Cardinal Vincent Nichols said he regrets Mr Welby's absence from the conversation after the Church of England leader announced he was quitting over failures in handling an abuse scandal.

Mr Welby had warned last month, as the assisted dying Bill was being officially introduced in Parliament, of a "slippery slope" in terms of who would be eligible for such a service if it was legalised.

On November 12, Mr Welby announced he would be standing down after an independent review concluded serial abuser John Smyth might have been brought to justice had the church leader formally reported him to police more than a decade ago.

Read More

The 26 bishops should "be on the side of those who … want a dignified, compassionate end to their lives", Lord Carey told the Guardian.

Carey, who retired as leader of the C of E in 2002 and still sits in the Lords, said he would back Kim Leadbeater's bill to legalise assisted dying "because it is necessary, compassionate and principled".

He said it was "ironic that I will represent the vast majority of Anglicans who favour change, and the bishops in the House of Lords will not."

Read More

His comments come as the Ministry of Health is conducting a mandated review of the End of Life Choice Act within three years of its implementation to assess its effectiveness and determine whether amendments are needed.

The current review will be finished by November.

Kleinsman was speaking on 1 News.

Changes needed

Kleinsman say the current legislation needs changing as it lacks:

• a formal assessment for coercion
• a requirement for an independent witness during the assessment phase
• adequate screening for depression and other mental health issues
• no cooling-off period after a request is made

He recognises that the case for assisted death is motivated by a desire to show mercy to those suffering.

While individual cases may appear justified without immediate harm, concerns arise about the cumulative impact of cases and shifting public perceptions, he says.

Kleinsman warns that the growth of habits and attitudes of mind gradually reshapes public perceptions of what is happening and what assisted dying means.

He points to several international examples that cause concern.

Countries like the Netherlands, Belgium, Luxembourg and Spain now permit assisted dying for mental illness, with several other countries also allowing it for minors, infants and individuals with dementia.

Then, in a related development, a 2023 Canadian poll revealed that 28 percent of respondents supported assisted dying for individuals experiencing homelessness, while 27 percent were in favour of those living in poverty.

The findings have fuelled further controversy as stories emerge in Canada of patients opting for assisted dying due to inadequate social support and healthcare rather than an autonomous choice driven by their medical condition.

"This shows us a glimpse into our own future if we loosen our eligibility criteria - the price could involve "severe unintended consequences" Kleinsman said.

He adds that we must continue to protect the integrity of palliative care and have AD-free spaces. Many people want this, and it's essential for upholding real choice.

He says that to replace the requirement for a terminally ill patient's life expectancy to be under six months with a clause like "grievous and irremediable suffering" would be wrong.

Forbidding doctors to raise the option of assisted dying with a patient must not change, he says.

Pro assisted dying changes

Social Justice NZ CEO Jackie Foster says she voted "no" at the referendum but has changed her mind.

Foster said, after losing her mother to cancer and having a close friend aged 51 die from a degenerative disease, it is often difficult for doctors to determine if people will die within six months, so she wants the removal of that time restriction.

She wants two changes to the legislation -

• the removal of the words "within 6 months" from section 5(1)(c)
• inserting a new sub-section 5(1)(g) into the Act that says "suffers from a degenerative disease that will ultimately end their life"

Foster believes that the first three years of this legislation have brought the country closer on the issue.

In 2020, 65 percent of voters said "yes" to the legislation but she believes that number would be higher today.

Source

• 1News

Health Minister Shane Reti (himself opposed to assisted dying) and the coalition partners are drawing up the review's terms of reference.

While Act Party leader David Seymour, who instigated the Assisted Dying laws, would like changes made to the eligibility criteria, he accepts nothing's likely to change any time soon.

The review itself won't change the law, he says.

That's because the review outcome is simply a report to Parliament. It will probably make some recommendations, but there was no requirement for the government to pick up the changes or Parliament to debate it.

It's more likely an MP will take the recommendations and put them into a member's bill which will need to be pulled from the ballot to be considered, Seymour explains.

Timeframe change needed

At present, assisted dying is available only to terminally ill adults with fewer than six months to live.

