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

The modernisation seeks to fill a twenty-six-year gap and reflect some of the modern challenges.

Dr John Kleinsman, director of the NZ Catholic bishops' Nathaniel Centre for Bioethics, is delighted with the bishops' update.

Kleinsman describes the new document as a "succinct overview of eight key moral areas, including a new section on information technology and artificial intelligence."

Among the modern challenges the bishops consider

• Information technology and artificial intelligence
• Justice and correction systems
• War and peace
• Poverty
• Discrimination and abuse
• End-of-life issues
• Beginning of life issues
• Integrity of Creation

Kleinsman says that people generally know what the Chucrh teaches but are unsure of why.

Te Kahu o te Ora - A Consistent Ethic of Life summarises key points which can give people greater insights into Catholic thinking, comments Kleinsman.

"It is a great source for open and informed discussions", says Kleinsman who, as well as being a theologian, is a married man, father and grandfather.

The original Te Kahu o te Ora was inspired by Cardinal Joseph Bernardin's A Consistent Ethic of Life.

Bernardin's work grew from his observation that we must act consistently because all human life is sacred.

It was Bernadin's view that it was inconsistent to protect life in some situations but not in others.

In the years following Roe v. Wade, Bernardin argued that human life is always valuable and must be respected consistently from conception to natural death.

Being pro-life is not only about abortion or euthanasia.

Being pro-life must encompass war, poverty, access to health care, education and anything that threatens human life or human wellbeing, he argued.

Stephen Lowe, the Bishop of Auckland, the Apostolic Administrator of Hamilton and President of the NZ Catholic Bishops Conference, describes the update as "Opportune".

Lowe says human life and emerging challenges are interconnected.

"The essence of Te Kahu o te Ora is the interconnectedness of all life, from the womb to the Earth," he said.

Lowe says Pope Benedict put it well some years ago:

"There are so many kinds of desert. There is the desert of poverty, the desert of hunger and thirst, the desert of abandonment, of loneliness, of destroyed love. There is the desert of God's darkness, the emptiness of souls no longer aware of their dignity or the goal of human life. The external deserts in the world are growing, because the internal deserts have become so vast."

"While traditional human life issues continue to need our attention, we are now facing many new problems, all interlinked.

"The key message of Te Kahu o te Ora is that everything is connected, whether it is life in the womb or the life of the Earth," Lowe repeated.

Sources

• Supplied
• Catholic Sun

Firstly, though, I want to help you think about the concepts of justice, love, compassion, mercy and caring not merely on a spiritual or emotional or philosophical plane, but in a grounded way.

What do I mean by that?

Reality is defined by the challenges thrown up by our own weaknesses and the weaknesses of others, including the flawed institutions that we move in and out of and that sustain us.

Reality is also perhaps defined by our personal fears, both real and imagined, which limit our vision and can cause us to renege on our ‘yes' to what is good and life-giving.

Cultural and social context

A few facts about the social and cultural context in which we currently live that I believe are relevant to the introduction of assisted death in NZ?

• It's a context in which more than 10% and rising of our elders are experiencing abuse, including physical and emotional neglect, mostly from their own family members. This despite the tightest of laws against such abuse - WHY?
• It's a context in which more and more people, our elders in particular, are feeling socially isolated - WHY?
• It's a context in which depression is on the rise while our mental health services are under stress.
• It's a context in which people who are elderly, disabled and dependant are increasingly feeling like they are unwelcome and a burden.
• It's a context in which our health system is under increasing financial pressure to provide the care people need in a fair and equitable way.
• It's a context defined by severe institutionalised racism because Maori and Pacifica people die on average 7 years earlier than the rest of us and are 2.5 times more likely to die of diseases or illnesses than the rest of us.
• It's a context in which quality palliative care is not equally accessible?

We need to ask

What sort of social and cultural dynamic will be created were we to enact the End of Life Choice Act in this context?

In my view, there has never been a more dangerous time to legalise assisted death as at this particular time in our New Zealand history.

• What does it mean to care about others as much as ourselves in this context?
• Will providing assisted death address any of these issues in a caring ethical way?
• Will it resolve the inequity issues for Maori and Pacifica or worsen them?
• Will it address the social isolation of our elders or will it add to a sense of abandonment?
• Will it resolve the issues of increasing elder abuse or mask them? Will it address the inequitable access to palliative care or compound the current shortcomings?
• Will it really be "good care" to introduce assisted death in this context?

