2003 Death with Dignity Bill

2003 Death with Dignity Bill

The second Death with Dignity Bill introduced by MP Peter Brown was similar to the Laws Bill which was defeated in 1995.

  • The main reason that is usually given in support of euthanasia is to end or avoid terrible suffering.
  • Opponents say that with all the advances in palliative care, once physical and emotional needs are met, euthanasia is not needed.
  • Peter Brown stated that the bill was not about euthanasia but voluntary euthanasia.
  • It was argued that the bill was more about comfort for the living than about dignity for the dying.
  • The bill was narrowly defeated by 60 votes to 58 with one MP abstaining and one not voting.
In May 2003 a private members bill entitled "Death with Dignity", the second of it's kind, was introduced into Parliament. According to its explanatory note:
"The purpose of this bill is to allow persons who are terminally and/or incurably ill the opportunity of requesting assistance from a medically qualified person to end their lives in a humane and dignified way and to provide for that to occur after medical confirmation, a psychiatric assessment, counselling, and personal reflection."
In May 2003 a private members bill entitled "Death with Dignity", the second of it's kind was introduced into Parliament. According to its explanatory note:
"The purpose of this bill is to allow persons who are terminally and/or incurably ill the opportunity of requesting assistance from a medically qualified person to end their lives in a humane and dignified way and to provide for that to occur after medical confirmation, a psychiatric assessment, counselling, and personal reflection."
The Bill, introduced by the deputy Leader of the New Zealand First party, MP Peter Brown, was similar to the Bill of the same name introduced by then MP Michael Laws in 1995.

A reading of both Bills reveals that wording is the same, except that Laws's Bill allowed for "terminally and incurably ill persons", whereas Brown's Bill says "terminally and/or incurably ill persons." The and/or means that the person does not have to be dying to be helped to die.

What the bill said
  • A person who is incurably or terminally ill may ask a doctor to end his or her life. The request must be written and witnessed
  • The doctor must then advise the patient, in writing, of the likely course of the illness and what would happen if the person decides to invoke the "Death with Dignity Bill"
  • A second written medical opinion must be sought that agrees with the first doctor's findings
  • The patient must undergo a psychiatric assessment that shows he or she is not depressed or suffering from any mental disorder.
  • The patient must accept counselling
  • The doctor must attempt to notify the patient's next of kin
  • 48 hours after all of the above the doctor can legally administer drugs that will cause death
  • The doctors, psychiatrist or counsellor can refuse to assist the patient to die
  • The person can make an ?advance directive' appointing someone to act for him or her should they become incapable of making the request for euthanasia themselves
  • Although it does not dictate the exact method of death, the bill strongly suggests that the doctor will administer medication which will terminate life
  • Death following the removal of life support systems is NOT covered
  • If passed through Parliament, the Death with Dignity Bill would become law if a majority of voters voted ?yes' in a referendum
The main reason usually given for allowing euthanasia is to end or avoid suffering. Opponents of euthanasia claim that palliative care is now so advanced that there is no need for euthanasia.

The Death With Dignity Bill would have allowed people to write a document giving another person power of attorney over their life in the event they became incapable of expressing their own will.

In a survey of 1100 GPs, 63% admitted that they had made a medical decision in the previous year that could have hastened death.

The bill sought to protect the patient's freedom of choice from coercion or external influence, by requiring a witnessed document confirming the request, counselling and a psychiatric assessment as well as a 48 hour period of reflection before the request would be carried out.

Possible Conflict with the Bill of Rights
A Ministry of Justice report suggested that the process for giving "advance directives" was arguably in breach of a right not to be deprived of life. Mr Brown said however,
"My legal advice is that the provisions surrounding advance directives are consistent with the Bill of Rights Act and with the general law. Following the Ministry of Justices report I commissioned a thorough review of the Death with Dignity Bill to ensure that it was in line with the Bill of Rights. The advice that I have received is that that is the case.

