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Home About Quiz Explained FAQ Media 首页 关于我们 English 홈 약 퀴즈 설명 English Quiz 测验 퀴즈 HomeAboutQuiz ExplainedFAQMedia首页关于我们English홈약퀴즈 설명English Quiz测验퀴즈 Scroll LETHAL DOSE WITH NO ASSESSMENT FOR COERCION PARENTAL KNOWLEDGE MENTAL HEALTH SUPPORT PHYSICAL PAIN ATTEMPTED TREATMENT REQUIRED Take the Quiz! See the Top 10 Risks WE ALL WANT COMPASSION, DIGNITY AND CHOICE BUT IS A POTENTIALLY UNSAFE LAW GOOD ENOUGH? From 3-17 October, we are all asked to vote in a binding referendum for or against the End of Life Choice Act. We’re being asked to vote on a specific law (not whether or not we agree with the ‘concept’ of assisted dying). This means that every New Zealander is expected to ‘think like a lawyer’ to understand the implications of this specific law when they vote. Votesafe.nz will help you know what the Act says – and importantly, what it doesn’t say, before you vote. Votesafe.nz is a public information campaign of the Safer Future Charitable Trust, funded solely by Kiwis like you. We’re passionate about health and wellbeing, and leaving a better, safer New Zealand for future generations. Our Board and advisors are creatives, lawyers and healthcare professionals keen to make a positive impact in our world. LOCAL STORIES View fullsize “Take away the risk, take away the vulnerability and show people genuine compassion.”– Vicki, Terminally ill, Palmerston North View fullsize “I think this law is very unsafe because it does not rule out depression and people with terminal illness are susceptible to clinical depression.”– Raymond, Counselling Student, Auckland View fullsize “The Act states that someone as young as 18 with a terminal illness can choose euthanasia. This really scares me as an 18 year old myself.”– Rachel, First-time Voter, Waikato View fullsize “I don't believe this law is safe for the disability community, for the Māori community or for anyone who has a risk factor.”– Dr Huhana, Lawyer, Ngāti Tāhinga, Tainui, Whakatōhea View fullsize “A law that intentionally cuts short the life of someone who might be mentally unwell is something that should affect all of us.”– Heather, Disability Advocate, Hamilton View fullsize “I’ve had people come to me and tell me that they are thinking of taking their life. It's often because of family pressures.”– Simonne, Grey Power President, Hibiscus Coast FORMS OF ASSISTED DYING THE END OF LIFE CHOICE ACT LEGALISES BOTH ASSISTED SUICIDE AND EUTHANASIA. (And yes, it’s important to know the difference) ASSISTED SUICIDE Where a health practitioner prescribes a lethal dose for the eligible person to administer themselves, usually by swallowing a combination of drugs. EUTHANASIA Where a health practitioner administers a lethal dose to intentionally end the life of the eligible person, usually in the form of a lethal injection. In the ten states in the USA where assisted dying laws operate, they have legalised only assisted suicide. In Victoria, the only Australian state where an assisted dying law is operating, euthanasia is allowed only if a person is unable to administer the lethal dose themself. THIS REFERENDUM IS NOT ABOUT THE FOLLOWING ALREADY LEGAL OPTIONS: It’s important for us to know what is already legal and to understand the options already available to us at the end of life. In order for us to understand what the End of Life Choice Act is, then we must also understand what it is NOT. TURNING OFF LIFE SUPPORT This is already legal. A common misconception is that the End of Life Choice Act will make it legal for someone to turn off life support, however this is something that is already legal in New Zealand. It is lawful to make an advance directive in which you refuse consent to receive life support. Read more + DO NOT RESUSCITATE ORDER This is already legal. It is already legal in New Zealand to have a ‘do not resuscitate’ order which means that if your heart or breathing stops you do not want a medical intervention to bring you back to life. A valid ‘do not resuscitate’ order is legally binding, and can cover CPR and other interventions (which you can specify in the order). Read more + REFUSING TREATMENT This is already legal. We already have the right to refuse any medical treatment – even if it may potentially be life-saving or life-prolonging. We can refuse consent when being offered a treatment, or express our wishes for the future by making a valid advance directive. We can also withdraw consent to treatment we have previously agreed to. Read more + PALLIATIVE MEDICATION THAT MAY HASTEN DEATH This is already legal. There are occasions where a person needs