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Photo: Getty Images.
Photo: Getty Images.

PoliticsOctober 30, 2019

In an ideal world, euthanasia would make sense. We don’t live in an ideal world                          

Photo: Getty Images.
Photo: Getty Images.

Proponents of the End of Life Choice say that controls on euthanasia will make it safe for all. But the reality is that euthanasia will be impossible to fully regulate, argues Jannah Dennison.

The End of Life Choice Bill has now made its way through the Committee Stage, and with the issue poised to be put to a public vote in 2020, the question of safeguards has been top of mind.

It’s essential to examine the finer details of any law, especially one such as this. But the bill rests on the assumption that we can control euthanasia; that if we try hard enough, we can prevent both misadventure under the agreed criteria, and the problematic widening of criteria over time.

The reality is, we cannot make euthanasia safe. It is inherently uncontrollable. The detailed safeguards are simply rearranging the furniture when the house foundations have crumbled. Yet many of us so deeply want to make it safe. And so we believe that the wanting will make it possible.

The conditions of suffering for every person are, in fact, so individual and contingent as to make it impossible to draw safe and consistent lines between a person who is eligible for euthanasia, and one who should not be. And the ongoing societal implications are enormous.

Euthanasia safeguards would need infallibly to prevent undiagnosed depression; identify subtle coercion; and consistently identify other underlying factors, such as a deficit in familial, professional, or social support; the fear of being burdensome; or financial concerns. And every one of these factors has been documented – some regularly – as the main reason for accessing euthanasia in overseas jurisdictions.

Safeguards must also prevent any confusion around the difference between assisted suicide, euthanasia, and general suicide, ensuring that no vulnerable person felt that death as a response to suffering had become normalised and thus attractive.

And then we have the clearly documented fact that even tightly prescribed criteria seem inevitably to widen. Which is, of course, a logical progression – and which no legal safeguard can prevent, once you have established the right to die as foundational.

Examples of problems abound. The United Nations Special Rapporteur on the rights of persons with disabilities stated in April 2019 that she was ‘extremely concerned’ at the impact of the Canadian euthanasia legislation on disabled people eligible for assisted dying, some of whom are being pressured to consider euthanasia.

Take the case of Canadian Roger Foley. Terminally ill, and with associated disabilities, he released recordings of staff offering him euthanasia whilst considering the high cost of his care. Similarly, the mother of severely disabled Canadian Candice Lewis has recounted a doctor’s recommendation of assisted suicide when Candice was ‘dying’ (she did not die, as it turns out), and the accusation that the mother was ‘selfish’ for not pursuing it.

In Oregon, Dr Charles Bentz described a keen sportsman who was diagnosed with cancer, developed depression, and sought euthanasia. Dr Bentz urged caution due to the depression; but later discovered the man had died from euthanasia through another doctor who did not acknowledge the depression. And a 2019 Guardian article told of a Belgian GP, ‘Marie-Louise’, who refused to euthanize a patient who was clearly being pressured by his wife. But when the GP returned from holiday, she found that another colleague had euthanized the man.

What does Mr Seymour do with such examples? Perhaps, we might say, they are isolated incidents. But even in themselves, do they matter? After all, people have died. At least, do they count as evidence that things can so easily go wrong? And what makes any intelligent person think that these are the only such cases?

Or, you could say: we will be different, with better safeguards. But all of these jurisdictions began with good, painstaking process – why would anyone do otherwise? The impossibility of safety does not finally lie with the process, but the issue itself. When inducing death early, it is naïve to think that nothing will go wrong across all the myriad intricacies of our suffering and our inter-relationships. The problem is people.

Time and again, David Seymour does not sufficiently address specific examples of the problems of implementing safeguards in real life. He comes back to the neatness of things on paper; in fact, he says, astonishingly, euthanasia is “safer than any other process in NZ healthcare”. Why? Because he so much wants it to be safe. And so he doesn’t have an answer to when it’s not.

Professor Theo Boer from the Netherlands – ethicist and former member of a euthanasia review committee – epitomises the discrepancy between the principle and the reality of euthanasia. He doesn’t completely dismiss euthanasia in principle. But he was in New Zealand recently to discuss his about-turn in his advocacy for euthanasia, having seen its uncontrollable complexity in real life: “For years I supported the Dutch law on assisted dying. But… I have more concerns now than ever before… A society’s signal that it is willing to organize the death for its citizens simply involves too many risks.”

Claire Freeman, NZ disability advocate, is the same. “I’ll be honest with you,” she says. “I would love to see people have that choice.” But she too has rejected it; she understands the huge ramifications that euthanasia would have in practice.

So what are we to do?

Given the high confidence of the palliative care sector (who work daily at the coal-face) in the rapid development of good end-of-life care, and given the broad array of medical, legal, and social support organisations in NZ and abroad who have rejected euthanasia, we have only one wise choice. This is to unify our resources and our education towards accessible, quality end-of-life care, and disability and elder support.

Other jurisdictions – over 30 just since 2015 – have faced this question and have chosen against euthanasia, as we should. We cannot introduce a regime that is so inherently uncontrollable. Idealism around our capacity to safely control death will introduce a whole new category of suffering that is impossible to regulate.

