End of Life Choice Bill

Mr Chair, thank you very much for this call. Part 1 of this bill deals with preliminary provisions. It starts by setting out the Act’s purpose—that the purpose is to give persons who have a terminal illness and meet the criteria lawful access to assisted dying, and to establish a lawful process for persons who so wish to exercise that option. There is an interpretation section, which defines quite a number of terms for the purpose of the bill. I think it’s important for people to recognise that those terms are used with very specific purpose throughout the remainder of the bill, and, therefore, often the full meaning of the bill as it’s read can only be appreciated if people look to that interpretation section.

Clause 4, “Meaning of person who is eligible for assisted dying”, sets out a number of criteria. A person must be 18 years of age. They must a New Zealand citizen or permanent resident. They must have, in the bar 2 version reported back from select committee, either a terminal illness likely to end their life within six months or a grievous and irremediable condition. I am proposing a series of amendments in a Supplementary Order Paper which would change those criteria, and that is the most significant amendment that I’m proposing in this part of the bill. What I’m proposing is that there be a limitation of the bill so that only those with a terminal illness judged likely to end their life within six months are able to become eligible for assisted dying. The other criteria, all of which must be met, are that the person must be in an advanced state of irreversible decline in capability. The amendment that I propose would change that and clarify that it be a decline in physical capability.

There is a change proposed in the amendment I have which says that the person who is eligible for assisted dying must be a person who passes a new test defining a person who is competent to make an informed decision. This test is that they can understand information about the nature of assisted dying that is relevant to the decision, retain that information, use or weigh that information, and communicate it in some way. I would add that this test is borrowed from jurisdictions around the world that have similar laws allowing people to have assisted dying. I would also say that it has been used in legislation passed by this Parliament in the interceding years since this bill was first drafted and introduced to the Parliament. Finally—a rather mundane clause—of course, this Act binds the Crown.

Taken together, those preliminary provisions set out what this bill is about, what the terminology used in the bill is, and what kinds of criteria people must meet in order to be deemed a person who is eligible for assisted dying. I look forward to the debate and discussion. I’m sure that there’s not really a huge amount to be discussed when people see that most of the issues that have been raised have actually been dealt with in the amendments that I have raised, and I hope that we can have a speedy, efficient, and civil debate on this matter. Thank you, Mr Chair.

I call Chris Penk.

Good choice. Thank you very much, Mr Chair. Sir, we have a deadly serious matter before us, and I will commence a detailed examination of certain aspects of Part 1 very shortly. Please allow me to prefix my remarks by noting the considerable importance of the detail that we are, as a House, about to consider in this matter—literally, life and death, of course.

I start with the purpose of the bill as set out in new clause 2A of Supplementary Order Paper 259, and note that it is part of a suite of changes that have arrived on the desks of members of Parliament very recently indeed—a little over 24 hours ago, in fact. And so it is that I take this opportunity to interrogate the detail of that very carefully. I will be making queries of the member who sponsored the bill to provide some guidance on these so that we can understand, in the absence of, particularly, much time to consider them before now, what it is that he is meaning and intending by it, and the extent to which this will be affecting the rights of New Zealanders who will be subject to the provisions for euthanasia and assisted suicide in this bill.

So let me start with the word “persons”. I ask the member if it was a deliberate choice to speak about “persons” with a terminal illness as distinct from “certain persons”, acknowledging that not all persons to whom the rest of this provision will apply will actually be eligible. So, for example, it will not be those who don’t meet the age criterion—and I don’t wish to get into the substantive detail of that at the moment. No doubt that will be fertile ground for much debate and discussion later by various colleagues across the House, who I know will take a serious interest in that matter. As a matter of drafting, it seems slightly strange to me and possibly unfortunate that Mr Seymour’s talking about persons with “a terminal illness.” I don’t know if he’s expecting that all these persons will just have one terminal illness between them. But it’s really just a matter of poor drafting rather than something substantive that I raise for his comment.

So we go, then, to the rest of that new clause 2A(a), and we see that if certain criteria are met, then the persons with this one terminal illness are to be given the option of lawfully requesting assistance to end their lives. I wish to propose to the member whether he’d consider an amendment to his amendment, whereby we would instead be considering “an option” of lawfully requesting assistance to end their lives—noting, of course, that a person who meets those criteria still does have, in fact, the option not to request assistance to end their life in the way that the bill contemplates. There is more than one option available, and so the indefinite article “an option” rather than “the option” of lawfully requesting assistance seems to me to be more appropriate, and I look forward to the member’s comments on that.

Going forward, then, to the rest of the purpose of the Act—the second part of that—we see that “a lawful process” is to be established for assisting eligible persons who exercise that option. Of course, the purpose of the Act is to do a lot more than this, and it seems to me that it would be helpful for a bit more detail in the purpose to be given at that point. But noting the member’s comments around the fact that it is to guide interpretation, that’s all the more reason for something that is quite unprecedented in New Zealand law since the abolition of the death penalty. That New Zealanders would be consciously killed by other New Zealanders other than in self-defence, the more guidance that can be given in a clause such as the purpose of the Act would be helpful.

So my final comment on that purpose of the Act, the new provision that’s been added, is why it doesn’t employ the language “assisted dying”, which I note is a defined term within the legislation, and instead we’ve got “assistance to end their lives.” It seems to me that it would be a matter of efficiency, albeit employing the euphemism “assisted dying” as a catch-all for euthanasia and assisted suicide, that at least the purpose of the bill and its definition and one of its key components, indeed, that of “assisted dying”, would at least be consistent. So if the member could provide some advice on that point, that would be very helpful indeed as well.

I also note, actually, one further note in relation to the purpose of the Act, that the phrase “terminal illness” is used. I commented before that it’s being used in relation—but I can’t understand why it’s being used in that way, in a rather short-handed fashion, so to speak, when it’s, again, not defined in the bill. I think the answer is obvious, probably, to all concerned, bar the member himself, why there isn’t a definition of that in Part 1 of the bill—the answer, of course, being that it is difficult to impossible to define such a thing as “terminal illness”. It’s not recognised in modern medical parlance, certainly not by the palliative care industry—if anyone would know about such things, you would expect that they would know. So it seems strange to me that we’ve got a purpose of an Act referring to such a key concept as “terminal illness”, but that’s not defined in there. So I would welcome the member’s comments on that aspect in particular, to the extent that it represents a departure from the bill that he previously provided to this Parliament some time ago, in which he’s now seeing fit to change so significantly in the last few hours—the dying days, so to speak—of the period prior to the committee stage.

So, moving to the interpretation clause—namely, clause 3 within that Part 1—I note that the member has attempted something rather interesting by deleting the words “a lethal dose of”. So what we now have under the heading of “assisted dying”, the definition of that, is “medication” as opposed to “a lethal dose of medication.” So too in the next subclause, “a lethal dose of medication” is removed. I wonder what justification the member can give for making the bill less clear by no longer referring to “a lethal dose of medication” and instead having a rather comforting and more generic term for medication, which has a totally different meaning to the minds of most people who would be subject to this bill, potentially, and certainly those medical practitioners who would be expected to apply it and to execute its provisions, if you’ll excuse the pun.

Then my next question in relation to the interpretation clause comes to the point that I can’t help but notice we’ve got a definition for “Code of Health and Disability Services Consumers’ Rights”. Well, that’s a good thing to define, because we might as well know what is meant by that. But how interesting that now we have inserted, whereas we didn’t have before in the member’s previous version of the bill—suddenly we have this code of patients’ rights being introduced. It’s a novel concept, perhaps, to the member, or certainly as far as this particular bill is concerned. It does raise the question what consideration he’s given to a situation where the provisions of the code—the patients’ rights—conflict with the provisions of the bill.

I think that, particularly in relation to the notion of informed consent, for which certain very specific criteria must be met in relation to medical practice generally, as would be judged in accordance with the code or not—as compared with the bill, in which there is rather a different meaning of “informed consent” and a different concept in relation to the amount of coercion that can be applied—is clearly intended by him to be effective.

Continuing, we’re up to letter H so far, if you’re following along, no doubt you are: “health practitioner”. So that’s all very well to have the definition of that—and I do note, pleasingly, this has actually survived through from Mr Seymour’s first crack—but, actually, what we don’t have there is a requirement that the health practitioner, in order to be defined as such and eligible to carry out the functions under this bill, doesn’t need to have held a practising certificate for five years or more, and yet that is the case later on where we have the definition of an independent medical practitioner. So I wonder, if two medical practitioners must be involved in signing off such a momentous decision as one that a person be subject to euthanasia or assisted suicide, why would one of those medical practitioners have to be relatively experienced and the other one not at all? It seems rather anomalous to have such a requirement in two different levels. I would welcome the member’s comments as to why he would establish such an anomalous arrangement in the first place, and whether he would consider changing it, perhaps, by way of amendment to his amendment. I think I could probably just about get that on there before the ink dries fully on these changes that he’s provided to us so recently.

I note in relation to the definition of nurse practitioner—interesting that we’ve had this inserted, and I wonder why, suddenly, whether lots of nurses have been lining up to say that they want to be involved in ending the lives of their patients, such that we now need—[Time expired]

Tēnā koe, Madam Chair. Thank you for the opportunity to contribute to what is an incredibly serious debate. I, firstly, want to acknowledge the member David Seymour, who has led this particular legislative reform, and acknowledge the changes that he has made within his Supplementary Order Paper (SOP). I do want to start with some preliminary comments about what I think this bill is about. Some people have said this bill is about life and death. Well, the reality of people who have a terminal illness is that this bill is only about death. There is no choice to live. I think that that particular purpose, that has now been added from David Seymour, I want to highlight, because we are here today debating this piece of legislation as it affects people who have a terminal illness.

So I think that clarification, actually, has made it really helpful, not only for us as a Parliament but also for New Zealanders. Can I say, having recently been through an experience of a family member who had a terminal illness, providing choice and providing an opportunity for people who are living with a terminal illness to actually take back some control of their lives when they have none, I think, is incredibly empowering. So I want to acknowledge that the purpose of this bill is now crystal clear; it will only apply to people with a terminal illness.

I do now want to highlight the difference between David Seymour’s definition of terminal illness and the one contained in the SOP, that I also want to acknowledge was co-written by my colleague Lawrence Yule, and, in doing so, I also have to acknowledge Sir Geoffrey Palmer and also Paul von Dadelszen—I always struggle with his surname—who assisted in us contributing to what is and was a discussion that seemed to be slightly chaotic. I hope that David Seymour and those who are interested in this topic realise that we did so because we are incredibly passionate about giving people the choice.

I do want to highlight that our definition of terminal illness means “a progressive condition that is reasonably expected to cause the death of a person within 12 months.”, and I’m going to talk about why 12 months. So 12 months, from our perspective, is incredibly important based on the mechanism, which is the second addition to the purpose of the Act. You need to establish a process. This isn’t random. It needs to have the checks and balances. We have to verify that a person has a terminal illness. We have to verify that the available treatments have been provided to the person, but, fundamentally, it was also about recognising that people in the last stages of their life need forms of palliative care that ensure that they die in a manner that means they do not suffer.

So when looking at a process that we felt had all the safeguards attached to it, we thought that a court consent process would allow that. We felt that 12 months provided the opportunity for people to prepare for death. Death is something that we will all face, but some of us actually have a bit of an indication of when that might be, based on a medical condition that we may have. So for us, 12 months would allow people to apply to the court with their physician. It would enable the court to verify, over a 21-day process, whether or not the person had a terminal illness, whether or not they’d exhausted all possible medical treatments, whether or not that person was receiving palliative care. From our perspective, it was really important that it was a joint application between the person with a terminal illness and their medical practitioner that was going to assist them in any process. It was also really important that we put, within the context of our mechanism, an ability for there to be an appeal based on technicalities of law, and, in doing so, we obviously thought that the time frame that we were proposing was sufficient to enable all those matters to be clarified before the person then actually had to deal with the fact that they were going to die.

One of the things that I’ve learnt recently is that people who are facing a terminal illness have lots of decisions to make. They sometimes have insurances that they have to claim for, and, in highlighting that, I want to acknowledge that if we look at the insurance sector, they’re really clear about who qualifies for a payout: it’s someone diagnosed with a terminal illness, and they’re expected to die within 12 months of diagnosis by a physician who specialises in that illness or condition. Why does the insurance sector have a 12-month time frame? They do it, again, so that people can apply, go through an administrative process, and it also enables them to settle any accounts they have, pay mortgages, obviously, setting up funds to pay for the funeral, but ultimately, it’s also about preparing—in my case, my brother leaving funds for his children and establishing trust accounts and those types of things.

I also want to highlight that Paula Tesoriero is our Disability Commissioner. We know she did not support this piece of legislation, fundamentally, but one of the things that she highlighted in her submission to the Justice Committee was that she would like to see the definition of terminal increase to “likely death within 12 months”, and she thought that was quite essential. I’m putting it out there because I would like David Seymour, the architect of this bill, to tell us why six months was deemed to be an appropriate time frame.

I guess the other aspect I’d like to highlight has been the narrowing of this bill so it won’t just apply to you if you’re old, won’t apply to you if you have a disability. Actually, it’s broader than that. You have to have a terminal diagnosis. One of the conditions that I’ve been incredibly aware of, in terms of the disability sector and their advocacy for this piece of legislation, has been the motor neurone disease sector. If you’re diagnosed with motor neurone disease, and the most common form is ALS—I’m not even going to try and pronounce that, Ruth; I know you know how to say it—but, essentially, a third of you die within a year, 50 percent within two years, and there’s no cure. So having a broader time frame for, again, people to prepare—that one year means that takes into consideration some of the phases of that particular diagnosis that can happen incredibly quickly. So you can move between phase two, three, four really quickly. So I think the time frame, from my perspective, is incredibly important when we think about how and why people need to prepare for death.

I just finally want to highlight that the House made, I think, quite a conclusive discussion about the fact that this piece of legislation is needed. You know, we’ve been discussing this topic now for over 20 years. It’s one of its time. Lawrence and I have been looking at all of the SOPs, and one of the SOPs that we talked about was Nick Smith’s, about the concept of unmanageable pain. His proposition is that if the physician says it’s unmanageable pain, then someone would qualify for help. That’s what we’re trying to do, is to help people and assist people in their final, maybe, months or days, where they’re having to cope with some of the consequences of having a particular diagnosis. I do want to highlight some of the cancers: pancreatic cancer, some forms of melanoma. People suffer. It’s not a nice way to leave this world. I think all of us would agree that the intention of this bill is to ensure that nobody suffers.

So from a first principled position, I just want to thank everybody. I think we’re going to have a constructive discussion. You know, everybody here has people that they love, that they have journeyed with through those final stages, and I know, for all of us, this is a topic that we will debate and discuss in a very respectful way. I might take a call later, but thank you, Madam Chair, for giving me the call. Kia ora.

