End of Life Choice Bill

I move, That the End of Life Choice Bill be now read a first time. I nominate the Justice Committee to consider the bill. At the appropriate time, I intend to move that the bill be reported to the House by the date that is nine months from the date the bill receives its first reading.

I have been approached by New Zealand First members regarding a referendum to give this bill its Royal assent if it passes through all stages. I want to put on record that I’ve pledged support for a suitable amendment. Whether there is such a referendum will depend on whether the committee of the whole House joins me in supporting such an amendment.

My fellow members, it is not pleasant to talk about painful death, but when our country’s laws do not work, it is incumbent upon us to have that discussion. Our laws surrounding end of life choice currently do not work and we must improve them. Let me explain why that is, using the people in this room. There are 120 of us here, and we can reasonably hope that the vast majority of us will live long lives and die easy, painless deaths. Sadly, some of us will get ill. Our illnesses may well turn out to be terminal, but we will be helped by palliative care to die comfortably, none the less. That leaves maybe half a dozen of us here who will die badly. Those half a dozen represent the 3 percent or the 4 percent who might seek an assisted death under this bill based on experience in countries where such legislation is in place, and based on the choices that New Zealanders currently make. Any one of us in this Parliament could find ourselves facing that situation.

I’m afraid to say that the options we would face in that situation are cruel. A person at the end of their life, suffering badly and unable to be helped by palliative care, can commit amateur violent suicide. We know from extensive studies of the coronial records of this country that 5 percent to 8 percent of New Zealand’s suicides were by people who were dying and wanted to take control of the end of their life. They didn’t want to die. They weren’t depressed. They weren’t suicidal, but they knew what was coming and they wanted control. One such person was Martin Hames. He was a staff member here in Parliament. He had Huntington’s disease and he killed himself. The only mercy was that he botched it and lived on for several days because that way he got to say goodbye to loved ones that he was not allowed even to tell what he was going to do under our current laws. The tragedy is that he did it many years before he would’ve liked to because he knew his capability was declining, and our current laws require him not to be assisted.

But there’s a second option that is not only legal but enshrined in our New Zealand Bill of Rights Act here in New Zealand: the right to refuse treatment, including food and water. Remember, there are no safeguards when you make that choice, there is no accountability mechanism, but it happens legally; in fact, it is protected under the New Zealand Bill of Rights Act to New Zealanders every single day.

The third option is involuntary euthanasia, and surveys of the doctors in New Zealand by Auckland University medical school tell us that 4½ percent of New Zealanders who die, die when they are informally euthanised—given pain medication with the express intent of ending their life.

A final option is none of the above: you just suffer until the bitter end, writhing in a body that lives on but gives no comfort. I know people in this room have watched it happen and said, “Never again.”

That, colleagues, is the moral case for this bill. It is wrong that in 2017 under the laws made by this House we tolerate a status quo where people suffer needlessly. We allow under our laws violent amateur suicide, barbaric suffering, and informal euthanasia, all perfectly legal, but the choice that we don’t allow is the person in question who is suffering at the end of their life to make a choice, make their choice, safeguarded under the rule of law. The current situation is an absurdity.

But there’s also, other than a moral case, a legal case. I acknowledge Matt Vickers is here tonight, and when his late wife Lecretia Seales sued the Crown in Seales v Attorney-General the judge ruled “I would be trespassing on the role of Parliament and departing from the constitutional role of judges in New Zealand if I were to issue the law declaration sought by Ms Seales.” In other words, colleagues, the judge said that if it is to be, then we in Parliament must act. We sit in the highest court in this country and we cannot shirk our duty.

The final reason that you might support this bill is democratic. We’re here to serve New Zealanders, and the overwhelming majority of them, when asked time and again by reputable polling companies, say that they want choice in assisted dying. They want assisted dying to be legalised. Public support for legalised assisted dying is 75 percent. Let me put that in perspective: never in the history of this country have more than 40 percent of New Zealanders watched an All Blacks game; 75 percent is one of the most unanimous agreements that New Zealanders have.

I know some members are worried about opinion in their electorates and amongst those people that they represent. I understand some of them have been receiving a lot of emails, some of them even from Australia today, but can I suggest it would be much more difficult to tell the people you represent that you denied a discussion at select committee—when it’s 75 percent of them—than it will be to tell the minority that you think this country deserves a proper debate on an actual bill.

Those are the moral, legal, and democratic reasons why the status quo as we have it now is not acceptable. I’m sure members will have another question: if we don’t like the status quo, is it possible to improve it? More specifically, is it possible to design a law that gives choice to those who want it while safeguarding those who want nothing to do with this law whatsoever? That is the critical question. If it is possible, then there can be no objection to this bill that a member of Parliament is wishing to impose their own social mores upon others.

So is such a law possible? Perhaps the best authority is the Supreme Court of Canada. Supreme Court justices are conservative types and they don’t often agree with each other unanimously. With that in mind, here is what the court unanimously found in Carter v Canada after an exhaustive trial considering evidence from around the world where assisted dying laws had been in place. They said, “We agree … that the risks associated with physician-assisted death can be limited through a carefully designed and monitored system of safeguards.” That is the conclusion of one of the greatest courts in the world, having looked at all the evidence. Shortly after that ruling, the Canadian Parliament legalised assisted dying.

