The End of Life Choice Act would allow more risk of pressure and wrongful deaths than the Oregon Act allows.
Several protections that are included in Oregon’s law have been left out of the End of Life Choice Act and largely without Parliament debating them.
1. Euthanasia is riskier than self-administration
In Oregon a person has to self-administer the lethal dose.
The End of Life Choice Act would allow the lethal dose to be self-administered or administered by a doctor or nurse practitioner (also called ‘euthanasia’). When the overdose is administered by another person, there is a higher risk of abuse, pressure and wrongful death.
2. No counseling or screening for depression / mental illness
The End of Life Choice Act does not require terminally ill people to be screened for depression or mental illness. An eligible terminally ill person who wants to die because they suffer from depression or a mental illness would not be excluded.
Oregon’s law requires doctors to refer the person for counseling if any of them suspect the person may be suffering from depression or another psychological or psychiatric disorder causing impaired judgement (Section 3.03).
3. No independent witnesses required
An independent witness is someone other than the person or health professional and who does not stand to gain from the death.
The End of Life Choice Act requires no independent witnesses at any point in the process.
Parliament voted down without debate Simeon Brown’s amendment to require a witness when the overdose is administered.
In Oregon two independent people need to witness the signing of the request and confirm to the best of their knowledge that the person is not being pressured to do so (Section 2.02). However, since there are no independent witnesses required at the death, there’s no evidence to confirm whether a person self-administered the lethal dose without pressure.
4. No cooling-off period before the prescription is written
A cooling-off period after the first request helps to reduce the risk of someone making an impulsive decision.
Under the End of Life Choice Act a person could die by lethal dose as soon as three days after being diagnosed with a terminal illness. The diagnosis, request and prescription of the lethal dose could theoretically happen on the same day. The only required waiting period is 48 hours between the writing of the prescription and its administration, to allow the Registrar to receive the paperwork.
In Oregon there is a 15-day minimum waiting period between the person’s initial request and the writing of the prescription (Section 3.08). In 2019 Oregon’s law was changed to waive this waiting period if the person is likely to die within 15 days.
5. Only one request required
Oregon’s law requires a person to make three requests: a verbal request, a written request and a second verbal request at least 15 days after the initial one (Section 3.06).
Hon Maggie Barry proposed an amendment to require a second request at least one week after the first. It was voted down by Parliament without being debating.
6. Pressuring another person is not an offence
In Oregon it’s a punishable offence for any person to pressure another person to request a lethal dose.
7. No specialist knowledge required from doctors
Oregon’s law requires the second doctor to be qualified by specialty or experience relevant to the person’s disease (Section 1.01(5)).
In contrast, the End of Life Choice Act allows even provisionally registered doctors, fresh out of medical school, to assess a person’s eligibility, without having any experience or training in the field of medicine related to the person’s condition.
8. No mental competency when receiving the lethal dose
In Oregon a person needs to be competent to make an informed decision when assessed as eligible and also immediately before receiving the lethal dose (Sections 3.01 and 3.04).
9. Weak freedom of conscience rights protection
In Oregon no professional organisation or health care provider may discriminate against any person for participating or not participating under the Act (Section 4.01(2)).
The End of Life Choice Act offers no protection for doctors who are contractors, no protection for employees who are not healthcare professionals and no protection against discrimination from bodies such as the Medical Council or educational institutions.
MP Chris Penk’s amendment to provide freedom of conscience rights protection to any person was rejected by Parliament without debate.
10. No protection for organisations such as Hospices and rest homes
Oregon’s law allows organisations such as Hospices the freedom to decide whether or not they want to allow lethal doses to be administered on their premises and to develop policies accordingly (Section 4.01(5)).
The End of Life Choice Act does not protect the freedom of organisations to determine their own policies.
MP Hon Michael Woodhouse’s amendment to protect organisations was voted down by Parliament.
11. No need to live in New Zealand
The End of Life Choice Act would allow some death tourism because it does not require an eligible person to live in New Zealand.
Oregon’s law requires that eligible people are resident in Oregon (Section 3.10).