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Death with Dignity Bill — First Reading
Death with Dignity Bill
PETER BROWN (Deputy Leader—NZ First) : I move, That the Death with Dignity Bill be now read a first time. At the appropriate time it is my intention to move that this bill be referred to the Justice and Electoral Committee. At this moment, though, I want to start by telling the House what this bill is not about. It is not about euthanasia. Euthanasia is defined as the painless killing of a patient suffering from an incurable, painful disease. There is no mention in that definition of who will administer it, and no mention of whether the patient wants it, requests it, or is even aware that it is happening. This bill is not about any of that.
This bill is about voluntary euthanasia. There is a world of difference between the two. This bill is about me being able to make a decision for myself—not my wife, not my doctor, not my family, not the hospital; nobody but me being able to make a decision for myself. Equally so, it is about every adult New Zealander being able to make a decision for himself or herself—nobody else; just the individual adult New Zealander. But there are two provisos. Firstly, the individual must be of sound mind and be able to make a rational, easily understood decision. Secondly, he or she must be terminally and/or incurably ill. Those are the two provisos before somone can make that decision.
The people we are talking about may be few in number, but they could well be experiencing much pain—much pain at a very vulnerable stage in their lives. Equally so, they could have lost most of their independence and be on the verge of losing it all. Or they could be in the category where the pain is controlled, but their bodies are disintegrating before their very eyes. So what do they have to do? Under this bill they have to get a medical practitioner’s agreement that they are in such a condition. Then they have to get the agreement of a second medical practitioner who agrees fully with the first diagnosis. Then they have to get the agreement of a psychiatrist to say that they are of sound mind and not suffering from a mental illness, like depression, and that they are capable of making a rational decision about their own future. Finally, they have to see a counsellor, whose responsibility is to outline the full implications of their request, so that he or she can ensure that patients know what they are requesting to happen. Under this bill the medical practitioners, in particular, have to ask patients whether they have consulted their family. That is mandatory. It is not mandatory, for very good reasons, that patients have to consult their family.
So if that is whom we are talking about, how many people are we talking about? The state of Oregon in the USA has had similar legislation for 5 years, and in that 5 years 128 people have taken advantage of death with dignity. One hundred and ninety-eight applied, but only 128 went through with it—that is, 60-odd percent. That tells me that for 30-odd percent the stress was removed from them, and that that was sufficient. Oregon is a state with a population of about 3.5 million people. We have 4 million people, so we can expect somewhere around 30 people per year to want to take advantage of this legislation.
What is this legislation? First and foremost, it stipulates the criteria a patient must go through—that is, the two doctors, a psychiatrist, and a counsellor. That is a very important part of this bill. Secondly, the bill provides for an advance directive, whereby fit and able people can make their views known in writing. So should they become inflicted with some dreadful disease and not be capable of making a decision, they could have made the decision beforehand. If they are injured in a car crash or contract Alzheimer’s disease or some sort of illness, so that they cannot make a decision, then the decision that they made some years before—or some time before—must be accepted. That is the second important aspect of this bill. The third important aspect is that I am not asking anybody here in the House to make the final decision. This bill, should it pass all stages, will go before the public of New Zealand, so that the public can make the decision by means of a binding referendum. That is what New Zealanders want on this type of issue. It is controversial but it is also sensitive, and it is very, very delicate.
I believe that everybody who has led a decent, law-abiding life is entitled, when their time has come, to die with dignity—to die in the comfort of their friends and family, and not to die a suffering, lingering death. That means not only being pain free but also dying in a peaceful and dignified manner. Currently, the medical profession will tell us that it cannot address the concerns of everybody. In a letter it produced the hospice association, which opposes this bill, stated: “However, when the storm calms”—that is, this debate—“the fact remains that pain and physical symptoms can be treated adequately by hospice specialists for the vast majority of patients.” This bill is to help the people who are not embraced by those words “vast majority”. Principally, this bill is aimed at assisting those folk. I am a firm believer in the hospice movement. I believe it does a great job, and I have the utmost admiration for the people who work in the industry. I support the industry being funded exceedingly well. I do not see this bill as being in conflict with the hospice movement but as compatible with it.
Another concern that comes up from time to time is that voluntary euthanasia will lead to euthanasia. There is no will for euthanasia—I outlined right at the beginning of my speech what euthanasia is all about. There is no will amongst the public, amongst politicians, or in the political world to introduce euthanasia, and the protections in this bill for the patient are pretty stringent. If they not stringent enough, then the select committee can make them tighter.