large doses of medication to control their pain and other symptoms. Sometimes there is a risk that the medication could hasten a person’s death as a side effect. As long as the health practitioner’s intention is to relieve symptoms, and not to end the person’s life, it’s legal to give such medication. Read more + TOP 10 RISKS LEGAL RISKS LAWYERS HAVE IDENTIFIED Over 175 New Zealand lawyers agree that the safeguards in the End of Life Choice Act are insufficient and have formed a group called Lawyer for Vulnerable New Zealand. WATCH ‘HOW TO THINK LIKE A LAWYER’ Learn more Click on the play buttons below to watch Queen’s Counsel Barrister Grant Illingworth explain each risk in plain English. THE END OF LIFE CHOICE ACT WILL MEAN THAT ELIGIBLE PEOPLE CAN ACCESS A LETHAL DOSE Watch WITH NO ASSESSMENT FOR COERCION REQUIRED > There is no requirement in the Act that a formal coercion assessment be > undertaken There is also no requirement that the health professionals ask the person whether anyone else has suggested they make an assisted dying request, whether anyone has exerted pressure on them of any kind; or whether they are seeking assisted dying to relieve a perceived burden or provide a financial advantage to others. If coercion is suspected, the assisted dying process must be stopped – but this is not the same as proactively and comprehensively ensuring that there is no coercion at play. Coercion is by nature subtle and often difficult to identify. Additionally, the Act does not require independent witnesses to be present for any stage of the process. (While the Act does include a requirement for the person’s eligibility criteria to be checked by an independent medical practitioner, that doctor has no role to play in relation to detecting whether the person has been subjected to pressure or coercion.) This limits the ability to ensure that the correct process was followed: that the person was eligible and that there was no pressure from health professionals or anyone else. The stakes are high: we need to ensure that the law avoids wrongful deaths at all costs. Read more + Learn more WITH NO PARENTAL KNOWLEDGE REQUIRED > Some teenagers could be assisted to die without their families knowing Under the Act, 18- and 19-year-olds who meet the eligibility criteria will be able to receive euthanasia or assisted suicide. It is that young person’s own decision whether to tell any of their friends or family about their plan. Although a health practitioner must “encourage” the person to discuss their wish with others, the health practitioner is required to ensure that the person knows they are not obliged to discuss their wish with anyone. This means that a very young person with a terminal illness could choose to receive assisted dying without crucial support and input from their loved ones. There is further concern that, if the Act is made into law, it will inevitably be extended to include even younger people. Already, New Zealand’s Attorney-General has stated that the Act is discriminatory because it denies 16- and 17-year-olds access to assisted dying. Read more + Learn more WITH NO MENTAL HEALTH SUPPORT REQUIRED > There is no required screening for mental illness or depression The Act does not require a person to be screened for mental illness or depression before they can be eligible for assisted dying. Under the Act, mental illness cannot be the only ground for requesting an assisted death. However, a terminally ill person who is also suffering from a mental illness, which may be treatable, could be eligible for assisted death. There is concern that someone could qualify as “competent to make an informed decision” (as defined by the Act) while also suffering from a mental illness that is impairing their judgement. There is a significant risk that, as a result of their mental illness, the person may believe that their suffering is unbearable, but if they were provided with the right support and treatment this would change and that person could find hope and enjoyment in their last months of life. Read more + Learn more WITH NO PHYSICAL PAIN REQUIRED TO BE ELIGIBLE > A person is not required to be in physical pain to be eligible To be eligible, the Act requires that a person is experiencing unbearable suffering. However, there is no definition of what unbearable suffering is. Under the Act, a person is not required to be in any physical pain whatsoever. The interpretation of “unbearable suffering” is left wide open to include suffering of any kind (such as psychological, mental, social and spiritual suffering). Read more + Learn more WITH NO ATTEMPTED TREATMENT