In addition, that legal advice has provided a number of suggestions for improving the Bill to ensure that the safeguards that it provides do not simply comply with the Bill of Rights Act, but are as effective as they could be. Those proposals will be put forward and debated, along with the rest of this Bill, during the Select Committee process.

My intention with this Bill is to allow the issues around death with dignity to be fully debated and discussed, both by Parliament and by the New Zealand public.

That is why the Bill would require a public referendum before becoming law. It is appropriate that this Bill be referred to Select Committee to allow that debate to begin."
Public Expectations
An informal newspaper survey of lawmakers conducted by the New Zealand Press Association, in early July, found 37 members of parliament (MPs) voicing support while 33 responded they would vote against the measure. That left another 50 or so MPs who, were either undecided or who, refused to make their opinions known. Prime Minister Helen Clark announced her support for whatever pro-euthanasia measure might come to her desk.

Faced with such uncertainty, SPUC New Zealand and Right to Life of New Zealand invited American Brian Johnston to help. Johnston is director of National Right to Life's Western Office, and author of the book Death As A Salesman: What's Wrong With Assisted Suicide. His work had helped defeat numerous state euthanasia bills as well as thwart euthanasia proposals in South Africa and elsewhere.

The organisations arranged for numerous public meetings and media interviews for Johnston. Johnston also was able to speak with key members of parliament before the vote. In addition RTL New Zealand sent copies of Johnston's documentary video Death As A Salesman to the 50 non-committed parliamentarians.

Johnston and others advocate palliative care, as provided by hospices, for management of pain for terminally-ill people. He argues that meeting a patient's physical and especially emotional needs dissipates suicidal desires, which studies have found to be a cry for help.

Lesley Martin, president of the pro-euthanasia EXIT New Zealand, predicted quick victory for the bill and subsequent passage of the referendum. She noted that opinion polls consistently show that 70-75% of New Zealanders would support legalising euthanasia.

First Reading
Wednesday 30 July 2003
PETER BROWN (Deputy Leader?NZ First):
I want to start by telling the House what this bill is not about. It is not about euthanasia. Euthanasia is defined as the painless killing of a patient suffering from an incurable, painful disease. There is no mention in that definition of who will administer it, and no mention of whether the patient wants it, requests it, or is even aware that it is happening. This bill is not about any of that.

This bill is about voluntary euthanasia. There is a world of difference between the two. This bill is about me being able to make a decision for myself?not my wife, not my doctor, not my family, not the hospital; nobody but me being able to make a decision for myself.

Equally so, it is about every adult New Zealander being able to make a decision for himself or herself?nobody else; just the individual adult New Zealander. But there are two provisos. Firstly, the individual must be of sound mind and be able to make a rational, easily understood decision. Secondly, he or she must be terminally and/or incurably ill. Those are the two provisos before somone can make that decision.
Hon BILL ENGLISH (Then Leader of the Opposition):
I oppose this bill for a simple reason: one of the strongest presumptions in our law is the presumption against taking a life. Our own Crimes Act makes it quite clear that the taking of a life is culpable?that is, if one takes a life, that is examinable by the rest of the community as to its purpose and intent. We as lawmakers have for the whole life of this Parliament now set a high threshold around the taking of life. I oppose this bill because it lowers that threshold. I do not believe that the proponents of it have mounted anything like a strong enough case that the threshold around the assumption against taking a life should be lowered.

The bill sets out a process by which we can validate the taking of a life. I have to say that no process is good enough to be free from the pressures, the envies, and the hatreds to which any human being can be prey. No process is good enough to be free from that, and if the House wants to look to a process that it has tried to construct in the past to achieve those ends, then it can look at the Contraception, Sterilisation, and Abortion Act, because it has a remarkably similar process to this one. It includes experts, doctors, consultants, and references to mental health, and everyone knows that it has become a conveyor belt to abortion.