Finally, I would like to address a concern that I wrestled with for a long time: is this bill compatible with Christian beliefs? I pride myself, if that is the right word, on being a man who has lived his life with Christian values.I found out I was a Christian when I was an 18-year-old cadet in the British merchant navy, in a storm in the North Atlantic. It was a huge storm, with waves as big as one could imagine—probably bigger than this Parliament House—and the ship started to break up. I found out then that I believed in God. So it was important to me that this bill was compatible with those beliefs, and I believe that it is. I am conscious that the apostle Paul once said “And now abideth faith, hope, and charity, these three; but the greatest of these is charity.” In the modern Bible that word “charity” is changed to love. When asked what were the most important commandments, Jesus said the first two: love your God, and love your neighbour as you love yourself. I say to people with Christian beliefs that they can support this bill. I ask them please not to let their faith blind their compassion.
Hon BILL ENGLISH (Leader of the Opposition) : I rise to oppose this bill, accepting the modus operandi and integrity of its parliamentary proponent. I oppose this bill for a simple reason: one of the strongest presumptions in our law is the presumption against taking a life. Our own Crimes Act makes it quite clear that the taking of a life is culpable—that is, if one takes a life, that is examinable by the rest of the community as to its purpose and intent. We as lawmakers have for the whole life of this Parliament now set a high threshold around the taking of life. I oppose this bill because it lowers that threshold. I do not believe that the proponents of it have mounted anything like a strong enough case that the threshold around the assumption against taking a life should be lowered.
The effect of our law, in the case of those people who find themselves in extreme circumstances, is predictable and straightforward. If one is involved in taking a life, then the circumstances of that will be examined. It will be in the hands of the Crown as a prosecutor, the police, the courts, and ultimately, juries made up of New Zealanders, to then dispense justice. As we look back through the occasions on which that has happened, at the cases that are commonly discussed in respect of voluntary euthanasia, we find that juries of our peers do make decisions according to reasons that they give as mercy, justice, compassion, and forgiveness. So it is not the case that our system of law is unable to distinguish one intent from another when it comes to taking a life. It is able to make those distinctions. It is able to determine whether compassion and mercy were involved, or revenge and hatred. That is why we should not lower the threshold against the taking of a human life, and that is the fundamental basis of my opposition to this legislation.
The bill sets out a process by which we can validate the taking of a life. I have to say that no process is good enough to be free from the pressures, the envies, and the hatreds to which any human being can be prey. No process is good enough to be free from that, and if the House wants to look to a process that it has tried to construct in the past to achieve those ends, then it can look at the Contraception, Sterilisation, and Abortion Act, because it has a remarkably similar process to this one. It includes experts, doctors, consultants, and references to mental health, and everyone knows that it has become a conveyor belt to abortion. MPs need to keep in mind that if that is the track record of this Parliament’s capacity to devise a process to protect the vulnerable, then we have failed utterly. As a Parliament we just simply turn our faces from the failure of that legislation, because it has now become a social norm that abortion is acceptable. That is 25 years on from when the legislation was passed, and I say we could stand here in 25 years’ time and say exactly the same thing about the process in this bill.
I shall comment on a couple of aspects of the bill. The first is the use of the term “incurably ill”. I can remember a chilling moment in the last debate on television about euthanasia when one of the proponents of the bill, Michael Laws, a former MP, was asked about the case of a dreadfully handicapped 14-year-old child and whether his legislation would include that child, to which he answered truthfully “yes”. At that moment he lost the debate. “Incurably ill” in this bill “means a medical condition which is generally accepted by the medical profession as seriously impairing the person’s quality of life”—how subjective is that—“and unlikely to be capable of cure, either at the present time or in the reasonable future”.
I have sat as a constituency MP recently with the parents of severely autistic children. If one wants to hear heart-ripping stories of the sadness and destruction of quality of life, then one should listen to those parents. Any medical practitioner would find it almost impossible to say that a seriously autistic 14-year-old of the type that I have been dealing with lately has not had a seriously impaired quality of life, and, as much to the point, has not seriously impaired the quality of life of the people who love and care for him or her. Those children are certainly not capable of being cured. So this is not a bill whose scope is limited to the aged or the terminally ill in their later years.
This bill, in terms of the definition of “incurably ill”—the term used in the bill; the definition I have quoted from the bill—includes anyone who has a seriously impaired quality of life, and who may not be able to be cured. I say to this Parliament that if we go down that track we make the most vulnerable people in our community even more vulnerable, not because they are being put under pressure to take part in death with dignity, but simply because we have made that possible. How will they feel? What protection will the most vulnerable people in our community believe they have, if we make it possible that two medical professionals, a counsellor, and a family can say to them that they have a seriously impaired quality of life? Do we imagine that pressure will never come on them? Of course it will! The vulnerability is not just about the process of making the decision, but about the ripple effect this legislation will create simply because it makes death with dignity possible.
