InterChurch Bioethics Council Disappointed that the “End-of-Life-Choice Bill” has been drawn
Press Release 14/6/2017
Last week David Seymour’s “End-of-Life-Choice Bill” was drawn from the private member’s bill ballot, engaging Parliament on a debate around voluntary euthanasia – the intentional ending of a life to relieve suffering.
Although this Bill has been around since 2015 and was preceded by bills from Michael Laws (1995), Peter Brown (2003) and Maryan Street (2012), it is the timing of this bill that is disappointing to the InterChurch Bioethics Council (ICBC). In particular, there is currently before the Health Select Committee the petition from the Voluntary Euthanasia Society to investigate “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.”
The Health Select committee process began in February 2016, receiving an unprecedented number of written and oral submissions (over 21,000) and their report is due by the end of June 2017. As the Care Alliance identified in a recent press release, 77% of submissions to the Health Select Committee oppose euthanasia (http://carealliance.org.nz/health-select-committee-77-of-submissions-oppose-euthanasia/, May 5, 2017).
To the ICBC it seems untenable that we now have two competing parliamentary processes – a Health Select Committee process which has sought public opinion, and a Parliamentary debate, especially given that with a looming general election it won’t be this Parliament that makes the final decision.
The ICBC also has some major concerns about the “End-of-Life-Choice Bill”. Although it provides for assisted suicide for those 18 years or older with a terminal illness, the bill also allows for those with a grievous and irremediable condition, or in advanced state of irreversible decline, or with unbearable suffering unable to be relieved in a manner the person considers tolerable. The fact that “unbearable suffering” is self-determined means that this bill effectively allows for assisted suicide on demand for any condition – not just the terminally ill. Yet the most common reason for people taking this view of their condition is depression, which is often poorly diagnosed and is potentially treatable.
There is in the bill the safeguard of needing two doctors to agree with the request and to ensure there is no coercion. However as seen in the US State of Oregon, a 2-doctor safeguard does not work over time, and neither doctor may know the patient sufficiently to be able to determine whether depression is present or if coercion is occurring.
Finally, the ICBC have concerns whether Parliament is culturally representative enough to decide this issue. The current debate is largely a rational, western, Pakeha conversation, however many cultures other than the majority ‘western’ culture have traditional ways of managing death and dying in family/whanau settings. For Māori and Pacific people physician-assisted suicide or euthanasia has no equivalent in language or practice, and talk of assisted suicide is seen as an unnatural conversation to discuss or contemplate. Therefore, the current debate risks imposing on all New Zealanders a largely “secular western worldview” without adequately considering all cultural viewpoints belonging to New Zealanders.
For the ICBC, the debate of the “End-of-Life-Choice Bill” should wait until after the Health Select Committee process is complete and findings made public, and after the General Election to prevent this highly emotive subject from being an election issue.
To view the ICBC’s written and Oral submissions to the Health Select Committee go to http://www.interchurchbioethics.org.nz/index.php/submissions-media/
Assisted suicide: death is not ‘a part of life’
Using the language of freedom to justify on-demand death is Orwellian and dangerous.
'When parliament is paralysed, the courts must act.' So said lawyer Joseph Arvay, representing the appellants in a case about the legal status of assisted suicide, at the Supreme Court of Canada (SCC) last October. The SCC now apparently agrees; last week it struck down the ban on assisted suicide and gave the government 12 months to draft a replacement law.
Euthanasia law would be open to abuse
24 July 2012
“The legalising of euthanasia would open up new pathways of abuse for many elderly and otherwise vulnerable people” says Director of The Nathaniel Centre and bioethics researcher John Kleinsman.
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 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.
Salvation Army Euthanasia Statement
‘End of life choice’ may lead to pressure to choose an ‘early exit’ cautions Salvation Army.
The Salvation Army notes the intention of Maryan Street (MP) to introduce a Private Members “end of life choice” Bill to legalise voluntary euthanasia and/or physician-assisted suicide.