MPs need to keep in mind that if that is the track record of this Parliament's capacity to devise a process to protect the vulnerable, then we have failed utterly. As a Parliament we just simply turn our faces from the failure of that legislation, because it has now become a social norm that abortion is acceptable. That is 25 years on from when the legislation was passed, and I say we could stand here in 25 years' time and say exactly the same thing about the process in this bill.

This bill is about comfort for the living. Let us not pretend it is about the dignity of those who have gone, because they have gone and we have different views about where they have gone to, depending on our beliefs. I do not think it is a duty of this Parliament to remove the basic presumption against taking a life, in order to give comfort to those who encounter the very human experience of watching suffering.
Hon DAMIEN O'CONNOR (Minister for Racing):
While Mr Brown is putting up a proposal that says we are allowing self-determination for when one should end his or her life, in the end the ending of someone's life?for the most part, just about every time?will depend upon assistance or judgment or influence by other people. We have different experiences in our lives?that is why we have different opinions on things...

There are many people who suffer, and, like many people, we have seen those around us suffer with cancer and go through different forms of treatment. Some people, through the action of doctors, take chemotherapy and are pushed to the limits of life to kill the unwanted cells, and then brought back to life through other drugs, it is hoped allowing just the life of the good cells and allowing the destructive cancer cells to be destroyed once and for all.

Through all those processes people go through highs and lows and go through different forms of suffering to be at a stage in their own lives where, perhaps, given the choice, they might choose to end their own lives. Perhaps, given the choice, relatives might think it best that those people no longer live.
RODNEY HIDE (ACT NZ):
We have heard two very good speeches tonight against the bill. I want to speak in favour of Mr Brown's bill, as a matter of principle and as a matter of personal experience. The principle is this. I believe that we, not the State, do own our own body and our life. I believe that if we choose to we can end our life. It is obviously the most drastic decision that a person can take, but one can do that. I believe that it is an affront to deny people who want to end their life the dignity of ending it in a way that is humane.

That is what our current law does. Of course we have to have a sharp line between suicide and murder, and this bill has that. That is why I support the bill. I ask members at least to send it to a select committee and hear what the people have to say.
MIKE WARD (Green):
We must ensure appropriate palliative care, but we should take all other possible steps to ensure that people want to go on living. But if, in spite of all our efforts, a person still wishes to die, the issue is whether that person should be able to choose to die. If we believe that there are any circumstances where that is a reasonable choice, we must make it possible for people to make the decision and carry out their wishes, supported by the medical profession and the people they care about. As the law stands, deciding to die, and involving anyone else in the process?that is, having someone else help a person to die, having friends and family around as that person dies, and having someone knowingly provide the means for a person to die?subjects helpers and witnesses to the likelihood of criminal action.

This is one of those issues on which it is appropriate to have a decision by referendum, but that does not negate the role of Parliament or the public through the select committee process to frame legislation that addresses the fears and concerns of the proponents, as well as the opponents, of voluntary euthanasia. How and when we die is an uncomfortable issue for most of us, but that should not undermine our compassion for those who have accepted their own mortality and who would choose to die with dignity in the presence of the people they care about.
GORDON COPELAND (United Future):
I rise to speak on the Death with Dignity Bill. I cannot say those words without my mind immediately going to the little nun from Albania who devoted her life to taking the dying from the filth and squalor of the streets of Calcutta into a specially prepared home where they were lovingly washed, clothed, and cared for until the last moment of their lives. As the news of her work spread throughout India and then throughout the world, Mother Teresa was asked repeatedly why she had made the decision to undertake such work. Her reply was simply that it was so that those people could die with the dignity that should be accorded to all human beings.

I can say without fear of contradiction that if Mother Teresa were here tonight, it would be to plead with us not to vote for this bill; for, in spite of its title, the truth is that this bill does not point the way towards death with dignity, but to physician-assisted suicide. A similar plea would be made to us by the thousands of doctors, nurses, and helpers who make up the worldwide hospice movement. They, too, have devoted their lives to the palliative ongoing medical care of those whose conditions mean that they are approaching the end of their lives. I know that to be true, for I have received many letters from them, couched in the most moving terms, asking me to vote against this bill.