I turn to the term “informed decision”. What is an informed decision from a person whose judgment, by definition, is impaired by incurable illness or pain, or by the fact that he or she is close to death’s door and is causing real distress to the people around him or her? This bill is a comfort for the living, not a ticket for those who want to die—because that is always how the argument arises. Someone says “It is because I feel distressed that I want death with dignity—because it gives me discomfort to watch the pain.” Well, pain is part of life, and watching it is part of our humanity. Many of us have become more human for watching it, whether or not we liked doing that.
This bill is about comfort for the living. Let us not pretend it is about the dignity of those who have gone, because they have gone and we have different views about where they have gone to, depending on our beliefs. I do not think it is a duty of this Parliament to remove the basic presumption against taking a life, in order to give comfort to those who encounter the very human experience of watching suffering.
Hon DAMIEN O'CONNOR (Minister for Racing) : I did not come to the House to speak on this bill, but I am going to take the opportunity to do that, given that I am here and that I feel quite strongly about it. I firstly acknowledge the integrity and the intent of this bill from Mr Peter Brown, someone who in my view has respect in this House from all parties. He has put this bill forward through personal beliefs—for what he believes are good intentions. I stand up as someone who has stated publicly that I oppose the bill. I oppose it on a couple of basically simple assumptions, I guess.
I will go back to the first one, and that is that Parliament provides a very complex process to give us comprehensive, complicated, but, hopefully, consistent law that does everything we can to protect life—human life, animal life, and vegetable life through conservation measures. Parliament spends a lot of time debating and arguing to preserve life in all its forms. I cannot understand that we can, as humans, make a judgment on when someone else should terminate that life. We do so for animals and we do so for vegetables, but when it comes to human beings I think we, thankfully, appreciate that that is a call that is very, very hard to make.
While Mr Brown is putting up a proposal that says we are allowing self-determination for when one should end his or her life, in the end the ending of someone’s life—for the most part, just about every time—will depend upon assistance or judgment or influence by other people. We have different experiences in our lives—that is why we have different opinions on things. I am just a simple farmer. I have had a lot to do with death and euthanising animals. If one spends enough time around a farm one appreciates that even in the lowest moments of an animal’s life, there is somehow some inner strength, an inner determination, that drives animals to live, that drives beings to live. If members have tried to destroy perhaps even the life of a plant, sometimes they would be amazed—
Stephen Franks: A possum!
Hon DAMIEN O'CONNOR: —a possum—at the resilience of the plant, but especially of the animal, to want to live, to remain alive. But there is something that I cannot quite understand. While as a farmer I have had different experiences in life, I was at one time working in a mine when unfortunately someone thought it wise to end his own life by pouring petrol over himself. I came along about half a minute after that horrible event. A person had put out the fire, but we had in front of us a person who was dying, and we were doing our best to try to keep that person alive. I will remember every detail until the day I die, and I am sure many of us can share an experience like that. The inner being of that person was something that lived right until the final moment, making noises, groaning, wanting to live, wanting to express some inner feeling about wanting to remain a being.
There are many people who suffer, and, like many people, we have seen those around us suffer with cancer and go through different forms of treatment. Some people, through the action of doctors, take chemotherapy and are pushed to the limits of life to kill the unwanted cells, and then brought back to life through other drugs, it is hoped allowing just the life of the good cells and allowing the destructive cancer cells to be destroyed once and for all.
Through all those processes people go through highs and lows and go through different forms of suffering to be at a stage in their own lives where, perhaps, given the choice, they might choose to end their own lives. Perhaps, given the choice, relatives might think it best that those people no longer live.
RODNEY HIDE (ACT NZ) : We are hearing tonight Parliament at its best, because we have a very fine bill put up by Mr Peter Brown. Whether one is for it or against it, Mr Brown’s motives are honest and true. We have heard two very good speeches tonight against the bill. I want to speak in favour of Mr Brown’s bill, as a matter of principle and as a matter of personal experience. The principle is this. I believe that we, not the State, do own our own body and our life. I believe that if we choose to we can end our life. It is obviously the most drastic decision that a person can take, but one can do that. I believe that it is an affront to deny people who want to end their life the dignity of ending it in a way that is humane.
That is what our current law does. Of course we have to have a sharp line between suicide and murder, and this bill has that. That is why I support the bill. I ask members at least to send it to a select committee and hear what the people have to say.