The Salvation Army believes euthanasia and assisted suicide are morally wrong regardless of illness, age or disability, and does not accept the view that euthanasia is “death with dignity”. It says there are two important misconceptions around euthanasia: that death is usually preceded by serious pain, and that modern medicine seeks to prolong the dying process for as long as possible.
“Society’s task is not to eliminate those who suffer, but to find better ways of dealing with their suffering,” says Major Stevenson, chair of The Salvation Army’s Moral and Social Issues Council.
The Salvation Army believes it is important to communicate by word and deed to the sick, the elderly and the dying that they are worthy of respect, they are loved, and that they will not be abandoned. Full palliative care should be available to anyone with a terminal illness.
“A mature society can learn more about itself and the importance of family and friendship by journeying with those who are dying - no matter how difficult this journey may become,” says Major Stevenson. “The dying days of an ill person can be extremely hard on family members and friends, but healing, forgiveness and the celebration of life and love also occur in such times.”
Debate around voluntary euthanasia needed to consider not only the straightforward but also the worst-case scenarios, he said.
“Removing legal liability from health professionals and family, as Ms Street is signalling she would do, could place these individuals under undue pressure to meet the expectations raised by such a change. By offering some the choice to end their life, even with the best of intentions, we may also be removing a choice from others who may consequently feel pressured to choose an ‘early exit’.”
Such a choice could be influenced by the convenience of bringing together family members with busy schedules and limited financial means for a final farewell, or by the desire to more quickly wind up an estate. It could also be influenced by views around the expense of continuing medical or palliative treatment.
As a Christian organisation, The Salvation Army believes in the sanctity of human life. It considers each person to be of immense value, and each life a gift from God to be cherished and cared for throughout all life stages.
Legalising voluntary euthanasia, even in limited form, would see New Zealand take steps towards non-voluntary euthanasia for those of limited mental capacity, says Major Stevenson.
Experience in other jurisdictions highlights the extreme difficulty of drafting law to adequately control the circumstances under which the killing of other human beings is legalised.
The Salvation Army looks forward to examining the proposed legislation carefully and encourages all New Zealanders to do the same.
Whatever our religious outlook, most people would agree that two scenarios we greatly fear are those of suffering a painful drawn-out death, or watching someone we love suffering such a death. This is, in part, what drives the current debate on euthanasia and the growing moves to decriminalise/legalise both physician-assisted suicide (where the doctor prescribes the drugs and the patient takes them) and active euthanasia (where the doctor administers a lethal dose of drugs).
The InterChurch Bioethics Council[i] suggests there is more to be considered in this debate. Many different cultures and religions agree that life is a gift and see the individual in the context of wider relationships. In the face of suffering, the Christian response is to maximise care for those in most need. For those with terminal illness this is now possible through palliative care which includes modern pain management and people trained to help the terminally ill die with dignity.
Ethically, there is a significant difference between actively/assisting in killing another person and withdrawing (or with-holding) treatment so that the person dies as a result of their illness. In both situations the intent of the action is critical. In forms of euthanasia, the intent is to relieve suffering by killing. By contrast, when treatment is futile and is stopped or withheld, palliative care given by skilled professionals who address the pain and suffering caused by terminal illness, provides the best means to respond compassionately to terminal illness and suffering. The intention here is to address the many needs of the suffering person and their family, and to enable a dignified pain-free death. Another ethical consideration is that health care professionals are trained and trusted to promote health and well being and provide appropriate treatment for the living and dying. They are trusted not to cause death.
Much of this current debate centres on a patient’s right to choose when and how to die in the face of severe suffering in a terminal illness. But the right to choose does not take place in a vacuum – no-one is completely free, we are embedded in family and society involving critical relationships that go beyond the care of those who are dying. Our personal freedom is always held alongside the rights of others, and from a Christian perspective, our personal rights have to be considered alongside our responsibilities to others that reflect our love of God as indicated in the command to love both God and neighbour (Mark 12:28-32). The importance of purpose or intent to end life along with our responsibility to others also resonates with traditional Maori customary practices where physician-assisted suicide or euthanasia have no equivalent in language or practice.