Keep going!
Phil Twyford in campaigning mode. Photo by Hannah Peters/Getty Images
Phil Twyford in campaigning mode. Photo by Hannah Peters/Getty Images

PoliticsOctober 29, 2019

Why Phil Twyford should absolutely be sacked (and why he absolutely shouldn’t)

Phil Twyford in campaigning mode. Photo by Hannah Peters/Getty Images
Phil Twyford in campaigning mode. Photo by Hannah Peters/Getty Images

Transport minister Phil Twyford is under fire again, and is facing calls to be sacked over delays around Auckland’s light rail system. Should he stay or should he go? Alex Braae assesses the arguments. 

The drums are beating for Phil Twyford. The failure to get the government’s Auckland light rail plans out the door, and the possibility Twyford misled the public in the process, have led to calls for either his resignation or sacking.

However, that doesn’t mean Twyford’s political demise is inevitable. Sometimes ministers survive turbulent weeks intact, and sometimes they’re forced out before anyone has seriously suggested the possibility. Iain Lees-Galloway faced down repeated calls for his resignation over the decisions he made in the Karel Sroubek saga, while Twyford himself immediately offered his resignation (and was stripped of responsibility for Civil Aviation) when he was snapped using a cellphone while his plane was taxiing. These matters are unpredictable, and depend on political calculations as much as those around policy.

So, should Phil Twyford stay or go? Here are the two competing cases, broken down into the various arguments that will be thrown around over the next few days.

Go

This was Labour’s big idea for how to cut through the Gordian knot of Auckland’s traffic congestion. It would have taken cars off two crucial and frequently clogged roads – the Southwestern motorway and the Northwestern motorway. Twyford’s insistence on hearing out the Super Fund bid to build light rail has caused interminable delays to it actually getting started, and commuters deserve better.

Stay

Hang on, isn’t it the job of ministers to weigh up competing options so as to find the best one? These are hugely complicated projects, and delays are inevitable if you want the best possible decisions to be made. What a waste it would have been to get a couple of years into the construction of a project that turned out to be inadequate.

Go

Phil Twyford has been accused of misleading the public. NZ Herald columnist Matthew Hooton made this claim last week, saying the Super Fund’s bid to build their version of the mass transit network was clearly solicited. That cut against repeated claims that the Super Fund bid came entirely off the organisation’s own bat.

Stay

Phil Twyford has declared this allegation totally wrong and defamatory. Either way, does it actually matter much? Is this not simply one of the eggs that might need to be broken to make the ministerial omelette, as it were? And again, if it results in a better outcome being achieved, then don’t the ends justify the means? This is government, and government in the real world is sometimes messy and complicated.

Go

Come on, this is being far too generous. This is twice now that Phil Twyford has been tasked with rolling out a Labour policy which promised to be transformational. And just like with Kiwibuild, this has dented the credibility of the government as a whole. These debacles are directly in his portfolios, and being a minister means wearing that responsibility when things go pear shaped.

Twyford was moved out of housing after KiwiBuild crumbled

Stay

Why would you get rid of someone overseeing a complex project right in the middle of crucial decisions being made? It is impossible to imagine that Phil Twyford hasn’t learnt useful things over his two years as minister of transport – surely that knowledge is best put to use by keeping him on as minister of transport? Besides, Twyford is a big vision sort of guy, and the government needs that. In fact if not for big visions, what’s the point of anyone going to the trouble of getting into government at all? We should all want our politicians to aspire to more than simply keeping things ticking over.

Go

The Royal Navy once shot an admiral in the 18th century, ostensibly according to Voltaire “to encourage the others.” For PM Jacinda Ardern to get rid of Phil Twyford would show that she’s serious about incompetency not being acceptable. While former minister Clare Curran was sacked for improper diary keeping, there was plenty of speculation that she was sent packing for not being up to the job. Twyford deserves the same.

Stay

Which lucky sailor would get to be the next admiral of the ship? Julie Anne Genter might have done a fairly competent job in her limited areas of responsibility as associate transport minister, but the confidence and supply agreement between the Greens and Labour would make promoting her a messy business. Is there anyone in Labour’s ranks who would be up to it? Kris Faafoi and Deborah Russell (an Auckland MP, at that) are both talked about as potential senior ministers, but that would be a huge step up.

Go

Why wait? Two years of failure is long enough. Jacinda Ardern’s credibility is on the line here.

Stay

Phil Twyford is one of Labour’s top five. The jobs he was given were central to what Labour promised the country. To remove him now would be a huge admission of failure, and would basically mean the PM telling the country that her decision to put him in had been wrong. That would arguably dent Jacinda Ardern’s credibility even more.

A compromise …?

Could there be a wider reshuffle in which responsibility for various aspects of transport gets split up among a few different people? After all, it’s how the government managed to get Megan Woods the title of minister of housing, with Twyford shuffled diagonally downwards to become the minister for urban development. Don’t rule this out as being the best available for the PM.

Won’t happen

A reshuffle so close to the election? It’s just under a year away, and the government are navel gazing about who gets to sit in which chair? Surely not.

Or could it?

The election is just less than a year away, and no matter which poll you consult, the opposition is really only a small swing away from taking back power from the coalition. Imagine being a one term government because Aucklanders felt let down by Phil Twyford.

But wait there's more!