First Reading

The First Reading of the End of Life Choice Bill took place on Wednesday 13 December 2017. It passed through to Select Committee stage by 76 votes to 44. Take a look at how the votes went below and view some of the speeches from the night.

Votes

MPs who voted YES

Speeches

Out of the 11 speeches on the night, six Members of Parliament spoke against the Bill. These were the Rt Hon Bill English, Simon O’Connor, Nuk Korako, Hon Aupito William Sio, Hon Maggie Barry, and Chris Penk. A few of those speeches are below.

Rt Hon Bill English

“it removes a principle at the core of the law written to protect everybody, and particularly the most vulnerable, and that is the blanket prohibition against taking the life of another. That is at the core of our criminal law that protects everybody, particularly the most vulnerable. In removing that prohibition, which has been in our law for as long as this country has existed, this Parliament is taking a huge step.”

Rt Hon BILL ENGLISH (Leader of the Opposition): I rise to oppose this bill, principally for the reason that this House has defeated such legislation twice in the last two decades, and it is this: it removes a principle at the core of the law written to protect everybody, and particularly the most vulnerable, and that is the blanket prohibition against taking the life of another. That is at the core of our criminal law that protects everybody, particularly the most vulnerable. In removing that prohibition, which has been in our law for as long as this country has existed, this Parliament is taking a huge step.

I appeal to our members tonight. I’m sure we’ve all had the experience—I know I have—or know about the experience, of witnessing the suffering, the fear, and the anxiety of a dying person and those around them, and, sometimes, a difficult death. Alongside that personal connection, we have to weigh up, in our role as lawmakers—not just as parents or children or siblings or friends of those who we’ve seen die, but as lawmakers. Our role is not principally to alleviate suffering; our role is to ensure that our society has a set of laws that protect those who most need protection.

Did you know that in our law, section 179 of the Crimes Act, it is a crime to incite the suicide of another person, even if they don’t actually commit it—even if they don’t actually commit it? Why is that there? Because we don’t want people encouraging a depressed disabled young person to think that their life isn’t worth anything. As lawmakers, the reason there is a blanket prohibition is because you are not always the best judge of the value of your life, and the price that our community pays for enabling a doctor to take your life, free of criminal scrutiny, is that many other people are more vulnerable. Their lives will become more fearful, and they’ll become more subject to the pressure to make the judgment themselves that their life has less value and therefore they should make the decision. It is a slippery slope. That is why this bill, with its cold, technical, bureaucratic process of death, tries to look like it’s safe.

We have to weigh it up, and every Parliament up to now has said that the balance between what is enabled for an individual and the cost of that enablement to the rest of society is too big a risk to take. I put the case that as lawmakers that is the question that we need to weigh up: is the gain in personal autonomy—because the research shows people embark on euthanasia principally for autonomy reasons; they may not be suffering that much—worth the broader cost to our community? I don’t think anyone can, in their heart of hearts, believe that this bill will make life safer for the disabled or that it will make our community more warmly embracing of our ageing population. Who pretends that? It won’t—it won’t.

That is why I will oppose it and invite others to. You know, we’re not creating medical procedure here; we’re creating an exemption from the criminal law against killing for a specified group—that is, doctors, who do not want to carry this burden—under some conditions that amount to box-ticking. So I ask the Parliament to consider that very carefully—the removal of the blanket prohibition against taking a life, which should be subject to scrutiny and accountability.

Simon O'Connor

“I spent two and a bit years chairing the Health Committee as over 21,000 Kiwis from across the spectrum spoke to us, and 80 percent, who had well considered it, said no. I’ve studied philosophy and human rights, I’ve been at hospital beds and hospices, I’ve seen more death and suffering than sometimes I care to remember, and, fundamentally, I do not believe doctors should be killing their patients.”

SIMON O’CONNOR (National—Tāmaki): I believe this is a sad day for the House. We are here talking about the State sanctioning killing of New Zealanders. This bill suggests that suicide is a solution under certain circumstances, and I stand today to reject this.

I spent two and a bit years chairing the Health Committee as over 21,000 Kiwis from across the spectrum spoke to us, and 80 percent, who had well considered it, said no. I’ve studied philosophy and human rights, I’ve been at hospital beds and hospices, I’ve seen more death and suffering than sometimes I care to remember, and, fundamentally, I do not believe doctors should be killing their patients.

Members of the House, this bill is about killing in two ways. The first is called euthanasia. It’s where the doctor takes an injection, usually something like phenobarbital, and injects it into you—only after they’ve sedated you, of course; couldn’t have the inconvenience of twitching. The other is physician-assisted suicide, where, again, they give you a massive dose of drugs. You take that yourself, at your own choosing—and hope that the kids don’t find it in the medical cabinet at the time.