Thank you, Madam Chair. Acknowledging what I think is a wonderful opportunity, the speaker who’s resumed her seat, Louisa Wall, noted 20 years this topic has been raised, but, actually, tonight starts a process where, I would suggest, for the first time we are able, as a Parliament, to properly interrogate this bill clause by clause, word by word. Fundamentally, we are about to change arguably one of the most fundamental principles of Western society, in particular, around life and death.

I would assume most in the committee will agree, as we start looking at Part 1 and eligibility, that if we are to provide the right for some, we must always make sure that the most vulnerable are protected and that no mistakes are going to be made. So I will immediately disagree with the member in the chair, David Seymour, who was suggesting at the start that we should get through this rather quickly. I find that unfortunately attempting to gloss over already what is incredibly serious, because I think, as I’ve mentioned in other speeches as I’ve been around the country, we get this wrong and people innocently die. I for one believe the number zero is fantastic. One would be too many.

The member who resumed her seat, Louisa Wall—and acknowledging her contribution—sparked in me a memory of a wonderful quote. It’s from an excellent book called A Canticle for Leibowitz, and it sums up my impressions of things, particularly around suffering. It says that it’s right and proper for the State to maximise security and minimise suffering, but, in seeking both, we found the opposite—it’s right and proper to maximise security and minimise suffering, but, in seeking both, we found the opposite. That’s the risk we have here tonight, so I’m looking forward to interrogating this very carefully, and I do it out of a sense of duty to those who may end up being able to terminate their lives through assisted suicide or euthanasia.

So starting with Part 1, we do need to look at the purpose of the bill. This is a major change. I think we have to note that there have been a number of changes, and I say that for two reasons. One—and my colleague Chris Penk has kindly pointed it out already—we’ve only just got this long-promised Supplementary Order Paper (SOP) 259 in the last 24-36 hours, so I think, myself—and maybe I’m just speaking for myself—I have been scrambling, if you will, to try and catch up on this. The second reason I mention is that we were we told, when this bill was first introduced, that it was perfect—that the greatest legal minds in New Zealand, and medical minds, had pulled this together from the brilliance of jurisdictions overseas. So I find it somewhat—hmm—ironic, to be charitable, that here we are once again, with the greatest legal minds and the greatest examples overseas, debating a bill which I’m about to show—and I hope in a few ways—has problems that we need to fix first.

So we have a new purpose of the bill. It’s been raised by, actually, some other lawyers who have engaged me already to, sort of, understand what it’s actually saying. So the member might want to take a call on that, particularly clause 2A(b) of SOP 259, which says “to establish a lawful process for assisting eligible persons who exercise that option.” It seems a bit odd that we have to add the word “lawful”, and what does that actually add? It would be—I don’t know—a redundant oddity in a Parliament that we were to be establishing a non-lawful process. So it just needs a little bit of tightening up there, and I would suggest the member look at that if he wants to put some further SOPs forward.

We then move into again what strikes me—and, look, granted, I’m not a lawyer. I rely very heavily on lawyers, QCs, judges, and others to provide me information in this field. But in Part 1, clause 3—this is the interpretation side—we now have a rather circular self-stating first definition or interpretation. It says an “approved form” means a form that’s approved. I’ll read that again. It’s an approved form means a form that’s approved and—granted—issued. So it’s sort of circular, and I wouldn’t mind the member sort of explaining why we need a definition of “approved form” which says it’s a form approved. I mean, I’m very conscious we’ve flipped the words around.

We then go into what I think is actually a fairly substantial and important element, and Chris Penk touched on it in a broader context, around—I would use the word, for the first time, I think, tonight—euphemism. I mean, I’ve spoken to this many times before. If we’re going to talk about life and death, let’s be upfront and honest about it. The Dutch—I don’t particularly like their law, but, by Lord, they’re very good at just laying it out clearly.

So we’re talking here about assisted dying. Well, I’ve just been, actually, at the hospital, somewhat about to farewell a friend, unfortunately, who’s on his last legs. He’s being assisted to die currently. He’s been assisted to die by family and friends, palliative care, doctors, and loved ones, in a way that I think most of us, if not all of us, would accept is quite accessible and acceptable. It would be something in my final days—whether that’s tomorrow, three months, 12 months, or 12 years from now; maybe, hopefully, a lot longer—I’m going to be assisted to die. I know a number of doctors have suggested that the wording, while also euphemistic, is incredibly loose, because, actually, doctors, particularly those in palliative care, assist people to die every day, but they don’t do it by injecting them with something like phenobarbital and causing a massive cardiac arrest.

Why then—I have to challenge the member once again, as I’ve done many times—is he not able to call this what it is, which is euthanasia and assisted suicide? So (1) euphemisms: why are they being used if we want clarity? Secondly, why does this bill not actually, in the interpretation section, clearly spell out the two forms of death or mechanisms of death: euthanasia, where the doctor will inject you with, as I say, something like phenobarbital, usually with the muscle relaxant earlier; and then assisted suicide, which is where you are given the pill, sometimes a liquid, and you ingest and take those at your leisure? So just clarifying why the two specific elements are not there.

Look, it’s been touched on why the word “lethal dose” has been taken out. Look, a medication intuitively, to the populace—and, again, this is a bill we’re writing for all New Zealanders. When we talk about medication, we talk about—and we think intuitively—that it’s something which heals us. It’s a balm, if you will. A medication that ends your life is not really a medication. You know, it’s like saying a cricket bat whacked over the head is medicinal. Well, no, it’s not. So, again, I just encourage the member, in the committee, to consider all these little changes. Why is there not the confidence to just call a spade a spade? OK, it is a lethal dose. The drugs which will be used are exactly the same that they use currently in America for the death penalty. They are not medications.

We then move on to “attending medical practitioner”. That says “in relation to a person, means the person’s medical practitioner”. Again, and this is why I really encourage the committee to prosecute every word carefully—and I’ll always defer to the lawyers. It seems great. Oh, it’s the medical practitioner—the person’s medical practitioner. Well, does that actually mean your general practitioner, the man or woman that you see and have seen for every year? Well, it doesn’t prescribe that in any way, shape, or form. It just says a “person’s medical practitioner”.

In other words, at this point—and I’m more than happy for the member in the chair to correct me—it actually doesn’t specify that it must be a doctor that knows you or a doctor that has known you for a significant time. In fact, as we’ve seen in other jurisdictions across the world, we’ve seen sort of death buses driving around, where two doctors will jump out and certify that you are terminally ill and can go, and it’s all done and dusted. I mean, they knew you because they’ve just met you, so again I suppose I’m just using this as a singular example at the start to illustrate the need for us to prosecute and ask very deep questions. So I’ll probably look to introduce some SOPs or amendments to this SOP to make it clear, if that’s the intention, that the attending medical practitioner—which means a person’s medical practitioner—must include their general practitioner, or perhaps it’s a doctor that has known them for over six months, for example. So it’s again just an encouragement that we don’t get caught up in what looks like nice language which actually can mean something quite different.

I just want to touch very quickly on the Code of Health and Disability Services Consumers’ Rights—a different angle that Chris Penk has gone down, and we’ll prosecute this a little further later, when we get particularly to clause 4. At one level, there’s been a delight from some that we are narrowing the bill—and I think, actually, Louisa Wall has touched on a really good point that all of a sudden those with the likes of motor neuron, Huntington’s disease, and so forth have been taken out of this equation. However, it’s also been trumpeted that those with disabilities will now not be included. Now, obviously, as someone who wants to protect the vulnerable, I like that. However, we are moving into a strange situation that, actually, we are developing a discrimination against disabled people. Put very bluntly, you have the right to die, but, I’m sorry, if you’re disabled, you don’t. Now, at one level, we can say yay, because that protects the disabled; on the other side, we can go that’s a discrimination prima facie. So that has to be addressed there.

We also have—moving now on to page 4 of this new SOP; I’m afraid the ink, Chris Penk, is actually stuck on my fingers. But it says “competent to make an informed decision about assisted dying.” If you jump then to clause 4A, you find it’s again a circular argument. That competency—[Time expired]

Madam Chair, as this is the first time I’ve spoken when you yourself have been in the Chair, can I take this opportunity of congratulating you on your position. I have no doubt you’ll do a superb job, and it is just another accolade in what has been a very significant parliamentary career that you’ve had since you came here in the 1993 election.

Can I just take this opportunity to make some opening comments on this particular legislation, and I do so because I was overseas at the second reading debate when I would’ve liked to have had the opportunity to state my position. I don’t intend to take numerous calls through the debate, but I will oppose this legislation, and I’ll oppose it for one significant reason: I cannot be assured that there won’t be some elderly person who is coerced into accepting assisted dying. In saying that, I want to acknowledge the work that David Seymour has done with this bill. I know that he has attempted to take away that risk, but I don’t believe anybody can give me 100 percent assurance, a guarantee that in the future, if this legislation is passed, some person won’t be pressured—maybe quite deliberately by family; maybe almost subconsciously by family—into feeling that they take pressure off a family situation by euthanising themselves or agreeing to be euthanised.

I want to also acknowledge, as this debate has progressed through the House, the very strongly held views on both sides of the argument, and I respect each and every one of you for your strongly held views. That’s why it’s a conscience debate. I’ve seen this legislation now come before this House—this is the third occasion, and as with any of the conscience debates we have in this House, I think we have some of the best-quality debates that we have at any time that I’ve been a member of Parliament. So I look forward to the debate as it develops, and wherever the result goes, I respect the democracy of this House. I’ll respect the views that are finally espoused through the debate and the result that is agreed to.

A lot of people say that as people are in their last days, you wouldn’t treat an animal like that, and I accept that argument. I’ve farmed for well over 40 years. I’ve, sadly, taken a number of my working dogs to the vet to have them put down because they were at the end of their life and suffering, but I don’t think you can have an analogy between a veterinary process and this legislation. Medical science is far better than that, and I do not accept that anybody should suffer in their final days. I think the ability of medical care, the palliative medical industry, is responsible for making sure people can live with dignity in their final hours.

On Monday of this week, I visited a friend who has not got many days to go; he is dying of cancer. I went through primary school with this man, I went through secondary school with this man, I’ve been associated with him in a business sense throughout his working life, and as we talked to him—I certainly didn’t raise the issue of euthanasia, but he knew he didn’t have long to go. But he was using that time incredibly profitably in that he was spending time with his family, with his business acquaintances. He was clearly preparing everything in a very logical, methodical way to make sure his wife and only son were left in a very tidy position. He was on medication—he talked about that. He wasn’t suffering. He was using those final days in the best way possible.

So I don’t, as I said at the start, intend to take lengthy calls. I just wanted to take the opportunity of explaining quite clearly to the committee why I respect the views of Mr Seymour and those that will argue with some passion for this legislation. I will not vote for it, for the simple reason that I fear someone will be coerced at some stage in the future into feeling they have to accept this option—deep down, they probably did not want to.

Thank you, Madam Chair. It doesn’t get any more serious than this when you’re in this House as a legislator, when you’re debating and deliberating the issues of life and death. I was honoured to be and privileged to be at a number of different public meetings throughout the stage of the select committee, and I can remember quite clearly a number of health practitioners when they stood up and they declared the fact that they swore an oath that they shall do no harm. That was the oath that they had, and hence the reason why a number of them spoke so strongly against and opposed this bill, because the intent of the bill continues to ask that question.

I believe that for us in this House as legislators, as lawmakers, we too need to ask that question, that we too shall do no harm. The question that we need to put to ourselves in debating this—and hence the reason it needs and deserves a robust process in this House, because at the second reading people talked about the fact of what couldn’t be achieved in a select committee process of 39,000 submissions, of over 400 meetings up and down the country, around a number of people actually coming and providing their submissions—that what couldn’t be decided there should at least have a robust process in this House. So I hope that that will continue, that we will allow for that robust process. This is not about filibustering. This is about as serious as it gets, and a number of us are taking these calls not only because we personally hear from people in our community but because we know the importance of this bill and what it will set as a precedent in this country. So I, like others, am willing to be able to do that. We want to take that on board as we continue to progress through the House.

When we begin the process of Parliament, there is a prayer that has been prayed for over 165 years. It began on 24 May in 1854, when Parliament was actually constituted in Auckland before it came down here to Parliament, and inside of that prayer it says this: “Laying aside all personal interests, we pray for guidance in our deliberations”. I know that there are personal interests. As the Rt Hon David Carter said, there are a number of stories. We’ve all got personal stories of family and friends who’ve suffered at times through a difficult process, and at times through a difficult death as well, but we cannot allow a personal process, like this prayer says—“Laying aside all personal interests, we must pray for guidance”. I do hope that we will look for the guidance of deliberation, the evidence that we can put forward in regards to this issue that is before us. It doesn’t get any more serious than this.

In talking to Part 1 of this bill, in proposed new clause 2A(b) of Supplementary Order Paper 259, it states this: “to establish a lawful process for assisting eligible persons who exercise that option.” I want to pick up the point and the word that talks about eligibility, and in this case, in eligibility, the age of eligibility is set at 18 years. Now, the Attorney-General’s report—when he wrote, he regarded three areas of recommendations. The one area that he stated was inconsistent with section 19 of the New Zealand Bill of Rights Act was in regards to the age of eligibility. In New Zealand, we’ve set that age of eligibility through this Parliament at the age of 16. So already we see that there is a weakness in this bill, because what it does do is it leaves an open door for an opportunity for litigation around opening the opportunity for this, in this regards, to not just being 18 but 16, 17, and maybe even further.

I can remember that when we were debating, a number of those who spoke on behalf of euthanasia in New Zealand who stated quite clearly “Well, we’ll not go to the discussion and the debate around age; that may be a bridge too far right now.”, but later on it could be a conversation. So when people talk about the slippery slope, maybe we’ll call it another name: there’s an open door that’s now made available for litigation to now see that in other jurisdictions—as I read from some of the summary of the 39,000 submissions that were supported, there were a number of submissions there that talked about countries like Belgium, other countries that have now opened that door where, now, the eligibility criteria has not only been challenged but now has been reduced down to even the youngest of children.

So people need to understand and know, not only in this House but also in the public, if our intent is not to do harm, then we could be opening the door around the eligibility criteria, not only at 18 but later on, as others have said. Right now, it’s a bridge too far, but the door will be open for that eligibility to go even further. I think it’s important that the consciousness not only of Parliament but of the nation needs to understand the importance of this point that we’re raising right here now.

Firstly, I want to commend the member David Seymour for his courage, because the matter before us is probably the most visceral of any matter that we will discuss in our political career. So I thank the member for your courage for bringing this before the House.