Indeed, this bill is a contradiction of all that they stand for. They tell me that they employ their expertise in ensuring that people are able to die with dignity. They tell me of the enormous progress they have made in controlling pain, and ask us to give our support to their attempts to kill the pain?not, by deliberate action, to kill the patient.
GEORGINA BEYER (NZ Labour?Wairarapa):
It is with pride that I take a call on this member's bill, which I intend to support going through to a select committee. From thereon I am torn, but I believe that this bill deserves the dignity of at least being debated. I believe that this country is ready to have this full debate, and for the bill to have the scrutiny of the select committee process to proceed, so that, maybe, once and for all, we could settle this matter in a fully discussed way?albeit I understand we could dispatch it from this House tonight, never to be seen again for many, many years.
BRIAN DONNELLY (NZ First):
I had long been persuaded that the answer to the suffering of people with terminal illness was better palliative care. Upholding the sanctity of human life demands that we provide the best possible level of palliative care. I have little time for Michael Laws, but I can understand his bitterness towards those who voted against his bill and then did nothing to raise the level of palliative care in this country. In fact, many of them allowed the resourcing of palliative care to be diminished. No one who works in the area of palliative care, however, has been able to provide me with an assurance that even with the best treatment we are able to provide we can ensure that such care will catch all circumstances. There are still some who are doomed to an undignified, agonising death, and it is for those people that I will be voting for this bill to go to the select committee. If, through the select committee process, I can be convinced that palliative care can catch all, I will reconsider my position.

I commit myself at this point in time simply to vote for the bill to go through to the select committee. That is the right place for the issue about palliative care to be vigorously scrutinised in a balanced, public debate. It is also the place where the regulations to ensure that the law does not spread its intended coverage are robust and tight. We hear evidence from the Netherlands, and we want to make sure that that scenario will not be able to be repeated in New Zealand, if what we hear is true. I hope that I do not have to draw people's attention to the fact that it will go to a binding referendum.
Dr LYNDA SCOTT (NZ National?Kaikoura):
I think that I, more than anybody else in this House, have had more experience with people when it comes to death and dying. As a nurse, as a doctor, and especially as a geriatrician who worked in the hospice movement, I dealt with death and dying every day of the week, and I cannot support this bill. There are people who are admitted to hospices who say: "I want to die.", but what they are saying is: "I want the nausea to go away. I want the pain to go away." When one treats them, they want to continue to live.

As a geriatrician I dealt every day with people who felt they were a burden to their family. I dealt with elder abuse, and I dealt with people who were slowly dying?and a slow death is never easy. But I remember when my own father died of cancer, and my favourite aunty. When I look back at the days I spent at my father's bedside, I see them as being probably some of the best days. I spoke to my father probably more in the last two weeks of his life than I had in the 20 years before, and I value that immensely.

We must remember that this bill is about active euthanasia. This is about actively taking a person's life. It is not about passive euthanasia. We heard about Martin Hames, who made the choice not to have treatment and die?that is passive euthanasia, and it happens every day in our hospitals and in our homes, when people say: "I do not want to be treated any more. I do not want the antibiotics. I do not want the operation. I want you to let me die." That is passive euthanasia, and it happens. This is not passive euthanasia; this is active euthanasia. It is about actively taking a person's life.

It is a doctor's ethical responsibility to save life, not to take it. The Hippocratic oath reinforces that. To ask somebody else to take a life is a line we should not cross with regard to active euthanasia. Euthanasia is described in the dictionary as the act or practice of killing someone who has an incurable disease or injury, or assisting that person to die. How does one define 'incurable illness'? How does one define an advance directive? Advance directives are very dangerous. When does somebody lose his or her mind? When is the actual day when somebody no longer recognises his or her family? I have dealt with people with dementia for years. One day they may recognise their family, and the next day they are not so good. When is the day one is going to kill them? That is an extremely hard decision. It is easy to think about this bill in terms that do not come down to the practical realities of what one is doing.