This bill combines both of those. That’s almost unheard of in any other jurisdiction around the world. This bill before us tonight is the worst example of euthanasia legislation in the world. I say that as someone who has looked at every piece of legislation.

Where it starts, really badly, is clause 4. We hear it a lot: it’s all about terminal illness, up to six months. But the doctors, the medical people, will tell you that six months is just an indication; it’s not a guarantee. And the doctors will tell you too that they misdiagnose all the time.

They also talk in this bill about irremediable, grievous conditions. That’s incredibly broad, undefined. What is “irremediable”? What is “grievous”? Basically, it includes everyone, including those with disabilities.

But the bill also, rather insidiously, talks about suffering that a person deems intolerable—what you deem intolerable. Sorry, Mr Speaker—what members may deem intolerable. This is a clear indication that it is the courts who will be making decisions and choices, not this Parliament and certainly not the person.

In the debate in this space, I’ve often said, it’s between choice and public safety. Let’s be very clear: the current laws as they stand mean that no one will die against their will, but this proposed law that we consider tonight will make involuntary deaths possible. We know in this House we do not make things perfect, because changing this law will allow some to assist the suicide—well, sorry. People who choose to assist in suicide will put others at risk.

We know that this law applies to everyone. It does not apply simply to the rational and articulate; it applies to the elderly, the disabled, the sick, the vulnerable—all of us. Not everyone is fortunate enough to live with a loving, caring family. Not everyone has a doctor fully in tune with them and their needs. This law will apply to the depressed, the lonely, those who feel a burden, the disabled, the fearful. I should point out that these are the same feelings of a 16-year-old who is keen to suicide, the 40-year-old who has lost their farm, or the 80-year-old on the deathbed.

I repeat again, as I did a few months back, that you cannot stand in this House and decry the suicide of one group of people—say, the youth—and then encourage the suicide of another group—say, the sick. They are the same feelings that are there. And I don’t say it alone. It’s very easy for the media and others to attack, but, actually, this is the opinion of the major medical groups, the psychologists, and the youth workers. I add their voice tonight.

There’s a lot of talk about choice. Let me say one thing about choice: the patient in this space never makes the choice. If they did, there wouldn’t need to be doctors and psychologists and boards and panels. The doctors make the choices. The family makes the choices.

If you think I’m exaggerating, go and look up an example in the Netherlands recently. A woman with dementia who, yes, years ago, had said that she would like to die by assisted suicide, was held down after being sedated by her doctor and family—they put drugs in her tea. They sedated her, held her down as she screamed and yelled, and then they killed her. The doctor was able to report it, and they just said, “Oh, well, you acted in good faith, but she’s dead now.” So much for the choice and autonomy that she exercised.

And I’d point out too that if it’s about choice and autonomy, we all have it. If it’s a human right, all humans have it. There is a slippery slope, and one only needs to turn to Canada, which has already been mentioned, which is already pushing the boundaries.

There are no safeguards; there are just lots of criteria. Being 18 is not a safeguard. All the reporting comes after the fact. If you get it wrong, the person’s still dead.

Doctors don’t want to be part of this. The few that do will make a business of it, and there will be doctor-shopping. The conscience rights in this bill are a nonsense. If you oppose, the doctor must hand that person over to someone who will.

It’s a very, very poor bill, and, fundamentally—thousands of health professionals and others have argued in the recent public debate—this is an issue where the public safety will be put at risk. So I ask this House how many involuntary deaths and errors are we willing to accept through this law: one, five, 10—

Mr SPEAKER: Order! The member’s time has expired.

Nuk Korako

“The process of dying, for us, is a process of whānau. We hear of terminal illness inside the whānau. We know the time has come to mobilise and gather. We give the immediate whānau our physical, spiritual, and, if needed, financial support. The process of death is not just about a loved one, it’s also about our whānau. This process is an essential component of binding our whānau together.”

NUK KORAKO (National): Tēnā koe e Te Mana Whakawā. It was the late Ngati Porou kaumātua Amster Reedy who stated, “We bring people into this world. We care for them right from the time they are conceived, born, bred, in health, sickness, and death. The rituals still exist for every part of their lives.” Those rituals still will exist and we need to have faith in our ancestors. Euthanasia is foreign to Māori and has no place in our society.

In all my life, raised as a Ngāi Tahu Māori, I have never heard or known of a Māori concept that validates assisting dying. Witnessing the death of a whānau member is as intimate as it gets. To watch a painful death can be shattering; the indignities we may have to see our loved one suffer—unable to undertake the most basic human functions without support, watching their agony, feeling their helplessness and, often, their feeling that they are being a burden on their whānau—yet this is only part of the process. There is another side to death; that is the whānau side.

But death has never been a final ending for our people. It merely signifies the beginning of the journey to Te Rerenga Wairua and then onto the ancestral home of Hawaiki nui, Hawaiki roa, Hawaiki pāmamao. It is a life in the afterlife, where we gather once more with our tīpuna and our departed whānau, members, and friends.