Closer to home, our own Attorney-General assessed whether this specific bill is consistent with the New Zealand Bill of Rights Act, and he said, “There are multiple safeguards built into the process, including … stringent criteria for eligibility … the requirement for an independent second opinion and referral to specialist (if necessary), and the ability for the person to change their mind at any time.”

I would like to quote at much greater length from those two documents, but let me assure you that the conclusions I just read are the conclusions they reached after very fulsome consideration. I encourage any members who have not already done so to read the bill. They’ll see why the Supreme Court of Canada thought that such a bill was possible, and why this bill is one that gives people protection under the law and choice only if they want it.

This bill requires that a person be 18 or over, be a New Zealand citizen or permanent resident, and have either a terminal illness or a prognosis of less than six months or a grievous and irremediable condition. They must be “in an advanced state of irreversible decline in capability;”. This wording is critical when it comes to concerns that some people have about disability. You have to be “in an advanced state of irreversible decline in capability;”. It is not about your level of capability; it is about being in decline.

You have to be of sound mind—that is, you have to be able to understand the nature of the decision you’re making. Again, this wording is important. People with depression, for instance, by definition have a distorted view of the value of life, and therefore would not qualify.

All of this has to be signed off by two doctors, who must examine the patient. The doctor must seek to speak with the family members and others involved in the patient’s care to ensure that they can satisfy themselves there is no coercion at play. The second doctor is selected randomly, independently from the first, and if either doubts the patient’s mental state, they must refer the patient to a psychiatrist. Each case is then countersigned by a registrar at the Ministry of Health. The same registrar collects statistics and reports to this House.

There are those in this Parliament who say this is the worst bill that they’ve ever encountered. But I’ve challenged them privately, and they know they couldn’t name a better one. This bill’s been in the public domain since September 2015, and no critic has laid a glove on any aspect of it.

Colleagues, our fellow New Zealanders are suffering. I’m afraid to say some people in this House will suffer, and probably want the choices afforded by this bill. We don’t know who it will be, but in a way it doesn’t matter. Their suffering is needless, and it hurts all humanity if we allow it when we have a choice. Tonight, colleagues, you have a choice. The question is whether—

Order! The member’s time has expired. I’m going to call the Rt Hon Bill English, but in doing so I indicate that he has indicated to me that it is his intention to split his call with Simon O’Connor. The Rt Hon Bill English—5 minutes.

I rise to oppose this bill, principally for the reason that this House has defeated such legislation twice in the last two decades, and it is this: it removes a principle at the core of the law written to protect everybody, and particularly the most vulnerable, and that is the blanket prohibition against taking the life of another. That is at the core of our criminal law that protects everybody, particularly the most vulnerable. In removing that prohibition, which has been in our law for as long as this country has existed, this Parliament is taking a huge step.

I appeal to our members tonight. I’m sure we’ve all had the experience—I know I have—or know about the experience, of witnessing the suffering, the fear, and the anxiety of a dying person and those around them, and, sometimes, a difficult death. Alongside that personal connection, we have to weigh up, in our role as lawmakers—not just as parents or children or siblings or friends of those who we’ve seen die, but as lawmakers. Our role is not principally to alleviate suffering; our role is to ensure that our society has a set of laws that protect those who most need protection.

Did you know that in our law, section 179 of the Crimes Act, it is a crime to incite the suicide of another person, even if they don’t actually commit it—even if they don’t actually commit it? Why is that there? Because we don’t want people encouraging a depressed disabled young person to think that their life isn’t worth anything. As lawmakers, the reason there is a blanket prohibition is because you are not always the best judge of the value of your life, and the price that our community pays for enabling a doctor to take your life, free of criminal scrutiny, is that many other people are more vulnerable. Their lives will become more fearful, and they’ll become more subject to the pressure to make the judgment themselves that their life has less value and therefore they should make the decision. It is a slippery slope. That is why this bill, with its cold, technical, bureaucratic process of death, tries to look like it’s safe.

We have to weigh it up, and every Parliament up to now has said that the balance between what is enabled for an individual and the cost of that enablement to the rest of society is too big a risk to take. I put the case that as lawmakers that is the question that we need to weigh up: is the gain in personal autonomy—because the research shows people embark on euthanasia principally for autonomy reasons; they may not be suffering that much—worth the broader cost to our community? I don’t think anyone can, in their heart of hearts, believe that this bill will make life safer for the disabled or that it will make our community more warmly embracing of our ageing population. Who pretends that? It won’t—it won’t.

That is why I will oppose it and invite others to. You know, we’re not creating medical procedure here; we’re creating an exemption from the criminal law against killing for a specified group—that is, doctors, who do not want to carry this burden—under some conditions that amount to box-ticking. So I ask the Parliament to consider that very carefully—the removal of the blanket prohibition against taking a life, which should be subject to scrutiny and accountability.

I believe this is a sad day for the House. We are here talking about the State sanctioning killing of New Zealanders. This bill suggests that suicide is a solution under certain circumstances, and I stand today to reject this.

I spent two and a bit years chairing the Health Committee as over 21,000 Kiwis from across the spectrum spoke to us, and 80 percent, who had well considered it, said no. I’ve studied philosophy and human rights, I’ve been at hospital beds and hospices, I’ve seen more death and suffering than sometimes I care to remember, and, fundamentally, I do not believe doctors should be killing their patients.