Seymour wants the "cruel" six month timeframe to be scrapped.

Auckland's Totara Hospice - the only one in the country offering assisted dying on its premises - would "at best like to see that timeframe removed, or extended to twelve months".

"The Act says suffering is defined by the patient so we don't see the need for a time requirement to be put on suffering" chief executive Tina McCafferty says.

The 'gag clause'

Seymour and McCafferty want the rules preventing doctors from discussing assisted dying to change. At the moment, patients must raise the question with their doctor.

McCafferty says that restriction is "at odds with the actual responsibilities of healthcare professionals ... to inform patients of all choices they can have in their care".

"Not everyone is articulate when it comes to health literacy, and I want to see that potential bias or inequity mitigated" she says.

Hospice NZ chief executive Wayne Naylor agrees. He also wants the clause clarified and provisions for family bereavement and grief support considered.

Law review does not equal law change

Seymour says the government is not obliged to take any action on the review recommendations nor is Parliament required to debate them. The review in itself won't change the law.

Furthermore, the coalition government had to "speak with one voice".

"I know there are people in the Cabinet who would say it would actually conflict with their conscience to have to support this legislation" he says.

Whatever changes are recommended, there are a couple of restrictions Seymour does not want altered.

One is that end-of-life choices are restricted to mentally competent people.

The other is that these people must be adults.

"For me, children have always been out, [and] people who have lost the capacity to decide for themselves are out" he says.

Source

• RNZ

Hundreds more explored the service but chose not to proceed, she says.

However, Young's conversations with 19 individuals who opted for euthanasia paint a picture of the inner turmoil and the weight of making such a final choice.

According to her research, many did not foresee the difficulty in setting the date and time for their own death.

Young describes the waiting period as a double-edged sword.

While it provided time to say goodbye, it also initiated a distressing countdown.

"Waiting for the day to arrive was an opportunity to prepare themselves and their families and friends for death but, for some, it felt like an unwelcome countdown - and choosing it was very tricky" says Young.

Young acknowledged that it is not an easy task for providers to euthanise people, and families of those who chose to die this way described it as a bittersweet experience.

"Families are both relieved that their loved one is no longer suffering, but also it's really hard to have this date hanging over your head of when you will die ... it's bittersweet.

"Before the assisted dying law came in there was so much discussion about how contentious this was and it is certainly a sensitive subject," she says.

"But the stigma from colleagues that assisted dying providers expected has largely not eventuated, which is great" says Dr Young.

Young says she has not encountered much stigma from people disagreeing with people's decision to be euthanised.

She says she recently started discussing euthanasia applications with cancer patients, their families and physicians and is describing the feedback as positive.

However despite the positive feedback, Young found that those being euthanised experienced gaps in the service.

"Patients who wanted counselling found that some of the professionals they spoke to were ill-equipped to discuss assisted dying" she says.

"Providers said they faced a steep learning curve in terms of navigating the eligibility assessment requirements and the Ministry of Health portal, and families said that there was a big gap in support after death for them."

• Counselling and Support

Source

• Stuff

The End of Life Choice Act came into effect late last year and, from then till March of this year, 66 people have had an assisted death.

Of the applicants, 79 percent are Pakeha, six percent are Maori, two percent are Asian and 13 percent did not describe their ethnicity. Read more

The Assisted Dying Service which came into force last November has just released its first annual report for the period from November to March.

By the end of June, 400 people had applied for an assisted death, 143 had died and 68 were deemed ineligible.

John Kleinsman, a bioethicist at The Nathaniel Centre, is particularly concerned that the Ministry of Health has six full-time positions dedicated to assisted dying - and there is no dedicated team for palliative care.

"There is an action plan for palliative care developed after a review in 2017 but many health practitioners working in the palliative care sector are not seeing any action," he says.

"Proponents of the End of Life Choice Act promoted its introduction as being all about choice, but it's a 'Clayton's choice' (no choice) if palliative care, which we know is effective, is not accessible."

Kleinsman says that end-of-life "choice" is heavily weighted in favour of assisted dying, because of the increasing demands on New Zealand's underfunded palliative care sector.