When Michael Laws first put up his bill in the 1990s I, like many people, thought: "Well, maybe there is justification in this.", but when we look at the issues, and at what we are actually doing here, and at the line we are crossing, we see that the answer has to be emphatically no. Members have heard the arguments about the slippery slope, and they have validity. When it is acceptable for a doctor to take a life, one is crossing a line. When it is acceptable to say, "This person no longer knows who they are. This person left an advance directive. This elderly person has said to me that they want to die.", one crosses a line.

Does the line of incurable illness include mental health? Does that include somebody who is severely depressed, but who can become well again with appropriate treatment? If it does, this bill should never go any further than this House tonight. One has to think about what it would be like to hold the hand of one's mother or father and watch them being given a lethal injection, and think about how one would feel for the years ahead. The price is too high for this bill to proceed.
Hon MAURICE WILLIAMSON (NZ National?Pakuranga):
I think that the concept of somebody wanting to terminate his or her own life because of incurable agony, and the pain and suffering that is going to go on for a limited time before he or she finally dies, is a perfectly legitimate issue over which an individual should have a right to make a decision. But I think there are some issues about both overt and even covert pressures that may come on a person.

There are clearly the covert issues of elderly people, who are suffering and in pain, going towards the end of their lives and worrying about whether they are eating up the assets of their children, to whom they would like to leave some inheritance. Even though the kids may not be placing that pressure on them, it may finally get to them, and they might say: "Look, I know I could hang on for some time. I can bear the pain, and the morphine is keeping me OK, but I'm going to whittle away my kids' inheritance to a point where it's nothing, so I'm best to trundle off." I would like to know that we can make sure that that process could not happen. I would also like to make sure that the overt pressure that can be put on somebody?with people saying things like, "Come on, it's time you got out of here because you're just suffering, and we would like to get the inheritance.", or whatever?could not happen.

...if in the end the proper processes were there?with medical practitioners making the right interventions?and if we had put the necessary safeguards in place, there is one fundamental freedom that we should always protect for an individual. It is the right to make that final decision. I will be voting for this first reading.
PETER BROWN (Deputy Leader?NZ First):
This is a controversial issue, a delicate issue, and a sensitive issue, but the public have a right to talk about it. In an hour and five minutes we cannot possibly condemn the public to silence. It will not go away. I ask members to please send the bill to select committee. Please let the folk we are talking about, and the people who are concerned for them, have their say. I am on the side of the suffering. I will leave it to others to say, "let them suffer."

Sending this bill to the select committee is not binding on any member. Any member can change his or her mind later on. It is simply democracy in action?letting the public have a say about a controversial, delicate, sensitive issue. That is all the public wants at this stage, and I think that is a reasonable request. I urge all members to find compassion in their hearts?to the degree that they want to let the people that this bill will embrace talk to the select committee, make a submission, and discuss this issue publicly and openly. That is what I am asking at this point in time. I am not asking people to put a stake in the sand and say that they are with this bill for ever. I am?I believe that something has to be done for these folk. I have looked at the issue and wrestled with my conscience for quite some time, but I am asking members to think now of these people in a friendly and compassionate way, to allow them to come to the select committee and make their views, and the opposing views, known.
Narrow Loss
The Death With Dignity Bill failed when it was defeated at the first reading by 60 votes to 58 in a conscience vote for MPs. One MP abstained and one did not vote.

Peter Brown said after the vote that he was shattered. "The politicians have let the people of New Zealand down. I'm pretty brassed off."