Members of the House, this bill is about killing in two ways. The first is called euthanasia. It’s where the doctor takes an injection, usually something like phenobarbital, and injects it into you—only after they’ve sedated you, of course; couldn’t have the inconvenience of twitching. The other is physician-assisted suicide, where, again, they give you a massive dose of drugs. You take that yourself, at your own choosing—and hope that the kids don’t find it in the medical cabinet at the time.

This bill combines both of those. That’s almost unheard of in any other jurisdiction around the world. This bill before us tonight is the worst example of euthanasia legislation in the world. I say that as someone who has looked at every piece of legislation.

Where it starts, really badly, is clause 4. We hear it a lot: it’s all about terminal illness, up to six months. But the doctors, the medical people, will tell you that six months is just an indication; it’s not a guarantee. And the doctors will tell you too that they misdiagnose all the time.

They also talk in this bill about irremediable, grievous conditions. That’s incredibly broad, undefined. What is “irremediable”? What is “grievous”? Basically, it includes everyone, including those with disabilities.

But the bill also, rather insidiously, talks about suffering that a person deems intolerable—what you deem intolerable. Sorry, Mr Speaker—what members may deem intolerable. This is a clear indication that it is the courts who will be making decisions and choices, not this Parliament and certainly not the person.

In the debate in this space, I’ve often said, it’s between choice and public safety. Let’s be very clear: the current laws as they stand mean that no one will die against their will, but this proposed law that we consider tonight will make involuntary deaths possible. We know in this House we do not make things perfect, because changing this law will allow some to assist the suicide—well, sorry. People who choose to assist in suicide will put others at risk.

We know that this law applies to everyone. It does not apply simply to the rational and articulate; it applies to the elderly, the disabled, the sick, the vulnerable—all of us. Not everyone is fortunate enough to live with a loving, caring family. Not everyone has a doctor fully in tune with them and their needs. This law will apply to the depressed, the lonely, those who feel a burden, the disabled, the fearful. I should point out that these are the same feelings of a 16-year-old who is keen to suicide, the 40-year-old who has lost their farm, or the 80-year-old on the deathbed.

I repeat again, as I did a few months back, that you cannot stand in this House and decry the suicide of one group of people—say, the youth—and then encourage the suicide of another group—say, the sick. They are the same feelings that are there. And I don’t say it alone. It’s very easy for the media and others to attack, but, actually, this is the opinion of the major medical groups, the psychologists, and the youth workers. I add their voice tonight.

There’s a lot of talk about choice. Let me say one thing about choice: the patient in this space never makes the choice. If they did, there wouldn’t need to be doctors and psychologists and boards and panels. The doctors make the choices. The family makes the choices.

If you think I’m exaggerating, go and look up an example in the Netherlands recently. A woman with dementia who, yes, years ago, had said that she would like to die by assisted suicide, was held down after being sedated by her doctor and family—they put drugs in her tea. They sedated her, held her down as she screamed and yelled, and then they killed her. The doctor was able to report it, and they just said, “Oh, well, you acted in good faith, but she’s dead now.” So much for the choice and autonomy that she exercised.

And I’d point out too that if it’s about choice and autonomy, we all have it. If it’s a human right, all humans have it. There is a slippery slope, and one only needs to turn to Canada, which has already been mentioned, which is already pushing the boundaries.

There are no safeguards; there are just lots of criteria. Being 18 is not a safeguard. All the reporting comes after the fact. If you get it wrong, the person’s still dead.

Doctors don’t want to be part of this. The few that do will make a business of it, and there will be doctor-shopping. The conscience rights in this bill are a nonsense. If you oppose, the doctor must hand that person over to someone who will.

It’s a very, very poor bill, and, fundamentally—thousands of health professionals and others have argued in the recent public debate—this is an issue where the public safety will be put at risk. So I ask this House how many involuntary deaths and errors are we willing to accept through this law: one, five, 10—

Order! The member’s time has expired.

Tēnā koe, e Te Māngai o Te Whare. Should the timing of one’s end of life be a choice? Who knows when? How do you know? A terminal diagnosis seems to be a criterion. How about an exhaustion of all possible treatment options? That means you’ve reached a point in the illness that you have where doctors can’t help you, the health system can’t help you, and, indeed, society can’t help you. If one is to die, should they be able to choose when and how in exercising a private choice or making a private decision?

We are “born free and equal in dignity and rights.” That was part of the Universal Declaration of Human Rights, which was the third declaration that the UN passed on 10 December 1948. It was expressed in the International Covenant on Civil and Political Rights on 16 December 1966. Civil and political rights are defined as “a class of rights that protect individuals’ freedom from infringement by governments, social organizations, and private individuals. They ensure one’s ability to participate in the civil and political life of the society and state without discrimination or repression.” What is repression? It’s restraint, it’s something that we’re prevented from doing, or it’s an inhibition of.

In June 2015, Lecretia Seales received the High Court decision of a case that she had lodged in December 2014. The High Court said that she did not have the right to die. Justice David Collins said that it was unlawful for Lecretia to be allowed a doctor’s help to die at a time of her own choosing. Lecretia’s response to this decision was—and I quote—“Isn’t this my body? My life?” Then she died. That was six months after she had lodged the High Court appeal for the court to enable her to end her life.

My support for this End of Life Choice Bill is based on the judgment by Justice Collins, and he highlighted that “the status quo is not ideal [and] that people are at risk of intolerable suffering and … of ending their lives earlier than they would otherwise.” He put this kaupapa back to Parliament and said that it was for Parliament to address these issues. Parliament makes the law and then courts only interpret the law, and that’s actually a principle of our democracy. We have rule of law and the sovereignty of Parliament, and, actually, that’s why we are all here today.

