Monday, July 23, 2012

The End of Life Choice Bill

Earlier in the year, Labour's Maryan Street indicated that she would be raising the issue of death with dignity again this Parliamentary term. Her bill, the End of Life Choice Bill [PDF], has just been submitted for the ballot. It's a different bill from Peter Brown's old Death With Dignity Bill, but the crux of it is the same: any mentally competent New Zealander suffering from a terminal illness, or an incurable one which in their opinion makes their life unbearable, can ask their doctor for help to end their life. Any mentally competent New Zealander can also make an advance directive specifying the circumstances in which they want such assistance should they become incompetent. Doctors and others who follow the procedures laid out in the bill are protected from prosecution for assisting suicide.

(Yes, "New Zealander". The bill only applies to New Zealand citizens and permanent residents, presumably in an effort to prevent euthanasia tourism from backwards countries like Australia. This seems unnecessarily restrictive IMHO)

In terms of safeguards, the doctor must get a second opinion, as with Brown's bill. Unlike Brown's version, there's no requirement for independent witnesses (though given brown's restrictions, these may have been very difficult to find in any case). There's also no requirement for the patient to undergo counselling. The doctor must encourage them to talk it over with a counsellor and their family, and advise them of other options (such as they are), but there's no requirement that they do so. This is appropriate; counselling requirements are an attempt to influence the decision and humiliate the patient by questioning their decision. This bill is far more respectful of personal autonomy.

One sticking point is that there's a requirement for a 7-day waiting period before the process can even start. That is, patients must suffer for at least a week before a doctor can consider their request. In practice, the consultation requirements mean some period of suffering regardless, but front-loading it seems unnecessarily sadistic; Brown's bill instead had a 48-hour waiting period once everything had been approved, which is both shorter and gets things the right way round. People shouldn't have to undergo torture before being able to consider their options to end it.

Finally, there's a central register for End of Life Directives, and a Crown Entity to review compliance and implementation with the law.

Overall, its probably a workable law. I'd like to see changes made, particularly around waiting periods and the residency requirement, but that's what select committees are for. And given the past history of such bills, it will almost certainly make it to select committee if it is drawn; the real battle will be at second reading.