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Image: Tina Tiller
Image: Tina Tiller

OPINIONSocietyDecember 6, 2021

Now assisted dying is legal, hospices must not block access

Image: Tina Tiller
Image: Tina Tiller

Allowing hospices to set their own rules on assisted dying is an unfair and messy system that will lead to people dying the harrowing deaths they desperately sought to avoid, argues Frankie Bennett.

Last Monday, a hospice in Timaru announced it would not permit assisted dying on their premises. They hardly needed to say it. Before the referendum even passed, Hospice NZ went to the High Court to confirm its facilities could remain “euthanasia-free”. Tōtara Hospice in South Auckland is a lone voice in openly allowing and respecting assisted dying. But can a publicly funded hospice justify denying its patients a legal medical treatment that 65% of the public voted for?

At present, hospices, aged care homes and hospitals are free to decide their own rules when it comes to assisted dying. The End of Life Choice Act is silent on the matter. Hospice South Canterbury told the Timaru Herald it will allow a doctor on-site to discuss assisted dying with a patient, after which the person will be, as the article rather clinically put it, “discharged to their place of death”.

So far, so good. But Hospice South Canterbury’s approach assumes a person can be discharged. What if someone can’t be safely moved, or there is nowhere to move them to?

A person in the late stages of terminal illness may be too unwell to travel even a few kilometres down the road. There may be no alternative hospice nearby (pretty likely, given the few participating facilities). They may not want to leave a familiar environment where they have made friends and know the staff. Home may not be an option. What will happen then? Will the hospice really turf them out to seek an assisted death elsewhere?

My work in Australia, where five states have passed assisted dying legislation and two laws are already effective, suggests yes. We have received numerous reports of non-participating facilities blocking a person’s access to assisted dying, with little regard to what happens next.

Take Colin from Victoria, a 79-year-old former champion swimmer and philosophy professor who was dying of metastatic bowel cancer and found eligible for assisted dying in 2020. Colin’s aged care home, after nine days of deliberation, said they could not accommodate his assisted death. He was forced to move to a nearby hospital, where he knew no one, without saying goodbye to any friends or staff. Within two hours of arrival, Colin took the life-ending medication. The hospital doctor described Colin as feeling “abandoned”.

Or Tony from Western Australia, a 75-year-old gardener and opera fanatic dying of brain cancer. The first hospital he approached refused his assisted death. Tony’s daughters found an alternative aged care home that agreed, but at the 11th hour they too changed their mind. Dying at home was not possible for Tony. Instead, his daughters had to frantically search for a safe place for their dad to die during what should have been their final, peaceful days together as a family.

In Tony’s case, the aged care home claimed it needed to prepare its staff for an assisted death. But can that be true? In aged care, death is rarely a shock. Surely, the greater harm would have been staff having to watch Tony suffer, knowing they could not help? In fact, Tony’s daughter said all the staff respected his decision.

So why do most organisations offering end-of-life care really oppose assisted dying, and can their stance be justified?

Palliative care’s philosophy, pioneered in Aotearoa in the 70s, is to neither “hasten nor postpone” death. In other words, see it out to its natural end. But palliative care already makes use of modern medicine to manage symptoms and pain, as well as quietly enabling death with palliative sedation. Medication to end suffering is hardly a great leap – it’s just that now, the person rather than their doctor gets to choose when it happens.

Palliative care also proudly claims a “whole person” approach, placing equal importance on physical, spiritual, cultural, emotional and social needs. This all sounds great, but the hospices’ response to assisted dying is more akin to supporting the “whole person, minus the parts we disagree with”. What about a person’s need to die peacefully? The hypocrisy is deafening.

Less publicly acknowledged, but perhaps the root of opposition to assisted dying, is that much of Aotearoa’s hospice network was established by the Catholic church and retains strong links today. Catholicism’s pro-life beliefs oppose assisted dying on the grounds that life is sacred, to be given and taken by God alone. Although most of us are mightily glad the Catholic church did step in to establish hospice care, a loyalty to the sanctity of life is out of step with what most New Zealanders – and indeed most Catholics – believe today.

Whether the paternalism is coming from God or a doctor, the message from hospice care is clear: we know what’s best for you. No need to trouble yourself with notions of choice, control or bodily autonomy.

Given the hostile policies will be driven by management, I really feel for the staff working in these institutions – many of whom will have voted yes in the referendum and will now be complicit in the farce that the forensically safeguarded assisted dying scheme is somehow a threat.