"Demand is projected to rise 50 per cent in the next 10-to-12 years and access is uneven depending on where you live," he says.

"It has been well documented that palliative care is grossly underfunded in Aotearoa.

"The idea that assisted dying will become a solution to a lack of quality end-of-life care is extremely distressing and frankly unethical and undermines the notion of it being a choice."

The Assisted Dying Service's report also notes many want the threshold for accessing euthanasia lowered - they complain the End of Life Choice Act is too restrictive.

"The legislation is not as enabling as some people were hoping for with the criteria making an assisted death more restrictive than overseas jurisdictions," the report says.

Kleinsman says this is precisely the pattern that has unfolded in other countries and something that many warned about.

He says he hopes the Ministry will collect a broader range of data on assisted dying, including people's reasons for choosing the service.

At present, statistics are collected on applications, numbers accepted for assisted dying and those who don't qualify or died before being able to make use of the Service.

Additional statistics could help safeguard against wrongful deaths by helping to identify whether people felt a "duty to die" because they were a burden on family or caregivers, he says.

The Assisted Dying Service's first annual report says patients and family members say they are happy with the Service, the support from doctors and the "peaceful" and "dignified" deaths of their loved ones.

Sources

• NZ Herald
• Supplied - Nathaniel Centre

The Premier, who is a devout Catholic, said the debate is 'very real and very personal' for him because of his recent experience.

"This time last week I was in the last place many of us would want to be. In a hospital, next to a bed, visiting a patient with a terminal illness. That patient is my grandmother," he began his speech on Friday morning.

"She's over 90 years old and now she's dying from pancreatic cancer. As I sat next to her, holding her hand, I could tell that she was in great pain and that she wanted it to be over."

Read More

The End of Life Choice Act means people enduring unbearable suffering from a terminal health condition and have a life expectancy of less than six months may now ask for medical help to end their lives.

Provided those preconditions are met, any person aged 18 and over may request voluntary euthanasia - a situation that will potentially impact thousands of New Zealanders.

Disability advocate Chris Ford has two big concerns. One is that the legislation isn't broadened to include vulnerable groups.

The other concerns keeping complete records and statistics of those choosing assisted dying.

As regards to the possibility of the legislation being broadened, Ford says this: it is vital it is not further extended to cover, for example, people with psychosocial disability/mental distress or children and young people under the age of 18.

Both of these extensions have happened in recent years in Belgium and the Netherlands, with people from both groups being helped to die, Ford says.

Those of us opposed to voluntary euthanasia should be on our guard in relation to changes to the legislation, he says.

He points out that some of the Act's key proponents have vowed to have the law amended at the first available opportunity - even before the Act's first mandated review is completed in five years' time.

His other concern is possibly unanswerable. "Will we ever truly know that each and every person who opts to take this path has done so of their own free will?" he wonders.

"I hope that the vast majority of people will have done so without coercion but my fear is that some (including a not disproportionate number of older and disabled people) will be at greater risk of manipulation by well-meaning (and perhaps not so well-meaning) family/whanau, friends, and other networks, meaning that effectively they will have had no choice in the matter."

Ford says this is why he will be looking at the early statistics of people who have chosen to end their lives to see whether any clear patterns emerge.

"I will be particularly interested to see the age, ethnicity and gender composition of the people who do so," he says.

Ford will be looking for data about their geographical locations and - most he says importantly for him - whether they self-identify as people who live with pre-existing disabilities/health conditions/impairments which they have had prior to contracting terminal illness.

"I hope the ministry will collate disability data around this too as they are often remiss in doing so when it comes to other health-related data," he says.

Based on overseas experience, the Ministry of Health estimates about 950 people will apply a year, with up to 350 following through with the option.

The Otago Daily Times reports "It is widely recognised that collecting information on all the whys and wherefores of the process will be important to ensure the Act works as it should."

Source

• Radio NZ
• Radio NZ
• Otago Daily Times
• Image: Otago Daily Times

The law kicked in on Sunday.

People requesting it will have to be 18 and over, in an advanced state of irreversible physical decline with unbearable suffering, and able to make an informed Read more

"The choice is distorted towards aid in dying and away from palliative care."