I also want to challenge the committee and members who speak to this bill: it’s about accuracy of information, not misinformation. It is about debate, not conjecture. We must be honest with the public of New Zealand in the facts that we present, and I encourage all members to make sure that we are not creating a rod for our own backs when we say things that we cannot validate with fact. That’s my disclaimer to start off my conversation.

I won’t take a long time, because I know there are lots of people who want to speak on this, but part of my concern around this piece of legislation lies in the interpretation of “assisted dying” and what it’s intended to do. The discussion here is about the relief of suffering of one of our loved ones. Let’s face it, we’re talking about either ourselves, making a decision for ourselves, or supporting a loved one to make that decision.

Now, each and every one of us have got a personal story to tell about this, and my story is no different from many others, watching parents having terrible times at the end of life, where pain and suffering is something that, as family members, we have to sit and watch. Now, one of the discussions that hasn’t happened in this debate so far is the impact of death on those who are left behind. I’ve lost both of my parents and three of my siblings, and most of them did not have a happy end. I’ve lost many other people in my wider circle. The trauma that sits within me, watching that, is something that we have largely ignored in this discussion.

The issue is that family members should have an ability to be part of this discussion, because they are the people who are left behind, who witnessed the suffering, who witnessed the trauma of the death, and yet they have no say in this discussion; for me, watching particularly my mother pass, saying to myself “I just wish she would go.”, because I didn’t want to watch her suffer. However, when she did go, I just wanted to see her alive. So it’s this conundrum that we have as family members, is it not? We want to relieve their suffering, but actually we don’t want them to die. So that’s my contribution to this discussion—that in this we must ensure that the voice of families is considered, because we are the ones that hold the mamae, that hold the pain when our loved ones pass. Thank you, Madam Chair.

It’s a pleasure to take a call on this bill. First of all, can I congratulate David Seymour for getting this bill to this part of the process, and can I acknowledge your courage in doing so. This is a very difficult issue, and the last speaker, Poto Williams, has reiterated a lot of what I wish to say. But I did want to take a call tonight early on in this debate, because how we handle this part of the committee of the whole House will define our relationships in this House and how we get to a point of commonality, whether the bill passes or doesn’t, and along the way, over many hours, we’ll debate the various points.

I want to acknowledge Louisa Wall and the work she did. We worked together on a Supplementary Order Paper (SOP). You might say, “Well, how did that happen?” It happened because we happened to be at a function one day and we were talking about where this bill was, and we had very similar views about the concerns we had. So we worked together to draft up an SOP.

We are now in the committee of the whole House. I voted to support the bill at second reading because this is my opportunity to flesh out the things that I have concerns about. I also acknowledge David Seymour, the SOPs you’ve put up to try and acknowledge some of the concerns across the Parliament. This, for me, is not about choice, actually. For some it is, and I accept that, but for me it’s not about choice; it is about helping some people who have really difficult deaths and it is about managing that process and helping them. Even today as I flew back from Hamilton, I was in the airport with a lady and she said that she watched her mother die from pancreatic cancer and it was horrendous, and with the best of palliative care, there was still pain and suffering. That’s actually what I’m here to try and fix in this part of the process.

Louisa Wall and I did propose, and have got, an SOP which talks about 12 months. It talks about using the Family Court and it talks about using families, because in our view this is around a process of dying, a process of leaving. The previous speaker, Poto Williams, brilliantly articulated in a very sad way what happens. We don’t like or enjoy—and in fact, it is very upsetting—watching loved ones suffer, but we also don’t want them to go over that other side.

Many people have looked at our SOP, and some have said it’s too lawyer based, it will take too long, and the Family Court’s wrong. But I just want to say to this committee that our process of doing that is about trying to find a solution, because while I’ve heard people say already that people could be coerced or some people could die, on the other side of this debate there are some people that are having very difficult deaths. This Parliament simply needs to decide what that balance is.

I will participate and listen in these debates, because what happens here will determine what I finally do at the next reading. So in this Parliament and in this committee, as part of this, I am looking for solutions. I am not looking for this bill to be delayed for five months, as some I’ve read today said. I’m actually here to try and find some solutions to the concerns that I have, to see if there’s a way through this. I also think, based on my own electorate and what public opinion is, that the public of New Zealand do want us to try and find a solution.

I don’t know whether it’s going to go to a referendum or not. I don’t know where that’s going to end up. But if it does, I probably believe it will pass. And if it does, my job as a member of Parliament, and the job of other members of Parliament, is to make sure that the legislation is as good as it can be and as safe as it can be. The time I wish to spend in this Chamber at the committee of the whole House and on the nights and weeks ahead will be to try and find solutions that I believe get that balance right. Now, we won’t all agree and the vote will be tight, but I would hope that there is wisdom, decency, and maturity in this House so that we can get the best possible legislation.

Thank you, Madam Chair. I take this opportunity to answer some of the questions as best I can that have so far been raised.

We had the first speech, other than mine, from Chris Penk, who queried whether the use of the word “persons” would imply that all persons with a terminal illness were eligible for assisted dying under this law. And the answer to that is: of course not. One of the central concepts of Part 1 is eligibility, and having a terminal illness is but one of those potential criteria a person has to meet in order to be eligible. We were asked if terminal illness was defined. Well, yes it is; if the member cares to continue reading after the word “illness”, it says, “likely to end [their life] within six months”. So you’ve got a definition there. He asked about the words “Lethal dose of medication”; he asked why that had been removed. It simply is a matter of efficient legal drafting. If he cares to look at the interpretation section, which is part of Part 1, it gives the definition that medication is a lethal dose of that medication. As I said in my opening remarks, people should look very carefully at that interpretation section, because words defined in the interpretation section have the meaning given in the interpretation section for the remainder of the bill.

We were asked if the Code of Health and Disability Services Consumers’ Rights—what happens when that conflicts with the bill? Well, statute law overrides that particular code. I will have to check, but I understand the code itself actually says that. We were asked why one medical practitioner, the independent medical practitioner, must have five years of experience. The fact is that the bill, as introduced, didn’t require either of the medical practitioners—either the attending or replacement medical practitioner, or the independent medical practitioner—to have a given length of tenure in the medical profession because the fact is that the medical practitioners, as you also see in the interpretation section, are defined as a doctor who is registered with the Medical Council of New Zealand. That is not a low bar and I think members of this committee should be very careful about how they describe the experience of medical practitioners. Those who are doctors registered with the Medical Council are already extremely highly trained and experienced people. I think stating that the independent medical practitioner must have five years of experience is a useful reassurance that that medical practitioner will be even more experienced than the other medical practitioner that’s examined the person.

We were asked about nurse practitioners and how they have been included as capable of undertaking a role under the bill. Well, first of all, I think it’s worth talking a little bit about what a nurse practitioner is. It’s somebody who has had 300 hours of supervised clinical experience, who has a master’s degree, who specialised in an area of nursing for four years. These are highly skilled and experienced nurses who routinely carry out procedures, such as filling out death certificates for patients who have died. I see no reason why, under the supervision of a doctor, they should not be able to carry out certain procedures that they are used to carrying out in every other area of medicine, under this bill. Particularly for those New Zealanders who live in remote areas where it can often be difficult to get access to a medical doctor, being able to have a nurse practitioner who is perfectly qualified to carry out a role seems like an appropriate thing to do.

We then had a very well-appreciated contribution from Louisa Wall. Louisa, I want to acknowledge that you are giving this speech a week after your loss and only a day after a funeral. I know that people talked a little bit about courage; that takes courage very few members would have. I want to thank you for your support of the concept. I also want to thank you for your industriousness, along with Lawrence Yule, in bringing an amendment that, really, is an alternative bill. It gives an alternate way of achieving the overarching objectives of the End of Life Choice Bill of alleviating suffering and giving choice to those who want it, while protecting those who want nothing to do with it. So I want to thank you for that and commend you.

I want to say, with some difficulty, that I can’t support that amendment. There’s a few reasons for that—one is that all around the world where assisted dying has been put in place, the question of whether the two-doctor model is superior to various judicial models that have been investigated has been asked and answered in a number of courts and select committees around the world. People have said, look, on balance, you are better to have two medical practitioners—the reason being that they have medical knowledge; they understand the medical conditions. To introduce a judicial officer would add, inevitably, some delay, although I accept Lawrence Yule’s word that it won’t be as big as it’s sometimes made out. But on the other hand, the judges are still relying entirely on the expertise of the medical officers anyway. I’m just not convinced that it will introduce the greater comfort that’s been promised. I’d further say that there are some other issues with the amendment that, in my view, are problematic. One of them, for instance, is that judge is effectively making the decision about whether the person has carried out the other possible terms of treatment that might be available. It’s very clear in this bill that it is important—and several members who are opposed to the bill have raised this; I think it’s one thing we all agree on—that it is the person in question who makes the decision. It shouldn’t be a judge deciding whether or not the person should have other types of treatment. So I want to thank Louisa Wall.

The other issue Louisa raised is the 12 months. Around the world, six months is the time period that has been used. I agree that for the purposes of insurance, for the number of preparations that people may make when they are ill, they want to be able to have 12 months or even longer to prepare for their departure from this world. However, I’m not convinced that it takes more than six months to go through the process of applying to become eligible for an assisted death and having one of those. So I think six months is the best practice around the world and we should keep that.

We saw Simon O’Connor ask why it is that we say that we’re making a lawful process. I think it’s important that legislation communicates to people outside this Chamber what the intentions of elected representatives are. It’s very much the case that we make sure there is a process that is lawful. I guess some people might be pedants and argue about redundancy and drafting but, frankly, I don’t think it serves the committee to have debates at that level. He also said that assisted dying is euphemistic and we should define the process as available. Well, again I point the member—and I said this in my opening address and I knew it would come up—to the interpretation section, where both the process where the person takes the medication that ends their life and the process where the doctor applies it to them are defined. Mr O’Connor, again, mentioned that term “Lethal dose of”, which, of course, is defined in the interpretation section.

I want to turn to David Carter, who is someone I’ve enjoyed a very good relationship with and have had a lot of respect for over a long period of time. Look, I just put two propositions to Mr Carter. One is that people always say that there’s the potential for undetectable coercion. Two things about that: one is that when we look around the world, we don’t find evidence of it, and, second of all, I don’t believe that it’s a standard that people apply to other aspects of law. They certainly don’t apply it to any of the other medical decisions that people make, and if they did, the entire field of medicine would be unworkable. I think if the member’s been prepared to preside over a set of statutes since 1994 that allow all of those things, then I’d urge them to consider this bill by the same standards.

Second of all, the faith in palliative care. I’m a big fan of palliative care. I’ve got great faith in palliative care, but I want to point out to the member that while there are many, many successful instances of palliative care giving people good deaths—in fact, those are by far and away the majority. In the Lecretia Seales court case it was accepted by both sides, uncontested as evidence, that palliative care is great for many but it does not work for all. Lecretia Seales, of course, was one of those very public exceptions.

We then got to Alfred Ngaro, who said that we should, according to the parliamentary prayer, lay aside all private and personal interests. I agree with him completely. He said that the Attorney-General had said that we were going to get possible litigation on the age, because the Attorney-General section 7 report recommended an age of 16 rather than 18, according to the New Zealand Bill of Rights Act. I think we need to remind Mr Ngaro of why we’re here: we’re here because Lecretia Seales and her legal team took a case to the High Court calling on the Bill of Rights, arguing or claiming that Lecretia Seales’ rights under the Act had been violated by Parliament’s laws. The judge said, “I’m not going to make laws; you have to go to Parliament”.

Sitting suspended from 6 p.m. to 7.30 p.m.

Thank you, Mr Chair. I finished with a couple of calls just addressing some of the issues that had been raised by members in regard to Part 1 of the End of Life Choice Bill. In the first hour or so of the debate, I addressed things that have been said by Chris Penk, Louisa Wall, Simon O’Connor, David Carter, and Alfred Ngaro. I was about to get to responding to comments made by Poto Williams.

Poto Williams, I think, really made two important points. One is that death is very difficult, regardless of how it happens. There’s a paradox about it that Poto brought up, which is that on the one hand, you want to see one’s relatives stop suffering; on the other hand, as soon as they’re gone, you wish that they could come back. It’s a very difficult and paradoxical process that is part of the human condition. One of the things I’d say to Poto Williams and people that listen to her comments is that it is undeniably true that people come to the topic of death with a variety of perspectives, lived-experiences, faiths, and also a variety of practical situations—different conditions and different circumstances.

What this bill is about is giving choice and safety, giving people an ability to make a particular choice should it suit them. It doesn’t take anything away from all of the other choices people might have; it gives an additional choice to some people who might want it. I would put it to Poto Williams that for some people in certain circumstances—people of certain perspectives on the world—this is a choice that makes this suffering that much less than it currently has to be.

Poto Williams also said that we need to debate on the facts, something that we heard in the second reading very strongly from Deborah Russell in her contribution. I completely agree. I’ll make a quick comment that, on all of the issues that are debated on this particular topic, there is always speculation about what might happen were New Zealand to change its laws. But when we evaluate that speculation, we should always have reference to the considerable body of empirical evidence that has been formed in countries around the world—countries that are inhabited now by some 200 million people; countries that, in some cases, have had assisted dying laws on their books in operation for 20 years. That is where we should look if we want to demystify or clarify what we might think the outcomes of an assisted dying law in New Zealand should be.

Finally, Lawrence Yule made a contribution in regard to the Supplementary Order Paper that he and Louisa Wall have jointly covered. I’ve already addressed that Supplementary Order Paper to some extent, and that makes a response to Lawrence Yule’s views. But Lawrence also acknowledged something very important: that there is considerable support, and that we do owe it to think very carefully about the people at home and what it is that they might want, especially those who want choice. Thank you, Mr Chair.

Thank you, Mr Chair, for an opportunity to take a call on the End of Life Choice Bill. This is the first time and opportunity I’ve had to take a call on this bill. I come to this bill with a sad heart. This is not the type of legislation that I came to Parliament to debate. This, in my opinion, is one of the darker days in this Parliament’s Chamber, where we are debating legislation to do with the death of people caused by other citizens of this country.

I come to this debate and I challenge members who voted for the second reading of this bill to take calls, because many of them acknowledged they had concerns over the way that this bill was drafted. They had concerns over some of the safeguards—that they did not go far enough. And this is the opportunity they wanted, to be able to come down to this House, and to be able to make amendments to this piece of legislation. Well, tonight is that opportunity. Tonight is the opportunity for members of Parliament to come here and to propose Supplementary Order Papers (SOPs), to explain their concerns, to have those addressed, and convince other members that those changes should be made.

I acknowledge the sponsor of the bill has tabled a large SOP with a number of changes—I believe around 30 changes in that Supplementary Order Paper. But I also note that that was only tabled yesterday. I have tabled a number of Supplementary Order Papers on this bill, and I intend to speak to them. I think it is important to highlight and to use this opportunity to highlight the danger that this bill does pose to vulnerable New Zealanders. I would like to highlight the Human Rights Commission, which defines a person as vulnerable if that person has been diagnosed with a chronic illness or a terminal illness.