The process of dying, for us, is a process of whānau. We hear of terminal illness inside the whānau. We know the time has come to mobilise and gather. We give the immediate whānau our physical, spiritual, and, if needed, financial support. The process of death is not just about a loved one, it’s also about our whānau. This process is an essential component of binding our whānau together. The act of caring for a whānau member is a process of learning, of grieving, of laughing, of despairing, of reminiscing, and of coming to that moment of peace when we can finally let them go. This process of death is as much for the living as it is for the dead. Many Māori see this as an essential expression of taha wairua [the spiritual side], or being a part of something that is greater than ourselves. The final act of dying is the point where the ancestors come to take that loved one home. It is a moment of extraordinary sadness but also joy, as we become aware that an ancestor is now in the room with us to accompany the loved one on their final journey.

In the debates throughout the country that have preceded this tonight, Māori voices have been few and far between because some Māori choose not to discuss such things and fear that their fundamental beliefs are treated as native superstition. To me, assisted dying is to fast-forward a process that ultimately denies our loved one the chance to be taken to their ancestral home and is, instead, left in limbo, on their own, in a transitional afterlife until their time finally arrives.

The real challenge is to ensure all whānau across Aotearoa have access to the full range of palliative care available to ensure that we can ease the passing of our loved ones and the burden of care that falls upon whānau, without resorting to artificially ending their life. Then, we will truly, here, have succeeded. On that basis, I cannot support this bill.

Āpiti hōno, tātai hōno, rātou ki te hunga mate, ki te hunga mate ki a rātou; āpiti hōno, tātai hōno, tātou ki te hunga ora, ki te hunga ora ki a tātou.

[The lines are joined and linked, they to the dead and the dead to them; the lines are joined and linked, we to the living and the living to us.]

Let the dead be the dead and the living be the living. Kia ora tātou.

Hon Maggie Barry

“As the Minister for Seniors over the past three years, I have seen up close the horrors of elder abuse, the scourge where family members inflict physical, psychological, emotional, and mental violence and neglect on their own family members. More than three-quarters of abusers are family members. A family is not a safe place to be, and the abuse of our elders, with an ageing population, is something we need to take into account with this particular bill. This bill will enable more people to predate on the vulnerable, with far too few—negligible, even—protections and safeguards.”

Hon MAGGIE BARRY (National—North Shore): Thank you, Mr Speaker. There’s been a lot of talk tonight about choice, with this bill, and how important it is for people to have choice. But I ask you to pause and consider this all very carefully indeed. To give choice to some is to take away the choice of thousands of others, and this is the kind of situation that we are seeking to avoid as legislators.

We have heard from Bill English earlier that it is our responsibility as lawmakers to try and prevent the wrong things from happening, the unintended consequences, and we need to be very careful, because one person’s choice and autonomy will be another person’s death sentence. Hard cases make very bad laws, and our law, in my view, should not be changed for a few persistent cases where it will expose far greater numbers of people to premature death.

As the Minister for Seniors over the past three years, I have seen up close the horrors of elder abuse, the scourge where family members inflict physical, psychological, emotional, and mental violence and neglect on their own family members. More than three-quarters of abusers are family members. A family is not a safe place to be, and the abuse of our elders, with an ageing population, is something we need to take into account with this particular bill. This bill will enable more people to predate on the vulnerable, with far too few—negligible, even—protections and safeguards.

I read the previous two bills that have come before this New Zealand Parliament, but this one is by far the worst. It is poorly crafted and drafted, in my view. It is irretrievable through the select committee process. We’ve consulted widely with medical and legal experts and believe that the Seymour bill and version is so fatally flawed that it couldn’t even be fully rewritten to prevent vulnerable people from being predated on.

So let’s look at what this bill actually requires. A person needs to self-assess that they experience “unbearable suffering that cannot be relieved in a manner that he or she considers tolerable;”. What does that mean? It is way wide open to interpretation. For example, an 18-year-old—it could be your son or your daughter or grandchild, a person with a significant disability or a chronic illness, including mental illness, depression, or schizophrenia. Once that person, by simply expressing the wish—and that’s the word that is used, wish—to contemplate suicide, then there is an obligation on the medical practitioner to take it further. This highly prescriptive bill has a regime all of its own that triggers an automatic series of mandatory steps that a medical practitioner is then obliged to follow with the sole aim of facilitating that person’s death. How can an 18-year-old—or an 80-year-old, for that matter—make such a decision in a mentally unwell state?

Of course, they can’t get help from the doctor, who’s not allowed to recommend other treatments or even encourage the patient to discuss it with family. This is the detail of the reality of this bill.