Gray - an associate professor with Otago University's Department of Primary Healthcare & General Practice says the new Act's funding mechanism focuses on the wrong things.

"Should funding euthanasia be a health priority for New Zealand's public health system especially when compared with palliative care?" he asks.

Gray says the funding mechanism for the new legislation provides "…funding for health practitioners to deliver assisted dying services is to support equity of access to assisted dying services for eligible persons."

The ‘health practitioners' in this case are medical doctors and nurse practitioners (as against registered nurses).

Research suggests assisted dying in this country will be predominantly taken up by a small number of mostly educated white people, Gray says.

There is no additional legal patient revenue stream available other than the resource provided under the Act.

Privately employed doctors and nurse practitioners can claim a gazetted government fee, but can't charge patients a co-payment. District health board-employed doctors and nurse practitioners can provide assisted dying services in this capacity but they can't claim this fee.

Gray also observes the funding objective means assisted dying is different from the vast majority of other services general practice and hospital specialist private practice provide. Unlike most of those services, assisted dying is fully funded by the Government.

In his view, the differences highlight two issues.

Firstly - why is ‘End of Life Choice' fully funded when most other services, particularly palliative care, are not?

Secondly, funding is critical for the Act's implementation. If the funding does not cover the cost of providing the services, very few can be expected to provide them.

To fully fund euthanasia while and not providing fully funded palliative care makes a mockery of the "End of Life Choice" Act's title, says Gray.

He says the ‘choice' between fully funded assisted dying and severely underfunded palliative care is "horribly distorted".

Responding to calls to increase euthanasia funding would be even worse in the absence of addressing the underfunding of palliative care, he says.

He observes there was nothing in the Assisted Dying referendum, or discussion beforehand, that addressed whether it should be fully funded.

This is likely to significantly limit the already limited numbers of general practitioners willing to provide aid in dying, he says.

If he's right in this, public hospitals will face demand for assisted dying when their services are already very stretched, Gray says.

He thinks the answer is for assisted dying to be partially-funded under the existing government capitation payments to general practice, with a patient co-payment to reflect the cost of providing the service.

Source

• Scoop
• Image:University of Otago
  

Chaplains, priests and other Catholic professionals are being given guidelines and pastoral help to work with people who decide to die under the End of Life Choice Act which takes effect on 7 November.

Called "Ministers of Consolation and Hope," the guidelines stress accompaniment with those choosing assisted dying. They describe the ministry of accompaniment as a commitment and a ministry of hope and support.

The guidelines also say spiritual accompaniment with someone contemplating euthanasia or assisted dying is "a partnership of good intent,". They call for ministers and caregivers to make available resources of care, prayer and the sacraments.

Accompaniment involves working with family members, known as whanau whakapono in Maori and tribal cultures.

"Whanau and other loved ones may hold varying views about assisted dying. Any division or tension within the family needs to be listened to and attended to with great sensitivity," the guidelines advise.

They also make it clear that accompaniment is "always voluntary and respectful of conscience.

"No priest, chaplain, pastoral worker, health care professional or caregiver should ever feel obliged to do or say something that goes against their own conscience. Any cooperation in the act of facilitating or administering an assisted death must be excluded in all cases."

He stresses that "The legal availability of euthanasia in New Zealand does not change Catholic convictions about the practice."

Though the Church opposes the deliberate taking of human life, it cannot turn away those who choose "assisted dying" under the new law, says Hamilton Bishop Stephen Lowe.

He notes that there is no place or situation, no matter how uncomfortable, where our faith cannot be expressed, or God's grace encountered.

"Life puts before us many questions and choices.

"As a Church we try to help people look at these questions and choices through a Christian lens. Individuals often find themselves in complex places. In these times the Church tries to offer guidance to people as best as she can, but people make their own choices.

"Often, as a Church, we find ourselves caring for people dealing with the consequences of such choices. Our pastoral practice is always called to be a reflection of our God, who does not abandon his people."

Lowe says "medically assisted dying" or euthanasia would not be offered in Catholic rest homes or hospices, just as many non-Catholic carers would not offer it.