The questions I am posing are not questions about the rightness or wrongness per se of assisted suicide and/or euthanasia.

Actually, the question about the contextual implications - which is essentially a justice question - poses an even more important question for us as voters than whether assisted death is morally right or wrong.

This is precisely what the NZ Catholic Bishops are speaking about in their recently released Election Statement where they write:

"An informed decision requires consideration of the economic, social, whanaungatanga-kinship and cultural factors that limit many people's freedom to choose. Well-intended laws can have significant negative repercussions because of matters not anticipated by the law or because we don't all have access to the same choices.

"In coming to an informed decision, we advocate that voters embrace a perspective that gives priority to the impact a law change will have on others: ‘How will such a law affect us as a community? Who will be most negatively affected by the law in question? What are the consequences for those who are most vulnerable?"

Haves and have-nots

I am not saying that this law won't work for some, for example, the likes of Sir Michael Cullen, who has been a vocal, articulate and very public supporter of the Act.

Sir Michael is not one of the people I worry about in terms of being vulnerable when it comes to this law.

He already has choices, lots of choices.

He is articulate and well-connected.

He clearly has a good understanding of what is involved in the law. I do not have a fear that he will be coerced.

There are many others in the same position as him - able to talk about accessing the best of palliative care until they want to take control over the last few days.

For Sir Michael and others like him, legalising assisted death will provide another choice to add to the many choices for healthcare he already has.

Neither am I particularly concerned about myself being coerced into an assisted death.

I am also articulate and in a position where my saying ‘no' comes out of a place of having a family who will care for me whatever; comes from a place of knowing that I also have the choice to access quality palliative care so that I don't have to endure pain in the event I have a terminal illness.

Both Sir Michael and I, and may others are among those people capable of dying (or not dying) in a way that the Act allows … more than capable of making a truly free choice that is not the result of being bullied or coerced.

So, no, we don't have to deny that the law will work for some … but will it work for all and, in particular, will it work for the most vulnerable?

To draw again on the words of St Paul - it's about caring for others as much as, and not less than, we care for ourselves.

Taking on the same attitude of Christ Jesus is not to look at the Act from the perspective of the strong and articulate - those who have power and the luxury of choices - but rather to look at it from a perspective that considers the impact on the vulnerable - those who are disempowered and on the margins and who lack basic choices including access to good healthcare.

Not voting on law about assisted death

My experience is that most people know very little about the actual law.

My fear is that many, if not most, who decide to vote yes will decide to cast their vote based on their belief that some form of assisted death is a good idea - it's all about choice, right?

My fear is many, if not most without any reference to either the context in which we live or the robustness of the Act itself.

But we are not voting on the idea or concept of assisted death.

We are voting in this referendum on a particular law - a law that differs in critical ways from other laws overseas because it lacks many of the safeguards present in those laws; a law I regard as poorly drafted and weak.

1. There is no mandatory stand-down period in the End of Life Choice Act as there is in other countries. Under the proposed New Zealand law, a person could be dead less than 4 days after diagnosis. Hawaii has a 20-day stand down.
2. Unlike overseas laws, the EOLC Act does not require independent witnesses in the decision process.
3. A person does not need to be competent at the point when they make the final decision to die, unlike overseas laws.
4. The NZ Medical Association and the College of GPs have noted that there are no processes for effectively detecting pressure or coercion - a doctor simply has to ‘do their best'.
5. There is no screening for depression and no requirement to assess or provide mental health support?
6. There is no specific test for competency required. Rather, under the Act, the starting point for a doctor is that everyone is presumed to be competent unless it is obvious they are not - that is an extremely low threshold.
7. A person with a terminal illness does not need to be in pain to avail themselves of this law. It is not an act of last resort as many think. Up to 25,000 people will fall within the scope of this Act annually - in some ways, the structure of the Act makes it more akin to an ‘opt out' law rather than an ‘opt in'!
8. A person with a terminal illness does not need to try palliative care first!
9. The Act does not provide for a legal right to access palliative care - overseas, people are choosing assisted death because of a lack of other choices and it is well accepted that palliative care is not yet universally accessible in New Zealand.
10. It will not protect our elders who are being abused, mostly by their own families, from a premature death. Elder abuse affects 10% of our elders and continues to rise.
11. Neither of the two doctors need to know or have met a patient previously.
12. Neither of the doctors has to be a specialist in the area of your life-limiting illness as is the case overseas or be a specialist in palliative care.
13. All eligible persons, 18 years plus, can end their life without telling a family member or significant other.