The End of Life Choice Act already protects the rights of health workers to conscientiously object. Individuals can opt out, no questions asked. Yet to allow entire organisations to do the same disproportionately favours institutions over patients. After all, people suffer in ways that institutions cannot.

Institutions do not have consciences to offend. Institutions do not suffer bodily and emotional harm. And institutions don’t have loved ones left traumatised at bedsides. How about putting people first?

I understand why hospices feel defensive. They perceive assisted dying as a criticism of their care. Unfortunately, no matter how well funded and excellent the care they offer, a small number of people will still suffer terribly as they die. This is not down to hospice or aged care inadequacy, but evidence of how profound the suffering caused by illnesses such as cancer and motor neurone disease can be.

During the referendum campaign, equity in healthcare was a hot topic. Assisted dying, we were warned, should not become a substitute for palliative care. On that we all agree. But those same voices are now building a new inequity into the system: whether or not your aged care home, hospice or hospital decides to block you from accessing assisted dying.

For all the conversations about people being coerced into using the law, should we now be more worried about hospices coercing eligible patients out of it?

Hospices should not be left to make up their own rules. This unfair and messy system lacks clarity and will lead to conflict, not to mention some people dying the harrowing deaths they desperately sought to avoid. We deserve to know hospice, hospital and aged care facilities’ policies on assisted dying in advance. That’s why the Ministry of Health must urgently establish enforceable guidelines to protect terminally ill people and ensure equity of access.

The End of Life Choice Act hands power back to the dying person. The onus is on hospices to show why their needs should be more important than their patients’. Dying people are not the enemy and their choices deserve respect too.

Frankie Bennett campaigned in the End of Life Choice referendum with Yes for Compassion. She now advocates for voluntary assisted dying laws with Go Gentle Australia.

December 7: This post has been amended from the original to refer to one hospice in Timaru rather than two. 

Rixen

SocietyDecember 5, 2021

The women who occupied a Levin factory for 96 days

Rixen

Today marks 40 years since the Rixen factory occupation ended. Huw Morgan speaks to the women involved.

At 3.30pm on Saturday December 5, 1981, Ann Waddell and 26 of her colleagues walked out of the clothing factory in Levin that they’d been occupying for 96 days. It was the longest workplace occupation in Aotearoa’s history and one which historian Toby Boraman calls “the most important in this country’s history”. That August, they were told the Rixen factory was closing and they would not be receiving any redundancy pay. Four decades later, Waddell says they “felt like a bit of shit being thrown out of the paddock”. Though the women left without winning redundancy for themselves, their actions forced a redundancy clause onto the Clerical Workers award at the same time. 

During the 1970s and 80s, New Zealand’s economy, like most rich nations, was ”de-industrialised”. Factories were closed, their assets were stripped, and blue-collar workers, such as those in textiles “were the first ones hit,” says Boraman. Between 1974 and 1981, the industry lost 14,000 jobs. But at the Rixen clothing factory, business was good and they sometimes struggled to keep up with orders. The sudden closure, Waddell says, “was the last thing we expected”.

The factory had previously been taken over by Fred Ellison and Ted Dungey, businessmen based in Napier, and Rixen became a cut, make and trim operation. It was a mail order business, and the garments, “run of the mill womens clothes”, were sent to Napier for distribution. The 67 staff got on reasonably well and were mostly working-class Māori and Pākehā  women.

Aged 24, Waddell had been working at the factory doing the wages for a couple of years and “I was just working at the factory and back home again”. She went to the inaugural Sweetwaters music festival in Ngāruawāhia in 1980, where she’d been filmed coming out of the showers topless, “I was a bit of a wild child, I suppose,” she says, laughing at how shocked her mother had been to see her on television.

Waddell found out about the factory’s closure on Tuesday August 25, 1981, when the Clerical Workers Union called. “What are you talking about?” she asked, and went to find the manager, who had no idea either. By the next morning, everyone knew. “It was pretty devastating,” she says.

The first signs of resistance were three days later, on the Friday. Dungey had sent a lawyer from Auckland but “he didn’t tell us very much”, and they decided not to carry on working until he’d talk to them. Dungey had been “quite an impressive person…very suave”, but he hadn’t shown up himself, so “we just wanted to stick it to him”. On the following Monday, the Clothing Workers Federation arrived. Its secretary Frank Thorn, inspired by a woman-led occupation in Scotland that had days earlier overturned a factory closure, suggested something similar. Waddell says it was unanimous: “we’re going to strike, picket and occupy 94 Oxford Street, Levin”.