"However, it will become available in a number of hospitals and other public care facilities throughout the country.

"These are the places of work or ministry for some of our Catholic community. We do not need to deny the objective wrong of euthanasia in order to accompany, with consolation and hope, those who might feel drawn or pushed towards this type of death."

The Church's Te Kupenga-Catholic Leadership Institute has been organising workshops on working with the law.

Source

• Crux
• New Zealand Catholic Bishops' Conference
• NZ Catholic
• Images: Catholic News Service

Described as being a social and economic conservative, Perrottet won a NSW Liberal party room ballot on Tuesday morning. He replaces Gladys Berejiklian and will be the New South Wales' 46th premier, the youngest in the state's history.

Perrottet's views on same-sex marriage, abortion and assisted dying match those of the Catholic Church.

He firmly opposes same-sex marriage, on the grounds that "marriage is about every child's fundamental right to grow up with their own mum and dad".

He voted against decriminalising abortion and once told supporters of abortion rights that they were on the "wrong side of history".

He is likely to vote against the voluntary assisted dying laws that will soon come before the NSW parliament, but says he will allow a conscience vote on any such issues.

"My view has always been in the Liberal Party that when we have certain moral debates in the parliament that they are dealt with, with respect and through a conscience vote, and that's important.

"It's important that we have a diversity of views; that's what makes our parliament great and allows our state to flourish. We should embrace diversity of views and values, not marginalise difference."

But in recent days, Perrottet's Catholicism has drawn ever louder and harsher criticism from media.

Critics say he is such a conservative Catholic - he has six children - that he should not lead the state; that his brand of Catholicism is one of "righteousness and self-righteousness around central questions of identity, sexuality, gender politics, minority rights and an unwavering conviction that this is the one true faith".

Those comments stack oddly against the figure Perrottet has cast for himself: as an advocate for freedom, who expresses his conservative values in public discourse and his voting record in parliament.

He has spoken about how his religious beliefs have had a fundamental influence on his work in politics, including framing his views on issues such as abortion.

"Faith is personal to me, as it is for millions of people across our state, and anybody should be able to put their hand up to serve in public life, and should not be disqualified, based on their faith or their heritage," he says.

He also says he's "very passionate about freedom.

"Freedom is the overarching value that I hold and that is that people of different religions, cultural backgrounds have a great place in our society."

"I certainly believe in diversity. I believe in tolerance. I believe in values of respect for all people. And people should be judged on their actions, not based on an attribute that someone thinks shouldn't have a place in public life."

"I believe in freedom, because it is only by exercising freedom that individuals can develop the habits of generosity, hard work, fairness and concern for others," he said.

"I believe that these habits have made our country great and are ultimately the foundation for the pursuit of the good life. You cannot do good without striving to be good."

Source

• The Australian
• News.com.au
• SBS News
• Image: News.com.au

That's one of a number of ethical and legal questions being asked by palliative care experts who say we are woefully unprepared to introduce assisted dying.

Senior nursing leaders are also concerned New Zealand won't be ready when the law takes effect on 7 November.

The nurses union said its request for legal advice had been ignored by the Ministry of Health and nurses fear they could face disciplinary action and be struck off if they go too far discussing euthanasia with a patient.

Palliative care professor Rod MacLeod said ending a life was not always a simple matter.

"I think the public has this idea that assisted dying is quite clear cut - you take the drugs and you're dead," MacLeod said.

"But death doesn't necessarily follow within minutes or even hours, it can take a lot longer and well-documented cases of stuff not working."

It was not yet known which drugs would be used for euthanasia in New Zealand and under the law it would be an offence punishable by a fine of up to $20,000 to reveal the method by which the drugs were administered to the patient.

"You assume that it's the same as the United States [which] uses for lethal injections for the death penalty," MacLeod said.

"We know that doesn't always work. It's not always that comfortable. It's not like flicking a switch."

University of Otago bioethics researcher and palliative care physician Dr Janine Winters presented an international literature review to the Ministry of Health in February.

