Health Select Committee Inquiry

Petition of Hon Maryan Street and 8,974 others

Following the Seales case ruling, a petition organised by the Voluntary Euthanasia Society (VES) was presented to Parliament by VES President and former Labour MP Maryan Street, along with Matt Vickers, the husband of Lecretia Seales. 

The petition of Hon Maryan Street and 8,974 others requested:

“That the House of Representatives investigate fully public attitudes towards the introduction of legislation which would permit medically-assisted dying in the event of a terminal illness or an irreversible condition which makes life unbearable.”

Inquiry into Ending One's Life in NZ

In response to this petition, the Health Select Committee undertook an investigation into ending one’s life in New Zealand. The Committee considered all the various aspects of the issue, including the social, legal, medical, cultural, financial, ethical, and philosophical implications.

"This is an important subject and the committee needs to think carefully about the best way to examine it".

The Health Select Committee investigated:

  1. Factors that contribute to the desire to end one’s life,
  2. The effectiveness of services and support available to those who desire to end their own lives,
  3. The attitudes of New Zealanders towards the ending of one’s life and the current legal situation, and
  4. International experiences.

Submissions Process

 The submission process received 21,277 unique submissions from around the country between 27 August 2015 and 1 February 2016, and heard 944 oral submissions. 80% of submitters were opposed to the legalization of euthanasia or assisted suicide in New Zealand. 

The Care Alliance analysed all the submissions and released their findings.

Health Select Committee Report

The Health Select Committee released their report on the petition in August 2017. The Report echoed Justice Collins’ observation from the Seales v Attorney General court case, that the issue “is clearly very complicated, very divisive, and extremely contentious”. It provided a summary of the submissions, but made no clear recommendations about legislation on euthanasia or assisted suicide in New Zealand, stating that it was a usually a matter of a conscience vote. 

Instead, the Report encouraged “everyone with an interest in the subject to read the report in full, and to draw their own conclusions based on the evidence presented in it”. Below are the key points from its conclusion.

Some concerns from those opposed included:

Vulnerable people

These included populations such as the elderly, the disabled, those with mental illness, and those subject to coercion.

Innate value of life

Some argued that life has an innate value and that introducing euthanasia would undermine that idea.

Expansion of the law​

There were also concerns that once introduced assisted dying would rapidly expand well beyond what was first intended.

Lack of access

Submissions noted that there is a lack of awareness of palliative care, that access is unequal, and there are concerns about the sustainability of the workforce.

Relationship between assisted dying and suicide​

A common concern was the relationship between assisted dying and suicide. Some believed that assisted dying should not be considered until NZ’s high rate of suicide was reduced.

Submitters who supported euthanasia talked about:

Fear of loss

Supporters of euthanasia feared their loss of dignity, independence, and physical and mental capacity.

Fear of pain

Submitters also spoke about the fear of pain and of having to watch loved ones suffer from a painful death.

Personal autonomy

Supporters stressed their personal autonomy and that they should have the choice as to when to end their life.

Broader criteria

Some submitters thought the criteria for assisted dying should be broader than terminal illness and an irreversible condition.

This made it difficult for the Committee to consider what the safeguards should be. The Committee was concerned particularly about protecting vulnerable people and some members remained unconvinced that overseas models provided adequate protection.

Other issues referred to in the Report:

Pain and suffering

The Committee found it difficult to reconcile the two perspectives...

Many submitters recounted stories of family and friends who had died in pain over extended periods of time in hospital. Others feared that they might experience pain and suffering in the future.

Medical and health practitioners stated that no one should be dying in pain in New Zealand in the 21stcentury and that instances of this indicated a failure in care and a deviation from the norm.

The Committee found it difficult to reconcile the two perspectives and suspected that “greater communication between health professionals and the general public is required to explain the dying process and alleviate fear”.

Autonomy

The 'right to die' was a source of much discussion...

Supporters of assisted dying sought autonomy to make decisions about their end-of-life choices, that they had the right to make such decisions and current laws circumscribed their right to such decisions. Many felt that it was inappropriate to completely remove an individual’s right to choose because of the potential risks others may face.

Opponents argued that individual autonomy is frequently limited for the good of other members of society. Some argued that the belief that one could make a decision to end one’s life without being affected by many surrounding factors was highly contentious.

The ‘right to die’ was a source of much discussion, some arguing that if there is a right to life there must be a concomitant right to death. Others queried how such a human right could be limited to only certain groups, such as the terminally ill or those with an intolerable condition. To deny a ‘human right’ to any group would be discriminatory.

Dignity

Both supporters and opponents drew on the notion of dignity...

Supporters defined dignity on the basis of maintaining independence, and physical and mental capacity; maintaining bodily functions; not becoming reliant on others; not wishing to be a burden to family or society.

Opponents argued that this perspective undermines the idea of human dignity by equating an individual’s worth with their ability to contribute to society; that this was a threat to the elderly, disabled, and minorities; and that dangers could arise if some lives are considered to be not worth living.

Suicide

The distinction between 'rational' and 'irrational suicide' was not supported...

Some submitters argued that changing the law would be seen as normalising suicide. Others argued that the two should not be conflated.

A distinction was often made between “rational” and “irrational” suicide. However, this distinction was not supported by any submitters working in the field of suicide prevention or grief counselling, but on the contrary suicide is always undertaken in response to some form of suffering, physical, emotional, or mental and that all forms are deliberate and intentional.

Some submitters were concerned that their health issues would place an undue burden on the health system. They often spoke of ending their life so as to free resources for those more in need or younger. An organisation of health professionals spoke in support of euthanasia as an alternative to an increase in funding. It argued that in the absence of increased funding, assisted dying and euthanasia could play a role in sustaining the health system.

Health system funding

Some submitters were concerned that their health issues would place an undue burden on the health system...

They often spoke of ending their life so as to free resources for those more in need or younger. An organisation of health professionals spoke in support of euthanasia as an alternative to an increase in funding. It argued that in the absence of increased funding, assisted dying and euthanasia could play a role in sustaining the health system.

Read the Report here.

Care Alliance Analysis of Submissions

The Care Alliance analysed the submissions, excluding duplicates and a small number that could not be coded. An independent research company reviewed a sample of the coded submissions and concluded “with at least 95% confidence that the overall classification percentages are accurate within no more than 0.4% variation”.

Snapshot of the Care Alliance analysis on submissions made to the Health Select Committee.

In a press release announcing the analysis results, the Care Alliance stated:

“Quite simply, the Voluntary Euthanasia Society were able to get 8,975 signatures on a petition, but could muster less than half that number in actual submissions,” said Mr Jansen.  “By contrast, 16,411 people took the opportunity to say no to euthanasia.” Opposition to euthanasia was dominant across all submission lengths. For example, of the submissions longer than one page, 1,510 submissions opposed euthanasia while 523 supported its legalisation."

View the full analysis here.