Uncertainty compounds End of Life Choices Bill

Danielle van Dalen

Auckland, June 12, 2017

David Seymour is convinced his End of Life Choice Bill, drawn from the Private Member’s Ballot last Thursday, is an appropriate and compassionate part to end of life care.

I am not.

Despite Seymour’s reassurances that the safeguards included in the Bill are sufficient, reading the Bill reminds me that international experience shows that no safeguard has proven safe enough, and that legalisation of euthanasia or assisted suicide creates unreliable categories, that are subjective and easily expanded.

Ambiguous term

The Bill provides the option of euthanasia for any New Zealander, aged over 18, who has “a terminal illness or grievous and irremediable medical condition.”

If this terminology strikes you as vague, you would be right.

Terminology like “irremediable medical condition” creates two categories of people in our society. Those whose lives we deem worthy of protection by refusing access to euthanasia or assisted suicide even if they wanted to end their life, and those for whom we think suicide might be thinkable. Creating this distinction between people we’d like to stop from trying to kill themselves, and those we would assist, is hugely troublesome.

Categories needed

Even advocates of euthanasia would agree that there must be categories, that some people should be prevented from accessing euthanasia or assisted suicide. But where, and how, would we honestly draw that line?

Advocates for this Bill would say that these categories are clear cut, that doctors can easily determine who does have a terminal illness or irremediable medical condition and who does not. But this simply is not possible.

Seymour’s Bill states that euthanasia would be available to terminally ill patients only when they are likely to die within six months. At first glance this seems a reasonable and rigorous safeguard, but only if we can actually make these kinds of medical predictions accurately in all cases. As palliative care specialist Sandy MacLeod asserts; in the final days of life an estimated time and date of death may become more accurate, but in the weeks and months prior this is an estimate and could be completely incorrect.

Personal experience

I witnessed the reality of this uncertainty when a family friend was diagnosed with cancer and given only a few months to live. More than five years later, she is in remission, has seen her children finish school and head to university, enjoy life, work and holidays, and remains healthy and cancer free. Imagine if such a law had been in effect when she received her prognosis.

Uncertainty and lack of control surround issues of end of life care.

We want to know what it will be like, how much we will suffer and whether life will still hold value.

These are important and good questions, but while many reasonable and compassionate people promote euthanasia and assisted suicide as a solution, they forget several crucial elements.

They forget that life with a grievous and irremediable condition such as Alzheimer’s, a disability, or depression does have worth, and that a terminal illness does not always have the timeline we might expect.

Danielle van Dalen is a Researcher at the Maxim Institute based in Auckland.

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