A citizen of our country went to the courts for a right, and the courts have said that she didn’t have that right and that it was for Parliament to create a mechanism, to create an opportunity, for a person in Lecretia Seales’ position—someone with a terminal illness who’d fought that disease. She and her husband and her family fought it. She had treatment. Tumours were removed. She went into remission. She wanted to live. They were going to have a family. They’d engaged a surrogate. She wanted to live, and it came back—the cancer came back. When it came back, she had more treatment, and there was a point where we said, “We can’t help you any more. You are going to die.” So it’s up to us as a Parliament, now that the courts have intervened as much as they can, to provide a mechanism for people like Lecretia.

This isn’t about systemic change; this is about individual choice. I am standing up for Lecretia because her story moved me—a woman with much dignity that the courts said actually understood fully what she was asking for. She was competent, she was clear, and, with the support of her family, she wanted to choose a point at which her life would end. And why? Because she argued that her definition of dignity, which was her human rights argument, was actually about the respect that she was starting to lose for herself. She couldn’t care for herself. She couldn’t go to the toilet. People had to look after her. It was degrading for her, and I cannot see why, as a first step, we can’t allow this bill to go to select committee and have the discussion and fix this bill if there are issues with it. Kia ora tātou.

Kia ora, Mr Speaker. Thank you very much. I rise on behalf of New Zealand First to take a call on this bill. Can I first of all just acknowledge, with deep respect, every single member of the House and the opinion that they will share. This is a conscience vote, and every single member of the House is taking it seriously. There is no flippancy here.

But I look around me and I see farmers and accountants and lawyers and debt collectors and teachers and journalists and social workers and religious leaders. Not a single one of us is smarter than the people who placed us here. Not a single one of us has more of a conscience or less of a conscience than the people who voted us here. This issue should go to them. This is too big an issue for this House to decide that 120 New Zealanders have more conscience or more right to have this conversation than they do.

I want to acknowledge David Seymour, and I acknowledge the work that he has put into bringing this issue—his belief, his passion for it, and, I believe, his true empathy for those who are in these circumstances. I want to acknowledge the commitment he has made to New Zealand First, and the commitment that New Zealand First has made to him. New Zealand First will be voting as a bloc in favour of this legislation at first reading, based on the commitment that Mr Seymour and the New Zealand First caucus have made to each other, and we will honour that commitment.

I cared for my great-grandparents, my grandparents, and my father all through their passing. It is probably my grandfather that I think of most with regard to this bill, of when dementia started to take him, and the nights that he would wake and I would find him in the hallway, petrified of where he was and who I was. And then in the morning, after we had calmed him and sat with him and then he woke, I remember he would say to me, “Trace, if I could push a button, I’d end it now.” Did he mean the dementia, or did he mean his life? I don’t know.

For me, this is something I need to grapple with. Every single one of us needs to search ourselves and speak to those around us and have a bigger conversation with New Zealand. I take on board the comments by Mr Seymour with regard to those who in the public domain have run polls to say that the country is in favour of this—or 79 percent is in favour. But I take on board Mr Simon O’Connor’s comments with regard to the Health Committee and the huge percentage who came and said they were opposed. The issue we have is that it depends on how you frame the question—

💬 Hon Louise Upston: Which is why—

—hence why—I can hear, Ms Upston—there is a way that New Zealand First believes that this bill, in its entirety, should be placed in front of the New Zealand public. That is, with a regulatory impact statement, with all the information that we—we, who are no better than they—use to base our opinion on, our conscience on. We may need to actually change some other pieces of legislation as this goes through the process of the select committee, to make sure that if and when this House votes for a binding referendum in the public domain, we give the public the same information that we are given and that we are going to make a decision on here this evening. Thank you, Mr Speaker.

Tēnā koe e Te Mana Whakawā. It was the late Ngati Porou kaumātua Amster Reedy who stated, “We bring people into this world. We care for them right from the time they are conceived, born, bred, in health, sickness, and death. The rituals still exist for every part of their lives.” Those rituals still will exist and we need to have faith in our ancestors. Euthanasia is foreign to Māori and has no place in our society.

In all my life, raised as a Ngāi Tahu Māori, I have never heard or known of a Māori concept that validates assisting dying. Witnessing the death of a whānau member is as intimate as it gets. To watch a painful death can be shattering; the indignities we may have to see our loved one suffer—unable to undertake the most basic human functions without support, watching their agony, feeling their helplessness and, often, their feeling that they are being a burden on their whānau—yet this is only part of the process. There is another side to death; that is the whānau side.

But death has never been a final ending for our people. It merely signifies the beginning of the journey to Te Rerenga Wairua and then onto the ancestral home of Hawaiki nui, Hawaiki roa, Hawaiki pāmamao. It is a life in the afterlife, where we gather once more with our tīpuna and our departed whānau, members, and friends.