Beyond the desire to relieve individual suffering there are societal pressures which lead us to reflect on the reasons for this debate at this time. We recognise the escalating costs of health care (particularly in the last year of life) and ask whether this debate is convenient in the light of socio-economic concerns. This then raises the issue of justice where the Christian response is to ensure that people who are weak and vulnerable receive compassionate care. As international experience has shown, voluntary euthanasia quickly becomes non-voluntary euthanasia for conditions other than terminal illness (as in the Netherlands). The rights of vulnerable individuals are ignored when decisions are made without their input or consent, based on their perceived lack of value to, or burden on, society.
In light of this, the ICBC would not support legislation for decriminalising or legalising physician-assisted suicide or active euthanasia. Instead, we advocate recognising that death is a natural part of life, and that it is extremely important for skilled palliative care to be made freely available to all of those who suffer to enable them to die “well”.
[i] The InterChurch Bioethics Council (ICBC) represents the Anglican, Methodist and Presbyterian Churches of Aotearoa, New Zealand. ICBC members have between them considerable expertise and knowledge in science, ethics, theology, medicine, education, and tikanga Maori.
Infanticide prospect highlights horror of abortion
“If society allows abortions then there is no logical reason to say ‘no’ to infanticide,” says Catholic bioethicist
The controversial academic Francesca Minerva and her colleague have stated that parents could kill their new-born children for reasons relating to the social psychological or economic costs – the stress of adoption is even presented as good enough reason to kill a baby.
“This way of thinking turns children into commodities to be disposed of at will,” says Mr Kleinsman. “The prospect of deliberately killing children after birth is appalling”.
Using Human Embryos for Research
30 November 1999
25 July 2006
"Appealing exclusively to the future benefits that may come about as a result of destructive research on human embryos obscures broader ethical issues," says John Kleinsman, a spokesperson for The Nathaniel Centre, the New Zealand Catholic Bioethics Centre.
"We fully support the desire of stem cell researchers to seek cures that may one day provide the key to a wide range of serious illnesses and diseases. The key ethical dilemma is when human embryos are destroyed in order to source embryonic stem cells."
"While some people regard the embryo as merely a collection of cells, deserving of no special respect, and while others regard it as meriting some protection but believe that for very good reasons embryos may sometimes be used for research, Catholic teaching holds that without exception the living embryo is, from the moment of fertilisation, a living human being with an absolute right to life. A life is begun which is neither that of the father nor the mother. It is already the human being it will always be and will only grow in size and complexity. On that basis all embryos are entitled to the same respect as persons."
"Stem cell research holds real promise for the prevention and treatment of serious diseases. However, we have a moral obligation to pursue good outcomes by using only ethical means. It is an old axiom that the end does not justify the means. Sufficient account needs to be taken of the moral harm associated with the destruction of human embryos, including its wider repercussions for the way we look at all human life."
"Other stem cells known as 'adult' stem cells can be obtained from a variety of other sources in ways that do not require the destruction of embryos. This type of research provides an ethically acceptable alternative. There is also other promising research which is seeking ways of obtaining cells with the same properties of embryonic stem cells without the need to create or harm human embryos."
For a full discussion of the Catholic understanding of the moral and ethical issues associated with stem cell research refer to The Nathaniel Report:
- issue number five: The Moral Status of the Embryo
- issue number twelve: Stem Cell Research in New Zealand
The Assisted Suicide of a Healthy New Zealand Woman - Dr Philip Nitschke
4 February 2008
The New Zealand Catholic Bioethics Centre – The Nathaniel Centre – is deeply distressed at the comments of Dr Philip Nitschke as reported in The Sunday Star Times. [3 February 2008]
His comments reflect an appalling lack of understanding of the needs of the terminally ill as well as people who suffer from depression.
If people are depressed our efforts need to be focused on restoring their self-worth and supporting them with our caring presence rather than simply providing them with a recipe to kill themselves while leaving them in their isolation.
