Unaccountable Euthanasia Managerialism Slithers into New Zealand

Earlier this week the New Zealand Ministry of Health quietly released its first ever review of its euthanasia and assisted suicide regimen.

Such reviews are required by law, initially at the three year mark, and then every five years after that (because it’s not like anything serious could go wrong in just five years with the practice of purposefully administering lethal doses to patients, right?)

Aside from the glaring lack of accountability in a bureaucracy reviewing its own performances and practices on a matter as serious as the deliberate state sanctioned ending of patient lives, this report signals that the managerial classes are now the ones calling the shots.

There was a public submissions process involved in this first review (although it’s not certain if the voice of the New Zealand people will be welcome at future reviews), but the Ministry of health makes it clear that this was little more than window dressing:

“The views expressed [via the public submissions process]… were not considered by the Ministry as part of its review of the operation of the Act, as this was run as a parallel and separate process with a different purpose.”

I suspect the ‘different purpose’ they speak of was to create the appearance of listening to the public, or maybe allowing pro euthanasia activists yet another public forum (aside from that of the uncritical mainstream media) to make emotive demands for further expansion of euthanasia in New Zealand.

I don’t mean to sound cynical, but once you’re aware of the way that managerialism works its dark magic, you quickly learn to recognise their modus operandi.

They effectively give the game away on page seven of their summary document of public submissions (released alongside the three year review report):

“…the [public online submissions] portal provided an avenue for people to share points of view, or argument in support of their points…”

One rather notable oddity here is that at least one of these public portal submissions “not considered by the Ministry as part of its review of the operation of the Act”, not only appears almost verbatim in the offical report, but as an offical suggestion to Parliament no less.

That submission is this one, from the New Zealand Law Society, as reported by the Ministry of Health on page 13 of their Summary of Online Submissions Received on the End of Life Choice Act 2019:

“The Law Society recommended that section 5(1)(c) be amended to define ‘terminal illness’:

“Any such definition should also consider the reasonable availability of any such treatments for the patient, noting that while some treatments may technically exist, there can be practical funding or other availability limitations, meaning that all treatments are not reasonably available to the patient.”

This proposal made its way, almost verbatim, into the review report, on page 128, where it was effectively elevated to the level of an officially recommend possible change:

“Parliament may wish to consider amending section 5(1)(c) of the Act to define ‘terminal illness’. As in the example above, any definition should consider the reasonable availability of treatments for the person, noting that while some treatments may technically exist, there can be practical, funding, or other availability limitations that mean that not all possible treatments will necessarily be reasonably available to, or acceptable to, a person.”

I guess some submissions made via the public submissions portal were less ‘not considered by the Ministry’ than others were.

Like I said, the managerial bureaucrats are now running this show, and whatever they say goes.

Oh, and lest anyone is tempted to think that what is being proposed here is a major improvement of the legislation, just have another read of that suggestion and what it is actually saying. Most notably the point about the lack of available treatment options (very convenient for a government not willing to fund all options), or the point about available treatments not being acceptable to a patient.

David Seymour, author of the flawed euthanasia and assisted suicide law

Any rational person of goodwill, can see glaring problems contained within the pages of this report, where some of the most important issues are not even given the proper attention they warrant.

Right at the very start of the report, on page six, the Ministry of Health boldly asserts that the act legalising and governing the practice of euthanasia and assisted suicide:

“has largely been operating well, and has achieved its primary purpose of giving people with a terminal illness who meet certain criteria the option to request and receive medical assistance to end their lives.”

But then this very same report also goes on to highlight concerning aspects of the current euthanasia and assisted suicide act that were serious enough to have prompted the Ministry of Health to recommend possible changes.

For example, this piece of legislation, which is supposedly operating well, does not actually appear to make it a criminal offence to deliberately pressure a vulnerable person into euthanasia or assisted suicide.

So, 122 pages after declaring that the euthanasia and assisted suicide law has been working well, this exact same Ministry of Health report suggests to Parliament that changes might be needed:

“Under section 179 of the Crimes Act 1961, it is a criminal offence to incite, counsel, or procure a person to commit suicide, or to aid or abet any person in the commission of a suicide. A similar provision could be considered in relation to assisted dying, to address situations where a person induces or tries to induce another person to seek an assisted death.”

This is hardly a trifling issue, and this serious deficiency in the act points to a piece of legislation that - just as a group of lawyers and Kings Councils tried to warn before it was passed - is actually dangerously flawed.

This isn’t the only problem though.

The final pages of the report provide a comparison table contrasting the safeguards present in New Zealand versus other overseas jurisdictions where euthanasia and/or assisted suicide is legal.

What this table exposes is that, unlike most other jurisdictions who have legalised the practice of ending patient lives with lethal substances, the current New Zealand law lacks the following safeguards:

1. It is NOT a criminal offence in New Zealand to induce a person through dishonesty or undue influence to request euthanasia or assisted suicide.

2. It is NOT a criminal offence in New Zealand for an unauthorised person to administer the lethal substance that kills the patient.

3. It is NOT a criminal offence is New Zealand to fail to report on a euthanasia or assisted suicide.

4. New Zealand does NOT require review by tribunal of specific criteria that would make a person eligible/ineligible for euthanasia or assisted suicide (e.g. lack of coercion, decision making capacity, or residency).

5. It is NOT a legal requirement in New Zealand for the administration of the lethal substance which kills the patient to be witnessed.

6. It is currently NOT a legal requirement for euthanasia/assisted suicide assessors to complete mandatory training before assessing people who request euthanasia or assisted suicide.

7. It is NOT a legal requirement in New Zealand for two people to witness the written request for euthanasia or assisted suicide.

