New Zealand’s recently introduced laws on medically assisted dying, complete with rigorous safeguards, could prove a useful template for Irish legislators examining the issue, a medical doctor has told a public meeting on the issue.
Retired Cork GP Dr Sinead Duggan said The End of Life Choice Act (2019) which became law in New Zealand in November 2021 provided the sort of legislative safeguards which she believed were necessary.
“New Zealand’s legislation is very rigorous – you have to have capacity [to make the choice]. You have to have inevitable death within a short period of time. You can’t approach the patient about it, the patient has to bring up the subject with their doctor – there are a lot of very strict criteria.
“They get a psychiatrist to see if there are mental health issues involved. The numbers availing of it are very small and they have set up a group to look at reviewing the legislation in three years and again in five years. I am interested in how it goes there, and I think we could learn a lot from them.”
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The End of Life Choice Act was passed in the New Zealand parliament on the condition that a public referendum would be held on whether it came into force. On November 6th, 2020, the referendum results were released with people favouring the legislation by a near two-to-one margin.
Among the legislative requirements to avail of the service, the person must be aged 18 years or over, must suffer from a terminal illness that is likely to end their life within six months, must be in an advanced state of irreversible physical decline and must experience unbearable suffering.
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Speaking at a recent public meeting in Cork organised by the advocacy group, End of Life Ireland, Dr Cotter, a member of Irish Doctors Supporting Medical Assistance in Dying, acknowledged that the medical community was divided, with some doctors strongly opposed to the practice.
“It is a very polarising subject but from my 32 years in general practice here in Cork, I have had quite a lot of patients that I’ve seen suffer unnecessarily and they ask me specifically ‘Is there some way out of this? Can you help me in some way? I’m frightened about what’s ahead’,” she said.
Assisted dying advocate Tom Curran was the partner of the late Marie Fleming, a 59-year-old terminally ill woman then living with multiple sclerosis, who challenged the law criminalising assisted suicide but lost her case in 2013. He told how he had helped campaign for the new legislation in New Zealand.
Mr Curran said that while he agreed with many of the provisions in the New Zealand legislation, he did not agree with the provision that a terminally ill person must be within six months of death as it isn’t always possible to predict their life expectancy.
“Even in Marie’s case, to take the case to court, we had to get a statement from a neurologist that she had MS and gave some idea of her life expectancy.
“Marie died within 14 months but all he could say was it could be two weeks, two months, two years, 20 years because with a neurological disease, it is impossible to tell.”
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Speaking from the floor at the meeting, a retired consultant said he was opposed to introducing medical assistance in dying as he believed it would open “a Pandora’s Box”. He pointed out that palliative care specialists, who are experienced in dealing with terminally ill people, were opposed to the move.
“Palliative care is wonderful but it’s not for everybody and it doesn’t always work for everybody and it’s not what every patient wants,” said Dr Cotter. “This is all about choice – it might be only three patients a year who opt for medically assisted dying but for those three, it’s important the legislation is in place.”
The Oireachtas Special Committee on Assisted Dying, which was set up in the wake of the Oireachtas Justice Committee examining a Dying with Dignity Bill put forward in 2020 by Dublin People Before Profit TD Gino Kenny, is due to begin hearing public submissions on the issue on June 13th.
Meanwhile End of Life Ireland, together with Irish Doctors supporting Medical Assistance in Dying, are organising a series of public meetings on the issue over the coming weeks. including in Waterford on June 14th and Galway on June 21st.
