Monday 5 March 2018

Supporting voluntary euthanasia


Have you written your submission yet supporting David Seymour's bill, which supports your right to voluntary euthanasia -- his End of Life Choice Bill?

Submissions close at midnight tomorrow, so you really have to get going!. (And quit those excuses! It's not hard to write one.)

Here, today, is mine:

Submission on the End of Life Choice Bill 2017
To: Justice Committee
This submission is from Peter Cresswell
I do not wish to appear before the committee to speak to my submission.
I can be contacted at peter.organon@gmail.com

1. This submission is in support of the End of Life Choice Bill 2017. I support this Bill because it is my right to peacefully live my life – or end it – as I see fit. 

2. I wish to make the following general comments, concluding with specific recommendations.

General

3. It has been said that the best test of government might be that it allows people free to choose their own way of life — just as long as they don’t initiate force or fraud upon others. Another test, it has been argued, is how it treats the most vulnerable.

4. Both measures, both standards, are strictly on point in this Bill. This Bill will properly protect the right of every vulnerable patient to choose. Specifically, their right to choose the means of ending their own life.

The right to choose

5. A right recognises the ‘moral space’ in which one can act — or can authorise action taken on one’s behalf. The right to life that every living human being enjoys includes as an unflinching corollary that every human being bears the right to end that life. The job of parliament is to recognise that right, and protect that moral space.

6. We must all die one day. Reality makes that choice for all of us. What ailing patients seek however is simply the right to bring that day forward when the sufferings of their ailment makes extension of their life unbearable. They demand the right to make that choice for themselves – and it is within the power of this parliament to recognise that right.

7. That this decision is the most crucial of their lives – and could not be more irrevocable — means it could not be more important for parliament to recognise and protect that right. No choice could be more important in an individual life; nobody more vulnerable more deserves the protection of proper law.

8. That the choice is irrevocable demands that proper safeguards against abuse are put in place (and I comment on that below). That the choice is a reflection of right means it demands legal recognition.

Arguments against

9. It may be argued, and has been, that there is a religious or moral proscription against taking one’s own life. But even if one were to agree with this view, as a decreasing number of people do, it must be recognised that where there is no choice — where that choice, for example, has been barred by law — then neither can there be a moral action.

10. Yet if one follows religious doctrine, as many who hold this view do, then one must recognise that the Creator created human beings complete with the faculty of free will, and for precisely this reason: to give to human beings the ability to make moral choices. But to remove the possibility of choice by law is to remove the very possibility of morality that the Creator had enacted. Rather than the religionist protecting the choice of the Creator in whom they believe, they are instead betraying it. And the choice of legislators is instead substituted for that of the person whose moral space it rightly is.

11. As the British theologian Pelagius famously recognised sixteen centuries ago, we are each granted the moral capacity to choose, and it is only through the exercise of that capacity that moral action is possible. In other words, morality ends where compulsion begins.

12. The point being that without it being possible to make the choice to be (allegedly) immoral, then neither is there the choice to be moral.

13. There are honest folk who remain of the view however that a patient makes an immoral act in choosing to end their own life. Very well. But this view, however honestly held, must not and cannot overmaster that of the person who holds an opposing view, and whose life it is on which their choice rests.

14. That choice makes no demands upon others beyond seeking their voluntary assistance – and the right of medical staff to refuse that assistance must also be protected (and I believe that the provisions of clause 6xxx do so).

15. If it is true that there is a religious or moral proscription against taking one’s own life, then those with that outlook must be free to make their choices based upon that presumption.  But if I or others choose to end my life, or seek help to end it, this choice – this right! – in no way affects them, or demands that they make the same choice. To paraphrase one of history’s great statesmen, it neither picks their pocket nor breaks their leg, nor takes away their own right to make their own choice in the matter

Voluntary Euthanasia

16. It should not be forgotten that the argument here, and the legislation in whose case it is being made, is for voluntary euthanasia: for people to have the right to make the and carry out the choice to end their own lives, and not that of another. In that, there is and can be no right. That would remove choice, not protect it. That would give force to a power beyond right.

17. Yet it must be observed, and can be every day in every hospital and nursing home in the country that the present law already supports this power beyond right -- ad hoc nod-and-a-wink decisions being made on behalf of others every day, with the most benevolent of intentions it is true, but without any safeguards beyond the probity of the practitioners, the best of whom are left to guess at what would be the real wishes of folk — as medical staff must — because they are barred by law from talking explicitly about this most crucial decision.