If the doctor has a conscientious objection and won’t assist with the suicide, the doctor is then obliged and required to provide the patient with the names and contact details of practitioners on a special list of doctors who dispense death, who will facilitate the suicide. If they don’t refer them to someone on that list, that medical practitioner will be liable for criminal prosecution. But here’s the strange thing. For any doctor on the list who does assist a suicide, the bill provides a full defence and immunity, as long as they’ve acted “in good faith and without [actual] negligence”. So the full force of the law will not come upon that person but on the one who exercises their own conscience.

It’s putting our medical practitioners in an absolutely impossible situation, which is why they’ve all objected so strongly. The New Zealand Medical Association, the Australian and New Zealand Society of Palliative Medicine, nurses, geriatric medicine specialists—they’re all horrified by this bill and they’re on record with their objection on the basis that it is completely contrary to their code of ethics and relationship of trust with their patient. “Irreversible decline in capability” is used in the bill—essentially, that’s a definition of anyone living with a disability. So the clear message is, if you’re disabled in any way with an irreversible decline in capability, you’re better off dead.

The answer is not to coerce and to kill, as this bill dictates; it is to continue to invest in world-class palliative care, and that’s what we have in this country. Even if you are a person sympathetic to assisted suicide, this is not the bill to deliver it. And make no mistake about it, legalising assisted suicide and euthanasia is the exception and not the norm. New Zealand is on the right side of this. New Zealand law is adequate and has good provisions. We have world-class palliative care, and that is why I will never support this bill.

Chris Penk

“Those in favour of the bill, at least to the first reading stage, have described a situation of a life that they say lacks dignity at that point. Disabled constituents of mine have said to me, “Do not let anyone tell you that certain conditions equate to a lack of dignity. They are describing my life.” They say to me, “This is my life. I am happy with it. I have dignity, and for anyone in the Parliament to suggest otherwise is, quite simply, intolerable.””

CHRIS PENK (National—Helensville): Thank you, Mr Speaker. I rise to speak against this bill. At the heart of this bill is the question of choice, and yet we must all acknowledge that assisted suicide, or euthanasia, by whatever name we call it, is a choice to end all choices. It is, by definition, irreversible, the end; that it shares with any other form of suicide. As such, we should proceed exceedingly carefully before even considering whether safeguards, so-called, may mitigate some of the worst aspects of it.

It is this nature of choice that is being promoted by those who have brought this bill to the House that we must attack. We must understand clearly the concepts of undue influence and coercion that undermine choice and that play on the minds of those who are vulnerable, and those who are vulnerable are the very ones who would be wanting to access this in that moment of time in their vulnerability.

In their depression, people are vulnerable. To be depressed is literally to be pushed down. When one is pushed down, one is not capable of making good decisions. One is not capable of understanding fully the consequences of one’s actions, and yet this bill would allow people the ability to make, in that vulnerable state, in that vulnerable condition, a choice that would end all other choices.

So many of our fellow New Zealanders, young and old, have already made that choice; they have no further choices left. It is a subject that this House rightly concerns itself with and should continue to do so. We must do more to discourage suicide and other forms of ending life prematurely, and not encourage more of it.

Much has been said on the subject of dignity, too. Those in favour of the bill, at least to the first reading stage, have described a situation of a life that they say lacks dignity at that point. Disabled constituents of mine have said to me, “Do not let anyone tell you that certain conditions equate to a lack of dignity. They are describing my life.” They say to me, “This is my life. I am happy with it. I have dignity, and for anyone in the Parliament to suggest otherwise is, quite simply, intolerable.”

We’ve heard about so-called safeguards; for example, the suggestion that one might be able to exercise this choice if one has a terminal illness. One might have a diagnosis of a terminal illness but not, in fact, have a terminal illness. One may have a mistaken diagnosis or, indeed, a mistaken prognosis, and one might make a decision based on that. And if that factual basis is proven to be incorrect, what recourse then does that person have? The answer is none, because the person will have died. Our criminal justice system admits the possibility of mistake as to facts and as to law. Among other reasons, this is why we do not have a law of capital punishment; mistakes are made. If anyone in this House doubts that, they should ask Mr Teina Pora if that is so. If we allow people to be pressured into making a choice or to make the choice seemingly of their own volition but based on a mistaken assumption as to facts, and if the facts, so-called, prove to be incorrect later, there is no recourse, there is not opportunity to turn back the clock. They are, at that point, dead.

The intersection of our terrible rate of suicide in this country and our terrible record of elder abuse and neglect is this bill. There is much work we have to do in this Parliament on these subjects and, indeed, mental health in general. Will this bill encourage or undermine efforts to promote the real dignity, the real protection of life, the genuine role of the medical profession? I say, no; I say we reject it. And if you are in favour of euthanasia as a principle, I say to members of this House: this bill is not the one for you; it is far too broad. We should reject it.