So if the Parliament does accept the change which Mr Seymour is proposing, which is to limit this bill only to those with terminal illnesses, we are talking about vulnerable New Zealanders here tonight. One of the Supplementary Order Papers that I would like to speak to is in regards to clause 4, which does say that those vulnerable New Zealanders who would be entitled to this choice should have a terminal illness which will only give them up to six months left to live. That Supplementary Order Paper 282 proposes to replace six months with one month.

I bring this Supplementary Order Paper to this Chamber because I do believe that this is something which would actually, if this bill were to pass, put in place legislation which is for those who do genuinely only have a short amount of time left to live, rather than those who have up to six months.

I note that in the select committee report, which has been tabled, there were numerous submissions from doctors and medical experts who highlighted the difficulty in giving a prognosis of six months. It is, I think, highlighted particularly with the case of Lecretia Seales, who was diagnosed with weeks to live in March 2011, who then went on to live for three years. I acknowledge the campaign and the issue that she had been championing and she did champion. However, that in itself does highlight one of the weaknesses in this piece of legislation, which I do think members of Parliament do need to take very seriously.

This Supplementary Order Paper limits the risk of misdiagnosis. It limits the risk of diagnoses being made which are incorrect. It limits this risk substantially. There were people who came to the select committee who even had stories where there were family members who had been given months to live who are still alive today, and those diagnoses were given years ago.

I fear that vulnerable New Zealanders will be taking this choice upon themselves based on information which doctors themselves say is difficult to provide—diagnoses which are difficult to make. It puts enormous pressure and responsibility on our medical professionals who, under this legislation, will have to make these diagnoses, because, at the end of the day, this is a life and death situation. I ask members to support this Supplementary Order Paper.

Thank you, Mr Chair. I appreciate that. When members debated the second reading of this bill in the House a few weeks ago, this Chamber was packed, and so was the public gallery. I imagine that as tonight wears on, both will fill again, and I certainly hope they will, because this is such a significant issue that we are considering.

On that particular night, I listened for most of the evening, and then towards the end of the debate I sought a call on several occasions, but I was unsuccessful because, of course, there were so many members who wanted to take the call and it was a time-limited debate. So, as with my colleague Simeon Brown, this is my first opportunity to contribute to the debate. And just as the Rt Hon David Carter did before the dinner adjournment when he mentioned it was his first contribution—he set out a few general principles explaining why he was opposing the bill—I’d like to do the same, because we are on Part 1 where we’re talking about the purpose of the bill, so I think there is a degree of flexibility there.

Before we get into some of the more specific provisions, I think it’s important that each member puts on record what it is that underpins their view. I want to say right from the outset I am a person of faith and, yes, that’s in part how I have reached my opinion. But to those who have communicated with me—and there’s been one or two members of Parliament who have said, “Well, you’ve got to put that to one side because that’s of no bearing.”—I say, “Well, how on earth can you put something that is absolutely fundamental to who you are to one side?” I can’t do that. But I also want to stress that I don’t actually think that that’s the main reason why I have reached the view that I have, and I’ll try to cover a few of these in this call.

I do want to say that I not only acknowledge the absolute sincerity of the member in charge of the bill and admire the way in which he has in the main gone about promoting this issue, because I think it’s taken its personal toll. I do admire his generosity of spirit in declining a ministerial position in the last Government in order to promote something that he felt was very important. That’s admirable. I’ve seldom seen that in this House, and so I do commend him for that.

I also want to say that on the night of the second reading, I thought it was Parliament at its best. Regardless of those who spoke for or against the argument, I felt that the views that were expressed that night were compelling, sincere, extraordinarily well presented, and I also thought that all other members listened with great respect and sensitivity to the views that were put forward.

I want to acknowledge Deborah Russell. I didn’t agree with the final point that she made—and I think I’ve already dealt with that in this contribution—but I thought most of her speech was outstanding, and that was true of so many. I want to acknowledge Louisa Wall and the Hon Poto Williams, who tonight has spoken in ways that I think are deeply moving, and that is true of so many. I shouldn’t single people out, because I was very impressed and, as I say, I thought that it was Parliament at its best and I felt proud to be a part of it—of a discussion of that nature.

All of the contributions I felt were sincere and compelling, but I also want to acknowledge that that reflects the way New Zealanders generally have approached this issue. We have as members of Parliament been “bombarded”—I hope that’s not too negative a term, but we have literally received so many hundreds, thousands of emails and phone calls and letters from people on both sides of this issue. I’d like to say to New Zealanders who may be listening at home or watching on the television, “We have listened to you. We have reflected on the views that you’ve put to us. We do understand the sincerity which has led you to communicate with us.” The fact of the matter is the moment any one of us stands up tonight to take a call, we know that we are going to disappoint tens of thousands of New Zealanders. That, sadly, is absolutely inevitable.

To those who have said—and we’ve had a few calls and emails on this—that we must listen to a particular opinion poll because that tells us the way we should all be voting, or we must reflect on the majority of submissions and the tenor of those submissions because that tells us what New Zealanders are thinking, I say no; they’re all important. Of course we reflect on them. Of course we respect them. But ultimately, as members of Parliament we must be true to our own consciences. Ultimately, we must look within ourselves to our own values and reach our own conclusions and then be accountable to our electorates. I have said on more than one occasion to people who said, “Well, I’ll never vote for you again if you go that way.”, “Well, that’s fine. You have that right, and I encourage you to stick to your principles and, if necessary, go and vote for somebody else at the next election.” But I will be true to my principles. I will articulate them as clearly as I can, and that, I think, is what is required of us all in a conscience vote.

I wasn’t at that time—although I am now—a member of the Justice Committee. I did nevertheless take the opportunity whenever the justice subcommittee came to my city of Hamilton—and I think that was on three different occasions—to become a sub on the committee so that I could hear what my constituents were saying and I was deeply moved. [Bell rung] Mr Chair?

CHAIRPERSON (Adrian Rurawhe): The Hon Tim Macindoe.

Thank you, Mr Chair. I appreciate the opportunity to continue. Those who submitted in my city I’m sure were typical of people submitting all around the country. They were there in large numbers and their submissions were really heartfelt. Many of those who submitted had profound disabilities. Many of those had either nursed or witnessed a very painful, difficult death of somebody they loved and cared about deeply. It’s impossible not to be moved by those circumstances—as a result of which I want to say that even though I personally cannot for a number of reasons support this bill, I have the greatest of respect for those who do, and I have the greatest of respect for those who came to our subcommittees and who submitted to us who have reached a different view.

I have been in the home of constituents—one in particular who I remember, but I mustn’t name of course, who was in the final stages of a difficult death, and I wept with her over her circumstances. I don’t say that to be overly emotional; I just say it because I think that when we’ve had that extraordinary privilege of being that close to the issue, we cannot help but be deeply moved by it. So I do fundamentally respect the views of those who have reached a different conclusion from mine.

As I said, all MPs have been communicated with at great length and by many, many people around the country. I want to apologise to those who may be listening who will say, “Well, he didn’t reply to mine.” I did reply to hundreds of emails and letters, but I’m afraid I received thousands, and to those who I couldn’t reply to, I’m sorry; the spirit was willing but the task was impossible.

Last year, I held a very well attended forum in my city of Hamilton, attended by about 300 people. I want to thank David Seymour, who attended and, along with a well-respected Hamilton doctor, Dr Jack Havill, put the case for the bill. I acknowledge my very good friend and colleague Simon O’Connor, the member for Tāmaki, who at that stage was the chair of the Health Committee, who along with Dr Lara Hoskins, who is an equally respected consultant in the Waikato Hospital palliative care team, put the case against the bill.

We had, as I say, 300 people there of differing opinions. At the start of the forum, I asked them all to fill in a form to express their views on the issue and whether they had formed a view. I did that again at the end, and it was very interesting to see how many had shifted. The fact of the matter was a number had come along being undecided, and some had decided in favour of the bill, some had favoured it and decided against—in other words, the majority were no longer undecided.

What I hadn’t told them was that at the end of the event, I also intended to ask them the question of whether they would like to see this issue decided by MPs alone or by a referendum of all New Zealanders. I’m going to make myself unpopular, I know, with some of my colleagues on this side and on the other side of the Chamber by saying that, ultimately, I came to the view that I would feel far more comfortable—and that I think New Zealanders would feel far more comfortable—if everyone had a right to decide this issue.

While I want to be able to stay true to my own conscience, I don’t believe that my views should have any greater sway in this particular instance than any other New Zealander, and therefore I will, if we’re given the opportunity, support the option to go to a referendum, assuming that the vast majority of people will take an intelligent interest and attend meetings and study the issue carefully, because, ultimately, I think New Zealanders will accept the outcome with a greater degree of comfort if they feel that they’ve all had a chance to have a say in it rather than just 120 of us.

Nobody asked me my view on this issue at the last election. Why not—because it wasn’t an election issue. We didn’t know that we were going to be dealing with this particular bill. Suddenly, soon after the election, it was thrust upon us, and here we are in a position where 120 of us are having to make a decision on one of the most profound issues of our time without really having a mandate from our electorate. But as I say, I still believe that in conscience issues, we must as MPs form our own particular view.

The Rt Hon David Carter before dinner made a comment that I thought was very, very important. He said that no one can give us a cast-iron assurance that a vulnerable New Zealander won’t be coerced into agreeing to have their life terminated when this bill is passed—if it is passed. While I understand that there are arguments on the other side, I do think that we need to reflect deeply on that comment, because it is so true.

I want to respond to the many New Zealanders who have said that this is all about choice and to accept their argument that those who choose not to consider assisted dying are free to hold to that position but shouldn’t deny others who have a different view on assisted death and that option. On a superficial level that sounds fair, but I think it’s flawed. Unfortunately, I’m running out of time. I may have a chance to return to it at a later point.

I welcome this opportunity to engage on Part 1, and particularly the provisions that set down and define who it is that will be able to get the assisted suicide that’s provided for in this bill.

During my second reading speech, I made the very strong point that a fundamental part of New Zealand’s Kiwi values is a respect for life. What we see in clause 4 of this bill is a watering down of the protections that have long existed to ensure that our country treats human life with that respect. Now, the member in the chair told us when this bill was introduced that he had this definition 100 percent right. He was absolutely confident that the definition that we debate this evening on clause 4 was right. Yet what we see, as we see in other jurisdictions, is that the moment we go down this road of saying that assisted suicide is OK in some cases, we have an awful job in trying to define where in that grey space we should be. What we see already in the multiple Supplementary Order Papers (SOPs), including my own on clause 4, is that there is huge variation and judgment about who and who should not be eligible for assisted suicide.

Now, my concerns are this: the basics of this bill depend on a level of certainty from medical practitioners that does not exist. That is, at the select committee we heard from not hundreds but actually over a thousand different medical practitioners, who said that when we put in a law and say that this law on this assisted suicide should only apply to people, for instance, that have six months or less to live. The mover and supporters of the bill say “Well, that’s great. Nobody who’s got more than six months to live is going to be covered by this bill.” Well, that’s not true. The medical profession has made plain to the select committee and to the Parliament that these medical judgments are not 100 percent accurate, whether it is the judgment about the length of life that person has to live, whether it is the judgment whether that person is being coerced or is being inappropriately influenced, or the judgment—and actually one of the most difficult judgments is that judgment—as to whether a person is of sound mind. I’ll be upfront: if the doctors tomorrow gave me a terminal diagnosis, I would be depressed. I really would be finding it really tough. I’m not sure that I would say that I was of good sound mind to make a judgment about a suicide in my life. I think that would be true for many people when these difficult life and death questions are there.

So I say to this Parliament: if you really believe that we have a duty to protect life, and that this law would fail if even a single person dies when they did not intend to or should not have, then we need to be upfront that these provisions in Part 1 cannot give—impossible to be ever—100 percent surety that mistakes will not be made. I invite members to look at the very good evidence that was provided to the select committee in overseas jurisdictions about that very question. There is not 100 percent certainty. I just seek honesty from the proponents of this bill, including the member in the chair, to accept this fact. If this Part 1 is passed, there will be people who do not meet this criteria whose lives are terminated prematurely—have that honesty. Just in the same way in other areas of law, we need to be upfront that if we pass this law there will be people whose lives are lost, who are dead, from which there is no recourse, and that is something that this Parliament is prepared to accept. If we do not accept that reality, we are actually denying what this part says.

I’d like to continue the theme of the difficulties of determining somebody who has less than six months to live, but as this is the first time I have spoken at all on this bill, I’d like to just commence with a few opening remarks. Colleagues and the public are aware of my own opposition to this bill, and that’s not going to change throughout the passage of this legislation. That said, I am going to bring an amendment to Part 2 to expand on the member’s sensible suggestion on conscientious objection. I’ll discuss that at the appropriate time.

Members on this side of the Chamber have heard of a couple of stories over the weekend, very heartfelt stories, of people I’ve come to know very well. One is Tracey Elliot, who has advanced breast cancer and is terminal, but was told in 2014 that she had just days to live. We all know about Blair Vining and the fact that he was told that without treatment, he had less than eight weeks to live, and even with treatment, frankly, I don’t think the best prognosis would have been that eight months later, struggling though he is with his health, that he would still be here. So I support Dr Smith’s concerns about the arbitrary nature of the determination of a terminal illness.

Now, as some members know, I have run surgical and aged-care facilities. I look at this from a sort of bioethical lens. One of those specific bioethical principles is the principle of double effect. In plain English, that means it’s OK to administer a treatment that has the primary effect of alleviating pain even if the secondary effect is the unwanted life shortening. In fact, sometimes some people would consider that that would actually terminate someone’s life. I suggest—in fact, I’d submit to the committee—that that’s actually a bit of a myth. The best evidence is that palliative sedation and pain management does not hasten deaths, and that’s the outcome of many, many studies. It’s a bit of a myth that somehow if we were to inject a bolus of morphine into someone that’s under pain relief, needing of pain relief, that that could kill them. In nearly no case does that occur. I’m very happy to cite the international research that underpins that.