Do we want a law at any cost?

It's important to know that, if it passes, the Law will be enacted in its current form - it cannot be changed.

My own conclusion, and that of almost 200 lawyers who have signed up to a website called Lawyers for Vulnerable New Zealanders, is that the End of Life Choice Act is, from a legal and public policy perspective, poorly drafted and lacking in key safeguards found in other laws overseas.

And some of these lawyers support the concept of assisted death!

Good public policy does not provide choice for some - the privileged - at the cost of caring for and protecting the most vulnerable.

In contrast, having the same attitude of Christ means taking a preferential option for the disempowered and vulnerable.

• It's not ‘compassion' to vote for a dangerous law.
• It's not mercy to vote for a dangerous law.
• It's not caring to vote for a dangerous law.
• It's not justice to vote for a dangerous law.

Even those who favour assisted death in some circumstances have many good reasons to vote no to this Act.

• Dr John Kleinsman is Director of The Nathaniel Centre and bioethics researcher.

Ottley leads psychological pain management services at Southern Rehab.

He outlined his views in a submission to the Health Select Committee inquiry into euthanasia legislation.

Confusion of Terminology

The director of The Nathaniel Centre Dr John Kleinsman said that there seemed to be considerable confusion in the terminology and arguments Ottley puts forward.

"In the first instance it is a classic example of using hard cases to justify a law change.

"As any lawyer will tell you, ‘Hard cases make bad law'."

Secondly, he seems to be confusing ‘incurable pain' and ‘psychological suffering'."

Extremely rare for people to die in pain

Kleinsman said he has discussed the question of pain management with many skilled palliative physicians who repeatedly tell him that palliative medicine has now developed to the point where it is extremely rare for people to die in pain.

"In those rare instances where pain is difficult to control there is always the option of using palliative sedation."

"The ability of palliative medicine to address physical pain is well understood now by most proponents of euthanasia and assisted suicide - they readily accept that the issue is about suffering and the desire to exercise control rather than about physical pain," says Kleinsman."

"One only needs to look at the government statistics from places like Oregon and Washington State to realise that the people requesting assisted suicide do so for reasons other than physical pain."

Psychological suffering can be effectively dealt with

Kleinsman says the major reasons people give relate to things like fear of becoming a burden, loss of dignity, loss of autonomy, feelings of worthlessness, social isolation and various forms of psychological suffering - issues that relate to psychological and social concerns.

He says this suffering can also be effectively dealt with, and without advocating a regime that institutionalises premature death as a socially desirable and even dutiful thing to do.

Changing the law send out the wrong message

"Changing the law to allow euthanasia and/or assisted suicide will send a message to our society that killing one-self or being killed by another is an acceptable way of dealing with suffering," says Kleinsman.

"Firstly it will undermine our efforts to prevent suicide in vulnerable groups such as young persons and the elderly."

"Secondly, it will actually make it harder to help people who are trying to come to terms with an advanced progressive illness or disability."

Kleinsman point to countries like Belgium and the Netherlands where the same sort of argument based on the hard cases were advanced when they first discussed a law change.

"We only need to look at how widely available euthanasia is in those countries to know that it does not stop at the hard cases."

"Their laws have been continually expanded to include many categories of people who are not dying, including now a push for anyone over 70 to be eligible without any specific reason."

"It is not about where we start with respect to any law around assisted suicide and euthanasia but where it will take us and where we will end up."

Source

• Supplied
• stuff.co.nz
• Image: www.newswire.co.nz

In a statement released through the New Zealand Catholic Bishops Conference, Cardinal John Dew, Bishop Charles Drennan, Dr John Kleinsman and Sharon Cole spoke on Amoris Laetitia (The Joy of Love).

They noted the merciful and pastoral emphasis of the document.

Amoris Laetitia signals the Pope's vision for the Church as a family of families and reaffirms the welfare of the family as decisive for the future of every community and society.

Cardinal John Dew said "I haven't yet studied the document fully, but already I get the sense that what Pope Francis is saying is coming out of a real and very grounded understanding of the difficulties that face families and that the wider Church family is the place where people should find support and accompaniment through these times."

