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End-of-Life Choice - VOLUNTARY EUTHANASIA SOCIETY OF NEW ZEALAND INC

Answers to eight assertions about legal euthanasia

“Euthanasia-Free NZ” has produced a pamphlet called ‘8 Dangers of Legal Euthanasia’ which is handed out at various meetings they run. End-of-Life Choice (Voluntary Euthanasia Society NZ) has responded to each assertion of ‘Euthanasia-Free NZ’. The assertions are in large type, followed by our response, with references where applicable.

1. Legal safeguards cannot protect the vulnerable from euthanasia abuses

Answer: the above is simply untrue. In fact, there are good international studies to confirm that the vulnerable are not targeted and are safe. Rates of assisted dying showed no evidence of heightened risk to the vulnerable compared with background populations.

P. Battin, A. van der Heide and L. Ganzini et al., “Legal Physician-Assisted Dying in Oregon and the Netherlands: Evidence Concerning the Impact on Patients in ‘Vulnerable’ Groups.” J Med Ethics 33 (2007): 591–97.

Assemblée Nationale Québec, Select Committee “Dying with Dignity Report,” March 2012.

2. Euthanasia and assisted suicide are the ultimate tools for elder abuse

Answer: there is absolutely no evidence to support this statement. In fact about 75% of the patients who have doctor assisted dying are less than 75 years of age. Patients have to be competent (understand what they are doing) when initially requesting assistance and they have to be assessed for that at that time. They also have to have terminal disease or unbearable irreversible suffering. They are also encouraged to seek usual treatments such as hospice and palliative care. In jurisdictions where voluntary euthanasia is allowed, the reporting is compulsory.

3. It sends a hypocritical message about suicide

Answer: the difference between medically assisting someone to die who is already dying, and suicide for irrational reasons, does not seem to be understood. A person who is depressed can almost always be treated and therefore does not qualify. If they are very depressed with disordered thinking they are not competent and therefore do not qualify. Loneliness is not a criterion for voluntary euthanasia. 

4. The killing escalates over time

Answer: it is accepted that there will be some increase in Voluntary Euthanasia as it becomes more accepted as a way of managing dying, just as for all new treatments. However, it is remarkable how low the numbers are. For instance, in the Netherlands the numbers are relatively steady and have never been above 3% of all deaths.

B. D. Onwuteaka-Philepsen, A. Brinkman-Stoppelenburg, C. Penning et al., “Trends in End-of-Life Practices Before and After the Enactment of the Euthanasia Law in the Netherlands from 1990–2010: a Repeated Cross-Sectional Survey,” The Lancet 380, no.9845 (2012): 908–15. 

5. Mistaken diagnosis of terminal illness is not uncommon

Answer: mistaken diagnosis at the stage where a person might request assistance to end their life is very rare. Almost always the action occurs in the last few weeks before death is likely and its approach is self-evident.

6. A dignified death is not guaranteed

Answer: with properly trained doctors and nurses the likelihood of complications can be reduced enormously. If the patient is helped by an injection, vomiting or fitting are both rare. When an intravenous injection is used, the drugs used are identical to those used in anaesthesia – we don’t stop anaesthesia because the occasional patient vomits during their use.

7. It compromises the hospice movement

Answer: this has been shown to be untrue and opponents of Voluntary Euthanasia now agree that palliative care and hospice care has increased and improved in jurisdictions where assistance to die is legal. It is important to realise that Voluntary Euthanasia should be seen as merely one ‘treatment’ in a complex journey through palliative and hospice care.

8. Trust in doctors & nurses falls

Answer: this is not true. Probably the opposite is true. In the Netherlands, for instance, 85% of the population support Voluntary Euthanasia. In 2008 a report showed that 88% of respondents in Belgium and 91% in the Netherlands trust their doctors – one of the highest rankings in Europe.

It is the view of those supporting Voluntary Euthanasia that patients are more likely to trust their doctors because they remain with, and work with them, to achieve a peaceful death instead of walking away and saying ‘I can’t help you’.