REQUIRED > Assisted dying is not necessarily a last resort An eligible person is not required to have undergone any treatment for their illness before opting for euthanasia or assisted suicide. The Act has no requirement that assisted dying is only to be used as a last resort. There is concern that, over time, assisted death will become so normalised that society will consider assisted death as the logical next step when someone receives a terminal diagnosis, rather than focusing on providing emotional and medical support to help someone to process the grief of their diagnosis. Read more + Learn more WITH NO ADEQUATE COOLING-OFF PERIOD REQUIRED > A matter of days between diagnosis and death Overseas, assisted dying laws often have ‘cooling off’ or ‘stand down’ periods, which require people to wait for a period of time between requesting assisted dying and having a lethal dose prescribed. This important safeguard helps to ensure that someone doesn’t make an impulsive decision, and can help to identify other factors at play, such as pressure from family or friends. The Act doesn’t require a waiting period before the lethal prescription is written. The Ministry of Health has estimated there could be just 4 working days between a person’s request for assisted dying and their death. Read more + MEDICAL RISKS DOCTORS HAVE IDENTIFIED Over 1,700 doctors agree that there are insufficient safeguards in the End of Life Choice Act and have formed a group called Doctors Say No. Learn more Click on the play buttons below to watch Palliative Care Expert Doctor Lara Hoskins explain each risk in plain English. Learn more MISDIAGNOSIS OR WRONG PROGNOSIS We hear all the time about people who were ‘given’ six months to live, but survived much longer. That’s because even palliative care experts say that they can only provide an estimate of how long someone has left to live when death is imminent. In fact, according to a widely-known study from the US, only 34% of prognosis predictions were correct, so at least two out of three times clinicians are wrong one way or the other. It’s also because sometimes doctors just get the diagnosis wrong. This poses a real danger to people who could be misdiagnosed as terminally ill within 6 months but could potentially outlive this prognosis by months or years. Read more + Learn more UNDERMINING THE DOCTOR / PATIENT RELATIONSHIP The doctor/patient relationship is based on trust. This relies on the doctor’s legal and ethical obligations to only act in the patient’s best interests, and never to cause harm (as enshrined in the Hippocratic Oath). If health practitioners are allowed to intentionally facilitate a patient’s death in some cases, this relationship of trust is significantly undermined. Currently, when you go to your doctor, you know that the goal is to get you better and to improve your quality of life. If the Act comes into force, the doctor’s motivation suddenly comes into question. Further, the Act does not allow doctors to exercise their clinical judgement regarding whether an assisted death is appropriate in an individual case. Once a patient has made a request and been deemed eligible, they would have a legal right to receive assisted dying. Read more + Learn more PRESSURE TO CHOOSE DEATH DUE TO LACK OF OPTIONS Many assume that being able to choose an assisted death will give them peace of mind at the end of their lives. But if the Act comes into force there is a significant risk that a person with a terminal illness will feel pressure to end their life. Pressure does not even need to be explicit to be a real problem. A person with a terminal illness is particularly vulnerable. They will often be very unwell and potentially be highly reliant on others for their care and sustenance. With the option of assisted dying on the table, some will begin to feel that they must justify their “choice” to remain alive. To “choose” not to receive assisted dying means “choosing” to continue to drain public resources and “choosing” to be a burden on family and caregivers. This is not a choice that anybody should have to make. The Act does not do enough to address the risk of a person being explicitly pressured to end their lives. Elder abuse is already a real problem in New Zealand. The Act takes the risk to the next level. The doctor is required to “do their best” to make sure the person is not being pressured – not exactly a robust test. Also, that doctor is not required to have any prior relationship with the patient so the chance of being able to identify any pressure is significantly reduced. Read more + Learn more LACK OF EQUAL ACCESS