New Zealand shows why UK politicians must be wary of assisted dying reassurances
4 min read
I strongly encourage British parliamentarians to look at what has happened in New Zealand since the introduction of assisted dying.
Ahead of the introduction of assisted suicide and euthanasia in New Zealand in 2021, I chaired the New Zealand Health Committee, which undertook an inquiry into assisted suicide and euthanasia, and the similarities between the debate in the UK now and the one that took place in New Zealand then are striking.
First, just as the UK assisted suicide bill sponsor Kim Leadbeater and her allies argued, there is, or will be, no "slippery slope" when it comes to the expansion of legislation, so too, we in New Zealand were promised that the eligibility criteria would be strict and that the argument was a “fallacy”. The laws have been in place in my home country for less than four years, but I have already seen that slope in action.
Most significantly, a new members’ bill has recently been lodged in our parliament that would remove the requirement that a person is likely to die within six months. Instead, in a change which could have been inspired by the Canadian model, a New Zealander who "experiences unbearable suffering" with "a condition that is advanced [and] progressive" and "is expected to cause death", will be eligible for state-assisted suicide or euthanasia. It also proposes to limit conscience rights, force hospices to allow euthanasia on their premises, and propose more targeted promotion to reluctant indigenous groups.
These renewed efforts make clear that far from remaining tightly controlled as advocates once promised, the law is already being pushed in a more permissive direction.
Second, while the proposed legislation in England and Wales probably resembles the law in Oregon most closely, Leadbeater and supporters have seemingly stopped referring to the Oregon law entirely and didn’t invite oral evidence from any Oregon-based witnesses. Perhaps this was because inconvenient facts emerged from the law in Oregon, such as people with anorexia qualifying for the scheme and a high proportion of those opting for assisted suicide citing feeling like a "burden” as a motivating factor. The same dynamics happened here in New Zealand – the moment inconvenient statistics or examples came from other jurisdictions was the moment proponents stopped discussing their previous ‘gold standard’.
As a consequence of all of this, Leadbeater seemed to gravitate towards focusing on Australian models of assisted suicide/euthanasia. While the models used in the Australian states differ from the one proposed in the UK, a key advantage for advocates is that the laws have not been established for very long, resulting in limited data available for analysis. Therefore, it is more difficult to draw conclusions or examine where things may go wrong.
Third, the "End of Life Review Committee" in New Zealand, and the proposed "assisted dying review panels" in England and Wales are also very similar. In New Zealand, this committee was meant to be a key safeguard. Three experts sit on this committee, each with a two-year term that can be renewed. Two must be health practitioners, and one a medical ethicist. Its role is to review reports of deaths that have resulted from assisted suicide/euthanasia and, in particular, to scrutinise complex cases where something may have gone wrong.
Has this committee been the reliable safeguard it was sold to be? Hardly. In fact, developments since its establishment have been deeply concerning.
When it comes to the inaugural committee, one resigned (Dr Dana Wensley) due to her concerns regarding serious problems with the committee's ability to oversee the implementation of assisted suicide and euthanasia, and another (Dr Jane Greville) was pushed out, it is thought, because she was raising too many concerns about the operation of the new law.
Both Dr Greville and Dr Wensley went public and stated that the committee’s oversight of the law was so limited that wrongful deaths could go undetected. They cited being “extremely concerned” about how little information they received relating to patient deaths, leading to them feeling “constrained to the point of irrelevance”. This ought to serve as a warning to British parliamentarians about Leadbeater's proposed panels to oversee assisted suicide decisions.
In one deeply troubling case in New Zealand, the committee was able to establish that a patient suspected of having frontal dementia, and who did not speak English, was approved for assisted dying despite not having an interpreter present for their assessment.
New Zealand’s experience has not yet played a significant role in the UK debate so far. However, I strongly encourage members of the House of Lords to reflect on our experience ahead of the Second Reading of Leadbeater’s Terminally Ill Adults (End of Life) Bill, and take home two lessons: safeguards are rarely ever as strong as advocates suggest at the outset, and the “slippery slope” is not a hypothetical risk, but a real and present one that can manifest rapidly.
Simon O’Connor is a former New Zealand MP who chaired the parliament's health committee.
