Matt Vickers is continuing the fight for the right to die, begun by his wife Lecretia Seales, who died of brain cancer. Photo / Supplied
Only a week to have your say on one of life’s most difficult questions, writes Nicholas Jones.
New Zealanders have a week left to let Parliament know their views on the deeply polarising issue of voluntary euthanasia.
Lecretia Seales' legal challenge has led to some politicians pushing for a new law to allow doctors to help end the life of certain patients, and Parliament's health committee has launched an inquiry and called for public feedback.
Legalising voluntary euthanasia would follow in the footsteps of a handful of overseas jurisdictions, including the Netherlands, Belgium, Luxembourg, Oregon and four other American states.
This week authorities in Quebec announced the first case of legal euthanasia, after a change in provincial law in December.
Canada's Supreme Court has ruled to allow doctor-assisted euthanasia across the country in some circumstances, but has given the government time to pass a law to govern the practice.
Other countries such as Scotland have rejected such a move.
Lobby groups on both sides of the debate in New Zealand have become increasingly vocal, accusing each other of fear-mongering and spreading misinformation.
Advocates such as Act Party leader David Seymour say the tide of history is on their side, likening voluntary euthanasia to past policy battles on access to contraception, no-fault divorce, and homosexual law reform.
Opponents, including an alliance of the Salvation Army and the Australian and New Zealand Society of Palliative Medicine, are rallying to put down another effort to implement a change they see as unethical and fraught with problems including reliable consent.
A long time coming
Despite opinion polls showing strong public support for legalising euthanasia, the issue's extreme divisiveness has meant politicians have been reluctant to champion a change.
Labour MP Iain Lees-Galloway dropped a voluntary euthanasia bill in December 2014 at the request of leader Andrew Little, who said it was "about choosing the controversies that are best for us at this point in time".
Lees-Galloway took over the bill from former Labour MP Maryan Street when she was not re-elected.
Prime Minister John Key has said he supports the legalisation of euthanasia in some circumstances, and previously voted in favour of former NZ First MP Peter Brown's 2003 Death with Dignity Bill, which was defeated in a conscience vote 60-58 in its first reading.
Despite that, National will not introduce legislation. Many of its MPs, including Finance Minister Bill English, are strongly opposed.
With both the Government and Opposition unwilling to move on voluntary euthanasia, and no MP actively championing the cause, the issue was sidelined politically.
Lecretia Seales
It was thrust back into the spotlight by Lecretia Seales. The Wellington lawyer, dying of brain cancer, asked the High Court to give her the legal right for a doctor to help end her life.
On June 5 last year, soon after being told that her court bid was unsuccessful, Seales died of her illness, at the age of 42. A judge ruled that only Parliament could make a law change allowing that legal right.
At a press conference the day after his wife's death, her widow Matt Vickers addressed Key directly: "This debate needs to happen now. Prime Minister, I urge you to give the public what they want and start the debate."
The following month, Vickers was among supporters who presented a petition to Parliament, signed by Street and 8974 others, asking for its health select committee to fully investigate public attitudes to medically assisted dying in the event of a terminal illness or terminal illness.
The committee agreed to do so, and called for public submissions by February 1.
Opponents rally
The inquiry has galvanised long-time opponents of voluntary euthanasia. The Care Alliance formed in 2012 as a reaction against Street's bill, and has been particularly active in its opposition to the latest push.
The lobby group includes Family First NZ, Hospice New Zealand and the Salvation Army. It has urged New Zealanders who don't oppose euthanasia for religious or moral reasons to think through what a change would mean in reality.
Legislation won't be able to fully protect the frail and elderly from pressure to terminate their "burdensome" lives, or even be killed without consent, the alliance believes.
Other arguments include: terminal illness diagnoses can be incorrect, that even with euthanasia an easy death is not guaranteed, and assisted dying could undermine trust in health professionals and the hospice movement if it is seen as a more cost-effective treatment.