TO PALLIATIVE CARE In the vast majority of cases, a person’s end of life suffering can be significantly reduced through quality palliative care. Unfortunately, high quality palliative care is currently underfunded, and not equally accessible across New Zealand. There is a significant lack of palliative care specialists throughout the country, and medical students receive very little training in end-of-life care. Given that we do not have equal access to high quality palliative care across the country, someone may choose to receive assisted dying because we have failed to provide them with the adequate medical support that could have alleviated their unbearable suffering in their final months (or years) of life. If the Act becomes law, there will be less incentive to pump resources into improving palliative care. Let’s start by investing in this crucial area of healthcare rather than moving forward with euthanasia and assisted suicide. Read more + SO WHAT’S ACTUALLY HAPPENING OVERSEAS? AND WHAT COULD NEW ZEALAND LOOK LIKE IN THE FUTURE? Of all the countries in the world, only 10 (5%) allow some form of assisted dying. In America, only 10 of 50 states have legalised assisted dying, and in Australia, only 1 of 6 states have legalised assisted dying currently operating. > Only Assisted Suicide > Only Euthanasia > Euthanasia and Assisted Suicide VICTORIA, AUSTRALIA Victoria’s assisted dying law came into effect in June 2019. It legalises assisted suicide and euthanasia although, unlike our law, euthanasia is only lawful when the eligible person is unable to administer the lethal dose themselves. Victoria’s law contains a number of safeguards that the End of Life Choice Act does not have. These include the requirement that there be independent witnesses present, and that the person’s suffering be caused by their terminal illness. Read more + OREGON, USA In 1997, assisted suicide was legalised in Oregon, USA. In 2019, 90% of those who received assisted suicide cited as a reason 'concern about being less able to engage in enjoyable activities', and 59% cited ‘concern about being a burden’. Research has found that 1 in 6 people approved for assisted suicide were clinically depressed. Unlike the End of Life Choice Act which requires only one request to be confirmed in writing, Oregon's law requires a person to make an oral request, a written request and another oral request at least 15 days after the first one, unless the person is likely to die within this 15 day period. Read more + CANADA Canada introduced assisted death in 2016 and in the few years since there has been a strong push for its expansion. Similarly to the End of Life Choice Act, Canada’s law was written to only apply to those who are in an advanced state of irreversible decline and whose death is "reasonably foreseeable". However, just 10 days after the law came into effect, a 25 year old woman with a severe neurodegenerative disease sought a ruling that this safeguard was discriminatory. Within 12 months another court challenge on the same grounds was initiated by two Canadians with post-polio syndrome and cerebral palsy, who sought a declaration that the law violates their rights. This challenge was upheld and there is now a Bill before the Canadian Parliament that seeks to remove this protection. The Bill also proposes to allow euthanasia by advance directive for a person who has lost capacity at the time of their death. In May 2018, the Quebec College of Physicians wrote to the Health Minister warning that a lack of palliative care services in parts of Quebec could be forcing patients to choose assisted death as a way to end their lives. Noting that Quebec is suffering from uneven levels of palliative care services and a lack of specialist palliative care doctors, the College warned the Minister that patients requesting assisted death were getting priority access to available resources. Read more + THE NETHERLANDS Although the Act being proposed in New Zealand currently has more safeguards in place than that of the Netherlands and Belgium, there is a real risk of the categories being extended over time, both through interpretation in courts and through the law being amended. The Netherlands is a concerning example of where an assisted dying law in New Zealand may progress to over time, including: * In the Netherlands, children can request euthanasia from as young as 12-years-old (with parental consent) and 16-years-old (without parental consent). The Groningen Protocol also permits a doctor to terminate the life of a newborn infant who is considered to be in unbearable suffering with no prospect