8. There is NO mandatory cooling off period between the first and final request for euthanasia or assisted suicide in New Zealand.

On that last missing safeguard, the Ministry of Health considered this flaw in our current law, but explicitly rejects its implementation in this report, stating that:

“On balance, it was considered that a cool-down period should not be introduced in New Zealand. While safety might be marginally improved by such a requirement, it would create an additional barrier to access, particularly for those who are in a state of rapid decline or who may face other delays for any reason during the assessment process. To some extent, the request and assessment process under the Act naturally creates a cool-down period, over which a person can consider (and must sustain) their decision.”

Not only does this represent an astoundingly caviler failure to prioritise patient safety, but it is also patently untrue.

The point of a mandatory cooling off period is to ensure that there is a sustained period where the patient is not on the administrative conveyor belt leading toward euthanasia in order to aid sound judgement before they end their life.

In other words, and contrary to what the Ministry of Health claims in its report, there is no cooling off period for a person if they are still proactively taking the administrative steps towards having their life ended. Their entire focus is on achieving the act, rather than contemplating its ramifications freed from the momentum propelling them toward that outcome.

This same disregard for patient safety is also exposed by the fact that the report makes no attempt to address, or propose remedies, for the glaring absence of most of the other safeguards listed above.

We also see this same lack of prioritising patient safety in the report’s suggestion that the law should be loosened to allow the third assessment (to determine psychiatric competence) to be provided by a practitioner who is NOT a psychiatrist (as the law currently requires).

On another occasion, the Ministry of Health shows a troubling lack of sensitivity to patient safety, and the seriousness of these matters, when, on page 137 it blithely states:

“One person commented that they thought their loved one’s decision had been influenced by family members:

“My ma would have said she’d go ahead with it. My sister talked to her about it, and my ma is the kind of person who liked to please us all. I just think there was something not quite right there. People in that generation just want to please people, they don’t want to make a fuss.”

What has been relayed by the Ministry of Health here, is that the son or daughter of a euthanised person has told them that they suspect their mother may have been killed after being coerced into it by vulnerability or the undue influence of the family.

This may or may not be true, but surely something this serious warrants more than just a passing reference, with no further recommendations, or even any expression of concern about such a possibility by the very agency tasked with carrying out these acts of state sanctioned euthanasia and assisted suicide.

Meanwhile, the report also proposes that the current conscience protections of New Zealand medical professionals and care facilities should be weakened, in order to compel their cooperation so as to prioritise ease of access to euthanasia and assisted suicide.

This is typical of managerial bureaucracy - process and expediency are prioritised ahead of the far more important factor of moral considerations.

They have also signalled to the government that more euthanasia and assisted suicide agents are needed, including a proposal that the law be expanded to allow nurse practitioners to facilitate these deliberate patient deaths.

In other words, as far as the managerial bureaucrats at the Ministry of Health are concerned, easier access to euthanasia, and more of it, is of a higher priority than safeguards against wrongful killing or freedom of conscience rights.

Once again we are provided with a stark object lesson in the fundamental deceit of liberalism - it forces its will upon the entire community while claiming that it is acting solely to secure the end of personal autonomy at an individual level.

What makes this all the more troubling is that there doesn’t seem to be anywhere near the same concern from the Ministry of Health for prioritising solutions to the glaring palliative (end of life) care deficiencies in our country.

The fact that 1 in 4 euthanasia or assisted suicide requests are now being made by people who are not even receiving palliative care at the time of making the request should be raising serious red flags at the Ministry of Health.

Or perhaps the lack of concern for our vulnerable elderly is not so unintentional?

Unlike palliative care, euthanasia and assisted suicide are lethally efficient cost saving devices for a NZ bureaucratic managerial state that is now starring down the barrel of massively increasing healthcare costs from a disproportionally ageing population and a lack of younger taxpayers.

Irregardless, the simple truth is that this report should should not have been conducted by the Ministry of Health, and most certainly not while the very architect of a clearly deficient piece of legislation which empowers state officials to deliberately end human lives is currently the Associate Minister of Health.

Oh, and one last point, I have to say that nothing inspires greater confidence in the state than seeing one of its official reports recommending (on page 122) that the government should (emphasis added):

“Set out in the Act specific immunities for the [Euthanasia/Assisted Suicide] Registrar and the [Euthanasia/Assisted Suicide] Review Committee. The Act would also specify that judicial review is available as an accountability pathway.

This change would clarify the immunity protections for the Registrar and the Review Committee. This could be set out in a way that is tailored to the roles of the Registrar and Review Committee. Such a provision would enable these statutory bodies to operate more effectively, with clear accountability and without undue legal risk attached to their roles.

…This recommendation is aligned with immunity approaches in other New Zealand legislation…”

It’s almost like they don’t understand the seriousness of what they are charged with overseeing, and why the gravity of these affairs might actually necessitate extra accountability measures that are not required in other sectors where the raison d'etre is to heal or provide comfort to a patient rather than to deliberately end their life with lethal substances.

What happens next will be key.

This report contains a list of recommended legislative changes to our current euthanasia law, many of which will loosen and expand the current practice, and none of which have come from the floor of parliament.

Will a group of unelected managerial bureaucrats get their way because a dangerously compliant Parliament simply rubber stamps their proposals for euthanasia expansion without carefully considered scrutiny or pushback?

Or will a parliamentary champion for the vulnerable arise to challenge the managerial euthanasia juggernaut that has now clearly taken hold of this country?

Buckle up folks, and look after your loved ones, because the one thing that this report makes painfully clear is that New Zealand is now well and truly on the pathway to the same diabolical dystopian euthanasia outcomes we are witnessing in places like Canada.