The problem is, and it was brought up in a debate that I had with Mr Seymour in Timaru last year, that actually not even doctors are that well versed in this issue. It underscores to me the real need, the absolute need, for better training of palliative care in this country, and the dignified end of life care and support that is required for anyone that is going on that journey. What worries me about this is that while we have a bill that restricts, through clause 4, the eligible people for whom this bill will apply, there’s no doubt that this won’t be the end of the story. The select committee—and I only sat on a subcommittee in Dunedin—heard some fantastic submissions. Those submitters in favour of this bill suggested that there were many other factors that should be taken into account, including a desire to save families from watching. This is in addition to the grievous and irremediable suffering that they are perceived to be going through. A desire to save families from watching a family member suffer, a desire to avoid placing an undue burden on the health system, wanting to avoid being a burden on families, the right of those with chronic mental illnesses to choose end of life options, and the fear of the effects of dementia on the patient and their families—those were just an example of the sorts of submissions that the committees heard were preferred, as well as grievous and remedial suffering. I’m sorry to have to confirm, in my view at least, to the committee that this, regardless of what happens, if this bill passes into law, will be by no means the end of the discussion. There will be further attempts, I think, to broaden out. It’s that that worries me greatly, because doctors did not come to their professions to do anything harmful. I did not come to this House to enable life to be ended.

Tēnā koe e Te Māngai. Tuatahi, ā, ka huri ake au ki ngā tāngata i tino māuiui i tēnei wā. Kua kite a rātou i tēnei taupatupatu i tēnei pō, ā, ka nui aku mihi atu ki a rātou.

[Thank you, Mr Speaker. Firstly, I turn to the people who are very sick at the moment. They have seen this debate tonight, and I would like to strongly acknowledge them.]

I thought it’d be appropriate to, I guess, share some thoughts and ask the member who has presented this bill before the House a couple of questions this evening. I didn’t take the opportunity in the first reading to add my voice to this Chamber, but I want to commend you, David, for the work that you’ve done in this very challenging area. It’s an emotive one, and one that can be taken over by emotions when the issues that we have been asked to consider as legislators go a lot further, I think, than the hyperbolic rhetoric that can sometimes overtake the debate. So I want to commend you on the way that you’ve conducted yourself through the course of the time that you’ve been championing this bill.

I was one of the people that voted No at the last reading, and I voted No because I wasn’t satisfied with the bill and where it got to at the end of the select committee process. I made the decision for myself that at every opportunity I would consider what we had before us at each stage, and at that stage I was not of the view that there were sufficient protections in place for some of those people that are most vulnerable.

I want to commend the member for some of the amendments that you’ve made to that bill that we were asked to consider at the second reading, in particular the amendments to clause 4(1)(c), the definition of who is eligible for assisted dying, and the inclusion of new clause 4(2) in terms of some of the issues I think many members of this Chamber questioned in terms of the mental disorder, mental illness, and so on and so forth. So I just want to thank you and acknowledge you for those amendments in terms of addressing some of our concerns.

That said, I still have some fundamental concerns, I think, with this bill, and for me, after a lot of soul-searching, it’s come down to, I think, the role that the medical practitioners play. I want to thank my colleagues Louisa Wall and Lawrence Yule, under the guidance of Paul von Dadelszen and Sir Geoffrey Palmer. Morally, for me, this isn’t an issue around morality, but process-wise, in determining who, in fact, is the best person to make the determination about whether somebody should or could make the choice to end their life—that’s the issue that I’ve been focused on. I want to commend my colleague Louisa and my colleague Lawrence—sorry, the member Lawrence Yule. The approach that they’ve taken, and it is one that goes down the Family Court route—and I hear the opposition in terms of, ultimately, it could be quite a judicial route, quite confrontational, and unnecessarily so.

I had the opportunity to work for a couple of years under Paul von Dadelszen, who at that time was the Deputy Principal Family Court Judge in New Zealand. Part of his role was to go in and deal with folks who were compulsorily sanctioned. I watched, under his guidance, how New Zealand already has a legal regime that enables the court and the judiciary to deal with people who are in very vulnerable stages of their lives, and to do so in a very compassionate way that is not adversarial, as a lot of the dicta that have come from this Supplementary Order Paper (SOP) might suggest. Some of the provisions that are in the member Louisa Wall’s SOP provide the discretion of the judiciary to be able to go to people in the most appropriate fora, whether that be their homes, the hospice, or so on and so forth. That, essentially, is already a process or an infrastructure that our legal system already has.

I step back and I ask myself: why am I so concerned about the distinction between the role of the medical profession in contrast to the role of the legal profession or the judiciary in making that determination? Perhaps it’s a little Old Testament - like, and we’re living in a New Testament - like world, but if you strip it back to the Hippocratic oath—and, look, I know that there’s a lot of comments that can be made about that, but the medical profession, in its basis and its foundation, was essentially one that was focused around the preservation of life. In contrast, the legal profession is one that is, on its daily basis, required to look at matters factually. It’s asked to consider a whole range of issues, look at the law, apply the law, apply those legal principles, and make a determination. That’s what that profession is geared up to. In contrast, the medical profession—and, look, yes, so the Hippocratic oath, it’s a little dated, and I know that there’ll be some comments that come out from those that say, yeah, like I said, it’s a little Old Testament, but it still provides the foundation for the medical practitioners’ code of ethics now. In there still is the overarching—I think you can pull away and say that there’s an overarching consideration that, again, is around the preservation of life but also ensuring, you know, the rights and dignity of those that require medical attention.

I think that the SOP that my colleagues have presented before this committee for consideration is one that provides some security that citizens that do want to make that determination, they can have a medical practitioner provide their medical reports, and that goes towards a factual inquiry. You have a judicial person to make the determination, and on the facts and on the basis of the lawmaker’s determination, I think that that is a much better approach in these circumstances. I know that’s not the member’s view who’s introduced this bill to the House.

On that basis, I then am required to look at the range of other SOPs that are before this House, and I’ve considered them all in detail, and some I’ll vote for and some I’ll vote against—I won’t go into those depths. But, I guess, from the member tonight I am interested in particular on what your considerations were in terms of having the discretion be reserved to those in the legal profession and from the judiciary. The role of the medical practitioners—and we have heard substantive views from the medical practitioners in their profession about the discomfort that they might be put into. There might be multiple views there, but I am interested in what your considerations were there.

I do, I guess, want to say, as a caution for the full House—whether you’re for or against or any which way—that we were fortunate to, I think, at the second reading, be a little devoid of some of the emotional rhetoric, and I pray that that is a practice that we maintain as we progress through this committee stage. So those are my questions for the member. Tēnā koe.

Thank you, Mr Chair. I appreciate that. This is my first call on this bill as it’s proceeded through. Unlike some members, this was a topic that was raised very often during the election campaign in Ōhāriu. In fact, I don’t think I can recall a single public meeting where we weren’t asked for our view on this bill. I said at that time—and I continue to maintain and it is my fundamental view—that people are their own independent beings. They are the masters of their own destiny. Where they are able to exercise choice in their lives, they should be free to do so, free from influence of Government. I’m a believer that less Government is more. We need as much Government in our life as necessary, and no more. I hold the exact same view for the courts.

My concerns that I expressed at the time were, essentially, in three areas. One was around the principle of safeguards, particularly around coercion but also around a broad-based eligibility that could allow a simple choice other than for a cause that was going to be terminal in a more immediate sense. So it’s to that particular matter that I want to turn in this contribution, because I want to talk to Supplementary Order Paper (SOP) 259 on Part 1, and particularly clause 4(1)(c), from the member in the chair, David Seymour.

The member has chosen and I know publicly he’s stated that, while it wasn’t his preference and perhaps still isn’t, in order to achieve broad support for this bill, he was prepared, and has done so through this SOP, to limit the scope of the eligibility for assisted dying under this bill, and it restricts that solely to someone suffering from a terminal illness that is likely to end that person’s life within six months. That achieves all that I sought and I spoke to constituents at the time and since about the issue about broad-based eligibility, and I commend the member for making that choice.

It also, in my view, means that we don’t face, should this bill pass into law, the issue of a judicially-based scope creep to this legislation. It simply can’t happen. But it absolutely was a risk, in my view, when the grievous and irremediable condition existed, because the only way that condition could’ve been properly tested would’ve been in a court. But the idea of suffering from a terminal illness that is likely to end a person’s life is a diagnosis from a suitably qualified medical practitioner. The scope for a court in the future to extend or broaden the scope of cover is fundamentally addressed through this change—and, again, I commend the member in the chair for doing so.

I come to clause 4(2), an element which I think could be described as a belt and braces approach. I think clause 4(1)(c) sufficiently narrows the scope that 4(2) isn’t absolutely necessary, but I think it is helpful. It’s helpful for members in this Chamber as we debate this, but it’s particularly helpful for members of the public, who perhaps peruse legislation far less than we do, to know with absolute certainty that these conditions will, on their own—in fact, while they’re already excluded because of 4(1)(c), there’s just that almost double statement, which absolutely clarifies that position.

So the member, in his SOP to Part 1, has met one of my fundamental tests of “Could I go from qualified and conditional support to a statement that the bill is moving in a direction where I can continue that support and support it quite strongly?” I can, and I commend the member for listening to the concerns of other members of the public as well as members of this House. It will obviously change the scope quite considerably, but it certainly, I believe, presents a bill to the House which is more acceptable to members, particularly, perhaps, some members who have been somewhat equivocal in their support, waiting to see, as I was and have been, the condition, the state, that this bill would exit this stage of proceedings before finally determining support or otherwise for it. So I certainly commend the member for the change he is proposing.

Thank you, Mr Chair. It’s an absolute privilege to be able to stand and speak about this bill in this committee, and I start by raising concern about the sponsor of the bill’s statement and position that medical doctors who have, even for the first time, held a practising certificate is sufficient. He was stating this in reaction to the point made by my colleague Chris Penk, where there have been Supplementary Order Papers (SOPs) asserting for a prescription of qualifications or qualities of the medical profession that are to be involved in making this decision. So I raise the SOPs Nos 267 and 274 particularly, as they seek to prescribe for medical practitioners that they have held over a period of five years a practising certificate, and, for psychiatrists, that they have not been the subject of a written complaint to any relevant professional body in relation to anything done or failed to have been done in accordance with, or nominally in accordance with, this bill.

The object of trying to prescribe qualifications like these really goes to the possibility of the people having direct opportunity to determine the capacity of the person asking for assisted suicide or the provisioning of a lethal dose of medication to end their lives. The Oregon Public Health Division report from 2018 actually confirmed that, in practice, over the entire period the law has been in operation in Oregon, psychological concerns far outweighed related physical pain amongst the patients who were assisted in their suicide. According to the report, during 2018, the four most frequently reported end of life concerns and reasons for seeking assisted suicide were loss of autonomy, with 91.7 percent; decreasing ability to participate in activities that make life enjoyable, with 90.5 percent; loss of dignity, with 66.7 percent; and being a burden on family and friends or caregivers, with 56 percent. These were the main drivers of the decisions of many in Oregon over the lifespan of that law there.

I have heard and taken into consideration the life experiences of many members, and I would like to mention at this point that I do have life experiences as well in this regard. My mother is almost blind. She’s 86. She has a tumour growing in her lung, which we expect to escalate very, very quickly. My mother-in-law, whom I love as my mother, died of amyotrophic lateral sclerosis (ALS). She had ALS. She had been diagnosed, and from the point of diagnosis she was said to have just a little time left. The message that I would like to bring to all the members is that while we may be looking out for ourselves or family members or people that we love and know, we don’t want them to suffer. I would like to suggest that this matter of death isn’t exactly, and always will be, just about us; it isn’t exactly just about us and what we feel and what our relations—[Time expired]

Kia ora, Mr Chair, thank you very much. I rise on behalf of New Zealand First, to add our voice to the conversation this evening. I want to be very clear: New Zealand First members do not have a bulk position on the content of this bill. I take on board Mr Hudson’s contribution that this issue has come up during election discussions, not only in the last election but in the previous one; and as a New Zealand First MP, and my colleagues have done the same, we’ve answered that with what has been the standard policy of New Zealand First around this particular issue, knowing that New Zealand First MPs have brought this issue, in history, to this place—and that is that we believe that it is too large an issue for temporarily empowered MPs to make for the New Zealand public.

So my New Zealand First colleagues have delegated me to make sure that I put on the Hansard that New Zealand First will support David Seymour’s Supplementary Order Paper 259. We thank the member for listening, as others have thanked him. New Zealand First—as it’ll be no surprise to anybody who’s been listening to us over the last so many years—believe that this should go to a referendum, and we believe that the New Zealand public should have the best possible bill to consider at that referendum; for them to give their view, for them to give their opinion, they will be as informed as the majority of the members of this House. So New Zealand First will support David Seymour’s Supplementary Order Paper 259, because we want that bill placed in front of the New Zealand public. We believe that the member has listened to the submissions that have been brought forward, to the concerns not only of those who submitted but also of members of this House, and we believe he has done his best to represent what is the intent that he brings to this topic.

So I don’t feel that I need to contribute more. I feel I’ve made it clear why New Zealand First and the members of the New Zealand First caucus—dependent on a Supplementary Order Paper under Jenny Marcroft’s name—will vote in favour of this bill. In the first instance, we will vote in favour of David Seymour’s Supplementary Order Paper 259. We will also be advocating for support of Supplementary Order Paper 287, which would mean that this legislation would not be enacted until it had a majority Yes vote, at a referendum, by the New Zealand public. If that referendum did not take place within a five-year period, this legislation would be repealed.

Thank you very much, Mr Chairman. I have a question of David Seymour. Following his answer, certainly, I want to congratulate him for the way he systematically went through the queries that were raised. I also want to congratulate all members. As I said in my earlier contribution, these conscience debates bring out the best debate in this House. It’s a serious issue that’s been taken, but there’s respect for both points of view.

When I spoke earlier, I spoke about my fear of coercion. David Seymour attempted to answer that by saying that there is no evidence of coercion—people being coerced to feel the pressure, frequently because, perhaps, dependents are looking for an early divvy of an inheritance. So in saying there is no coercion, I assume he’s referring to evidence that’s collected from other jurisdictions that have had this legislation in place. My serious question is: how would you ever collect evidence as to whether a person has been coerced to accept euthanasia—because they’re not there to answer the question?

I give the member an example that I’ve watched in the media over the last couple of days. You frequently, sadly, see it, where a person dies and then a disputed family—particularly, a disputed family member—will contest that will into the courts, and I think there’s been one on either Stuff or in the New Zealand Herald in the last few days, and in this particular case, and it’s in many others, the courts have actually decided that the person writing the will was coerced, was put pressure on to change, perhaps cut one descendant out etc., and the courts have made that will null and void.

But in the case of somebody elected to undergo euthanasia: (a) there is no way you can seek the evidence from the person who’s deceased; and (b) if you could—but you can’t—the decision is, obviously, absolutely irreversible. So I seriously ask the member if he would take a call to answer my question, when he says, “Don’t be worried about coercion. There is no evidence of coercion.”, how, possibly, could that evidence be collated?

Tēnā koe, Mr Chair. I do acknowledge that I’ve had two calls, but just to let the committee know that if Part 1 of my Supplementary Order Paper (SOP) is out of order because David Seymour’s Supplementary Order Paper is voted on in the affirmative, then I won’t participate in the rest of the debate to push what we’ve been trying to do through our SOP, which, essentially, is to create another lawful process, and, in fact, I want to focus on that.