Although those seeking to introduce voluntary euthanasia promote safeguards and argue it is a treatment for a handful of people, opponents argue initial cases will be the "thin end of the wedge" and open the way for it to become widespread.
The Benelux countries (Belgium, the Netherlands and Luxembourg) are used as an example of this - in February 2014 Belgium legalised euthanasia for terminally ill children, without any age limit.
Writing in the NZ Catholic newspaper, National MP Simon O'Connor, also the chair of the health committee, said his opposition to voluntary euthanasia was because "I do not support the killing of another human being. Suicide is never the answer to a problem."
"It is not the solution for a teenager who is being bullied, a farmer losing his farm, a clinically depressed person, or someone with a terminal illness. All human lives have worth, all humans have an innate dignity, and to suggest that sometimes they don't is a very disturbing proposition," O'Connor wrote.
A less strident argument is that New Zealand needn't be a leader on the issue, and could wait and see if other countries opt for a law change, particularly similar countries like Australia and Britain.
The push for change
When the health committee agreed to the Parliamentary inquiry - a direct result of Seales' advocacy and the publicity it generated - a remaining problem for supporters was that no MP stepped forward to front the issue.
That changed when the Act leader put forward a member's bill in October. Seymour has since turned down ministerial posts, saying he wanted to focus on championing that bill if it is drawn this year. His bill is based on the earlier legislation drafted by Street. It would allow mentally competent New Zealand adults who have a terminal illness likely to end their life within six months, or have a grievous and irremediable medical condition, the choice to ask a doctor to help end their life at the time of their choosing.
The Director-General of Health would establish a group of medical practitioners who would maintain a register of health professionals willing to participate in assisted dying. A new process would require two medical practitioners to be satisfied a person meets the required criteria. The second would be independent of the patient and initial doctor.
Seymour's draft bill states that evidence and analysis in the Seales High Court judgment demonstrates that, without a change in law, some New Zealanders are suffering unbearably at the end of their life, and there was broad consensus that palliative care alone cannot alleviate all suffering.
Supporters say that concerns about the abuse of the vulnerable have not materialised overseas, and point to an Economist magazine editorial in June last year that stated that evidence from Oregon showed there were "scant signs of a slippery slope".
The criteria for voluntary euthanasia are wider in the Benelux countries than elsewhere, including the recent change in Belgium extending the right to children, but supporters say New Zealand can choose a more restricted model and stick with it. Oregon, for example, has had similar restrictions in place for 18 years.
Vickers, speaking to the Weekend Herald after it named his late wife New Zealander of the Year, referred to an article by a Christian author, Benjamin L. Corey, who wrote: "It seems disingenuous to force someone to choose between two ways of dying and then turn on them in judgment for picking the least painful of the two options".
The article was prompted by 29-year-old Brittany Maynard, who ended her life under Oregon's "death with dignity" law, and whose campaign sparked debate in the US.
What happens next
Officials will process the hundreds of submissions that have come in, and the health committee could then hear from submitters who wish to speak in person, which could involve trips to different areas of the country.
The committee can make recommendations, which are not binding, including that the Government consider legislation.
Seymour and other advocates are not confident of such a recommendation. The best hope for a law change is if Seymour's member's bill is drawn from the ballot. He has expressed confidence that it would pass a first reading in a conscience vote.
That comes after conversations with MPs in Parliament's corridors, researching public statements, and pressure from voters (Seymour polled Epsom before putting up his bill and 69 per cent were in favour).
He sees value in the inquiry as he expects the report to clearly state the evidence from overseas jurisdictions, which he is confident backs the case for voluntary euthanasia.
Opponents will be hoping the report concludes the evidence is on their side, and that most submissions are strongly against any change to the law. Whatever the detail, it will be more fuel to the fire of what will be one of the year's big debates.
To make a submission send two copies in writing to Secretariat, Health Committee, Select Committee Services, Parliament Buildings, Wellington 6160. For more information visit parliament.nz