The cardinal noted that Pope Francis took particular care in talking about those who are divorced and in new unions.

There is a need for careful discernment of situations and avoidance of judgment that does not take into account complexities and differing degrees of responsibility.

"The emphasis is on showing love and tenderness and working to integrate all people into the Church community no matter what their situation," Cardinal Dew said.

Among Bishop Drennan's comments were: "Francis says that our theological and pastoral language must reach the hearts of young people in such a way that they take up the adventure of marriage."

The bishop said the Pope stresses that marriage is a treasure for everyone in society, and marriage should be valued publicly as a unique relationship.

Dr John Kleinsman, Director of the Catholic Bioethics Agency, The Nathaniel Centre, is heartened by the "idea that it's not enough to simply stress doctrinal, bioethical and moral issues without knowing the actual situation of families and without encouraging openness to grace".

He is also heartened by the Pope's criticism of excessive idealisation in some of the teaching about marriage, rendering it less attractive.

Sharron Cole noted that Pope Francis emphasised that openness to children lies at the heart of authentic conjugal love and decisions about regulating birth must always respect the dignity of the person.

She also mentioned couples' priorities and the Church's role in allowing couples to form their own consciences.

Sources

• NZCBC
• Amoris Laetitia
• Vatican Radio (summary)
• Image: Church Militant

"The legalisation of voluntary euthanasia and assisted suicide is not merely a matter of individual choice and should not be based on high-profile individual tragic cases, such as the Lecretia Seales case which has been reported widely in the media," he said.

Kleinsman is the director of NZ Catholic Bishops Bioethics Nathaniel Centre.

He and Waipuna Hospice chief executive Dr Richard Thurlow were speaking to more than a 100 people gathered at the Central Baptist Church in Tauranga on Sunday.

Kleinsman said once the door had been opened it would be impossible to prevent abuses, no matter how many safeguards were written into a law change, and there were already examples in the Netherlands and Belgium which New Zealand needed to heed.

Dr Thurlow said while Ms Seales' case was "very sad and hard", any move to legalise physician-assisted suicide and voluntary euthanasia would be "detrimental to society".

Source

• Bay of Plenty Times
• Image: 1.bp.blogspot.com

In a blog post on the New Zealand Catholic Bishops Conference website, Bishop Drennan said there is a "marked air of openness" at the synod and no topics are off limits.

"Better put, the range of views on the same topics are far fetching and, understandably, this has already led to some impassioned interventions of quite differing positions," he wrote.

"For some, openness invites fear; for others it incites new possibilities.

"And already there is talk of factions, but I think it is fairer to say that already vast differences in pastoral circumstances, preoccupations, and needs are evident.

"All of that though against a backdrop of globalisation," he added.

Speaking to media on Wednesday, Archbishop Charles Chaput of Philadelphia said bishops at the synod are dividing amongst themselves to form lobbying groups in favour of various positions.

But this wasn't unusual at a Church gathering, Archbishop Chaput said.

"We shouldn't be scandalised or surprised by that, as long as it's done open and honestly and not in a way that tries to win than to arrive at the truth."

"We're not here to win anything, we're here to arrive at the truth that the Lord, through his Holy Spirit, is guiding the Church towards," he said.

Dr John Kleinsman from New Zealand, who is at the synod as an auditor, wrote that he had been amazed at the breadth of the interventions so far.

"For many of the countries represented, the issues affecting the family centre on the basic struggle to survive" Dr Kleinsman wrote.

Cardinal John Dew wrote about an intervention that had identified the family as the first place where the "dance of grace" is discovered.

Sources

• NZCBC
• National Catholic Reporter
• NZCBC
• NZCBC
• Image: Catholic Herald

NewstalkZB reports that the church describes the selection of 4 New Zealanders as a significant number for a small country, especially one with a small Catholic population.

The Archbishop of Wellington, Cardinal John Dew, and Palmerston North's Bishop Charles Drennan will be voting members.

The chair of Parents Centres New Zealand, Sharron Cole, and bioethics expert, Dr John Kleinsman, will be attending as non voting members.

Cardinal Soane Patita Mafi, Bishop of Tonga, and the Archbishop of Suva, Peter Loy Chong will be representing the Pacific Island nations.

The bishop of Kundiawa, Anton Bal, is representing Papua New Guinea and the Solomon Islands.