The vote went as follows:

FOR
 Marc Alexander (UF)  Helen Duncan (Labour) Luamanuvao Winnie Laban (Lab) Ken Shirley (Act)
Tim Barnett (Lab) Ruth Dyson (Lab) Keith Locke (Greens) Lockwood Smith (Nat)
David Benson-Pope (Lab) Gerrard Eckhoff (Act) Moana Mackey (Labour) Barbara Stewart (NZ First) 
Sue Bradford (Greens)  Ian Ewen-Street (Greens)  Steve Maharey (Lab) Nandor Tanczos (Greens)
Don Brash (Nat)  Russell Fairbrother (Lab) Murray McCully (Nat) Georgina te Heuheu (Nat)
Peter Brown (NZ First)  Jeanette Fitzsimons (Greens) Mahara Okeroa (Lab) Judith Tizard (Lab)
Mark Burton (Lab)  Stephen Franks (Act) Pita Paraone (NZ First) Metiria Turei (Greens)
Chris Carter (Lab)  Phil Goff (Lab) Edwin Perry (NZ First) Tariana Turia (Lab)
Brent Catchpole (NZ First)  George Hawkins (Lab) Jim Peters (NZ First) Mike Ward (Greens)
Steve Chadwick (Lab)  Dave Hereora (Lab) Winston Peters (NZ First) Maurice Williamson (Nat)
Helen Clark (Lab)  Rodney Hide (Act) Lynne Pillay (Lab) Pansy Wong (Nat)
Deborah Coddington (Act)  Marian Hobbs (Lab) Richard Prebble (Act)  Doug Woolerton (NZ First)
David Cunliffe (Lab)  Pete Hodgson (Lab) Matt Robson (Prog C)   
Rod Donald (Greens)  Jonathan Hunt (Lab) Heather Roy (Act)  
Brian Donnelly (NZ First)  John Key (Nat) Dover Samuels (Lab)  

   AGAINST
Paul Adams (UF)  Lianne Dalziel (Lab) Annette King (Lab) Mita Ririnui (Lab)
Jim Anderton (Prog C)  Peter Dunne (UF) Janet Mackey (Lab) Ross Robertson (Lab) 
Shane Ardern (Nat)  Harry Duynhoven (Lab) Nanaia Mahuta (Lab) Tony Ryall (Nat)
Donna Awatere Huata (Act)  Bill English (Nat) Trevor Mallard (Lab) Tony Ryall (Nat)
Larry Baldock (United Future) Taito Phillip Field (Lab) Wayne Mapp (Nat) Clem Simich (Nat)
Rick Barker (Lab)  Martin Gallagher (Lab) Ron Mark (NZ First)  Murray Smith (UF) 
Gerry Brownlee (Nat) Mark Gosche (Lab)  Craig McNair (NZ First) Nick Smith (Nat)
David Carter (Nat) Sandra Goudie (Nat)  Muriel Newman (Act) Roger Sowry (Nat)
John Carter (Nat) Bill Gudgeon (NZ First) Damien O'Connor (Lab) Jim Sutton (Lab) 
Ashraf Choudhary (Lab)  Ann Hartley (Lab) Bernie Ogilvy (UF) Paul Swain (Lab)
Judith Collins (Nat)  Phil Heatley (Nat) David Parker (Lab)  Lindsay Tisch (Nat)
Brian Connell (Nat)  Parekura Horomia (Lab) Mark Peck (Lab) Judy Turner (UF)
Gordon Copeland (UF)  Darren Hughes (Lab) Jill Pettis (Lab) Margaret Wilson (Lab)
Clayton Cosgrove (Lab) Paul Hutchison (Nat)  Simon Power (Nat) Richard Worth (Nat)
Michael Cullen (Lab) Sue Kedgley (Greens) Katherine Rich (Nat) Dianne Yates (Lab)

ABSTENTION
 
Dail Jones (NZ First)
 

DID NOT VOTE
John Tamihere (Lab)

Sources:
VES News www.ves.org.nz
NZ First Party website
Hansard 30 July 2003 Full Debate