of improvement. * There are growing numbers of dementia patients in the Netherlands being euthanised on the basis of an Advance Directive, despite not being competent, or even compliant, at the time of their death. * There has been an exponential increase in euthanasia of patients suffering from mental health conditions. One such example is of a woman in her 20's who had been the victim of sexual abuse as a child and received euthanasia due to her post-traumatic-stress disorder. Read more + BELGIUM Consideration of the assisted dying law in Belgium is similarly concerning, as follows: * In 2014, the law in Belgium was amended to allow children of any age to receive euthanasia if the child is judged to have unbearable physical suffering and is considered close to death. * Although the Belgian law requires a doctor who has performed euthanasia to report the death to the Review Committee, a study conducted 5 years after the Act came into force found that only one out of two euthanasia cases were being reported by doctors in the populated area of Flanders. * A concerning number of people have been euthanised on the basis of their mental disorders, including dementia, Alzheimer’s, mental health disorders including depression, bipolar disorder, personality and behavioural disorders, neurotic disorders, post-traumatic stress disorder, schizophrenia and psychotic disorders, and disorders such as autism. * There are examples of people who have received euthanasia due to their psychological suffering. Identical twin brothers who were born deaf were euthanised when they found out that they were both going blind. On 30 September 2013 a Belgian transsexual was euthanised because of his unhappiness following a sex change operation. Read more + TOGETHER WE CAN DO BETTER NEW ZEALAND! HERE’S SOME CHOICES THAT CAN TRULY HELP IMPROVE ACCESS TO PALLIATIVE CARE Let’s make sure that we are doing our best to support each other by improving the current access to palliative care to make sure that all Kiwis are able to utilise this service in New Zealand and no-one misses out. LEARN MORE ABOUT THE PROCESS OF DEATH AND DYING Death is often a taboo subject even though it’s a normal part of life that affects us all. Let’s learn more about death and the process of dying – the more we know, the less afraid we will be. SUPPORT EACH OTHER SHOWING TRUE COMPASSION We live within a community and the choices we make impact those around us. Let’s be a society that shows true compassion by providing support and care to those who need it most. GET VOTESAFE.NZ EMAIL UPDATES We’d love to keep you informed with our email newsletter highlighting key issues surrounding the End of Life Choice Act referendum. Sign up below! First Name Last Name Email Address Sign Up We’ll keep you updated with the latest news on the referendum. Thank you for making a pledge to votesafe! Please Get Involved to see more ways you can help spread the news. WANT TO KNOW MORE? SEPARATE FACT FROM FALLACY WITH THE FINAL CHOICE E-BOOK & FREE PODCAST Kiwi journalist and best-selling author Caralise Trayes on the End of Life Choice Act. Join her on a journey of discovery as she tells the stories of those with terminal illness and interviews lawyers, doctors, ethicists and clerics around New Zealand and the world. “New Zealanders, if you want to do your homework, that [The Final Choice] is the book.” – Jessie Mulligan, The Project Learn More Free Podcast GET INVOLVED > SPREAD THE WORD > > Help inform others Share this page so that others can be informed about the referendum and understand the implications and risks of this law. 94.3k Shares > DISPLAY OUR SIGNS > > We need your help We are in need of private road frontage locations around the country to display our signage, as well as general volunteers to help! Offer Help > DONATE > > Help reach Kiwis We’re fully funded by Kiwis like you. Bank Account Donations to: Safer Future Charitable Trust, ASB, 12-3136-0548490-00 (Use your name and phone number as a reference). For Credit Card donations use the link below. Donate Hero Left Hero Right Intro Hear From Kiwis Assisted suicide and euthanasia What It's Not About Risks General Problems Overseas We Can Do Better Pledge Book Can you help? NAVIGATION Home Quiz Our Quiz Explained About Petition Letterbox Feedback Form FAQ Media Donate Help The Final Choice LANGUAGES English Samoan Chinese Korean CONNECT info@votesafe.nz Registered New Zealand Charitable Trust CC58658. Donations given within New Zealand are eligible for a Tax Credit with the NZ IRD for donations over $5.00. POWERED BY SQUARESPACE 94.3k Shares Share Tweet Email Share