Drennan and Loy Chong and Kundiawa have been elected by their respective Bishops' Conferences as their representatives.

Cardinals Dew and Mafi are have been appointed by the Pope.

Cole, a mother of four adult children, says she is keen to offer her experience as an everyday Catholic woman and New Zealander.

"I'm not a theologian and there are lots of women who have that experience," she said.

"I see my role as bringing a pastoral perspective to what effect church teaching has on people in their everyday life."

John Kleinsman is director of the Nathaniel Centre, the New Zealand Catholic Bioethics Centre.

Communications advisor to New Zealand Catholic Bishops Simone Olsen said it was important for isolated geographic regions like New Zealand to be represented.

"I think in this case he has done that by including countries like Tonga and other Pacific nations that are not traditionally Catholic," Olsen said.

More than 360 participants, including 18 married couples from around the world are expected to attend October's Synod of Bishops on the family.

In addition to the 166 synod members elected by their national bishops' conferences, 22 heads of Eastern Catholic churches, 25 heads of Vatican congregations and councils and 10 heads of men's religious orders, the pope appointed an additional 45 synod fathers to take part in the Oct. 4-25 gathering.

Source

• nzherald.co.nz
• newstalkzb.co.nz
• Image: parentscentre.org.nz maristmessenger.co.nz

Maynard, a terminally ill 29 year old American ended her life last week home in Oregon, using drugs supplied legally to her under the state's Death with Dignity Act.

She worked as a volunteer advocate for the nation's leading end-of-life choice organisation, Compassion and Choices.

In the weeks leading up to her death, Maynard succeeded sparking a national discussion in the United States on "death with dignity."

A video explaining her choice garnered more than 8.8 million views on YouTube.

Kleinsman is sympathetic to individuals such as Brittany Maynard, but says he knows some young people in similar circumstances who don't want to end their lives.

"She offered herself up to be a poster girl for euthanasia. There would be immense pressure for a person in her position if she wanted to change her mind."

He says many people consider the argument as a question of choice, but it is not that simple.

He says legalising euthanasia "will actually take the choice of dying away and make people feel pressured into 'doing the right thing'."

He believes palliative care has improved so much that people don't need to die in pain.

Monsignor Ignacio Carrasco de Paula, one of the Catholic church's leaders on bioethical issues and head of the Pontifical Academy for Life, called the decision to end one's life undignified, the Associated Press reports. "Brittany Maynard's act is in itself reprehensible," he told the ANSA news agency. "What happened in the consciousness we do not know."

de Paula stressed that he did not mean to pass judgement against Maynard herself, but rather took issue with Maynard's argument that people faced with devastating, terminal medical conditions should have the freedom to end their lives at a time of their choosing. "The gesture in and of itself should be condemned," Carrasco de Paula said.

In New Zealand Right to Life has expressed disappointment that Labour MP, Iain Lees-Galloway, has announced that he is preparing to resubmit to the ballot a private member's bill, "End of Life Choice bill"

The bill was initially proposed, but later withdrawn, by fellow Labour MP Maryan Street before the last election.

She said she was withdrawing it because she feared it would become a political football.

Street, a list MP, had intended to reintroduce the bill after the election but she she did not retain her seat.

Source

• Stuff.co.nz
• CNN
• CNN
• Time Magazine
• Time Magazine
• 3News.co.nz
• Right to Life
• Image: Screen Shot CNN

He was speaking to close to 140 people at a public meeting in New Plymouth last week.

Kleinsman said his opposition to euthanasia was based on social concerns that its introduction, when coupled with increasing rates of depression and elder abuse, could see the elderly pressured to take their own life to avoid feeling like a burden and a cost.

"We have to be cognisant that elder abuse in the western world is one of the fastest growing problems we have."

"It's going to put pressure on people who are sick, people who are disabled. It's going to put pressure on people to justify why they are still alive," he said.

A Taranaki branch of the Voluntary Euthanasia Society New Zealand has been founded since the End of Life Choice Bill was introduced into the ballot box in Parliament last year.

People from the North Taranaki Catholic Parishes and Anglican churches united to organise the public meeting, against the bill.

Speaking prior to the meeting, New Plymouth general practitioner Dr Ian Smiley said, "Although the idea for the meeting has come from within the churches we are very keen that the meeting, looking at the implications of legalising euthanasia, should not be seen as a religious issue, but one that the community as a whole need to openly discuss and consider."