I want to raise a memory of a man whom many members knew—Martin Hames, who died last year on 8 August. If Mr Brown’s bill had been the law, Martin Hames would still be with us, I am sure. He would not have needed to take his own life, as he did. He had Huntington’s disease. He discovered in 1979 that his mother had it. He did not marry, because he had a 50 percent chance of getting it, and he was diagnosed with Huntington’s disease. He had watched his mother die a terrible death—a death where one loses one’s mind and loses control, to the extent that one cannot swallow.
Martin Hames loved life. He loved independence. He could not stand the thought of ending without the ability to swallow. Last year he prepared everything. He swallowed a whole lot of pills and he passed out. He had bought new pyjamas, and he had a note pinned to his chest saying “Please do not resuscitate”. The ambulance came, and they resuscitated him. He came to in hospital, and they said to Martin Hames that he had septicaemia in his legs and they wanted to take them off. He said: “What would happen if you don’t take my legs off?”, and they said: “You will die.” He said: “Well, good, because I have Huntington’s disease.”
They gave him some pain relief and pushed him off to the side in Wellington Hospital, and he spent the day dying. I dreaded going to see Martin Hames and saying goodbye to a very special friend, but one of the greatest things I have ever done is seeing a man dying with dignity. He told me, when I went in there, and he told all his friends—from Treasury, from Michael Cullen’s office, people from across the political spectrum who had worked with him, and from the National Party—that he was having a good death. He used to call me “Boss”, and he said: “I’m having a good death, Boss, because I didn’t think I’d get the opportunity to say goodbye to all my friends.” He had that chance.
We all went in there and, rather than feeling sad, I felt great to see a man who could face his death with such generosity and love of life and friends, and who had been dealt a cruel hand but was not complaining. Martin slipped away that night.
He had written a great book called The Crisis in New Zealand Schools, and he was well on the way to having written a second book, on the Treaty of Waitangi , which would have benefited us all. But he never got to finish it. We do not know whether Martin could have lived for another 10 years, working and writing, because he had to take his own life before it was taken from him.
MIKE WARD (Green) : While I will largely speak in favour of the Death with Dignity Bill, I want to make it clear that the Greens do not have a party position. Views range from the strongly supportive, to the belief that it is inherently and ethically wrong to kill another human being, even for the alleviation of suffering as this bill proposes. Some believe that the prohibition on the intentional killing of another person is the cornerstone of our ethical, moral, and medical codes, as well as of our law and social relationships, and that it would be dangerous to weaken our prohibition on intentional killing, or weaken the fundamental moral, ethical, and legal values that underpin that prohibition. They believe that it would undermine our respect for the sanctity of life and blur the line between lawful and unlawful death.
While acknowledging that people yearn for a peaceful and easy death without prolonged suffering, and want to be able to decide on the manner of their death, they believe that those arguments are not sufficient reason to weaken society’s prohibition on intentional killing, especially when palliative care has advanced to the point where the vast majority of people do not need to suffer unbearably, and when patients can already decline lifesaving treatments if they wish. They point out that inquiries into voluntary euthanasia in the United Kingdom, Canada, New York, and Tasmania all reached the conclusion that it was not possible to frame adequate safeguards against non-voluntary euthanasia in law, and decided against voluntary euthanasia.
I share the belief that life is important, but it is interesting that we tolerate the debilitating effects on the quality of life of poverty, loneliness, and disability, yet should someone look like dying, we start to take care. We must ensure appropriate palliative care, but we should take all other possible steps to ensure that people want to go on living. But if, in spite of all our efforts, a person still wishes to die, the issue is whether that person should be able to choose to die. If we believe that there are any circumstances where that is a reasonable choice, we must make it possible for people to make the decision and carry out their wishes, supported by the medical profession and the people they care about. As the law stands, deciding to die, and involving anyone else in the process—that is, having someone else help a person to die, having friends and family around as that person dies, and having someone knowingly provide the means for a person to die—subjects helpers and witnesses to the likelihood of criminal action.
As the law stands, people are unlikely to seek the kind of counselling that might persuade them that they have other choices. They are unlikely to discuss their plans with family or friends, because of the legal and emotional trauma and the risks that involving others may pose. As the law stands, even if a person is able to take his or her own life, dying must be a lonely prospect. It is unlikely to be death with dignity. Families in these circumstances are deprived, perhaps, of the opportunity to make their farewells, and left with the thought that maybe there was something more they could have done or circumstances they could have avoided.
There are risks. Some of the risks exist now. As the law stands, people may choose to die, simply because their care is inadequate. Bringing the issue out into the open and discussing it is likely to draw attention to their needs and ensure that the pain is controlled, etc. If taking one’s own life becomes possible, will the elderly feel obliged not to become a burden on their families, and shuffle off before their time? I cannot deny that that is a concern, but it is not a new concern. It is an indictment on where we have come to as a society that our elderly should ever feel that they are a waste of space and a burden. If folk who feel like that and are contemplating ending their own lives have their motives subjected to the scrutiny that this bill provides and have their concerns allayed, that will have been a worthy outcome.