But before I do so, I just want to make a mention about the use of the word “suicide” in the Chamber tonight. A lot of people have talked about this being suicide. In fact, that was one of the rationales for the legislative reform in Canada, because people actually were suiciding because they didn’t have a choice, and they were taking their lives months before it was necessary, because there were no other options. So what I want to highlight about this bill is that the qualification is that you have a terminal illness, and then, obviously, we’re trying to create a lawful process, a lawful mechanism that then gives effect to a medical procedure. That medical procedure, as outlined in David Seymour’s SOP, is the administration by a medical practitioner of medication to relieve a person’s suffering; or the self-administration by the person. So to categorise that as suicide, I actually am incredibly offended.

Suicide by our experience of it here in New Zealand, are people who are traumatised, who have hurts, and who actually choose to die. As I’ve said earlier tonight, if you’re faced with a terminal illness, this isn’t a life and death decision; it’s a death decision and it is about how and when, as a person who has a terminal illness, you will die, and trying to give that person a sense of control over a situation that actually is incredibly uncontrollable. So the proposition, I think, we all need to consider tonight is: should someone with a terminal illness have that right to choose how and when they die?

That gave effect to the SOP that Lawrence Yule and I created, because, essentially, we suggest it does; but, obviously, it does have to have a context around it. And so for us it was about the patient and a medical practitioner involved in their care—whether that be their GP or an oncologist or a palliative care specialist, whoever—with their whānau, being able to apply to the Family Court, jointly, meeting certain criteria: that is they have a terminal illness, exhausted all possible treatment options—there aren’t any more options left that the public good provides—and that they were receiving palliative care. So we thought, as a context that would be permissive, right?

So then, I guess, the issue is what is the best mechanism? We thought it was the Family Court. I want to acknowledge my colleague Kiri Allan for talking about the Family Court and what Family Court judges have done within the context of the Mental Health (Compulsory Assessment and Treatment) Act 1992, because, in fact, within the context of legislation, to get a compulsory treatment, order applied for by a relative of a person, essentially it’s a 14-day process where the judge talks to the person, talks to their doctor, and can seek other medical professional advice. But, essentially, that medical procedure means somebody can go into a facility to receive mental health treatment for up to six months. So it’s a familiar process, which is exactly why we thought it would be the best process, from an objective position, to determine whether or not the person who had the terminal illness then could give consent.

I guess the extra criterion that we’ve included in ours is the involvement of, either, a psychiatrist, or a psychologist that, firstly, can attest to the fact that the person has the capacity to give informed consent and then, obviously, whether or not that person thinks the person has given informed consent by applying to the court with their medical profession, for the court then to give consent for that person to die, which is—Mr Chair, I’d like to continue just to explain—[Time expired]

Thank you, Mr Chair. I’d just like to start by acknowledging Mr Seymour for his management of the process of this bill. I think that it has brought out the best of this Parliament, and is, actually, Parliament as it should be, as it can be.

I just want to start by speaking to the changes to the bill that he has proposed in his Supplementary Order Paper (SOP) 259, and I am speaking on behalf of all eight members of Parliament who are members of the Green Party. That is because, although this is a conscience vote, we have been through a process in the Green Party some years ago to come to a position around how we feel about this, and, as a matter of conscience, we are supporting Green Party policy on this. So all Green Party MPs voted to support this bill on second reading so that we could get to this point with the debate in the House, and work towards these kind of amendments, and I really do want to thank David Seymour for his work with us, and with other members of the House to get to this.

As I said, our MPs are guided by a very clear party policy that was developed by our members, and it was a very difficult, and, occasionally, fraught process to arrive at that party policy, and of course it is, because this is a very emotional, and very personal, principles-based, and difficult issue for pretty much everybody. So we recognise that, quite rightfully, it’s one that New Zealanders care a great deal about, and from a number of different perspectives. So obviously where that leaves us is that there will be members of the community, right across the community who are unhappy with (a), where we land, and (b), with different aspects of where we land when we get there.

The policy that we’ve got is that terminally ill New Zealanders should be able to choose their end of life in a supported and an open way in circumstances of their own choosing, as long as there are clear safeguards, and I just wanted to enumerate those. First of all, that they are terminally ill. Second of all, that they are suffering enduring physical or psychological suffering that is intolerable to them, and cannot be relieved under conditions that they consider acceptable. Third, that they have made durable and persistent requests for assistance in dying. Fourth, we also want to see a second opinion that can help confirm that that person has decision-making capability, and, fifth, that they are making an informed decision free from undue influence. The changes that David Seymour has set out in his SOP bring this bill very closely in line with our member-led policy, and that is why we will be supporting this SOP.

We will also be supporting two other SOPs, which closely align with Green Party policy, and they’re both from Simon O’Connor. First, that we make an explicit requirement for an education programme for medical practitioners to complete before administering assisted dying, and, second, to prohibit assisted dying advertisements. So we think those are both very sensible amendments, and we’ll be supporting those as well.

On the referendum SOP, we understand that supporting this is the most likely way to be able to achieve the legislative outcomes to ensure that medically-assisted dying in New Zealand—and for that reason we’ve chosen to support it, even though it wouldn’t be our first preference. I do want to acknowledge that amongst our members, amongst the wider public and supporters of all parties here, there are a diverse range of opinions, and I do want to acknowledge those who have come to us directly with passion, with fear, often, and with anxiety about this issue. I also want to acknowledge that this is an important issue for Māori, for whom issues of individual decision-making, and relationship to iwi and hapū and community cannot be easily disaggregated. So the importance of understanding those connections is an important part to this.

We know that for the disability community, this is a particularly difficult issue, and we would not have been able to support this legislation without restricting it to people who are terminally ill, and that’s because we simply cannot be confident that it wouldn’t further marginalise people with disabilities in the form that it was, up until the amendments that Mr Seymour’s made. We’ve met with the Disability Commissioner, with members of our own Green Party disability network, and with other people in the disability community to talk through what this means, and our policy is explicit that we could not support the extension of medically-assisted dying for people who are not terminally ill, until New Zealand has in place policies and practices that ensure full social inclusion.

Before I give the next call, I’ve noticed people are venturing off outside of Part 1, and I just want to let everyone know, namely, to come back, and just speak specifically to Part 1.

Thank you very much, Mr Chair. I spoke at both of the previous readings, and I’ve outlined many of my concerns, in a general and philosophical sense, against euthanasia and assisted suicide. I have been the deputy chair of the Justice Committee, and have read, and listened to many thousands of submitters, and it is my intention in this call tonight to focus on some of their voices in relation to Part 1. But I would say to colleagues in the Chamber how important it is that we do retain a respectful dialogue here and that we debate things and listen to each other—qualities which are not always seen when we debate bills in the House.

But I, as a member of the select committee, was involved in the gathering of the evidence and the material. The select committee process has come under a lot of criticism, unfairly so. I would like to commend the staff, and the people who have worked extremely hard to do their very best with 39,000 submissions, and the logistics of it have been extraordinary. This document here, which is our report from the Justice Committee, really details, and summarises some of the people who have made submissions, so I urge members to read it, and, also, to understand that we were unable to agree that this bill be passed. Eight people had different views on this matter. It was very appropriate that it comes back to this place, and, in this process, that we all argue through the various points, and have our say, and reflect and channel and advocate for the people whose voices are not always heard in this place, and the people who have strongly submitted to us, that they feel that this is a very dangerous bill, and with many risks. The proposals that have been put forward in the Supplementary Order Paper (SOP) in the name of the sponsoring member David Seymour, number 259, do not change that. They do not make any material difference to the risks and the dangers that people feel about this bill.

So I would like to start by looking at some of the aspects of this bill, the purpose of the Act: to give persons who have a terminal illness the options. So how do you define “terminal illness”? How do you understand what that means, and, for many occasions, when we were at the select committee process, we had a variety of people who came forward to us, and told us that the prognosis is not an exact science, that doctors, on their own admission, get this sort of thing very wrong, very often. In particular, I’d like to draw the attention of members here tonight to the New Zealand Medical Association’s submission. They talked about “While advances in diagnostic tools and improvements in knowledge [generally] regarding the progression of disease continue, it is still an inexact science.” It is something where “Errors occur and individuals can still prove all of the experts wrong. According to The American Journal of Medicine and [The British Medical Journal] Quality and Safety,11 published studies indicate misdiagnoses occur anywhere from 10-15 percent of the time.” So the idea that anyone would rely on a doctor’s diagnosis of a terminal illness with six months—it is an arbitrary figure. It’s not used internationally. It is one that has no particular application and, really, does not give anyone any real safeguards.

So I think that while the member has pretended, really—or has attempted, perhaps would be a kinder way of putting it—to make the safeguards better by determining that a terminal illness should apply, I think it is still deeply flawed, and there is not anywhere near enough detail involved in that process.

I have looked at a number of elements in Part 1. I’ve put a couple of SOPs in. I’ll talk about the competency one in this call, but I would like to draw attention to Chris Penk’s Supplementary Order Paper 207, which looks to replace the name “End of Life Choice Act 2017” with “Euthanasia and Assisted Suicide Act 2019.” I support that as a Supplementary Order Paper because I believe it tells it like it is. Words are important and definitions are important, and the euphemisms that the member has applied in refusing to use the exact terminology, I think, has really clouded a lot of the important issues that we need to discuss and embrace.

So from the point of view of Supplementary Order Paper 262 I have put in around competency, it looks very much at the Victorian model, which the member has drawn on for his amendment, but it goes into a lot more detail. I think part of the issue—and we heard this from the Alzheimer’s society, who made several submissions to us on this subject, and it’s part of the major issue for them—is the issue of competency and how on earth you tell that somebody has reached the point where they are no longer able to decide. The pressure on vulnerable people to end their lives—[Bell rung]

CHAIRPERSON (Adrian Rurawhe): The Hon Maggie Barry.

Thank you, Mr Chair. The competency issues that they drew our attention to include four main points, and I would like to spell those out in some detail because I think that they are not well served within this bill. It is a weak piece of legislation, and the new definitions don’t change that.

They’ve talked about a lack of a cooling-off period. So in other jurisdictions—and remembering there are only 5 percent of the world’s jurisdictions that have gone down the euthanasia path; many billions of people manage to live very safely without it. And, by the way, if we do bring it in, there’s no going back, so that’s another reason why we need to pay particular attention to this.

But the nature of the tests for mental capacity, Alzheimer’s New Zealand told us, were very inexact. The tests are either open to question or they really don’t exist. This is from the body of experts. So psychogeriatricians typically would have a half a dozen episodes and appointments with people. I know with my own mother, who had dementia, it was a very long, slow process to reach a diagnosis. It’s not something that can be done in one or two sessions with a doctor. So good and safe decisions currently are not capable of being done under one or two appointments. That is a very clear point from Alzheimer’s New Zealand.

Also, people’s ability to understand can vary over time from complete to non-existent, and it depends on the day. These are the factors and the sorts of details that need to be incorporated if we want to have any sense at all that this is safe for people with dementia conditions.

Competence as a definition may provide little protection for vulnerable individuals was another point that the dementia groups made to us—that a small number of physicians making euthanasia their core business could result in people or families seeking out doctors to facilitate that easy path.

And I come back to the point the Rt Hon David Carter and others have made about coercion. Elder abuse in this country has far too many victims. Many of the people that perpetrate it are from within their own families—something like 75 percent of the people who are abusers are family members. When it comes to dementia and the subtleties around that and the easy ability to confuse, as we see from the Alzheimer’s society, there are no genuine ways in a very short appointment where doctors will be able to make use of what is a very low threshold for competence in this bill. In fact, as has been pointed out, it is easier to open a bank account than it is to get euthanasia under the provisions that exist in this bill.

The other point that they make: temporarily or partially impaired individuals are also at risk. So for those of us who know about people with dementia, we know that from time to time, from day to day, where their mood varies and where they might be upset with infections and so forth, their competency flies out the door, and it is apparent. Then they go back to another state where it becomes extremely difficult to gather whether they really do understand what is being put to them or not. So in the Supplementary Order Paper I’ve put forward, I want to emphasise that practicable and appropriate support really does need to embrace all of the information and the formats to give it the time to really process the information: to go back to the patient, to get psychogeriatricians, to get the right people in there to make decisions around whether somebody is competent or not to make an informed decision.

So the jurisdictions that have dealt with euthanasia and have had tests around dementia have not come up with particularly good ones. I know that in places like Holland, for example, they grapple with this all the time. The likelihood of people arriving on the right side of the ledger, and determining whether somebody wants to actually have assisted suicide or not, is an extremely difficult thing to do. So I believe that it is very important that when we are doing the competency tests, this bill is still not in any way appropriate or thorough enough to do the job and to do the people who have, perhaps, dementia, but in an early stage, justice.

So if the person is assessing whether someone is competent to make an informed decision for the purposes of this legislation, they must make reasonable steps and that assessment of time and the environment. So they need to actually go to the person’s home. They need to be alongside them, and they need to understand their needs. This is not somebody who is on a group of doctors on this committee that the bureaucracy in the ministry would set up. They are not in a position to know—they already; what do they call it? These are the doctors who are “willing to act”. Those are not the sorts of doctors who should be working with people with dementia and other mental health injuries. So that is why I would like to do the SOP.

Well, thank you very much, Madam Chair, and thank you to the, I think, almost 11 members who have risen and contributed since I last got up and addressed some of the concerns raised. I’d like now to address some of the accumulated concerns.

We had Simeon Brown, who suggested that we should support an amendment, Supplementary Order Paper 282, to reduce the prognosis period—the prognosis for somebody’s illness being terminal—down to one month. I can see his intention, but, frankly, this is a process where people are asked to talk to their doctor at times suitable to their condition. People are asked to talk to friends, family, and counsellors. Doctors are required to talk to those people. People really should have time to think and reflect about this, if they wish for it. To compress the process into a mandatory one month before a person could become a person eligible for assisted dying, I think, would actually run counter to many of the things that I suspect the member would say he was in favour of.

I want to really thank Tim Macindoe for his candour and the way that he got up and talked about his motivations, his considerations, and how he’s been considering the issue. Thank you, Tim. I always like a public meeting with 300 people, but the one that you put on was particularly good, there in Hamilton.

I want to also turn to Nick Smith. Nick Smith was critical of the fact that I have previously defended the inclusion of the criterion “grievous and irremediable”. He seemed to believe that I had somehow resiled from that defence. That is simply not true. The term “grievous and irremediable” is not something that we got from nowhere. It is in the Canadian legislation. It is a very well-defined term that has come out of jurisprudence of no less than the Supreme Court of Canada. I still think, and always will believe, that it is a good criterion for somebody to access assisted dying.