Source

• Stuff.co.nz
• Stuff.co.nz
• Image: 3.bp.blogspot.com

If euthanasia is legalised the right to die will all too easily become a duty to die.

The crux of this debate is whether what a suicidal person proposes - to kill themselves - is a goal which should be shared and facilitated by the state, the medical profession and family members. Continue reading

The reason Street gave for her decision on Thursday to withdraw was that there would probably be only two more days this year in which members' bills would be considered by the House and "Anything that is drawn, including the ones drawn today, will be debated in election year, and I don't want my bill debated in election year," she said.

"I'm concerned that it would not get the treatment it deserves. It needs sober, considered reflection, and that's not a hallmark of election years in my experience."

Kleinsman says, "The current law provides the best possible protection for people. We have always had grave concerns about the consequences of state-sanctioned killing of persons as well as moves to promote easier access to suicide as a way of dealing with suffering. We will continue to highlight the dangers and negative social consequences that would flow from legalising assisted suicide or euthanasia.

"While the Bill has been withdrawn for now, we know the debate will continue. Ironically, Street's decision coincides with reports in the media of a high-level review into suicide prevention amongst those with addictions and mental health issues. Why would we want to make suicide easier to access when, at the same time, we recognise it as a major social tragedy?"

"Ultimately, the law change being proposed in Ms Street's End of Life Choice Bill would have eroded the choices of many and would not have lead to good robust decisions or better end of life care. We remain committed to advocating for equitable access to quality palliative care, disability support, and mental health services for people and their families," he said.

Source

• Stuff.co.mz
• New Zealand Catholic Bishops' Conference
• Image: inthehouse.co.nz

The committee is the first of a two stage approach to talking with stakeholders about the issues. In this first stage they have presented arguments about six key issues where there is potential for a significant clash between New Zealand requirements and those elsewhere:

• altruistic donation v. commercial supply
• right to access identifying information about donors v. no right to access identifying information about donors
• family size requirements
• use of sex selection
• scope of informed consent
• use of gametes and embryos overseas in procedures or research prohibited or precluded in New Zealand.

Among the submissions are the minutes of a meeting held between Dr John Angus, the Chair of Acart, and John Kleinsman, the director of the Nathaniel Centre, the New Zealand Catholic Bioethics Centre.

ACART has been established under the Human Assisted Reproductive Technology (HART) Act 2004. As an independent advisory committee, ACART sits between the government and the people of New Zealand and formulates advice and guidelines for the regulation of assisted human reproduction. ACART is required to undertake extensive public consultation before issuing advice or finalising guidelines.

Source

• Acart
• Image: Blog.babycentre.com

In a study carried out by Auckland University researchers interviewed 11 healthy men and women aged between 69 and 89 asking why they supported voluntary euthanasia.

Reasons included not wanting to be a burden on their families and healthcare resources and fears of losing their independence and dignity.

"If you couldn't do your basic care, couldn't wash yourself or go to the loo by yourself, I don't want to go on after that," an 86-year-old woman said.

Kleinsman said he was familiar with the New Zealand study and that it was consistent with findings overseas. The 2011 statistics from Oregon, where physician-assisted suicide is legal, show that 42% cited being a burden as a reason for wanting to die, up from 35% the previous year. We have to carefully consider the sort of message the legalising of euthanasia would give to those who are elderly, ill or disabled and the message it would send to the rest of society about a person's worth.

Kleinsman says other studies have shown that persistent requests for euthanasia are also driven by a sense of social isolation and a desire for control. This explodes the myth that the push for euthanasia is about the relief of people's physical pain. It is, in fact, influenced by various social and cultural drivers, including the increasing fragmentation of families and a growing sense of alienation felt by many elderly and sick people.

"In a society in which euthanasia was legalised these social and cultural drivers would create a new form of coercion that cannot be safeguarded against by any kind of legislation. If people who have an illness or have become increasingly dependent are citing a sense of feeling a burden as a reason for euthanasia then this is not ‘free choice'. It is also noteworthy that all participants in the study were European. Other cultures, including Maori and Pasifika, have a very different attitude to the care of persons at the end of life. They are able to show us a different way."