This bill is about voluntary euthanasia, and putting in place the independent safeguards necessary to protect both the dying and their families. I suspect that most people will continue to cling to life with all the tenacity that human beings have always exhibited, but perhaps it is time to acknowledge that life is a terminal condition, and time that we put as much attention, compassion, and energy into the quality of our dying as we do into keeping people alive long after they have ceased to value the quality of that living.
This is one of those issues on which it is appropriate to have a decision by referendum, but that does not negate the role of Parliament or the public through the select committee process to frame legislation that addresses the fears and concerns of the proponents, as well as the opponents, of voluntary euthanasia. How and when we die is an uncomfortable issue for most of us, but that should not undermine our compassion for those who have accepted their own mortality and who would choose to die with dignity in the presence of the people they care about.
GORDON COPELAND (United Future) : I rise to speak on the Death with Dignity Bill. I cannot say those words without my mind immediately going to the little nun from Albania who devoted her life to taking the dying from the filth and squalor of the streets of Calcutta into a specially prepared home where they were lovingly washed, clothed, and cared for until the last moment of their lives. As the news of her work spread throughout India and then throughout the world, Mother Teresa was asked repeatedly why she had made the decision to undertake such work. Her reply was simply that it was so that those people could die with the dignity that should be accorded to all human beings. Can any of us forget her passing, just a few weeks after the funeral of Princess Diana, when monarchs, presidents, and prime ministers came to a funeral organised by the world’s second-most populated nation to honour one of the great saints of our age.
I can say without fear of contradiction that if Mother Teresa were here tonight, it would be to plead with us not to vote for this bill; for, in spite of its title, the truth is that this bill does not point the way towards death with dignity, but to physician-assisted suicide. A similar plea would be made to us by the thousands of doctors, nurses, and helpers who make up the worldwide hospice movement. They, too, have devoted their lives to the palliative ongoing medical care of those whose conditions mean that they are approaching the end of their lives. I know that to be true, for I have received many letters from them, couched in the most moving terms, asking me to vote against this bill.
Indeed, this bill is a contradiction of all that they stand for. They tell me that they employ their expertise in ensuring that people are able to die with dignity. They tell me of the enormous progress they have made in controlling pain, and ask us to give our support to their attempts to kill the pain—not, by deliberate action, to kill the patient.
History will also be our judge tonight. Three and a half millennia have passed since this world received the gift of the Ten Commandments through the Jews. One of those commandments states, simply: “You shall not kill.” This bill breaks that commandment. Two and a half millennia have passed since the emergence of the Hippocratic oath, which specifically states: “I will use no medicine to kill my patients, even if requested to do so.” This bill breaks that oath.
The importance of the Hippocratic oath cannot be overstated. It was the gift of the Greeks to civilisation. It set the physician aside as a person whose sole vocation was to heal, and never to kill. Prior to that, what in those days were called witchdoctors had carried within them the power to heal and to dispatch, so that they were regarded with a mixture of awe and fear but never with trust. The Hippocratic oath changed all that, and it is fundamental to the trust and esteem in which we hold the medical profession today. That trust will be breached and lost for ever should this bill become law. People, and particularly the elderly, will once again begin to fear the doctor.
This bill is dressed up in attractive and emotional clothes. The reality, however, is set out in clause 4, which authorises a medical practitioner to “assist” a person to end his or her life by “the administration of a substance to the patient”—in other words, a lethal injection or similar.
The New Zealand Medical Association strongly opposes this bill. According to both Paul Rishworth, co-author of the book The New Zealand Bill of Rights, and to the Attorney-General, Margaret Wilson, this bill is contrary to the right not to be deprived of life, which is enshrined in the New Zealand Bill of Rights Act. On behalf of all those I have mentioned, and of the many other thousands of New Zealanders of like mind, I, too, now tonight enter my plea in this Parliament for members to vote against this bill.
GEORGINA BEYER (NZ Labour—Wairarapa) : It is with pride that I take a call on this member’s bill, which I intend to support going through to a select committee. From thereon I am torn, but I believe that this bill deserves the dignity of at least being debated. I believe that this country is ready to have this full debate, and for the bill to have the scrutiny of the select committee process to proceed, so that, maybe, once and for all, we could settle this matter in a fully discussed way—albeit I understand we could dispatch it from this House tonight, never to be seen again for many, many years.
