the New Zealand government in policy areas such as fisheries, environmental management, public health, conservation and biosecurity. Risk management is integrated into every area of public policy. The experience of countries and states which have legalized euthanasia or assisted suicide, or both, clearly shows that it poses considerable risks.

We are deeply concerned about the risk to the vulnerable people we work with every day, those who are elderly, disabled, chronically ill, depressed or suicidal. Our concern includes those who think that there is no way to deal with their terminal or incurable illness other than by assisted suicide and those who are not ill but who have a great fear of dying, perhaps because of an experience in the past.

We like to think that as a country we are independent and courageous enough to go against an international trend or pressure from other countries. Why do we need to follow an overseas trend riddled with risks to vulnerable groups in our society when there is a practical alternative?

Quality accessible palliative care addresses the underlying problems which lead people to believe their only option is kill themselves and helps people to die well. In terms of good risk management, it eclipses the easy and dangerous route of legalizing euthanasia or assisted suicide.

In the light of our experience with the ill and dying, it is our considered view that euthanasia and assisted suicide are both unnecessary and dangerous. We strongly recommend that the Health Select Committee rejects the possibility of changing the current legislation, and instead recommends that more resources are made available across New Zealand for services to support those with chronic and terminal illnesses.

Origins, Catholic News Service documentary service.

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