Frequently asked questions about voluntary euthanasia and assisted suicide
1. Can New Zealanders ask a doctor to relieve their suffering before death?
Yes. Palliative care (hospice) is all about relieving suffering in the lead up to death. In New Zealand we have the tools to ensure that everyone can die comfortably, peacefully, with dignity and with their pain controlled. In the rare cases where pain medication is not enough, a person can also be sedated in order to make them comfortable.
2. Is there an ethical difference between switching off life support, withdrawing futile treatment and voluntary euthanasia?
Yes. When life support is switched off or treatment is stopped, the person dies from their illness, from natural causes. When euthanasia is performed, a person dies from a lethal injection deliberately given to cause death. So to legalise voluntary euthanasia means making it legal for a doctor to intentionally kill a patient – A shift in medical ethics that has been established for thousands of years. Read Dr David Richmond’s article here.
3. What is meant by the term ‘euthanasia’?
The word is a derivative of two Greek words meaning ‘a good death.’ In recent times it has come to mean the deliberate killing of people – usually, but not always seriously ill or disabled – who are judged, either by themselves or others, to have such a poor quality of life, that they would be better off dead. In the countries where voluntary euthanasia has been decriminalised (The Netherlands, Belgium and Luxembourg) the killings are supposed to be performed by medical practitioners but sometimes they are done by nurses. In New Zealand, all the cases brought to public attention in recent times have been at the hand of relatives.
4. What is physician-assisted suicide (PAS)?
This is the term used for the situation where a medical doctor prescribes lethal drugs for a patient who desires to commit suicide but doesn’t want to, or is unable to, end their own life without assistance. In the States of Oregon and Washington in the USA where physician-assisted suicide is legal, the patient is expected to self-administer the drugs. In practice, the person sometimes do so with help from relatives or from members of the local pro-assisted suicide lobby group.
5. Isn’t euthanasia already occurring in New Zealand hospitals?
Many people are confused about what is and what is not euthanasia. They have been led to think by backers of voluntary euthanasia, that patients who die whilst taking large doses of morphine or similar pain relieving drugs have been euthanased. Voluntary and involuntary euthanasia are illegal in New Zealand. Very large doses of morphine and similar drugs may be used in the course of palliative care but when this is necessary for the control of symptoms, the doses are gradually increased until control is achieved. Under such circumstances, people can tolerate very large doses of drugs such as morphine which, if administered to people whose systems had not been able to adjust by incremental dose increases might well die under the influence. Those administering lethal drugs to achieve euthanasia inject extremely large doses, but even then, the drug by itself may not cause immediate death; so where it is legal, it has become the practice to also administer a second drug to stop breathing.
6. What is meant by the principle of ‘Double Effect’?
This is a term used to differentiate morally between the ethical intentions of those who administer drugs for the purpose of relieving symptoms and those who administer them with the intention of killing the patient. What it states is that if drugs are administered with the intention of relieving symptoms and the patient should happen to die (‘double effect’) during this procedure, no ethical guilt attaches to the procedure because it was not done with the intent of causing death. In contrast, it is not ethically acceptable (or, in New Zealand legally acceptable) for any person to administer drugs with the primary intention of killing the recipient.
7. What is the difference between ‘mercy killing’ and euthanasia?
‘Mercy killing’ is a euphemism for euthanasia. It implies that there are situations in which killing a person is a merciful act which ought not therefore lead to any legal repercussions for the perpetrators. Whilst suicide is not a felony under New Zealand law, assisting a person to commit suicide currently is. In practice, where people accused of euthanasia have plead ‘mercy killing’, the New Zealand Courts have been quite lenient in their sentencing.
8. Should a person have the right to request voluntary euthanasia if their life is unbearable?
Everyone has the right to request voluntary euthanasia. But society has the right to deny such a request on several grounds. They include: granting it for any individual will make it impossible to deny it for an increasing flood of applicants whose concept of what makes life unbearable becomes increasingly a social (loneliness, boredom) rather than a medical construct; that the argument will be put that allowing it only for people who are capable of requesting it is discriminating against those who cannot so that decisions may be taken on behalf of confused / dementing /non-communicative adults and very young children without their consent; that it compromises the very basis of attempts to reduce the current epidemic of suicide by providing a legally sanctioned way of committing suicide at the hands of the medical profession; that people with disabilities or who are growing older in years will be pressured overtly or covertly to seek it because they are made to feel a burden to society and / or their families; that certain potentially treatable conditions (e.g. depression)that affect a person’s reasoning will increasingly be accepted as a ground for requesting euthanasia and that economic factors will increasingly determine who is euthanased and who not. None of the above is fanciful: all are trends noted in countries such as The Netherlands and Belgium where voluntary euthanasia has been decriminalised.
9. Surely people should be able to control their own destinies and decide when and how they should die? Isn’t it a private matter?
It is a self-evident myth that people are able to have control of their lives and destinies. Changing fortune has a habit of arriving ‘out of the blue.’ Personal autonomy is not an absolute right: for the sake of harmony in society everyone has to modify their behaviour and personal desires. As noted in the answer to question 6, what might be thought desirable for a tiny minority of people has the potential to put the lives of hundreds of thousands of others at risk. And voluntary euthanasia is no private matter: it is a public one in that at least two other people are involved in the process of vetting the patient, prescribing the lethal dose and administering it.
10. Pro-euthanasia advocates recommend voluntary euthanasia as the way to ensure one dies with dignity. What’s wrong with that?
Dying with dignity has little to do with whether it is a natural death or one precipitated by voluntary euthanasia. Advocates of voluntary euthanasia are often heard declaiming that: “I wouldn’t let my cat suffer like that” the inference being that just as they would have the cat ‘put down,’ so sick humans should be similarly treated. Treating humans like animals hardly seems dignified. Moreover overseas experience shows that up to one in three recipients of voluntary euthanasia suffers some unintended side-effect such as fits, vomiting or waking up again out of a drug-induced coma. So voluntary euthanasia does not guarantee a hassle-free death.
Dignity is a combination of one’s own attitudes and behaviour towards others and the situation in which one finds oneself, and the respect for the person that these engender. Disturbances of bodily function such as vomiting and incontinence at the very end of life do not detract from the individual’s dignity. Indeed, the way a dying person handles such issues can be totally inspiring. In any case modern therapy properly applied is capable of preventing the vast majority of such symptoms. The attempts by pro-euthanasia advocates to paint every death as carrying a high probability of loss of dignity are self-serving and totally without merit.