However, part of politics, as it turns out, is about listening. I have listened to the likes of James Shaw, from whom we heard a few moments ago. I’ve heard from people on both sides of the House, to my left and my right, and I accept that this Parliament does not want to pass a bill with that criterion in it. It’s with some regret, I have to say. There are people such as my namesake, David Seymour from Whangarei, who has motor neurone disease, is a strong supporter of the bill and bitterly disappointed at it being limited, but also, as the name would suggest, he is a man of great magnanimity, and he has accepted that this is the political outcome and he is supporting the bill still, as some people will have seen on Newshub tonight.

There was a question that came up, actually through multiple contributions to the committee, about the certainty of a doctor’s prognosis. The argument is, effectively, we all know, and I’m very pleased to know, people who had terminal prognoses a decade ago who are now walking around living very full lives and are very, very happy to still be alive. It is true that if we know somebody like that, it’s very likely that we think of them. What is true is that the overwhelming majority of people who have a terminal prognosis do not get such miracles, and, unfortunately, I can think of quite a few more people in that camp than people who do have miracles.

Now, bear in mind, it is entirely a choice for somebody who has a terminal prognosis and meets all of the other criteria to seek assisted dying. What those who say “What if you have a miraculous recovery?” are really saying is that they want to condemn every single person to suffering and hoping for a miracle when the reality is, for most of us, it won’t happen. If this bill passes, there will still be every choice for people who want nothing to do with this bill or assisted dying to hold on and hope that they have one of those cherished miraculous recoveries, but to pass this bill is to give those who want to choose to go on their terms, with their timing, the choice to have it their way. I believe that that is the nub of the issue, bearing in mind that the criterion of having a six-month prognosis then having two doctors independently judge that one is likely to have their life end within six months is but one of a number of criteria, the most important of all being that the person makes their own choice.

Nick Smith then got up and said that we need to be honest and clear that under this bill, people will die. Well, I’ve never denied that—I’ve never denied that—but I think what he was trying to say in his contribution was something that was echoed by David Carter in his second speech, and that was that there might be a case of somebody who was unknowingly coerced into an assisted death. The interesting thing about David Carter’s contribution is he started out arguing that it would be impossible for somebody to know or for it ever to be found out that coercion had occurred, and then, I have to say—and he may need to take another call—I struggled to follow his logic, because his proof that coercion occurred was actually citing court cases where coercion had been discovered after the person was deceased. You can’t hold these two beliefs simultaneously. If he has shown that there are examples of coercion being discovered posthumously, then it would be possible to discover coercion in the case of people who had an assisted death, but the difficulty for Mr Carter’s argument is that there are not examples of such findings in the case of assisted dying over 20 years in a dozen or more jurisdictions that now have an assisted dying law. So I would put it to him that the evidence is findable but is not found.

I’d like to continue my dialogue with Mr Carter, because I know that he’s a thinking man, and I would put it to him that he’s put in place a false premise. He said there could possibly, somehow, be a case of undetectable coercion somewhere, and that is enough to say no to this law, but, remember, by voting to oppose this law, he is also voting to retain the status quo, and he will have—and anyone that opposes this law will have—on his conscience the finding of our own High Court and the findings of the Supreme Court of Canada that a prohibition on assisted dying leaves people with a cruel choice. Some suffer terribly in their final days, and not only that, others take their own lives through what the Supreme Court called “violent amateur suicide”. Our own court, in Seales v Attorney-General, accepted that, actually, people’s lives are shortened through that practice, shortened, in effect, by the prohibition on assisted dying under the law that he continues to support.

So I’d put it to Mr Carter that he is supporting a status quo where people do die badly and do die wrongly in order to oppose a proposal on the speculation that there might be undetectable coercion, when he’s argued himself it could be detected if it existed but accepted that it cannot be found anywhere in the cases where assisted dying has been legalised. I see Marja Lubeck, whose ancestry goes back to the Netherlands. She’s very familiar with the experience of that country, and she’s nodding as I say it. So I put it to Mr Carter that he should think again, and I look forward to continuing this dialogue.

Brett Hudson—I want to thank him for his support, and I’m glad that we’ve satisfied one of his three key objections. I hope that we can go three for three on this.

Michael Woodhouse made a very interesting contribution where he said that palliative care does not hasten death. I say it’s interesting, because he needs to talk to Chris Penk, who has a Supplementary Order Paper which says that we should change the wording in this bill to say that assisted dying is hastening death. On the other hand, we hear from his colleague that, in actual fact, there is never any hastening of death in the case of palliative care. There’s going to be a contradiction between the two there that they may want to think about.

Then we come to Kiritapu Allan. Now, Kiritapu Allan made, I think, one of the most fulsome contributions so far. She asked about the consideration that had been given to the amendment proposed by Louisa Wall that she had worked on with Lawrence Yule. She asked, you know, had I thought about it and had I given a lot of consideration to it, and I can assure Kiritapu Allan that I most certainly have. I’ve had considerable legal advice from within the machinery of Government, from lawyers outside in the private sector, from people from Lecretia Seales’ legal team who are familiar with the laws from around the world, and come to the conclusion that it is not something that we can support, for a number of reasons. I hear what Kiritapu Allan has said about the fact that there is a process and a compulsory assessment and treatment where the courts are involved, but I think that is a mistake. It’s important to recognise that it is quite different for the State to impose something on somebody as opposed to an individual making a choice for themselves. So that’s the first really significant difference that needs to be considered in regard to whether or not the courts should be involved in making this decision.

The next thing I would say is that I don’t believe it introduces new information. Actually, instead of two doctors, it’s the testimony of only one doctor that’s relied upon in that amendment. So in terms of the amounts of clinical information available to be processed, it’s actually less than under the status quo. Then you come to the fact that, in a sense, the judiciary has been, I guess, in a way, involved in the decision. So if there was ever to be a suspicion of foul play or a complaint, one of the defences that the people involved are going to have is “Your Honour, a judicial officer was involved in this decision.”, but, of course, the judicial officer only had the information to go on that was provided to them by the doctor. So it’s very difficult to see how it helps to bring the judiciary into something that the judiciary is also the backup for judging at a later date, if necessary. I could go further and say that there is some difficulty with process and procedure here, which is that we’ve introduced, effectively, a new bill at the committee stage. I think that that presents some real difficulties. There are other issues that I think we can argue about: the stress and whether or not it is too confrontational.

I think an argument can be made that the Family Court is actually quite different from most courts in the way it operates. Nevertheless, I would also raise a couple of other questions around what Kiritapu Allan actually said—that this is not in the nature or in the essence of a doctor to be involved in assisted dying. I would argue, first of all, that in any groups of humans there’s a wide variety. There will be doctors and lawyers who are both opposed and not against. So I’m not sure when you apply it to any particular individual, bearing in mind that they have the right to conscientiously object, that their particular characteristic is what is important here, because there will be individuals in both camps that have different views.

I would also say that as far as the Hippocratic oath goes, that the Hippocratic oath, for example said that only men should practise medicine. It also said palliative care was a waste of time. People should be very careful quoting the Hippocratic oath.

💬 Kiritapu Allan: I said it was Old Testament.

Yeah. And I’d also add that we view this as a doctor alleviating suffering, very much something that a doctor is supposed to do. It’s difficult to see where people really draw the distinction between the various forms of palliative care and assisted dying, particularly when you get as far as things like palliative sedation. So I think the point is made. I’m happy to further dialogue in any context, but we really have looked into this pretty hard and I think if the members are of a mind to support that amendment, they should be of an even stronger mind to support the amendments I’ve put up in the final version of that bill.

I want to thank James Shaw for his engagement. That has been very sound and very enjoyable. Sometimes I agree with the Green Party, sometimes with Simon O’Connor, but both at once is far too much for me. So I won’t be supporting those amendments for reasons I’ll, hopefully, get into a bit later. I completely agree with Louisa Wall. Some of the trivialisation of suicide in this debate is, frankly, disgusting. I won’t say any more about that. Maggie Barry, I won’t get to the things that she raised in the time that I have remaining, but I want to thank the chair for her indulgence over three calls. Thank you.

Thank you, Madam Chair. I will start by admitting that I have never participated in this debate, not one call during the first reading or the second reading. However, I have taken part in some of the select committee proceedings and I have to say I want to thank everyone who participated, who made submissions, and actually came to the select committee to have their say. Hearing all those people, whether they are on one end of the argument or the other, I have to say they spoke with passion and they spoke with their heart. In this particular circumstance, I have to say it is rather an emotional topic for me. I have a friend who is actually dying in hospital with cancer, with days to go. On that note I’d like to acknowledge my friend Louisa Wall, who lost her brother. My heart goes out to you.

Look, the topic of death is actually a taboo subject in my culture. We don’t talk about it and this is the very reason why I didn’t want to talk about it in the House. We don’t talk about death just like we don’t talk about sex. Funny—[Interruption] Yes, we don’t talk about these things. I mean these are issues that concern all of us and actually have a major impact on our life, and yet we don’t talk about them. But I took the courage to talk to the Korean community to find out how they actually felt about this particular issue.

Their thinking is that this is actually not about end of life choice. This is actually about killing their loved ones, particularly when David Seymour gets up from his seat and actually talks about what the Rt Hon David Carter—who actually questioned him in terms of the issue of coercion. And when he actually states that there is no proof in the history of euthanasia—that you cannot prove that there was coercion, guess why? It is because people who have been coerced here are dead.

I will tell you that on Monday this week I had to deal with a constituent whose daughter had coerced her into signing a power of attorney document and she has been ripping the parents off. They are now having to prove that they’re competent enough to drive. They have to prove that they are mentally, physically, psychologically competent to deal with their own affairs. The daughter has taken their car. The daughter has taken tens of thousands of dollars from these parents. If we had this particular bill in place, I worry what she would be doing to these parents.

Her father has dementia. Her mother has had cancer. They’re elderly people in their 80s. I fear for them if this bill becomes law in this country. I honestly did not come into this country and actually believe that I’d become a member of Parliament to vote for people, for all of us, to make a decision to kill another human being. This bill will, in fact, do that, and I fear for the people in the ethnic communities who do not speak English as their first language. Often they can’t even decide what to order for dinner. For David Seymour and his supporters to actually think that doctors can decide and be competent enough to talk to patients who are suffering and stressed out in the final days of their lives to decide, in their stressful time, in a foreign language that they can competently say that they want to be put to death, I do not believe that they can.

So I’d like to take this opportunity to move Supplementary Order Paper 269 in my name to replace the definition of “attending medical practitioner” as well. I don’t think a medical professional who just comes to a patient who is actually ill, who is terminal, can just decide that they can actually be put to death. I think they have to have a personal relationship with the patient for at least six months. They should have been attending for at least six months, in my view. And they have to have a reason to—they must understand where these patients are actually coming from. And I do not actually believe that anyone—anyone—I certainly do not believe that I have the right to decide if I can put someone else, another human being, to death and I will not be voting for this. I cannot do it.

Thank you for the opportunity to take a call, my first call on this bill. I’d like to acknowledge David Seymour. Thank you for bringing this to the House; Maryan Street and others who previously have brought this to the House. I’d like to acknowledge all of those.

When I talk to people out there in the community, there is often a view that someone in their, sort of, 80s, 90s, even nearing 100—they’ve lived a good long life. They’re sick. They want to go. I often hear people say “Just let them go. You know, they’ve lived a good life. They’ve done their dash. Let them go.” I understand that there are a number of people out there who have that view.

I’d like to bring some balance to that view, which I don’t often hear as much, which is somebody in their maybe 20s, 30s, 40s, who is suffering, who may feel like they want to go. And it relates to this aspect here in Part 1, where a person is eligible for assisted dying if they’re over 18 years of age. One of the submissions on this bill that really stuck with me was the submission I heard—and I have permission to use their names but I’ll just use their first names. There’s a man and a woman, Glenn and Heather, and they got married in their early 20s. When they were in their mid-20s Glenn developed a brain tumour. About that time, they had a young daughter named Rachael. Glenn was given three months to live by the doctor. He was in his mid-20s and given three months to live. He defied the doctor. He lived for another period of, sort of, three or four years. Again he was given the diagnosis: three months to live, two months to live. He defied again. He lasted a few more years. Again, he defied the doctor three times.

He finally passed away when his daughter Rachael was nine years of age. Now, Rachael had nine years with her father and during that time Rachael as a young girl used to dress up as a nurse and look after her father. She had that valuable time with him. I actually spoke to Rachel and I said, “What was that time like? What were those nine years like?” She said, “Look, there is nothing that I wouldn’t trade for those nine years.” She values those nine years so highly. She once said to her mum, Heather, “If you and dad had decided to euthanise dad I really don’t know how I would have forgiven you for that.” Now, I know that’s quite an emotive story but it really does stick with me because Rachel had those nine years with her father that she wouldn’t have had if, under this legislation, her father had chosen to be euthanised.

The point—and it has been raised tonight, but it’s that doctors sometimes get it wrong. Now, we all value our doctors in society. They do an excellent job, but they don’t always get the prognosis right. We’ve heard from the member David Seymour that—he acknowledged, sometimes, miracles do happen. In this case you probably could call it a miracle. But the member said that more do not get miracles than do, and I agree. That’s correct. But then the member said, “Why put a large group of people through pain, for the sake of only a few who might get a miracle?” But I would say for those who do receive a miracle, their families benefit in such a huge manner by having that time with their loved one, that I believe it’s worth it. So Rachel had those nine years with her father that she wouldn’t have had. She is now 16 years of age. She often speaks of her father; she speaks, obviously, very fondly of her father, because she got to know her father because of this.

There’s just one final point I’d like to raise in the last few seconds, and that’s the aspect around dignity. We often hear this phrase “Death with dignity”. We enter this world in an undignified manner. We often leave this world in an undignified manner. That’s life; that’s simply the cycle of life. There’s a philosophical question there that members need to think about, and that is the aspect of: how much do we tamper with life? There’s a phrase, “The sanctity of life”, but we need to think about that. How much do we tamper with that life—the beginning and the end? So thank you for the opportunity to speak.

It is an absolute pleasure to make a contribution to this stage in the End of Life Choice Bill, on what is a very dignified evening that we are experiencing this evening. I acknowledge that we are on Part 1, so I will try to stay as close to Part 1 as I possibly can. Now, I do want to say congratulations to the member for getting his bill to this stage. Of course, it will be on record that I voted against the bill at the second reading. But I want to be clear to my constituents that although I remain sceptical of this bill, I will do due diligence and make sure I read every possible amendment to this bill, and on the merits of those amendments before making my final decision.