It included a 2000 study from the Netherlands wherein 21 of 114 cases, the patient did not die as soon as expected or woke up and the physician had to give a lethal injection.

"When it's given orally the person can throw up or they can have a long period between swallowing the medication until death and that can go on for many hours."

Medical Council Chairman Dr Curtis Walker said the New Zealand law required that the doctor stay with the patient until they had died.

"What the Act envisages is that somebody doesn't get a cocktail of medicines and then the person disappears and they don't have that immediately available support."

But Dr Winters said there were other legal and ethical issues such as whether the patient would again have to give consent - something she believed the New Zealand law had not contemplated.

"It's one of a very long list of difficult and troubling issues that can be expected to occur that are going to need guidelines before provision begins," Winters said.

Minister of Health Andrew Little said he had not considered that issue before RNZ raised it.

"Failed administration of medication to achieve assisted dying - I haven't thought through and, look, the system will have to think that through," Little said.

He did not think medical practitioners would need to get legal consent again after an initial failed attempt.

"If you've given your consent, you've given your consent. Unless there's some sort of proximity of time between a failed administration of a lethal dose and an attempt to do so again I would have thought that consent is enduring, at least for for a short period of time."

Palliative specialist Dr Catherine D'Souza said that still left questions about how to handle a patient whose initial euthanasia attempt had failed.

"Say you get to the home and then you try to put in an IV line and you can't get an IV line in. Often when people are frail that's a very real issue. So what then? Do we transfer them to hospital?.

"Is that what they want? Do they want to die in a cubicle in hospital? That's probably not how they were imagining it. They were maybe thinking it'd be at home surrounded by family." Continue reading

• Guyon Espiner is an investigative reporter for RNZ

In their second year, almost 65 percent of medical students at Otago University supported euthanasia or assisted dying.

Support for the practice reduced during each year of training: by their third year it fell to 62.6 percent of students, 51.5 percent in their fourth year and 39.1 per cent in their fifth year.

"We suggest that this difference is most likely due to their time in medical education," the researchers say.

The structure of medical school was likely a factor, one of the research group, Simon Walker, says.

First and second year students see few patients and their views mirrored the results of the End of Life Choice referendum held last November: 65 per cent in favour of legalisation, 34 percent opposed.

By fifth year, however, the students see many patients and are "confronted… by the complexities" that can come up in end-of-life situations, Walker says.

Otago med students are taught palliative medicine and end-of-life care throughout most of their education.

They are also taught bioethics, although generally focusing on identifying issues and enabling students to think for themselves, Walker says.

Walker is a bioethicist and teaches some of these classes.

Professors, doctors and nurses with strong views on euthanasia probably make impressions on the students as well, he says.

In addition, he thinks the students are "working out how to survive in the profession and that requires a kind of conformity," he adds.

Ending a life was "contrary" to what med students were trying to become, Walker says.

"Their whole orientation is to try and make things better, and ending a person's life doesn't feel that way."

Surveys of working doctors have showed they oppose, by wide margins, what the New Zealand Medical Association calls "doctor-assisted suicide."

A 2018 survey of 298 working doctors, for example, found 34.5 percent would be willing to prescribe lethal medication. This percentage is similar to the fifth-year Otago student survey.

Research team member Luke Nie​ initiated the student survey in 2018, when he was a second-year medical student at Otago.

Now in his fifth year of training, he will survey his peers again this year to track changes.

He also plans to repeat deeper interviews with a small group.

Walker hopes the new survey will provide greater insights into how medical students are thinking through assisted death and the major factors affecting their positions.

He expects to see them raise ethical concerns and an awareness that assisting death was a "hard thing to do and a hard thing to be involved with."

The End of Life Choice Act comes into force in November, meaning these students will soon graduate into a New Zealand where assisted death is legal and sought.

A total of 326 of the 1152 Otago students answered the survey, or 28 percent.

The study was published in the peer-reviewed, open access journal, BMC Medical Education.

Source

• Stuff
• Image: Stuff

Gary and Trish Nichols of Edmonton are publicizing the case of Gary's brother, Alan, who died in 2019 at age 62 in Chilliwack General Hospital through a Medical Assistance in Dying (MAiD) procedure he had requested.