After the first groups appeared in 1970, the Women’s Liberation Movement produced a dizzying array of campaigns and organisations. Like most movements, there were disagreements between radicals and moderates and in Up From Under, Christine Dann writes that the years between 1977 and 1981 saw the most ideological turbulence. At the 1979 National Women’s Conference, Donna Awatere and Mona Papali’i famously accused the movement of racism.

Kanya Stewart was a recently-out lesbian and as a middle-class Pākehā, believed their criticism “was very good”. She’d witnessed racism before, having had an Indian husband. On moving to Dunedin together, she’d been “absolutely horrified” by “how racist New Zealanders could be.”

She’d worked at the National Film Unit and was an editor on the groundbreaking Women series. Commissioned by TV One, it was a series “made for women about women by women”. Unsurprisingly though, Stewart recalls, in the halls of television “we were feared a little bit…especially by the men” and no further projects were commissioned.

In 1981, Stewart left a two-week video production course at university “fired up” and joined Auckland Community Women’s Video, a group making films about women. Stewart read about Rixen and thought “we’ve got to do this”. They made contact, packed up and drove down to Levin.

The occupation was in its ninth week and 67 had become 43, all of them women but four. Dungey had come to see them on September 16 and offered $30,000. But the sum included money already paid to people who’d left, so amounted to just a few hundred dollars each, and wasn’t based on the length of service. 

The staff rejected it and eight days later he called the police. As they arrived, there were only a few people inside the building, at risk of easy arrest. The call went out to get as many people inside as possible. “I locked myself in my office,” says Waddell. She opened the window and people clambered through. Not just Rixen workers, but people from the Mullan car plant nearby also piled in, like Waddell’s cousin. “What the hell are you doing here?” she said, as he climbed through the window. “We got a call to come and support you,” he answered. Copying the direct action from the Springbok Tour protests earlier that year, they sat in the main hall and linked arms, hoping that police would avoid mass arrests of mostly women. 

Dungey tried to cut the power to the building but the workers at the power board refused, and the Union stepped in to pay the power bill.

One of the most extraordinary aspects of the Rixen story is that the factory was not a hotbed of political militancy. They didn’t even have a union delegate. Lettie McDermott, a worker who features in the documentary, explained how they’d tried to pick one, but were thwarted by the owners and were too timid to try again. “No one was game enough to call that meeting.” Given the industry’s decline, Waddell says, people didn’t want to be seen as “stirring the pot”.

The documentary Even Dogs Are Given Bones shows the day-to-day activities that kept the place going and is soundtracked with a song written by Mereana Pittman. Most of the women were “fine about us just hanging out and taking the shots of them,” Stewart says. There was a day shift and a night shift, committees for food, action and knitting and living was marae style. 

Luminaries of the political left like Sonja Davies and John Minto came to Levin and the feminist magazine Broadsheet wrote about them. “It was just phenomenal,” Waddell says. Other unions gave money, and they were able to take $100 a week each, enough for food and rent. Waddell was sent to a meatworks to speak. “Pretty daunting,” she remembers. It was an industry renowned for staunch unionism, and often sexism, but she left being “cheered and clapped”. They picketed outside Dungey’s distribution centre in Napier, and organised a 600-person march through the centre of Levin, the biggest in the town’s history.

On November 13, the Federation of Labour came to help with negotiations. Joyce Hawe, a former clothing worker and the first Māori woman elected to its executive, was their link. There was another vote on whether to continue, and of the 27 people left, not one voted to give up. A few weeks later, with no sign of an agreement, they’d had enough and decided to leave.

There were significant strikes elsewhere, but Rixen “was a special event,” says Boraman, because “it was an example of workers taking over a building and running it themselves”. When asked whether they recognised the significance of what they were doing, Waddell says no. “Shit, I had no idea! We just wanted to stick it to him because he didn’t want to offer us anything.”

Despite all their work, no one from Rixen was offered work in the trade unions afterwards, and the story was largely forgotten until the documentary was recovered and screened at parliament in 2018. Since then, McDermott and Hawe have died but Waddell still sees a couple of the others. She’s been a member of unions ever since.