Care of the terminally ill and the depressed requires a holistic approach that also and necessarily addresses the spiritual, emotional and social dimensions of health and well-being. We are all ill-served by Dr Nitschke's impoverished view of end of life care and medical practice.
Dr Nitschke is also on record as saying that the knowledge he provides should be readily available to "anyone who wants it, including the depressed, the elderly bereaved, the troubled teen." Is this where we really want to go in New Zealand society?
Dr Nitschke's message is the complete antithesis of the clear message given by the Mental Health Foundation of New Zealand to encourage people to seek help for depression.
Rev Dr Michael McCabe
The Nathaniel Centre
The New Zealand Catholic Bioethics Centre
Toi te Taio: The Bioethics Council Report - Who Gets Born?
19 June 2008
The report on the cultural, ethical and spiritual aspects of pre-birth testing provides a comprehensive and fair overview of people's thoughts and comments on this complex topic.
The process of deliberation has been a genuine attempt to listen to the breadth of views of New Zealander's and to foster a broader understanding of the differences in opinion on this complex topic. Having been involved as a participant in the process of deliberation, we commend the Council's efforts in bringing an awareness of the cultural and spiritual aspects of pre-birth testing to the ethical questions it raises.
The report clearly shows there is broad acceptance among New Zealanders that pre-birth testing must be regulated to some degree – this acceptance reflects a deeper awareness of the power that technology has to reshape our perceptions of pregnancy, parenthood and the way we think about and view children in a negative way.
Catholic teaching on human dignity asserts the inviolable right to life from the moment of fertilisation to death – this right is totally unrelated to questions regarding the quality of life. We are disturbed that there is a growing trend amongst some to equate the right to life with the absence of disease or with a certain notion of normality.
From a Catholic perspective all embryos are equal and deserve unconditional respect. Therefore, embryos with genetic abnormalities have as much right to exist and be selected as those who are supposedly free of genetic abnormalities. The availability of PGD in effect fosters a situation whereby the protections around the right to life of specific groups of persons are removed on the basis of their genetic makeup. This sets a bad precedent.
Evidence from overseas shows that amongst some people the availability of genetic testing technology is contributing to expectations of "perfect children". Our role, as parents, is to welcome our children in an unconditional way – this is what love demands. It seems to us that one of the critical issues highlighted by the report is the need to create a society that will welcome all children equally. Our efforts and resources first and foremost need to be aimed at the promotion of a just society.
We also note that the report has uncovered widespread public concern about the high abortion rate in New Zealand and a sense of dissatisfaction for this state of affairs. We welcome this finding while remaining concerned that the increased use of pre-birth testing has a potential to contribute to the further marginalisation of those who are most vulnerable in our society – those who are unborn and those who are disabled.
Among other things, the report highlights the pressure many couples come under upon receiving their test results to make "very rapid decisions" – this at a time when they are extremely vulnerable. This situation is hardly conducive to free and informed decision making. Given time and appropriate counselling, couples will be in a position to see the situation from a different and less emotive perspective which could lead to very different decisions being made.
While it is encouraging to read that information "must not present termination of pregnancy as the automatic option after a test result indicating a disorder", this does not go far enough. We would like to say that the debate is not just about choice and balanced information but also about paying close attention to the broader context in which couples are making their choices. It is of great concern to us that couples speak of encountering pressure from the health system to terminate a pregnancy on the basis of genetic test results.
We are also worried that it is will become increasingly difficult for couples to exercise a choice not to be tested or to continue with a pregnancy in the light of test results indicating a disorder. The proper role of pre-birth testing is to help the parents to prepare the best they can for their new child or to enable medical interventions that are aimed at the well-being of the child in-utero, not to eliminate certain types of children.
Sex selection for family balancing reasons takes us into new and uncharted territory. It takes pre-birth testing out of a medical context and allows its use for non-medical (social) reasons. We ask: "What then stops parents using the technology for other non-medical reasons that reflect nothing more than parental desires? Where will it stop? We believe that parenthood is about welcoming the children we are given rather that ordering them according to specific specifications. There is a liberating truth in knowing the unconditional nature of our origins.