18. Being so crucial, so final, it is imperative that there are proper safeguards put in place to protect those making the decision against 
1.     being bullied into it by others;
2.     having the decision taken out of their hands; or
3.     making a decision without proper contemplation.

19. I believe it is possible to put proper legal safeguards in place that will give proper protection in all three cases. These may include all or some of the following:
1.     The patient must affirm the decision several times before several different witnesses. There is no necessity for these affirmations to be made with or even in the presence of medical staff, and nor should the opinion of medical staff be allowed to outweigh that of the patient. The law should protect against undue delay in these repeated affirmations.
2.     As a minimum however, the Bill should allow sign off of this choice by 2 doctors and a psychiatrist. But the opinion of medical staff must not be allowed to outweigh that of the patient.
3.     The Bill should allowing the set-up for the means of euthanasia to be done by others, and (where possible) the final ‘button’ to be pushed by the patient. Thus, at the final moment, the actions taken by practitioners would solely be one of assistance, not of the euthanasia itself.

Recommendations

20. Section 4. Meaning of person who is eligible for assisted dying
 The right of any New Zealand citizen to make their own choice in this matter must be preserved. We recommend the retention of clauses 4a, 4b and 4f. The other clauses in this section remove the right of choice, and should be removed.

21. Section 6, Conscientious Objection
This is a most important section, protecting the right of refusal by practitioners. I strongly support its inclusion, and that of section 7, and even strengthening.

22. Sections 8 to 13, Request and Opinions
While understanding the reasons for the process described herein, I argue that the process calls for unnecessary delay and (crucially) leaves the opinion on termination in the hands of anyone but the patient in question. This is wrong, and should be remedied. The only opinion that matters, in the end, must be that of the patient. We recommend instead that a process be put in place to record before suitable witnesses a series of the patients’ un-coerced affirmations of their wish, and no more.

23. Section 16
The section talks of medication being “administered.” I argue that, for any patient able to administer it themselves, that the medication and means of delivery be made available to the patient in as simple a mechanism as possible for their own administration of the lethal dose. This provides the ultimate safeguard against a coerced termination.

7 comments:

Mark Hubbard said...

Great submission, Peter.

Unknown said...
This comment has been removed by the author.
Unknown said...

Looking very good and I haven't reached the end yet. Trying to get Philip Nitschke to read my draft and offer his input before time runs out..

Ben said...

"1. The patient must affirm the decision several times before several different witnesses. There is no necessity for these affirmations to be made with or even in the presence of medical staff, and nor should the opinion of medical staff be allowed to outweigh that of the patient. The law should protect against undue delay in these repeated affirmations.

2. As a minimum however, the Bill should allow sign off of this choice by 2 doctors and a psychiatrist. But the opinion of medical staff must not be allowed to outweigh that of the patient"


No, no, no. If the medical staff judge the patient to be senile (for example), then their opinion comes first. In fact, if the patient's opinion outweighs the medical experts then that pretty much makes the experts redundant.

This is tricky because being of sound mind is often not such a clear cut issue. Medical staff need to be convinced of this, and that there is no coercion from family.

I'm certain Seymour's bill would pass if it addressed these issues.

Peter Cresswell said...

"In fact, if the patient's opinion outweighs the medical experts then that pretty much makes the experts redundant." Precisely.

Who could be any more expert about one's life than oneself? Who else is entitled to make such a decision?

I agree there need be a threshold of sound mind -- and above all proper safeguards against coercion. But the bill as written has too few safeguards, and places too much weight on so-called experts. That needs to be reversed, in my opinion.

Peter Cresswell said...

How are you going with that?

Anonymous said...

"Who could be any more expert about one's life than oneself? Who else is entitled to make such a decision?"

There is a point when we seek advice from experts about all sorts of ailments because they are more expert about that aspect of our life than we are. That the final decision to top oneself remains with the person is an ideal but if that is the end point I see no need for medical experts unless the person seeking death asks for such medical advice.

I remain of a view you overplay the religious aspect, especially Christianity. The religious probably have a view that varies as widely as the secular but they have no real influence any more so pose no threat. Your submission is at least respectful to that alternative view in that it addresses that potential influence in a professional manner.

Apart from that I think its the most professional submission effort on the blog so far so well done.

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