Gary Nichols said his brother suffered the effects of a brain injury sustained as a child and was depressed, mentally incompetent, and certainly did not face imminent death.

"My whole problem with (MAiD) is, like, the government opened the door and, of course, people and physicians just make it wider," he said in an interview.

Read More

The health centre's chief executive officer Karl Metzler has announced it will not be carrying out any end of life procedures.

Metzler says Gore Health's decision was made by its prescribing physicians. Not one of them support the bill.

"None of them got into medicine to end lives," he says.

Instead, the organisation will continue focusing on the good palliative care that it already provides, Metzler says.

"We like to think that that's what we're here to do."

Gore Health is run as a community trust rather than a Crown entity.

As a result, it is in the fortunate position of being able to refuse to offer the assisted dying service, Metzler says.

Gore Hospital offers a range of integrated services, including a 24/7 Emergency Department, Maternity Service, GP and Dental practices as well as the health centre.

Official referendum results for the End of Life Choice Bill released on Friday showed overwhelming support for the bill from the New Zealand public.

Nonetheless, there is still uneasiness about assisted dying among physicians, Metzler says.

The bill allows terminally ill patients over the age of 18, who have less than six months left to live, the right to ask their doctors to help them end their lives.

In the Southland electorate, 68.28 per cent of voters voted in favour of the bill.

Just over 63 percent of voters in the Invercargill electorate voted for the bill, and 65.5 percent of voters in the Taieri electorate were in favour of it.

Source

• Stuff
• Image: Stuff

Assisted dying will become legal from 6 November 2021.

The preliminary referendum result at last month's election shows 65.1 percent of voters supported the act and 33.8 percent opposed it.

The New Zealand Medical Association (NZMA) opposed the changed law. However, its chair Dr Kate Baddock says now the results were out, the NZMA says it will work with its doctors and with the public to improve understanding of the act and its implications.

Braddock says the NZMA aims to "ensure everybody understands what the act will entail and what people's obligations, responsibilities and options will be."

New Zealand doctors will be allowed to be conscientious objectors of euthanasia.

Braddock says one of the first steps will be to create a list showing which doctors want to be part of the process.

"Doctors will be making their choices well before the 12 months are up as to how they feel about being engaged - first of all in the process of decision-making and then the execution of the medication itself."

No-one knows what the next year will entail, she says.

"It's going to be really important as an organisation that we engage with our membership over what the provisions of the law mean. So as a doctor, what does it mean precisely in terms of your responsibilities and your options."

The Royal College of General Practitioners is neutral about the new End of Life Choice Act. Its president Dr Samantha Murton says the College will advise and support its members through the transition.

"There'll have to be training and learning about the legislation, how it works, what your requirements are, what you do if you think someone is under coercion, how do you access the services if you don't want to do it yourself."

A lot of planning around logistics will be needed, Murton says.

"There might be places where you don't have two doctors to be able to provide the services in a particular centre, there may be logistics around that."

"It's just making sure all the checks and balances are in place and that the system's very robust and people know how to access the services if they want it."

Given the work to do and the timeframe, implementing the law will need "extremely good management," Murton says.

It is anticipated many of those who choose to access euthanasia will be terminal cancer patients.

The Cancer Society is neutral on the issue.

"I would never want to see anyone presented with the false choice of either suffering or assisted dying, because that is not the choice that should be available to people. It should be excellent supportive care with all possible efforts to relieve suffering made in all cases, at all times," its medical director Chris Jackson says.

Source

• RNZ
• Image: New Zealand Parliament

In an interview on Magic Talk on Monday National Party Leader, Judith Collins, seemed to blur the line between managing pain and a deliberate choice for a person to end their life.

Asked how she reconciled her Christianity with support for decriminalising abortion and making euthanasia legal, Collins said "... I've seen my father with a whole dose of morphine put in him in the hospital that he was in. I tell you what, that was a lot better than watching my sister-in-law basically starve to death," Collins told Magic Talk.

However Palliative Care Speciality, Sinead Donnelly says there's a clear distinction between administering morphine for pain and deliberately terminating a life.