The process of dying, for us, is a process of whānau. We hear of terminal illness inside the whānau. We know the time has come to mobilise and gather. We give the immediate whānau our physical, spiritual, and, if needed, financial support. The process of death is not just about a loved one, it’s also about our whānau. This process is an essential component of binding our whānau together. The act of caring for a whānau member is a process of learning, of grieving, of laughing, of despairing, of reminiscing, and of coming to that moment of peace when we can finally let them go. This process of death is as much for the living as it is for the dead. Many Māori see this as an essential expression of taha wairua [the spiritual side], or being a part of something that is greater than ourselves. The final act of dying is the point where the ancestors come to take that loved one home. It is a moment of extraordinary sadness but also joy, as we become aware that an ancestor is now in the room with us to accompany the loved one on their final journey.

In the debates throughout the country that have preceded this tonight, Māori voices have been few and far between because some Māori choose not to discuss such things and fear that their fundamental beliefs are treated as native superstition. To me, assisted dying is to fast-forward a process that ultimately denies our loved one the chance to be taken to their ancestral home and is, instead, left in limbo, on their own, in a transitional afterlife until their time finally arrives.

The real challenge is to ensure all whānau across Aotearoa have access to the full range of palliative care available to ensure that we can ease the passing of our loved ones and the burden of care that falls upon whānau, without resorting to artificially ending their life. Then, we will truly, here, have succeeded. On that basis, I cannot support this bill.

Āpiti hōno, tātai hōno, rātou ki te hunga mate, ki te hunga mate ki a rātou; āpiti hōno, tātai hōno, tātou ki te hunga ora, ki te hunga ora ki a tātou.

[The lines are joined and linked, they to the dead and the dead to them; the lines are joined and linked, we to the living and the living to us.]

Let the dead be the dead and the living be the living. Kia ora tātou.

Thank you, Mr Speaker, for the opportunity. I want to, firstly, acknowledge that there are people in the stands here who have taken great interest in this issue. I also want to acknowledge that there are people listening to this debate, and I just want to acknowledge that this is an issue where many people have a variety of views. Within the Pacific communities themselves, I am aware that there are those who do not support this cause, there are those who support it, and there are those who have no view on it because of the fact that when we talk about death we also must talk about birth, or the creation of life. From a Pacific perspective—or from my perspective—can I say that when we talk of death, there is a tendency for many of us to acknowledge that death is only a pathway to another life. But I want to lay out for this House, and particularly for those members who have joined this House this year, some of the background that I think is important for people when making their decision.

There have been two first reading debates in Parliament on similar bills on this particular issue. Both were unsuccessful. In 1995, members voted 61 to 29 against Michael Laws’ Death with Dignity Bill. In 2003, members voted 60 to 58 against Peter Brown’s Death with Dignity Bill. On 23 June 2015, this Parliament received a petition by the Hon Maryan Street and 8,974 others, requesting that the House of Representatives investigate fully public attitudes towards the introduction of legislation that would permit medically assisted dying in the event of a terminal illness or an irreversible condition that makes life unbearable. The Health Committee, which received this petition, formulated its own terms of reference in considering that petition. Since the petition asked for a change to existing law, the committee’s terms of reference were wide and comprehensive. To fully understand the public’s attitudes, it set out to consider all the various aspects of the issue, including the social, legal, medical, cultural, financial, ethical, and philosophical implications.

The Health Committee received more than 21,000 written submissions from individuals and organisations. They heard from the petitioner of the petition on 14 October 2015. They agreed to hear from more than 1,800 submitters who had initially indicated that they wished to appear before that Health Committee. Submitters were invited to meetings held in Wellington, Christchurch, and Auckland. Those who were unable to make these venues were heard by teleconference. They began hearing from submitters on 24 August 2016 and concluded oral hearings on 5 April 2017. The committee spent over 108 hours of hearing. In the meantime, Mr Seymour’s bill entered the ballot in October 2015 and was drawn on 8 June this year.

I considered voting in support of this bill to go to the select committee, but based on that information, which is available for all to see, I believe that I’m able to make a decision not to support this bill going into the select committee.

My personal experiences are probably irrelevant for what Mr Seymour is attempting to do, but from a Samoan perspective—who have grown up to value life and that there is a purpose to life and that if people do not experience the pain, they’re also unable to enjoy what joy is. If people do not accept the reality of death, they cannot then see the purpose of life. And for those reasons, I believe that there’s been sufficient consultation on this matter.

I want to finally say that our laws follow values. Our laws traditionally follow traditional values. I believe that one of the most fundamental values that we need to uphold is the value that life is sacred, and when we’re dealing with suicides, this is one issue that doesn’t balance out our desire to keep life valued.

Tēnā koe, Mr Speaker. Tēnā koutou e Te Whare. If there’s one thing that all of us in this House have in common, it’s that we are all going to die and all of our loved ones are going to die. And I’m sure that we all also agree that life is precious and sacred, and that all of us have an aspiration to have a long, healthy, happy life. We want that for our loved ones. We want that for our community.

We’re also not just individuals. Well, we are individuals in one sense, in that we want to have control over our own lives and some autonomy. We are also interdependent members of communities, and the health of our communities influences our own happiness and well-being. In recognising that interdependence and also our autonomy, I think it is incredibly important that we recognise the passion that is held on both sides of this debate.

I sat on the Health Committee when it listened to days and days of submissions on this very issue, and there are very strongly held views on both sides. I think it’s an absolute privilege to be here as a representative and to have the opportunity to consider the evidence, consider the weight of the views, and to cast a personal vote. That is unusual, actually, for the Green Party, because often we vote along with our party policy—and we do have party policy on end of life, but Mr Seymour’s bill goes further than our party policy.

