Medically Assisted Dying

Health Select Committee: Petition of Maryan Street and 8974 Others

Submission from 9 Anglican bishops in Aotearoa New Zealand, 1 February 2016

Contact Person: Bishop Richard Randerson (details supplied).

We would like to make an oral submission.  

Summary: While recognising the great distress of patients, families and friends in the case of some intractable and prolonged terminal illnesses, it is our view that legalising medically-assisted dying will open the gateway to many foreseen and unforeseen consequences which will be damaging to individuals and the social fabric. We recommend that no change be made in the existing law, but that resources to enhance palliative care and counselling support for both patients and their whanau be increased.

Moral Principle: In our view the protection of human life is a fundamental cornerstone of society, and one that is affirmed universally whether as a result of religious conviction or from other code of ethics. Every person and every life is of worth, and to legalise medically assisted dying is to undermine this moral cornerstone and open the way to damaging outcomes (see The Dangers, p2).

In particular there would be a significant shift in an individual’s trust in the positive support of official, professional, social and family networks. Trust in the life-supporting intentions of one’s human environment is replaced by a fear that systems and individuals may be planning to terminate one’s life. Trust would be destroyed, and insecurity and anxiety would set in. This could happen even with members of one’s own family.

Hard Cases: Over many years of pastoral care we have experienced how distressing and prolonged a terminal illness can be. We have experienced it with our own family members. Pain, dementia, and the indignities of failing bodily functions can be extremely distressing. We do not in any way subscribe to rigid moral principles that override human compassion and care.

We are not clinicians, but colleagues in the medical profession, and especially in palliative care, advise that new technologies and drugs can do much to alleviate most pain. An Australian doctor, Karen Hitchcock, who has worked for 12 years in large public hospitals, caring for hundreds of dying patients, says she has often had patients say they want to die, but… “it is rarely because of pain, but is often because of despair, loneliness, grief, the feeling of worthlessness, meaninglessness or being a burden. I have never seen a patient whose physical suffering was untreatable”.

Not Prolonging Life: we accept the practice of withdrawing life support systems in cases where a patient has slipped into a coma or long-term unconsciousness, there is no future prospect of recovery and the person would die naturally without the support of mechanical devices. Artificial prolongation of life in such circumstances is contrary to the natural order of dying, and not necessary. Such a step would be a decision reached by doctors and family, and may be in line with the expressed advance intention of the patient through a Living Will.

Likewise we accept that the provision of morphine or other drug for the purpose of pain relief is both acceptable and desirable, even although one of the side effects may be the shortening of a person’s life. The latter is not the intention and hence this widely established form of medical care to relieve pain is an important palliative treatment.

The Dangers of Legislation:  we believe the legalising of medically-assisted dying, while intending to assist in hard cases, could open the way for many unfortunate outcomes:

1. The creating of a legal option establishes medically assisted dying as an acceptable and socially approved form of ending life which could encourage its use.
2. Instead of being restricted to intractable cases of terminal illness, categories might extend to include other forms of treatable illness, depression, loneliness, the handicapped or babies born with severe deformities. Many suffering such conditions, or their parents or guardians, might take advantage of a new way out of the situation.
3. Official committees set up to approve applications might in time adopt a de facto “death on demand” ethos, turning down few applications.
4. Elder abuse is a well-established reality of our society. Family members and care providers might bring subtle, or not so subtle, pressure to bear on an ageing family member to “do the decent thing” and exit this life. We have known situations of such pressure driven by family members alarmed to see their inheritance evaporating with the costs of caring for an ageing parent.
5. Ageing family members themselves may feel the guilt of being a burden on their families, or they may see long-term friends taking the step and feel pressured to do the same.
6. In times of budget constraints, governments may see medically-assisted dying as a way of saving on the health budget and reduce funds for aged care.
7. This could lead to a restriction of resources for palliative care, quality aged care, or providing social support for the lonely or depressed.

Conclusion: We feel the tensions in this very difficult debate on how to maintain the principle of the worth of each individual along with adequate care for those in stressful situations. Our view is of an “on balance” nature weighing up the pros and cons of the options. We therefore believe:

1. New Zealand should not enact legislation that would establish medically-assisted dying as an authorised form of terminating life, thus undermining a fundamental ethical principle.
2. We should take steps to increase resources for palliative care, and the provision of social support for the lonely, ageing and depressed.
3. We should enhance support for families caring for those with terminal illnesses to assist them in understanding what is happening and likely to happen, how to manage stress and grief, and how to build positive relationships with the dying, remembering that dying can be an important last phase of life in resolving conflicts of the past and establishing new relationships of love and care.

Signatories (Bishops of the Anglican Church in Aotearoa, New Zealand and Polynesia)

• Philip Richardson, Bishop of Taranaki, Archbishop for Tikanga Pakeha
• Ross Bay, Bishop of Auckland
• Justin Duckworth, Bishop of Wellington
• Richard Ellena, Bishop of Nelson
• Helen-Ann Hartley, Bishop of Waikato
• Andrew Hedge, Bishop of Waiapu
• Muru Walters, Pihopa o te Upoko o te Ika
• Bruce Gilberd, retired bishop
• Richard Randerson, retired bishop