So we come to this debate in Part 1, which really focuses around the purposes of the End of Life Choice Bill, the interpretation, and the criteria that people must go through in order to be qualified for the End of Life Choice Bill. Now, I think it’s quite reasonable to assume that in someone’s mind you can create a perfect candidate for this bill—someone who is at the end of life, who’s in an excruciating amount of pain, who wants to go, clearly wants to go, and who has a terminal illness. I absolutely empathise and can appreciate anybody who is in that tight definition who wants to come under this bill. But then there are a host of people who are in what I would call the grey area; those that are, in particular, vulnerable to using this bill, or perhaps for coercion—or not. Those are the people that I am particularly concerned about, those people who may, in fact, go down this line, who aren’t necessarily part of those tight criteria. Those are the people that I spoke about in my second reading speech around the most vulnerable people in our society. The most vulnerable people in our society that I see are the elderly, the mentally ill, the disabled, and our young.

Now, I can totally appreciate David’s Supplementary Order Paper (SOP) 259 that seeks to address some of these vulnerable concerns. I do want to acknowledge the member for what is an SOP—

CHAIRPERSON (Hon Anne Tolley): Full name.

David Seymour, who has made attempts to tighten up the criteria, to help address some of our concerns—for those who voted against the bill. So I do think that the SOP has some merit, although I do have severe reservations about the criteria in his SOP, particularly as it relates to our young because I think 18 years of age is still too young. I can appreciate that the other countries throughout the world who have this also have 18, but there’s no reason why New Zealand should not consider an age that is fit for purpose for this society. That is why I would absolutely support an SOP in my colleague’s name, Simeon Brown, which is SOP 283 which increases the age to 25 for assisted dying.

Death is not pretty. I think we’ve talked a lot about death tonight; we’ve heard a lot through the select committee process about death. It is very clear from the criteria that no doctor on terminal illness can, in fact, be clear that you’ve got six months to live. We heard that in select committee, and I’ll be listening very carefully to the member’s thoughts around tightening that up even further. But it is—again, death is not pretty. It’s a necessary part of life and it’s, in many cases, valuable. The final moments of people’s lives are valuable for those that are left behind, and that is why I still remain not convinced with Part 1 of David Seymour’s SOP. Just to those in my electorate of Northcote, I’ll be reading all of the SOPs very carefully and considering them on their individual merits. Thank you.

I want to drill down into Part 1 and clause 4, and ask a question, again, of the member in the chair that goes to the core of the debate. It’s this: how many mistaken deaths is he prepared to tolerate? I say to this Parliament: how many mistaken deaths are we prepared to tolerate?

I reflect back on a conscience vote that was held in this Parliament 58 years ago when the death penalty was abolished—fascinating argument.

💬 Simeon Brown: I was there.

Simeon says he was there; I was not, despite the record. But the debate was fascinating in this regard: some members said, “There will be the odd innocent person who gets strung up, but I’m prepared to tolerate that so the bad bastards who really have done it face their punishment”—I make no apologies, Madam Chair. I’m on the side that says this Parliament should err on the side of life. I am not prepared even though—we look at the awful tragedy that occurred in Christchurch, part of me would love to string that man up. But my view is I don’t want the death penalty in New Zealand because I’m a realist and I know mistakes were made, and I don’t want to see a single innocent person die.

Now, the member in the chair has said he accepts that there will be mistakes. He has said that he acknowledges—quite honestly, and I agree with him—that there will be people who are diagnosed, who only have six months to live, who will not—and I acknowledge my colleague across the way who gave such a situation at the select committee. We met dozens of people who have been given a terminal diagnosis who still lived. So we must be honest as a Parliament and say there will be people who are diagnosed who are not going to die.

Then let’s go to the second test in the bill. The test is that the person is competent. The medical evidence is that that is one of the most difficult judgments for a medical practitioner to make. There will inevitably be mistakes. If you’re trying to diagnose where the person is depressed, particularly when we’re dealing with people that may be unwell, this Parliament needs to acknowledge that there will be people who are clinically depressed that will not be picked up, who will be authorised to die.

Then there’s the third test. Again, I would challenge this Parliament: put hand on heart and say every medical practitioner who signs a form and says, “That person’s not under undue influence.” will get it right every time. That is an incredibly hard test. How do you know, when you’ve got a patient in your surgery, that their son, their daughter, or some other person is not trying to unduly influence them? I don’t believe there’s a single member in this Parliament who believes that there will not be examples where that test is not met, the doctor does not pick up undue influence, and the person, as a consequence, has their life terminated.

Now, my very first experience in a Parliament was as a pageboy in the Delaware state legislature in the US as an exchange student. They were having a debate about the death penalty. There were two groups. There was one group who said, “Actually, we have absolute faith in the judicial system and the legal tests in clauses like clause 4, and there’ll never be a mistake.” The more honest said there will be mistakes. So my question of the member in the chair, and my question to members of the House is this—and let’s be honest—is the member in the chair and the members that are supporting this part saying, “Yep. The honest truth is there will be mistakes, and we’re happy to have mistaken deaths because we believe in the overall public good of the other people who may be in pain and want to die early being able to do so?” That’s a fair argument, but make it.

This Parliament cannot and should not pretend that this bill will not result in mistaken deaths, and we should err on the side of life.

Thank you, Madam Chair. I’m pleased to make this contribution—my first one to the debate tonight. During the dinner break, I was fortunate to be able to attend a Pacific celebration in Wellington. It was the opening of the Pacific office of the University of Otago in Wellington. It is on this backdrop that I start my contribution to this debate. I’d also like to acknowledge all the members of the House that made contributions during the second reading, which I was also fortunate to be able to do. In particular, I thought that all those speeches from both sides were very well—they came from the heart, and they brought in the various experiences that we all have in this debate on life and death, and I believe it is about life and death. I’d also like to acknowledge the sponsor of this bill, David Seymour. Largely, I would agree with David on some other issues, but on this bill we will depart.

So I want to talk to this bill, in particular around the lens that I think has been missed in terms of how this bill has been constructed—the lens in terms of the Pacific community that I come from: the Pacific voices, the Pacific culture and the values that I have been raised in—

CHAIRPERSON (Hon Anne Tolley): I just remind the member though, we are on Part 1. This isn’t a general debate about the bill; it’s on Part 1.

Madam Chair, thank you. So I want to talk to an amendment that I would like to contribute to this Part 1. The amendment is Supplementary Order Paper (SOP) 275. I would ask the member, David Seymour, if he would consider this amendment in terms of clause 3. The change would be the definition of “psychiatrist” to have been a psychiatrist for a period of at least five years. I think it’s important if we’re looking to really tighten up this bill any way we can, in terms of providing that minimum level of expertise of a specialist that’s in a very influential position in this bill. Ultimately, I would like all members of the House just to consider this SOP 275 in my name, which is really just to tighten up that minimum level of experience for a psychiatrist.

On that note, in terms of specialists who are in a position to convey information about this option to vulnerable people—and it’s one thing I’ve looked through in Part 1 of this bill. What is the contribution or the undertaking to understand the cultural context in terms of communication and language for people in Pacific communities or others where English is a second language? For example, there wouldn’t be that many doctors—a lot lower number of doctors and specialists—who would be able to help convey what the option is to someone that’s vulnerable, particularly when a family member isn’t in the same room and isn’t able to be part of that discussion. So I really would like the committee to consider that amendment on David Seymour’s amendment—five years as a minimum. I think that would really just help to add and to tighten up this particular part, as we move through. There will be other SOPs, but I would like the committee to consider my SOP. Thank you very much.

Thank you, Madam Chair. It’s a privilege for me to speak on the End of Life Choice Bill. It’s the first time I’ve made a contribution, and I want to acknowledge Melissa Lee for her bravery, because I have experienced a similar situation. I believe the impact of this bill will impact the vulnerable people in our community. I am concerned that, in many cases, those who will have access to the End of Life Choice Bill are the old, the unwell, and the people with devastating and difficult diseases. By definition, these people are often in a vulnerable position.

I stand to speak in support of Supplementary Order Papers (SOPs) 208, 207, and an SOP in the name of the Hon Maggie Barry on new clause 4A. I belong to the Tongan community. I came here when I was 10 years old, and yet I still struggle to understand some of the English language. In the bill, the sponsor of the bill talks about, in terms of new clause 4A, “Meaning of competent to make an informed decision about assisted dying” In this Act, a person is competent to make an informed decision about assisted dying if the person is able to—(a) understand information about the nature of assisted dying that is relevant to the decision;”.

I want to go to Supplementary Order Paper 262 by the Hon Maggie Barry that talks about the meaning, replacing clause 4 with new clause 4A—the meaning of competent to make an informed decision about assisted dying. It explains in subclause (a) “understand the information relevant to the decision relating to access to assisted dying and the effect of the decision;”.

Many languages are spoken in this country, and at every select committee that I’ve been to, all the communities—there are disparities in the Māori or Pacific community or new migrant communities. They are always put in the most vulnerable people where we struggle to provide the best services.

I want to share my experiences in the Misuse of Drugs (Medicinal Cannabis) Amendment Act 2018. The words “terminal illness” were talked about and discussed and debated by professionals, by medical professionals, in terms of the use of medicinal cannabis for those people who would be caught with cannabis in their possession if they have a terminal illness. At the end, the actual Act said those requiring palliation have an exception and statutory defence to the charge of possession, of use, of illicit cannabis. It was in defence of the green fairies who delivered this cannabis to people who were in their dying days.

I want to ask the sponsor of this bill: what was the conversation about the term “terminal illness”? Did anyone actually explain what “terminal illness” is—because in my experiences in the Misuse of Drugs (Medicinal Cannabis) Amendment Act, not many people could do that.

I did say that I would support in terms of Supplementary Order Paper 207—I want to call out what I believe firmly that it is. It is the End of Life Choice Act replaced with the “Euthanasia and Assisted Suicide Act” of 2019.

CHAIRPERSON (Hon Anne Tolley): Unfortunately, that is clause 1; not Part 1.

Clause 1, not Part 1—sorry, I’m a bit emotional because it’s the first time I am making a contribution.

I want to use that because I firmly believe that we should talk about it—what it is. We should put emotions aside and actually talk factually, because when you are in a court of law, no emotions are there but actually lawyers defend things in terms of what’s written in the law.

We have pardoned a lot of people in terms of the fact that the judges got it wrong, that the jury got it wrong, that lawyers and courts got it wrong. The difference with that when this bill—[Time expired]

I move, That the question be now put.

Thank you, Madam Chair. It is sad but a privilege to speak on this bill. I do say this is the first time that I’ve spoken on the End of Life Choice Bill, and I find it very, very difficult to actually do this. Three weeks ago, my sister passed from cancer. She lay in a hospice bed and we all gathered around her. She lasted for six days and during those times my older sister and my younger brother spoke a lot about this bill, actually—of all things to talk about while your sister is dying in the bed. We spoke about it when we were away in the lounge and how her children, should this bill have been passed as legislation, may not have had the time with their mother to the end.

This bill goes against everything that is in my culture. We have our children. We treasure our children. We treasure each other. And there is no way that we would ever want to see a bill like this passed into any piece of the legislation of this country. I don’t want to be part of it. And it will be a sad day for this Government, for this Parliament, should this bill end up passed into legislation. And I ask all of those who are supporting this bill to walk in my shoes. I have had a history of my whānau dying from cancer-related diseases whereby we sat through their journey as they passed over. And I would never trade that for anything in the world. They would never have opted or even thought about the possibility of dying, or being forced, or having options like this because we treasure life. And I believe that many of us in this Parliament actually treasure life. We treasure life. And you need to have your hearts come out and actually vote against this bill.

I stand here today and I am saddened that the sponsor of the bill admits that there may be mistakes if this bill gets passed—there may be mistakes. Has life—has human life—got so little and inconsiderate and we’ve become so inconsiderate that we treat it like that. “Oh, it’s just a mistake. That was a mistake.” That’s terrible. That’s absolutely terrible and we look at each other and we have to look at each other. And whatever happens if this bill goes through—will we feel good about it? I don’t think so. I will feel ashamed to be standing in this Parliament to have this bill go through.

As I look through it there’s so many gaps, so many gaps. The cultural gap—the cultural gap—and I can say my people won’t support it. And I know that, even to make little changes in it, to put in clauses. And as I stand here today, I look at the clause of the Hon Maggie Berry who has been a champion in driving and leading our side of the House in going against this bill. I stand here and I want to say to her—to congratulate her for trying to make some sort of sense, to give it some sort of something. So we look at her new clause 4A or Supplementary Order Paper 263 where there’s an insertion of new clause 4A, some principles. Because this bill doesn’t have any principles. It has nothing. It doesn’t value life. It values death over life, and that’s a damn shame. And everybody should be hanging their heads in shame if they support this bill.

Everybody will say “Oh, you know, it’s really hard watching people pass and that and the pain that they suffer.”, but that’s what whānau are there for. These principles that the Hon Maggie Barry is proposing in her Supplementary Order Paper 263 are some way through helping—some way through helping. You know we’re Ngāti Porou women in our family, and everything that she has in her Supplementary Order Paper 263, new clause 4A, for the principles—[Time expired]

I move, That the question be now put.

The question is that the question—

I move, That the Speaker be recalled.

CHAIRPERSON (Hon Anne Tolley): You have to tell me what for.

There are 10 substantial Supplementary Order Papers on this part. While it might be your assessment that there has been sufficient debate on this, there are a number of people here who could not be in the Chamber earlier who have come down in the latter stages or come down in the last hour or so to listen to the debate.

I have been here for a long period of time now waiting for Mr Seymour to answer the reasonable questions that he should answer for the New Zealand public. There has been no answer. There’s been no attempt by him, and, therefore, I think—

CHAIRPERSON (Hon Anne Tolley): You need to actually—

—the debate should continue.

Right. [Interruption] No, no, no, no. No, you can’t. So what is the point of order that you—

I’ve recalled the Speaker. I don’t need to do much else.

So I’m going to put the question that the Speaker be recalled. All those in favour say Aye, to the contrary No. On the voices I would say that the Ayes have it.

💬 Hon Gerry Brownlee: Personal vote called for.

CHAIRPERSON (Hon Anne Tolley): You want a personal vote?

Yes, I’ve called for it.

The Speaker has already ruled that on a procedural motion there will be a party vote. I have declared that the Ayes have got it because I could not tell on the voices. I’ve resorted to recalling the Speaker. Do you—you still want to—

Speaking to your ruling, Madam Chair. That is utterly ridiculous. The Speaker makes somewhat of a fool of the Parliament if he’s prepared to say that all substantive motions, individual motions, are given by individual vote but somehow parties choose whether or not the procedures of the Parliament continue or not.

The member will be seated. I have ruled. You are challenging my ruling when you are the recipient of that ruling. We’ve had a vote. I have declared that the Speaker will be recalled. Are you withdrawing your challenge to that?

Yes; yes I am.

Motion agreed to.

House resumed.

Speaker Recalled