The Green Party’s agreed party policy on this recognises that there should be a framework within which someone with a terminal illness who has less than six months to live can apply to have assistance to end their life, and that that be very carefully regulated to ensure that there’s no abuse of that power. But this bill goes slightly further than that, and I do have concerns about how broad the nature of the bill is. I want to voice the concerns I know are out there, particularly in the disability sector, that this bill as drafted is a bit too broad and may in fact jeopardise those who are more vulnerable, who are not in a position to make a necessarily fully informed, autonomous decision or who might feel pressure from others to end their lives early. But, having listened to all those submissions and looked at the evidence, I also think that there is a very compelling case that this issue isn’t about suicide. It’s about what happens when somebody is already very close to death.

Modern medicine has enabled us with an incredible ability to extend life, to the point at which we may question whether the quality of life is what we would want. So, understanding all of the concerns that I have heard, I do think that this bill should progress to the select committee. I personally would like to see it amended, because I do believe that the evidence, in other jurisdictions, is that it is entirely possible to have a framework in which people are secure that there is no risk of abuse. In fact, the evidence from jurisdictions that have physician-assisted dying show that it’s very, very small numbers of people who end up using it, so the idea that somehow there would be doctors out there licensed to kill people at will is very far from what I think we are actually debating with this bill.

I think we heard from enough people who raised the issues of how difficult it was and how unfair it seemed that, while we have modern medicine to enable us to extend life, when there was no choice, no option, but for someone to die, they weren’t able to have that death assisted in a way that made it more comfortable, made it possible for them to have family around them, and made it possible for them to avoid being in horrific situations such as what happens with things like motor neurone disease and other types of illnesses. So I will be voting for this bill to go to the select committee, and I’m sure that it can be amended in a way that would ensure the safeguarding of those with disabilities and other vulnerable people.

Thank you, Mr Speaker. There’s been a lot of talk tonight about choice, with this bill, and how important it is for people to have choice. But I ask you to pause and consider this all very carefully indeed. To give choice to some is to take away the choice of thousands of others, and this is the kind of situation that we are seeking to avoid as legislators.

We have heard from Bill English earlier that it is our responsibility as lawmakers to try and prevent the wrong things from happening, the unintended consequences, and we need to be very careful, because one person’s choice and autonomy will be another person’s death sentence. Hard cases make very bad laws, and our law, in my view, should not be changed for a few persistent cases where it will expose far greater numbers of people to premature death.

As the Minister for Seniors over the past three years, I have seen up close the horrors of elder abuse, the scourge where family members inflict physical, psychological, emotional, and mental violence and neglect on their own family members. More than three-quarters of abusers are family members. A family is not a safe place to be, and the abuse of our elders, with an ageing population, is something we need to take into account with this particular bill. This bill will enable more people to predate on the vulnerable, with far too few—negligible, even—protections and safeguards.

I read the previous two bills that have come before this New Zealand Parliament, but this one is by far the worst. It is poorly crafted and drafted, in my view. It is irretrievable through the select committee process. We’ve consulted widely with medical and legal experts and believe that the Seymour bill and version is so fatally flawed that it couldn’t even be fully rewritten to prevent vulnerable people from being predated on.

So let’s look at what this bill actually requires. A person needs to self-assess that they experience “unbearable suffering that cannot be relieved in a manner that he or she considers tolerable;”. What does that mean? It is way wide open to interpretation. For example, an 18-year-old—it could be your son or your daughter or grandchild, a person with a significant disability or a chronic illness, including mental illness, depression, or schizophrenia. Once that person, by simply expressing the wish—and that’s the word that is used, wish—to contemplate suicide, then there is an obligation on the medical practitioner to take it further. This highly prescriptive bill has a regime all of its own that triggers an automatic series of mandatory steps that a medical practitioner is then obliged to follow with the sole aim of facilitating that person’s death. How can an 18-year-old—or an 80-year-old, for that matter—make such a decision in a mentally unwell state?

Of course, they can’t get help from the doctor, who’s not allowed to recommend other treatments or even encourage the patient to discuss it with family. This is the detail of the reality of this bill.

If the doctor has a conscientious objection and won’t assist with the suicide, the doctor is then obliged and required to provide the patient with the names and contact details of practitioners on a special list of doctors who dispense death, who will facilitate the suicide. If they don’t refer them to someone on that list, that medical practitioner will be liable for criminal prosecution. But here’s the strange thing. For any doctor on the list who does assist a suicide, the bill provides a full defence and immunity, as long as they’ve acted “in good faith and without [actual] negligence”. So the full force of the law will not come upon that person but on the one who exercises their own conscience.

It’s putting our medical practitioners in an absolutely impossible situation, which is why they’ve all objected so strongly. The New Zealand Medical Association, the Australian and New Zealand Society of Palliative Medicine, nurses, geriatric medicine specialists—they’re all horrified by this bill and they’re on record with their objection on the basis that it is completely contrary to their code of ethics and relationship of trust with their patient. “Irreversible decline in capability” is used in the bill—essentially, that’s a definition of anyone living with a disability. So the clear message is, if you’re disabled in any way with an irreversible decline in capability, you’re better off dead.

The answer is not to coerce and to kill, as this bill dictates; it is to continue to invest in world-class palliative care, and that’s what we have in this country. Even if you are a person sympathetic to assisted suicide, this is not the bill to deliver it. And make no mistake about it, legalising assisted suicide and euthanasia is the exception and not the norm. New Zealand is on the right side of this. New Zealand law is adequate and has good provisions. We have world-class palliative care, and that is why I will never support this bill.