"Then there is also the issue of elder abuse and the fact that a law change would open up new pathways for abuse of those most vulnerable. We know from overseas experience that no law can prevent such abuses. For example, a recent Belgian study found that 32% of all euthanasia deaths in the Flanders region were without request or consent. The debate about euthanasia is actually a test of our commitment to those most vulnerable, says Mr Kleinsman. The introduction of state-sanctioned killing is not the way to go."

Source

• The Nathaniel centre
• Image: Local List.co.nz

His comments were made in response to MP Maryan Street's End of Life Choice Bill being put into the Ballot.

Ms Street has publicly admitted her Bill, like any other law, would be open to abuse and that no law can effectively prevent abuses. "The key question we must all think about is whether such a law can be safely implemented. There is ample evidence abroad to suggest that it cannot be. The current law is the most effective protection we have against such abuse," says Mr Kleinsman.

"It is the role of lawmakers in a democratic society to ensure that the interests of the majority are not prejudiced by choices granted to a few."

"The irony is that such a Bill, while being promoted as extending choices at the end of life, would take away the choice and right of many people to live. It is not just a matter of leaving a space in our society for those who are sick, disabled and frail - they need to know they are welcomed and valued. If euthanasia is legalised many people will come to question their existence - seeing themselves as a burden and a drain. Indeed, the desire to continue living may come to be seen as a ‘selfish' decision."

"We would be asking those most vulnerable to justify their existence. This is not free choice but a subtle and powerful form of coercion. The right to die will too easily become a duty to die."

Mr Kleinsman also challenged the idea that the debate is about alleviating pain.

"Today more than at any other time in our history, with all of the medical advances in treatment, medication and knowledge there is no justification for such dangerous legislation on the basis of pain relief. Ms Street's comments on the Bill show her clear intention is that the so-called right to die be available not just for those with terminal illness with limited time to live but also for those with other irrecoverable conditions. This takes us into very subjective and dangerous territory. Where will it stop? This is another reason that New Zealanders must question the need for this legislation."

The Bill and its contents have now been made public and the Nathaniel Centre will be looking more closely at the proposals in due course.

Source

• NZCBC
• Image: TehranTimes

Pullicino was reported as saying doctors had turned the use of the Liverpool Care Pathway into the equivalent of euthanasia of the elderly. The Liverpool Care Pathway, which was created at the Marie Curie Hospice in Liverpool in the 1990s, is used in New Zealand with Ministry of Health funding.

"It is alarmist to say that patients ‘are being killed' by The Liverpool Care Pathway (LCP). It is incorrect to say, as reported, that it brings about the death of patients in the sense of causing their death. For persons who are dying the LCP is designed to provide caregivers with a set of standards that define quality care," Kleinsman said.

"It arose out of the hospice care system and has been developed as a way of ensuring excellence in, and consistency of, care. The overwhelming majority of people are able to experience better care at the end of life than they would have previously. It provides a mechanism for accountability and a means to standardise care across the country."

"It is a mistake to equate the introduction of LCP with euthanasia. Of course, like any tool, it is only as good as those who are using it. We do need to maintain vigilance to make sure that patients are receiving the level of care that accords with their human dignity," said Kleinsman.

Source

• The Nathaniel Centre
• Image: Bedfordnow.co.uk

"Dictate what you like to your own flock, stay the hell out of the affairs of people who want nothing to do with your beliefs."

The point being made by these commentators is that religion should have nothing to do with the debate about euthanasia.

While I think Christians have as much right to express their views as any other New Zealander, I am, in all honesty, not interested in imposing my religious views on anyone. Actually, with respect to euthanasia, my own personal view is irrelevant.

But so, I would argue, is every other personal view. Whether or not people are personally in favour of, or opposed to euthanasia, is ultimately beside the point. To ask this question, as a recent Sunday Star-Times' poll did, is to ask the wrong question. The crucial question is whether euthanasia can be safely implemented in the current context. Maryan Street, MP, glibly asserts that it can, while ignoring overseas evidence that says otherwise. I and many other New Zealanders of no religious persuasion believe differently. Our argument centres on safety and protection of those who are vulnerable. As another commentator puts it: "No-one's trying to force their religion down your throat so take a deep breath, try and consider the argument in a rational manner."

That the dangers of euthanasia are real is readily acknowledged by those wanting to legalise it. It explains why a lot of emphasis is placed on building in so-called safeguards. It has also been admitted by Maryan Street, in a public debate, that no amount of safeguards can stop the law being abused. So the argument about dangers cannot be dismissed as the rantings of "meddling god-botherers".