‘No more will die but fewer will suffer’

Frequently Asked Questions about Euthanasia

What is 'euthanasia'?

Answer: the term used in NZ is Voluntary Euthanasia (competent patients request help), which under the EOLC Bill would be available to patients with terminal illness, and also some patients who have irreversible illness causing unbearable suffering. If the disabled have one of those conditions they would qualify, but unless they have those criteria, the disabled would not qualify. In other words, to be disabled is no different than being fully able. The seriously ill would also have to meet the criteria.

What is physician-assisted suicide (PAS)?

Answer: we believe it is best to use other words than ‘suicide’. The term ‘medically assisted dying’ is more accurate. ‘Suicide’ in its normal sense and ‘medically assisted dying’ are quite different. One is irrational and hurtful to loved ones etc; the other is compassionate help on request under strict criteria and medical supervision in a person who is already dying or undergoing irreversible, unbearable suffering.

Isn't euthanasia already occurring in New Zealand hospitals?

Answer: this opens up very grey ethical and practical areas. Terminal or palliative sedation is where the symptoms of the dying patient are so bad that they have to be drugged to the point of unconsciousness. Usually, at this stage, fluids and food are stopped. Whether the doctor intends to hasten death or not, the result is the same – death is hastened. There is also the possibility of doctors and nurses and relatives giving extra drug to secretly hasten death because they want to help the patient out of their suffering. This is shown in a 2004 study where doctors and nurses in NZ admitted that they hastened death from time to time.

Also in intensive care situations many patients who are dependent on life support, have that removed when the treatment is considered futile and harmful, with a resulting predictable immediate death. If that had not happened, they would have survived longer – this is a form of euthanasia, usually not voluntary.

K. Mitchell and G. Owens, “End of Life Decision-Making in New Zealand General Practitioners: a National Survey,” NZMJ 117, no. 1196 (2004)

Should not the person have the right to request euthanasia if their life is unbearable?

Answer: Yes. During their life an individual has the option of undergoing treatments to prolong life and also has the legal right to refuse treatments, yet they cannot under NZ Law request medical assistance to die. The law produces the apparently irrational result that people can choose to die lingering deaths by refusing to eat, by refusing treatment to keep them alive, or by being disconnected from respirators and suffocating, but they cannot choose a quick, painless death that their doctors could easily provide.

Surely people should be able to control when and how they should die? It's a private matter after all.

Answer: we agree that no one can have complete autonomy and nor is it an absolute right e.g. driving on the correct side of the road. However, in the case of VE, the statement that hundreds of thousands of others lives are put at risk is untrue. The main risk is that without VE, many would have to endure meaningless suffering at the end of their life because of an ideology held by a minority of the population.

Pro-euthanasia advocates recommend euthanasia as the way to ensure one dies with dignity. What's wrong with that?

Answer: some argue that dignity is not guaranteed. However, at the end of their life when dying from a terminal illness, currently many patients have fits, vomiting, hallucinations, pain, breathlessness, psychological suffering, extreme indignities, and some spend their last days in and out of drug induced coma. They are very happy to risk a small complication of the medical assistance process. Waking up after oral administration is extremely rare but can occur. Waking up after an injection is almost unheard of. Loved ones uniformly attest to the dignity around assisted deaths.

DID YOU KNOW?

1. Voluntary Euthanasia (VE) has been legalised in the Netherlands, Belgium, Switzerland, Luxembourg, Quebec, USA States (Oregon, Washington State, Vermont). Britain, Australia, and other European States are very active in efforts to legalise VE.

2. The Horizon Poll conducted independently in NZ (2012) showed 63% and above for legalisation of Voluntary Euthanasia as described in the End-of-Life Choice Bill (Maryan Street Members Bill 2012). Only 12% were opposed.

3. Recent polls of people with religious affiliations in both Britain and Australia have shown over 70% support of legalisation of Voluntary Euthanasia. This includes Catholic adherents.

‘No more will die but fewer will suffer’

© End-Of-Life Choice • PO Box 48 241, Silverstream, Upper Hutt 5142 • Email: office@ves.org.nz




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