Bioethicist: questions still on euthanasia Bill

Simon Walker
Simon Walker
Ethical tensions about how assisted dying relates to suicide prevention are not resolved by the End of Life Choice Bill, a University of Otago bioethicist says.

The Bill passed its second reading in Parliament on Wednesday, and it will now go to the committee of the whole House to be debated and have amendments proposed.

Simon Walker was involved in a University of Otago-organised citizens' jury on euthanasia last year, in which the 15 jurors selected from the Dunedin South and Maori electoral rolls failed to reach a verdict.

He said from an ethical standpoint he questioned how the category of "assisted dying" in the Bill related to suicide prevention.

"The End of Life Choice Bill, like any legislation of its kind, will create a legal distinction, but I am not confident that the Bill in its current form adequately reflects the intuitions most New Zealanders - even supporters of the Bill - have about this critical distinction."

In the Bill as it stood, two medical practitioners had to establish the person was eligible for assisted dying.

Eligibility was restricted to people with a terminal illness, which brought it more closely in line with people's intuitions - but uncertainties remained, he said.

Section 4 (e) of the Bill stipulated the person had to be experiencing "unbearable suffering that cannot be relieved in a manner that the person considers tolerable" to be eligible.

"Does it mean that the person is suffering unbearably now, or that they perceive a time in the future when they could be?" Dr Walker said.

When it came to meeting the "unbearable suffering" criterion it appeared the degree of suffering would also be assessed and reported by the individual sufferer.

While that approach might work for some people - for instance those confident in their ability to negotiate the health system and to make their own decisions - many were not in that position.

Elder abuse could be hard to detect, and suffering may be existential as well as physical - and unbearable due to a "troubling" social situation, not just physical illness.

In the Netherlands, doctor and patient had to agree there was also no treatment that could alleviate the patient's suffering - while in Canada, only the patient could decide as to whether there was any treatment worth trying.

"This [Bill] seems to follow the Canadian model.

"In my view, it may lead to the State sponsoring a person's death, where that person might have changed their mind had adequate care been provided."

The burden the Bill placed on doctors - making them the arbitrators of whether someone was eligible - was also asking a lot.

"Research from overseas shows that many doctors find the process of administering assisted dying very stressful - even those that support the practice."


 

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