Thank you very much, Mr Speaker. Tonight the House has a once-in-a-generation opportunity to remove the invidious choice presented to some individuals under the status quo. It’s the choice described by the Supreme Court of Canada in Carter v Canada: “people who are grievously and irremediably ill cannot seek a physician’s assistance in dying and may be condemned to a life of severe and intolerable suffering. A person facing this prospect has two options: [he or] she can take her own life prematurely, often by violent or dangerous means, or [they] can suffer until [they] die from natural causes. The choice is cruel.”—the choice is cruel. We have an opportunity tonight to begin to create a more compassionate society, one that upholds human dignity and protects the right to life.

My first point is that legalising assisted dying is morally the correct thing to do. Legalising end-of-life choice is supported by the values of a civilised and decent society rather than contradicting them. It upholds human dignity—the ability to end your life at a time and manner of your choosing, rather than in cruel and intolerable conditions. It recognises and affirms human agency and autonomy. Assisted dying places primacy on the individual and their choice to end their life with dignity.

But beyond morality there is a strong case for supporting this bill based on hard practical evidence alone. The status quo is manifestly inadequate. After reading the extensive evidence on this subject and talking to people in the community, it is clear that some people experience unbearable suffering at the end of their lives despite the best available palliative care. In the Seales v Attorney-General case, experts on both sides, for both the plaintiff and the defendant, concurred on this conclusion. As Justice Collins said, “Palliative care cannot … provide relief from suffering in all cases”, and extensive medical evidence was presented at the trial to support this conclusion. It’s worth noting this is a conclusion that the Palliative Care Council of New Zealand agree with.

It’s also abundantly clear from the evidence that people are already taking their own lives prematurely and that doctors are assisting in this already, except the system is unregulated. Now we have the chance to create a better system, one that is more transparent and has strong safeguards in place around the vulnerable.

My third point is that it is possible to design a system that stops terrible suffering by a few while avoiding harm to others, and that must, of course, be the goal of public policy and of this bill. Why do I say that? Because other jurisdictions have done exactly this, and I encourage members to go and read the Supreme Court of Canada judgment. What they found was that the risk associated with physician-assisted dying can be limited through a carefully designed and monitored system of safeguards. The court found this after an extensive and thorough review of the evidence, including cross-examination of leading experts from around the world. The court considered many of the arguments arrayed against this bill and against this issue tonight: that assisted dying leads to abuse and that it can create a slippery slope. Justice Smith, on behalf of the court, rejected this. She instead found that a properly designed system could “with a very high degree of certainty” prevent vulnerable persons from being induced to commit suicide.

I encourage members to go and read the recent judgment of the Supreme Court, because it is an extensive canvassing of all the arguments for and against physician-assisted dying. The court found that the prohibition on assisted dying breaches the right to life and encouraged—in fact, told—the Canadian legislature to design a solution that was consistent with the right to life. We have that opportunity with this bill now.

Parliament has twice considered voluntary euthanasia in the last 22 years. The last bill, in 2003, failed by just two votes; a lot has changed since then. Scores of countries and jurisdictions have legalised assisted dying. It is time the New Zealand Parliament considered this issue substantively and in a serious and rigorous way. The right place to do that is at the select committee.

Let me end by saying that in a modern and compassionate society the law should allow for a decent death. That’s what this bill sets out to do, and that’s why I’ll be voting for it at first reading.

Thank you, Mr Speaker. I rise to speak against this bill. At the heart of this bill is the question of choice, and yet we must all acknowledge that assisted suicide, or euthanasia, by whatever name we call it, is a choice to end all choices. It is, by definition, irreversible, the end; that it shares with any other form of suicide. As such, we should proceed exceedingly carefully before even considering whether safeguards, so-called, may mitigate some of the worst aspects of it.

It is this nature of choice that is being promoted by those who have brought this bill to the House that we must attack. We must understand clearly the concepts of undue influence and coercion that undermine choice and that play on the minds of those who are vulnerable, and those who are vulnerable are the very ones who would be wanting to access this in that moment of time in their vulnerability.

In their depression, people are vulnerable. To be depressed is literally to be pushed down. When one is pushed down, one is not capable of making good decisions. One is not capable of understanding fully the consequences of one’s actions, and yet this bill would allow people the ability to make, in that vulnerable state, in that vulnerable condition, a choice that would end all other choices.

So many of our fellow New Zealanders, young and old, have already made that choice; they have no further choices left. It is a subject that this House rightly concerns itself with and should continue to do so. We must do more to discourage suicide and other forms of ending life prematurely, and not encourage more of it.

Much has been said on the subject of dignity, too. Those in favour of the bill, at least to the first reading stage, have described a situation of a life that they say lacks dignity at that point. Disabled constituents of mine have said to me, “Do not let anyone tell you that certain conditions equate to a lack of dignity. They are describing my life.” They say to me, “This is my life. I am happy with it. I have dignity, and for anyone in the Parliament to suggest otherwise is, quite simply, intolerable.”

