Will NZ have a higher standard for sexual consent than for euthanising a patient?

Earlier today a story appeared in the New Zealand media about the serious questions that are starting to be asked by our medical professionals about euthanasia and assisted suicide.

In just over seven months the End of Life Choice Act (EOLC Act) will take effect, and patients will regularly have their lives ended upon request by lethal injections or doses.

The architects and proponents of the EOLC Act sold New Zealand voters the concept of a utopian fantasy in which death would come quickly after a foolproof and easily worked through process of consent.

As we and many other anti-euthanasia campaigners warned however, things are never that simple in the real world.

Human beings are made for life, not death, and deliberately ending someone’s life can be a lot more complicated and elongated than the architects of this new law sold it as being.

All of this raises serious questions around the consent process when lethal doses don’t work as quickly as hoped, or simply fail to work at all.

As Palliative care professor Rod MacLeod points out in today’s article:

"I think the public has this idea that assisted dying is quite clear cut - you take the drugs and you're dead… but death doesn't necessarily follow within minutes or even hours, it can take a lot longer and [there are] well documented cases of stuff not working.”

It is still not clear what lethal drugs will be employed to end the life of New Zealand patients, but MacLeod goes on to say:

"You assume that [NZ will use the same lethal drugs] as the United States uses for lethal injections for the death penalty. 

We know that doesn't always work. It's not always that comfortable. It's not like flicking a switch."

The article also features comments from University of Otago bioethics researcher and palliative care physician Dr Janine Winters.

She presented an international literature review to the Ministry of Health in February which included a study from the Netherlands where in 21 of 114 cases, the patient did not die as soon as expected or woke up and the physician had to give a lethal injection.

All of this raises serious questions about consent.

A patient may have consented to one act of assisted suicide or euthanasia, but what happens if that doesn’t go as planned?

Surely even the most diehard euthanasia advocate can see that consent would need to be obtained again before any further actions were taken to kill a patient?

A failed euthanasia attempt could easily result in a patient changing their mind, or at the very least opting to pause and not immediately follow through with another attempt.

What makes this all the more shocking is the response from Minister of Health Andrew Little upon having these serious concerns put to him.

Firstly, he stated that “he had not considered that issue.”

Such a response from an ordinary Kiwi voter would hardly be surprising in light of the utopian fantasy that legalised euthanasia activists sold to the country during the EOLC Act debate.

They encouraged voters to embrace emotionalism rather than to think rationally and properly evaluate all of the evidence about what the law change would actually mean in practice.

In fact, euthanasia activists regularly scoffed at and openly denied the long and growing list of euthanasia harms that have been well documented overseas.

It is extremely concerning however to hear that the Minster of Health, who was also the Minister of Justice during the passing of the EOLC Act has never considered these issues.

This isn’t just an ordinary Kiwi, this is an MP who was supposed to have weighed the EOLC Act properly before voting in favour of it, and who is now charged with overseeing its implementation.

On the question of consent after a failed euthanasia, Little went on to state:

"Failed administration of medication to achieve assisted dying - I haven't thought through and, look, the system will have to think that through," Little said.

He did not think medical practitioners would need to get legal consent again after an initial failed attempt.

"If you've given your consent, you've given your consent. Unless there's some sort of proximity of time between a failed administration of a lethal dose and an attempt to do so again I would have thought that consent is enduring, at least for a short period of time."

If we consider Little’s comments in relation to the issue of sexual consent, they seem to indicate that he envisages a looser standard of consent for ending the life of a patient then what is required for sexual activity in NZ.

As if all of that wasn’t concerning enough, the article also contains this extremely troubling sentence about the nurses union:

“The nurses union said its request for legal advice had been ignored by the Ministry of Health and nurses fear they could face disciplinary action and be struck off if they go too far discussing euthanasia with a patient.”

What does that even mean?

The EOLC Act explicitly states that health practitioners cannot discuss euthanasia or assisted suicide with a patient unless the patient first raises it with them.

So why would the nurses union even be asking this question?

The question seems to indicate scenarios in which nurses are not only initiating and actively suggesting euthanasia to patients, but are then also engaging in potentially coercive conversations with them about it.

More importantly, why hasn’t the Ministry of Health replied to the nurses union already and clearly stated that it is illegal for nurses to raise euthanasia with a patient or to engage in any coercive conversations about it?

This article invites serious questions about how vulnerable people can ever hope to be kept safe from the incoming euthanasia regime.

Despite the Minister of Health’s lack of consideration, this isn’t a new problem either.

These issues speak to the very heart of the anti-euthanasia case that we and other campaigners made loudly and consistently during the EOLC Act debate.

The notion of a safe euthanasia regime with foolproof protections against coercion was always a utopian fantasy, and just like every other country that has trod this path, it won’t be realised in New Zealand either.

Sadly it seems that many vulnerable Kiwis will be put at serious risk and even prematurely killed as a result of this failure to properly consider all of the facts before legalising euthanasia and assisted suicide here.