"Morphine is used legally and appropriately every day to relieve a patient's pain and shortness of breath, but not to terminate a life", Donnelly told CathNews.

Legitimising what we think has been the practice for many years is not what the End of Life Choice Act about, she says.

"This euthanasia Act will be legalising the use of agents like phenobarbitone and propofol at high doses to end people's lives.

"The use of these agents carries with them the intention of ending someone's life not the relief of their symptoms", she said.

Studies have shown that patients live longer when morphine is used appropriately and carefully to relieve pain.

Often families think that morphine led to the patient's death when actually the patient is actively dying, morphine is given to relieve their pain and the patient coincidentally dies, Donnelly says.

This is vastly different to a medical practitioner or nurse giving a patient high doses of phenobarbitone and propofol with the intention of ending their life, she says.

We do not need to vote for giving people Morphine to relieve their pain, it is already legal.

This vote is about something completely different, it has a different intent. This euthanasia referendum is about a deliberate act to end a person's life early.

In a recent discussion on NewTalkZB, Hospice NZ clinical director Rod Macleod and Wellington GP labelled the euthanasia Act poor law.

English said the law was "very weak", noting the absence of a requirement for a patient to consult their family or friends about their decision to request an assisted death.

Under this law an 18 year old could request to be euthanased, English said.

"And the first those parents might get to know about this is if they get a phone call or a death certificate coming to them. And that's something that no parent wants."

English and Macleod voiced concern that if the vote passed, New Zealand like other countries will broaden their laws, for example in Canada euthanasia could be made available to non-terminal patients.

Dr John Bonning, an emergency medicine specialist from Waikato Hospital defended the euthanasia Act.

"They're allowed to vote, they're allowed to go to war, they're allowed to make their own choices", Bonning said.

Sources

• Newshub
• 1 News
• NZ Herald

There have been the inevitable losses of parents, something for which, despite the inevitability, you're never quite prepared. And the sudden passing of those mates you thought you'd grow old with. Each of those deaths has been unique.

Some have been swift and merciful, others harrowing and haunting. There has been beauty and compassion to be found in all of them.

They have all brought something special to those intimately involved in the caring process.

I have come to realise it's not death I fear but the suffering that comes with it for so many.

For there has been suffering, suffering no amount of palliative care can allay.

In just under two months we will be asked, in a public referendum, to choose whether or not to support the End of Life Choice Act.

The Act will open the door to Euthanasia or medically assisted dying, for people in the final stages of a terminal illness.

If more than 50 per cent of us vote ‘Yes', then the Act will become law.

It's one of the most important and far-reaching legal decisions we will make in our lifetime.

Caralise Trayes's book, The Final Choice: Is assisted dying the answer? comes along at an opportune time.

Trayes is a journalist of 10 years experience, formerly at Fairfax Media.

Her style is chatty and generally straightforward. Her book consists of a brief history and summary of the Act and a series of interviews with those whose views cover both ends of the spectrum, with lawyers, advocates, palliative care specialists, those who have actively considered taking their own lives, and those who will be at the sharp end of implementing the law if and when it passes.

The right to end suffering is what David Seymour says his bill is all about.

Trayes's book voices concerns over whether the bill has been clearly thought through.

• Are there enough safeguards against coercion?
• Will euthanasia become normalised?
• Could it become economically expedient?
• What becomes of the mental health of those required to administer the fatal dose?

A number of overseas jurisdictions where euthanasia is legal - Canada, Belgium and the Netherlands among them - have reported an increase in requests for euthanasia as time goes on.

The Belgians and the Dutch have now extended their law to cover children and people with dementia and mental illness.

Before Covid, the Netherlands parliament was about to consider draft legislation that proposed anyone over 70 could have assisted dying irrespective of any medical necessity.

The proposed law is targeted towards people who are lonely, bereaved or "disattached."

What of the elderly and chronically disabled who may be feeling they are a burden to their families? Does the Act protect the vulnerable, the weak, the lonely? Will the "right" to die ultimately become "the duty" to die?

At the heart of the book is the question: why is it that people want to die? Continue reading