We’ve heard about so-called safeguards; for example, the suggestion that one might be able to exercise this choice if one has a terminal illness. One might have a diagnosis of a terminal illness but not, in fact, have a terminal illness. One may have a mistaken diagnosis or, indeed, a mistaken prognosis, and one might make a decision based on that. And if that factual basis is proven to be incorrect, what recourse then does that person have? The answer is none, because the person will have died. Our criminal justice system admits the possibility of mistake as to facts and as to law. Among other reasons, this is why we do not have a law of capital punishment; mistakes are made. If anyone in this House doubts that, they should ask Mr Teina Pora if that is so. If we allow people to be pressured into making a choice or to make the choice seemingly of their own volition but based on a mistaken assumption as to facts, and if the facts, so-called, prove to be incorrect later, there is no recourse, there is not opportunity to turn back the clock. They are, at that point, dead.

The intersection of our terrible rate of suicide in this country and our terrible record of elder abuse and neglect is this bill. There is much work we have to do in this Parliament on these subjects and, indeed, mental health in general. Will this bill encourage or undermine efforts to promote the real dignity, the real protection of life, the genuine role of the medical profession? I say, no; I say we reject it. And if you are in favour of euthanasia as a principle, I say to members of this House: this bill is not the one for you; it is far too broad. We should reject it.

Thank you, Mr Speaker, and thank you to all members who have made themselves available and made a contribution to this debate tonight. I’d like to briefly rebut some of the arguments that I’ve heard, attempt to allay some of the concerns that have been expressed, and thank those who have expressed support for this bill.

I felt, when I was listening to Bill English’s contribution, that we were talking at each other from different ages. The age when a blanket prohibition on all end of life was required as the cornerstone of our law may have been a good argument in 1995. It may have even been a good argument in 2003. It is not a good argument today because, as Chris Bishop so ably outlined, we now have almost a dozen jurisdictions around the world that have designed a law that does give choice to those who want it and protects those who want nothing to do with it whatsoever. We are like ships in the night: one speaking from 1995; the other speaking from 2017, when so much of history has moved on.

I heard from Nuk Korako that euthanasia is foreign to Māori. Well, I can tell members that the polling company that does all the work for Mr Korako’s party, Curia Market Research, has extensively polled the community to the point where we can drill down quite precisely to different groups, and the figures for Māori, or New Zealanders who identify as Māori, are that they support having choice by a ratio of 2:1—50 percent support, 25 percent opposed, 25 percent undecided.

I heard from Maggie Barry that choice would be taken from thousands of others. Well, again, that simply does not acknowledge the reality that times have moved on, that jurisdictions have legislated. Other jurisdictions have studied their experience exhaustively and found, actually, that it is possible to have a law that gives choice to those who want it while protecting those who want nothing to do with it.

We heard from Aupito William Sio that because there has been a select committee already, somehow New Zealanders do not want choice. Well, I make the point that that committee did not conclude with any particular recommendation. It did not consider a bill, and the people who submitted, many of them writing in a single line, do not reflect the overwhelming majority of New Zealanders, who support choice. No member of this House, when polling in their electorate, would rely on a self-selecting sample to establish what New Zealanders really thought.

I hear the concerns of Julie Anne Genter. There will be a lot to discuss as this bill goes forward through to select committee, if members are agreeable to do that tonight. I’m open to having that discussion. While I think the bill I’ve drafted is pretty good—and it’s the first one that has got approval under section 7 of the New Zealand Bill of Rights Act by the Attorney-General—I believe that we can all learn from each other and that a select committee process is likely to suggest improvements that will make this a better bill.

The question now, members, is whether or not we are prepared to allow that to happen. Are we content to live in a society where people are informally euthanised; where people refuse food, water, and treatment with no safeguard, no accountability structure whatsoever; where people commit amateur violent suicide years before they would have liked to have died because they knew that their capability was declining, and they couldn’t have done it later, so they had to do it alone without the assistance of anybody else? That’s the society that we live in. That is the society where doctors routinely use painkillers saying they have the intent of alleviating pain, but actually end people’s life.

Where is the protection for the sanctity of life in that world? And if anyone is happy with that status quo, how can they possibly oppose a bill that would give the protection of the rule of law to those people—those few people—suffering at the end of their life, who cannot be helped in any other way, to go through a safeguarded process that will allow them to choose how they go and when they go? Thank you.

A personal vote was called for on the question that the End of Life Choice Bill be now read a first time.

Can I ask members to resume their seats. I have a ruling that I want to give while we’re waiting for the tellers to come back. It’s been drawn to my attention that there has been some photography occurring in the lobby during the vote. Members will be aware, or some members will be aware, that during the last Standing Orders debate there was considerable discussion about photography in the House—whether it should be allowed or not. There was a wide range of views. I, personally, was in the minority that supported a liberalisation of the rules; that was not supported by the Standing Orders Committee.

The question is whether, when a vote is occurring, the lobby is, effectively, a part of the House. It is my view that in fact it is, and the prohibition within the Standing Orders Committee report, the continuation of that prohibition, does apply to the lobbies during a vote.

Now, at other times, if members want to take photos out there and they have the permission of the people involved—if they’re doing live streaming or they’re doing whatever they like that doesn’t involve other members—I think that’s fine. But in these circumstances, I think it is not appropriate to take or publish photos, so if members have done that, I’d appreciate if they got rid of them. Thank you.

I raise a point of order, Mr Speaker.

💬 Mr SPEAKER: I think it’s a call, Mr Seymour.

Well, I’d like to move that the End of Life Choice Bill be reported to the House by the date that is nine months from the date the bill receives its first reading.