I also acknowledge Peter Brown for his courage, commitment, and what I believe to be humane intent in bringing this bill forward toward the House. It takes a great deal of courage to deal with a matter as profound as this, and, considering we have recently had a conscience debate issue, I would have to say that between that matter and this one, this, of course, is the more profound at the end of the day. It is not often that anyone would like to be given the opportunity to decide whether he or she wishes—and excuse the expression if I offend anyone—to play God in these matters. I am sure they are matters that will be traversed if this bill is successful in going through to the select committee.
Knowing that there are many people on both sides of the argument who have much to say, I believe that the country is mature enough, in the social and moral advances it has made so far, to be given the respect to be able to join in this debate, rather than for the debate to be the personal preserve of those of us who sit in this House. For example, I am looking forward to hearing from the palliative care sector, and from the medical sector. I know they have a lot of stuff out there now, but I really want to hear more. I also look forward to hearing from those who are in full support of the bill already—right through to the conclusion of this bill being successful—who will promote it as a humane issue.
In conclusion, I add the very important point that Mr Brown made in his speech, which was that this is not euthanasia; this is voluntary euthanasia. I would like to think that, as a person who I believe is humanitarian in my approach to life, and who indeed believes in human rights, I might have the personal choice to make my own decision about those matters when the time comes. However, that may not be the case for everybody, and I have heard some very good points made already this evening in that regard. But we will not get to the bottom of this, really, until we have a full and open public debate.
Hon BRIAN DONNELLY (NZ First) : My mum and dad got engaged immediately prior to my dad going off to 5 years of active service in World War II. When he returned they got married, and over the years five little Donnellys came out. But at the wedding was a mate of my dad’s who had gone through the same years of service in the same arena of war as my dad had, and he became more or less like an uncle to us children. As a young child I can remember my mother telling us of the awful experiences he had had to encounter during the war. He told my mother of the nightmares he still had as a result of those experiences—ex-servicemen do not often talk to people other than ex-servicemen about those things. They were experiences of having his men, on more than one occasion, trapped under burning tanks, with no possibility of escape but facing an agonising last few hours—minutes, whatever it was to be—of life as they pleaded with him, their officer, basically, to shoot them. My dad’s friend had reacted to their pleas. He had shot his men. I can still remember reflecting on this story of the dilemma that had been faced by a man, who, as I say, had become like an uncle to us children. The question I asked myself then, and the question I ask myself now, is: did he do the right thing in shooting those men, his friends, under those circumstances? Every time I have come to the only possible conclusion: yes, he did.
I ask Bill English, who said we should just sit and watch those people suffering, whether he believes that my dad’s friend should have watched his men suffer all the way to their deaths. People may ask what that has to do with this bill. It has everything to do with this bill, because this bill is about people caught in exactly the same situation, with no hope of being saved, doomed to a torturous, agonising demise, and pleading for someone to bring the suffering to a close. People will say that a different morality prevailed during the war. I dispute that. Rules may change, but the moral principles do not. After all, war is a human construct, and to those who come to this issue with an absolutist, moralist viewpoint, I ask why would the Omnipotence—whatever that Omnipotence may be—presuppose a differential morality around a human construct, when, presumably, the Omnipotence existed before humanity.
I have a fundamental suspicion about absolute laws of morality, because it would seem that, when they are applied rigidly, around the fringes we inevitably end up with injustices. We have only to reflect on the hundreds of millions who have died over the centuries in wars over absolute commitment to religions that uphold the sanctity of human life. Because of my upbringing—and it was the same upbringing as that of Damien O’Connor and Bill English—I have a strong belief in the sanctity of human life. But I do not have that to such an absolute extreme that would condemn my father’s friend. I say that laws that force people to undergo horrendous suffering and indignity do not uphold the sanctity of human life. They are the very antithesis of that principle.
I had long been persuaded that the answer to the suffering of people with terminal illness was better palliative care. Upholding the sanctity of human life demands that we provide the best possible level of palliative care. I have little time for Michael Laws, but I can understand his bitterness towards those who voted against his bill and then did nothing to raise the level of palliative care in this country. In fact, many of them allowed the resourcing of palliative care to be diminished. No one who works in the area of palliative care, however, has been able to provide me with an assurance that even with the best treatment we are able to provide we can ensure that such care will catch all circumstances. There are still some who are doomed to an undignified, agonising death, and it is for those people that I will be voting for this bill to go to the select committee. If, through the select committee process, I can be convinced that palliative care can catch all, I will reconsider my position.
I commit myself at this point in time simply to vote for the bill to go through to the select committee. That is the right place for the issue about palliative care to be vigorously scrutinised in a balanced, public debate. It is also the place where the regulations to ensure that the law does not spread its intended coverage are robust and tight. We hear evidence from the Netherlands, and we want to make sure that that scenario will not be able to be repeated in New Zealand, if what we hear is true. I hope that I do not have to draw people’s attention to the fact that it will go to a binding referendum.
