End of Life Choice Act: Only one doctor needs to check for pressure

 

Voters in Referendum 2020 need to be aware that the End of Life Choice Act has weak safeguards against pressure and coercion.

David Seymour incorrectly stated that the second doctor in the process also needs to check whether the person is pressured (coerced).

During the debate on Part 2 of the End of Life Choice Bill Mr Seymour stated (in his last speech par. 1):

“I thought I should try to address some of the concerns raised by members as quickly as I can. First of all, starting with Alfred Ngaro asking: does the second doctor have to be sure that the person is not coerced? Well, yes they do, because as I was at pains to stress in my opening contribution to this debate, they have to make sure that the person at all times is a person eligible for assisted dying. That means a person who has decided, in their view—no one else’s, in their view—that this is the best way to alleviate their suffering. So the answer to that question is: yes.” (emphasis added)

David Seymour’s claim was incorrect.

 

Only the attending medical practitioner needs to check for pressure 

 

The independent medical practitioner (second doctor in the process) is not required to stop the process if pressure is suspected. Only the attending medical practitioner (first doctor in the process) and nurse practitioner need to do so. [s 24B].

The independent medical practitioner only needs to assess whether the person is eligible [s 14]. The Interpretation section [s 4] states that, “eligible person has the meaning given in section 5”.  Section 5 does not mention coercion or pressure at all.

Section 5 does require that the person “experiences unbearable suffering that cannot be relieved in a manner that the person considers tolerable”, but there is no requirement for a doctor to ascertain that the person has come to this view independently and free from pressure.

By the time a person expresses their decision, they may claim it as their own, but they may have come to that decision as a result of pressure that had occurred some time ago. A skilled manipulator could make a victim believe that a decision was their own when it fact it wasn’t.

According to Section 11, the attending medical practitioner only needs to:

do their best to ensure that the person expresses their wish free from pressure from any other person by—

  • conferring with other health practitioners who are in regular contact with the person; and
  • conferring with members of the person’s family approved by the person; ….” [s 11(2)(h)]

 

“Do their best” is subjective, unmeasureable and therefore unenforceable.

Again, the person may claim the decision as their own, when in fact they have been influenced by pressure that had occurred earlier. Pressure can be exerted in subtle ways and behind closed doors. Elder abuse and relationship abuse often remain unreported.

How is a doctor, who may not have met the person before, who does not need to speak to the person face-to-face, and who may be blocked from speaking to key family members, supposed to “ensure a person expresses their wish free from pressure” that had already occurred?