Sources

• John Kleinsman in The Sunday Star Times
• Image: ProLife NZ

The Sunday Star-Times reader poll of more than 1000 people also found almost three-quarters of people would help a terminally-ill loved one commit suicide, and that support for a law change is highest among men, and those over 60. Labour MP Maryan Street has been working with the Voluntary Euthanasia Society on her End of Life Choice Bill, which would give people the right to "choose how and when they exit this life".

The private members bill will have to be drawn from the ballot to get a hearing, but Street says the reader poll had the highest support she had seen, with most polls getting 75 per cent backing for a law change.

Continue reading

Kleinsman is the director of the Nathaniel Centre which is the New Zealand Catholic Bioethics Centre. He was speaking at a public forum on euthanasia and assisted suicide for healthcare and palliative care specialists, politicians, academics and activists hosted by the University of Otago Centre for Theology and Public Issues on Thursday.

At the forum, Labour MP Maryan Street explained the details of a member's bill to legalise end of life options she is presenting to Parliament.

She said she thrashed the issues out with a couple of Nelson preachers before deciding to sponsor the bill on behalf of a Nelson group of euthanasia advocates, because the debate shoud be religious as well as secular.

Sean Davidson, the Dunedin man imprisoned last year for helping his mother Patricia commit suicide, and who today returns to his family in South Africa, also spoke in support of the bill

Kleinsman said there is a need for honest and open discussion about the potential unintended consequences for society as a whole if euthanasia were legalised. "We should all be concerned about what it could mean for the severely disabled or terminally ill if euthanasia becomes an option," he said

"It is often argued by those advocating to legalise euthanasia that it will not impact on the choices of those who do not want to end their life. They remain free to make that choice. On the other hand, the prohibition of euthanasia unfairly prevents some (albeit a small minority) from exercising their personal choice. However, the reality is that we don't make our choices in isolation; our so-called ‘free' choices are constrained by factors beyond our control,"

"There is the very real danger that people who feel neglected and undervalued will see themselves as a burden and will want to do the ‘right' thing, especially when there are growing economic pressures on providing health and other forms of care for the aged. The ‘right to die' will quickly become a ‘duty' to die,"

"No euthanasia legislation can effectively protect against the misuse that would arise. This issue is about the protection of those most vulnerable at a time in their life when they most deserve to feel safe, valued and cared for. When making laws, the first priority must be to ensure that the rights and well-being of the majority are not prejudiced,"

"While protections and safeguards may be promised by those proposing legislation, there is no law that can adequately protect against abuses, no matter how much we want to offer such protection. The very act of legalising euthanasia will remove the most effective protection against abuses because the message it would send would be that human life can be traded against other things. It will open up new pathways to abuse of the elderly, sick and disabled,"

"We cannot even contemplate creating a legal ‘right to die' for some when it means many more will lose their right or will to live."

Source

• NZCBC
• Stuff.co.nz
• Image: TVNZ

The article entitled After-birth abortion: why should the baby live? by Alberto Giubilini and Francesca Minerva was electronically pre-published by the Journal of Medical Ethics

Catholic bioethicist John Kleinsman who is Director of The Nathaniel Centre, the New Zealand Catholic Bioethics Centre, says the prospect of deliberately killing children after birth is appalling but he agrees that if society allows abortion, there is no rational basis for forbidding the killing fo the new born.

"While I'm appalled about infanticide, I think it actually highlights, really, the problems with abortion."

"If society allows abortions then there is no logical reason to say 'no' to infanticide," he says. "This way of thinking turns children into commodities to be disposed of at will."

The editor of the Journal of Medical Ethics has defended his actions. He said that the arguments presented were are largely not new and have been presented repeatedly in the academic literature and public fora by the most eminent philosophers and bioethicists in the world, including Peter Singer, Michael Tooley and John Harris.

"The novel contribution of this paper is not an argument in favour of infanticide - the paper repeats the arguments made famous by Tooley and Singer - but rather their application in consideration of maternal and family interests. The paper also draws attention to the fact that infanticide is practised in the Netherlands," he said

Read After-birth abortion: why should the baby live?

Source:

• New Zealand Catholic Bishops' Conference
• Journal of Medical Ethics Blogs
• NZ City.com
• Image: The Blaze