Dr LYNDA SCOTT (NZ National—Kaikoura) : I think that I, more than anybody else in this House, have had more experience with people when it comes to death and dying. As a nurse, as a doctor, and especially as a geriatrician who worked in the hospice movement, I dealt with death and dying every day of the week, and I cannot support this bill. There are people who are admitted to hospices who say: “I want to die.”, but what they are saying is: “I want the nausea to go away. I want the pain to go away.” When one treats them, they want to continue to live.
As a geriatrician I dealt every day with people who felt they were a burden to their family. I dealt with elder abuse, and I dealt with people who were slowly dying—and a slow death is never easy. But I remember when my own father died of cancer, and my favourite aunty. When I look back at the days I spent at my father’s bedside, I see them as being probably some of the best days. I spoke to my father probably more in the last 2 weeks of his life than I had in the 20 years before, and I value that immensely.
We must remember that this bill is about active euthanasia. This is about actively taking a person’s life. It is not about passive euthanasia. We heard about Martin Hames, who made the choice not to have treatment and die—that is passive euthanasia, and it happens every day in our hospitals and in our homes, when people say: “I do not want to be treated any more. I do not want the antibiotics. I do not want the operation. I want you to let me die.” That is passive euthanasia, and it happens. This is not passive euthanasia; this is active euthanasia. It is about actively taking a person’s life.
It is a doctor’s ethical responsibility to save life, not to take it. The Hippocratic oath reinforces that. To ask somebody else to take a life is a line we should not cross with regard to active euthanasia. Euthanasia is described in the dictionary as the act or practice of killing someone who has an incurable disease or injury, or assisting that person to die. How does one define “incurable illness”? How does one define an advance directive? Advance directives are very dangerous. When does somebody lose his or her mind? When is the actual day when somebody no longer recognises his or her family? I have dealt with people with dementia for years. One day they may recognise their family, and the next day they are not so good. When is the day one is going to kill them? That is an extremely hard decision. It is easy to think about this bill in terms that do not come down to the practical realities of what one is doing.
When Michael Laws first put up his bill in the 1990s I, like many people, thought: “Well, maybe there is justification in this.”, but when we look at the issues, and at what we are actually doing here, and at the line we are crossing, we see that the answer has to be emphatically no. Members have heard the arguments about the slippery slope, and they have validity. When it is acceptable for a doctor to take a life, one is crossing a line. When it is acceptable to say, “This person no longer knows who they are. This person left an advance directive. This elderly person has said to me that they want to die.”, one crosses a line.
Does the line of incurable illness include mental health? Does that include somebody who is severely depressed, but who can become well again with appropriate treatment? If it does, this bill should never go any further than this House tonight. One has to think about what it would be like to hold the hand of one’s mother or father and watch them being given a lethal injection, and think about how one would feel for the years ahead. The price is too high for this bill to proceed.
Hon MAURICE WILLIAMSON (NZ National—Pakuranga) : I think I am probably the longest serving of all the MPs here tonight, other than you, Mr Speaker, and I have been through a number of conscience votes. I have always been on the libertarian side, and I will be again tonight, by supporting this bill. But I have some questions that I want answered, which are to do with whether this legislation can be abused. If it can be, how do we tighten it to make sure that it cannot be, because my rights finish at the end of my nose, and do not go further into other people’s purview.
I think that the concept of somebody wanting to terminate his or her own life because of incurable agony, and the pain and suffering that is going to go on for a limited time before he or she finally dies, is a perfectly legitimate issue over which an individual should have a right to make a decision. But I think there are some issues about both overt and even covert pressures that may come on a person.
There are clearly the covert issues of elderly people, who are suffering and in pain, going towards the end of their lives and worrying about whether they are eating up the assets of their children, to whom they would like to leave some inheritance. Even though the kids may not be placing that pressure on them, it may finally get to them, and they might say: “Look, I know I could hang on for some time. I can bear the pain, and the morphine is keeping me OK, but I’m going to whittle away my kids’ inheritance to a point where it’s nothing, so I’m best to trundle off.” I would like to know that we can make sure that that process could not happen. I would also like to make sure that the overt pressure that can be put on somebody—with people saying things like, “Come on, it’s time you got out of here because you’re just suffering, and we would like to get the inheritance.”, or whatever—could not happen.