The report makes it clear that many people were uneasy with the thought of parents using the technology for social reasons and that this would be paving the way for genetic interventions on embryos for the purposes of producing babies with certain "desirable" qualities. The Council thinks that further investigation of the reasons for apparent public concern about the use of PGD for sex selection is warranted (p.51) but then inexplicably recommends that there are insufficient reasons to ban it! This is quite astounding and illogical.
Technology and its use must ultimately serve the integral good of the human person. It is clear that if all of the recommendations of this report are heeded that we will be moving towards a society that is less just and less inclusive.
The Nathaniel Centre – The New Zealand Catholic Bioethics Centre
The Bioethics Council Axing
11 March 2009
The New Zealand Catholic Bioethics Centre is deeply disappointed at the axing of the Bioethics Council.
The Bioethics Council, which was set up as a recommendation of the Royal Commission of Enquiry into Genetic Modification, has provided a very important mechanism for informing and engaging with the public on the use of new biotechnologies and other bioethical issues. The Council has helped New Zealand society explore the cultural, spiritual and ethical implications of emerging biotechnologies and has done so between parties holding widely divergent views.
Bioethical issues will only increase in complexity and it is regrettable that the National Government has seen fit to close discussion down by axing The Bioethics Council.
The manner in which this decision has been made also reflects a lack of due public process.
For further information contact:
Rev Dr Michael McCabe
The Nathaniel Centre – The New Zealand Catholic Bioethics Centre
phone: 64 4 499 2251
New Zealand Catholic Bishops Challenge Society Not to Legalise Assisted Suicide
25 March 2010
The New Zealand Catholic Bishops' bioethics agency - The Nathaniel Centre - says that Margaret Page's decision to end her life by refusing food and fluids raises serious ethical and moral issues, not just legal ones.
Director of The Nathaniel Centre, Father Michael McCabe, says an important aspect seems to have been overlooked:"Mrs Page is severely disabled as a result of a cerebral hemorrhage: she is not terminally ill," he says. "In Catholic teaching the provision of food and water is not considered to be medical treatment, but is rather a fundamental expression of human care. Accordingly it is a duty of care to continue to offer food and water even if a patient refuses them".
Father McCabe says of equal concern is the way in which Dignity New Zealand founder Lesley Martin has used Mrs Page's case to promote the legalisation of assisted suicide.
"In the past Ms Martin has promoted the legalisation of euthanasia as a means to help the terminally ill achieve death with dignity. Now she is effectively advocating assisted suicide to anyone who wants it," he says.
"The greater challenge to us as a society is not to legalise assisted suicide but to respond to the relational, spiritual and medical needs of a person that emerge at the end of life".
Babies with disabilities need protection, says bioethics centre director
23 June 2011
In a society where disability is feared, certain groups of persons, such as those with Down syndrome, require additional protections in order to uphold their right to life, says John Kleinsman, Director of the New Zealand Catholic Bioethics Centre – The Nathaniel Centre.
"Prenatal testing must respect the right to life of the unborn child. At the same time we have to consider the pressure parents are under" says Mr Kleinsman.
In 2008 the Bioethics Council (now disbanded) carried out extensive consultation with New Zealanders on the question of prenatal testing. Among the findings released in its report to Government the Council members highlighted the pressure many couples experience upon receiving their test results to make very rapid decisions.
"All too often, whether overtly or covertly, termination of pregnancy is presented as the automatic option after a test result indicating a disorder. As a result parents feel pressure to terminate children with Down syndrome and other disabilities".
"This pressure comes at a time when couples are already extremely vulnerable," says Mr Kleinsman. "It is of great concern that couples speak of encountering pressure from the health system to terminate a pregnancy on the basis of genetic test results".
"In this environment it will become increasingly difficult for couples to exercise a choice not to be tested or to continue with a pregnancy in the light of test results indicating a disorder. Our role, as parents, is to welcome our children in an unconditional way – this is what love demands".
To interview John Kleinsman contact
Press release one