Killing Me Softly: a New Zealand report on euthanasia

Carolyn Moynihan
1 July 2014
Reproduced with Permission

Over the past 20-odd years New Zealand has seen three legislative attempts to legalise euthanasia. Only the first (1995) went through the legislative process - where it was defeated by 61 to 29 votes. The third, introduced only last year by Labour MP Maryan Street, was withdrawn by her from the private members' bill ballot to prevent it becoming a "political football" in the general elections being held this year.

There is no doubt, however, that if Labour was able to form a government after the September elections the Street Bill would reappear. They and the Green Party (their likely coalition partner) regard it as their mission to advance "progressive" causes - as the passing of New Zealand's same-sex marriage law in April last year showed.

It is particularly easy to push such controversial issues through the New Zealand legislative system since it is unicameral (there is no upper house) and has only 120 members. Similarly there are few national news outlets of significance and they are all typically progressive in mentality.

With this in mind the family values organisation Family First NZ commissioned a report that would be a comprehensive resource for anyone wanting to study the issue and prepare themselves for the next round of debate.

The report, Killing Me Softly , was prepared by Professor Rex Ahdar of the Faculty of Law at the University of Otago. The 34-pager is an excellent resource, reviewing the issue in its New Zealand context, and examining the arguments both for euthanasia and against. Up to date information about the practice of euthanasia in The Netherlands, Belgium and a few other jurisdictions where it is legal demonstrates the "bracket creep" of euthanasia to include people other than the terminally ill.

MercatorNet asked Rachael Wong , a postgraduate student in bioethics and health law at Otago University, to canvass a few of the questions surrounding euthanasia with Professor Ahdar. Here is a summary of their conversation.

Is this an issue that should be settled democratically, say, by a referendum?

I'd only be happy with a referendum after extensive public discussion and education. You have to be clear what it is. Opinion polls in newspapers usually don't ask about euthanasia as such but about withdrawal of futile treatment or the double effect of administration of drugs. So we would need a thorough public discussion and there is no rush to do this. It could be spread out over a year or two. It's not an urgent issue. You can have TV debates, debates on the internet.

You have shown in your report that most public opinion polls in New Zealand show a majority in favour of this move…

Yes, this is the case in most countries but often the questions are misleading because they are really asking about withdrawal of treatment or the double effect of increasing pain relief, rather than intentional killing. Also they are usually not scientific polls but mostly phone-in or text your yes or no, so you get a self-selecting sample of the population.

Having said that, it is true that even the more scientific polls usually favour euthanasia - that is, even where the wording is more precise. For example, when people are asked if they favour "the intentional administration of a lethal drug to kill a person" - probably a small majority still favour that.

I am ultimately a democrat and if the majority of people want it I would have to go along with that. I certainly favour a referendum more than a conscience vote by legislators. It should not be up to 120 MPs to decide, especially since there's often unofficial pressure to conform to party position. David Cameron has said that he will allow a conscience vote in his party, but at least in Britain you have 400 MPs.

How can we get an informed public?

I admit most people won't read a report, including mine -- at most the executive summary -- but what they are most likely to tune into and benefit from is a few good rollicking TV debates. There's probably about 10 percent on either side who are not going to change their minds, but perhaps 60-70 precent in the middle could go either way if they have convincing reasons put before them. Most debates tend to work like that.

Given the serious ethical issues that society is confronting, do we need to teach ethics, or moral philosophy, in schools?

It would be nice if people had some philosophical education at school, but the value of that depends on the content of the programmes. I would want to see the content before allowing my kids to go through any ethics programme. I would not want them just getting a utilitarian perspective on ethical issues.

Are ordinary people capable of understanding the principle of double effect - that is, the importance of intention in administering painkillers like morphine?

Oh I think so. I use some common analogies in the report such as the D-Day campaign in WWII. The commanders could of course foresee that many hundreds if not thousands of men would die during that onslaught but their primary intention was to seize control of the French mainland from the Germans. I think that most people can grasp the point that they did not intend the deaths of any of their men. Certainly the criminal law has always accepted the difference between intending something and merely foreseeing it as a possible unintended consequence.

People scoff at the slippery slope argument, but is it valid?

There's enough evidence from the Netherlands and Belgium to show that the ethical slippery slope is real. The availability and extension of euthanasia to new groups and to people who have not fully consented - there are independent empirical studies that show that. It's not on a huge scale and the percentage looks quite small, but the actual number of deaths, 150-200, is still significant. And that's in a small population; if you extend that across a country like the US there would be huge numbers.

Aside from that, there is a more subtle psychological change to the way people in a society begin to think about the issue. Once "therapeutic killing" is available as a legal option the onus of proof tends to shift, so that if you are old and suffering from a severe terminal disease you are more likely to think, "Why am I not taking advantage of this? I've had a good innings. I'm using up my children's inheritance, and valuable public resources."

People are capable of thinking sacrificially and they may see themselves as the ones who are unreasonable, eccentric and stubborn in not using this opportunity. Importantly, others also will think of them in that way, their own families may.

The bedside scene may not look like a Dickens novel with the nephews twiddling their moustaches as they impatiently await the end. But we all know human nature, and for every good family who want their mum or grandmother to hang in there as long as possible there's going to be a bunch of others who are all too keen to see their elderly relations exit this world - whether to inherit their money or to be relieved of the burden of care if they have been looking after them.

This sounds very speculative in a country like New Zealand, but doctors in the Netherlands, for example, have written about the effects of the "climate change" that euthanasia brings to society over a number of years.

How do advocates respond to the evidence of involuntary or non-voluntary euthanasia in countries where euthanasia is legal?

There's the old tactic of trying to discredit the methodology of studies showing these effects. But a lot of the time they simply ignore the evidence and keep playing their usual cards, such as the need for compassion, arguments about autonomy and people's right to choose, how we treat animals better and so on. Or they'll cite a contrary study that found a smaller percentage of abuses and so on. But even if five or ten people have their lives ended without their consent it's too many.

The other side would say the same of course: even five or ten cases of people suffering with uncontrolled pain is too many. And you have to concede that there are a small percentage of people who just can't have their pain completely controlled by palliative and hospice care, and who may suffer fairly lonely and painful deaths. I see from letters I have had from strongly anti-euthanasia people that they find it hard to accept that.

However, the fact that there is still scope for improvement of palliative care does not justify bringing in a whole regime that allows us to kill people.