But, having said all that, I believe that this is a question about the principle of an individual’s right to choose. I have been involved with some family members who have been in excruciating pain, and who have had all the palliative care one could possibly offer. They have been doped to the eyeballs with morphine and other things, and still, only weeks from death, they have been just screaming out for it to be ended. Members should think about that, and think about it for themselves. I am happy to put my hand up right now for that right to choose if I were in that situation of excruciating pain, knowing there was an end coming. That is not what Dr Lynda Scott was talking about—she spoke about someone who might have a mental illness that could be cured—because that is not right. I agree with her on that. But people who are going to die—and a lot of those cases are very clearly identifiable—and who will last for only a certain amount of time, should have a right to say what they want.
So I will be voting for the first reading of this bill, and then spending quite a lot of time listening to the debate, as I think every member of this House should. This is bigger than any of the conscience votes that I have faced before—selling wine in supermarkets, homosexual law reform, or anything else. This is much bigger. This is something that goes right to the heart of what we, as humans, believe we really are, and what makes a society decent, or not. As long as I am convinced, through a fairly elongated process and then through a referendum, that there are the necessary protections and safeguards in the bill, and that we watch it carefully as it goes through, I will probably be persuaded to support it right to the end. I will not give that commitment yet; I will certainly listen to the debate.
One thing I want to raise with members of this Parliament tonight is the fact that this sort of stuff goes on now, and if members do not think that it does, they have to be living in cloud cuckoo land. If members talk quietly and privately to some medical practitioners, those practitioners will say that they have allowed people to just slip away, or even assisted that in a non-acknowledged, “nod, nod, wink, wink” way, because it was the time that the person, who was going through simply excruciating agony and pain, wanted to go. I would want to know that that option existed for every human being. I can tell members that my mum and dad, who are still alive and in their 80s, have said that that is what they would want if they ever got to a position where they were in shocking agony and pain—and what a ghastly decision it would be for an individual to make. What a shockingly ghastly decision that would be! But, if in the end the proper processes were there—with medical practitioners making the right interventions—and if we had put the necessary safeguards in place, there is one fundamental freedom that we should always protect for an individual. It is the right to make that final decision. I will be voting for this first reading.
PETER BROWN (Deputy Leader—NZ First) : I would like to start my reply by addressing a few of the queries. With regard to the query raised by Gordon Copeland about the New Zealand Bill of Rights Act, I have to say that the Ministry of Justice advised the Attorney-General that there may be some conflict with the New Zealand Bill of Rights Act in one aspect of the bill. The emphasis is on the word “may”. I sought a legal opinion, and I am told that that is not true. With lawyers, I am meeting the honourable member, Margaret Wilson, tomorrow afternoon to discuss it. I believe that my case is a good deal stronger than the Ministry of Justice’s case.
I respect what Maurice Williamson said—I thought he hit the nail right on the head. It is happening now, and there are some hard questions to be answered. I want them answered as well, and I hope the bill addresses those questions, but I respect the abilities of the select committee to address them in more thorough detail than I have done. I want to point out that if we do not pass this legislation, the people we are talking about will not just sit down and suffer in silence. Many of them might, but some of them will go out and commit suicide and die in a horrible, undignified manner. That will happen if they cannot get the friendly doctor who will help them out of their situation that the Hon Maurice Williamson referred to. It is happening now to some degree, and probably more than we actually think.
All the recent polls taken in this country show a high level of public support for this legislation, ranging from 62 percent to 82 percent. One poll conducted by Massey University showed 73 percent support for this sort of legislation. This is a controversial issue, a delicate issue, and a sensitive issue, but the public have a right to talk about it. In an hour and five minutes we cannot possibly condemn the public to silence. It will not go away. I ask members to please send the bill to select committee. Please let the folk we are talking about, and the people who are concerned for them, have their say. I am on the side of the suffering. I will leave it to others to say, “let them suffer.”
Sending this bill to the select committee is not binding on any member. Any member can change his or her mind later on. It is simply democracy in action—letting the public have a say about a controversial, delicate, sensitive issue. That is all the public wants at this stage, and I think that is a reasonable request. I urge all members to find compassion in their hearts—to the degree that they want to let the people that this bill will embrace talk to the select committee, make a submission, and discuss this issue publicly and openly. That is what I am asking at this point in time. I am not asking people to put a stake in the sand and say that they are with this bill for ever. I am—I believe that something has to be done for these folk. I have looked at the issue and wrestled with my conscience for quite some time, but I am asking members to think now of these people in a friendly and compassionate way, to allow them to come to the select committee and make their views, and the opposing views, known.
I want to conclude by saying to the Hon. Bill English that this bill is not about children, at all. It is only for adults. If the bill needs to be tightened up to say that, then so be it.
|Carter C||Hawkins||Peters J||Ward|
- Motion not agreed to.