Euthanasia referendum: Four experts explain which way you should vote on the End of Life Choice Bill

Euthanasia isn't always an easy thing to discuss in New Zealand; it's taboo, it's polarising, and the likes of death and terminal illness have understandably never been popular topics of conversation.

But it's a discussion the country has been forced to have in recent times, as we mull over how we feel about making assisted dying legal ahead of this year's euthanasia referendum.

The vote, which will ask Kiwis if they support the End of Life Choice Bill becoming part of New Zealand's legislation, will be held alongside the general election and cannabis referendum on October 17.

The Bill will come into effect if more than 50 percent of those who take part in the referendum vote 'yes'.

To help you make your mind up, we've roped in four of the most passionate and educated experts on both sides of the debate to tell us which way they'll be voting, and why you should join them.

Have a read of what they said below.

Voting 'yes' in the euthanasia referendum

Dr Mary Panko - president of the End of Life Choice Society, an organisation that advocates for the legalisation assisted dying in NZ


Dr Mary Panko.
Dr Mary Panko. Photo credit: Supplied

We hold it to be unconscionably cruel to force unendurable suffering on the defenceless dying.  Unfortunately, as the law stands, this is not only possible but likely in certain circumstances.  

While we are strongly supportive of palliative care, we recognise that it cannot relieve all end-stage suffering.  Clinician data from Palliative Care Australia demonstrate that 5-6 percent of patients die suffering severely in their terminal phase. Annual reports from Oregon, where assisted dying has been legal for 22 years, show that 91 percent of those making a request for early death do so while in palliative care. Similar reports come from other countries. 

Nevertheless, in the many submissions made by New Zealanders to the Health and Justice select committees, thousands of people poured out their stories of the agonising deaths of loved ones, some even while receiving palliative care. They spoke of the fear that traumatised the dying - not knowing whether they would be forced to suffer unbearably, but being aware that their families would have to watch their agonies and listen to their screams. 

The Society supports the End of Life Choice Act 2019 as a safe, protective and necessary piece of legislation. In addition to meeting the medical and physical eligibility criteria, the patient must be mentally competent up to the last minute and entirely willing and uncoerced. The keyword here is 'choice' - not the doctors' nor the family's decision, but their own.

We reject the notion that this is a "life and death matter". Those who would be eligible under the Act are already close to death and suffering unbearably without the possibility of relief. It is a matter of a peaceful death versus a suffering death.  No more will die, but fewer will suffer. 

Our members will vote 'yes' at the referendum. We ask others who share our vision of compassion, choice and control to do so also. If you are unsure, leave the decision in the hands of those who need to have that choice. Please don't stand in their way.

David Seymour - Leader of the ACT Party and member who introduced the End of Life Choice Bill being voted on in the referendum

David Seymour in Parliament.
David Seymour in Parliament. Photo credit: Getty

Nobody wants to talk about painful death, but when the law doesn't work, we need to talk.

I hope you live a long life and die a painless death. But what about people who don't? What do we say to people who die badly?

Any one of us could face bad death. Terminally ill and unable to be helped by palliative care, impressive as it is. Should we be forced to suffer needlessly if it happens to us? The options we face in that situation are cruel.

In fact the Supreme Court of Canada called it a 'cruel choice'. The choices are violent amateur suicide, refusing food and water and treatment, informal euthanasia through too much morphine, or suffering to the bitter end.

We call ourselves modern and compassionate but still force people into that cruel choice. I believe it is morally right for adults who are competent, informed, and terminally ill to have another option. They should be able to choose assisted dying to relieve suffering under a safe law.

The End of Life Choice Act allows a safe choice enshrined in law. We know from other countries with similar laws internationally that these laws work and are safe. Some people will say anything to cast fear, uncertainty and doubt on that fact. Here is a simple fact that undercuts them.

The Netherlands have had assisted dying since 2001. Their law is much more liberal than what New Zealanders will vote on this year. What do the Dutch people think of it? After 15 years of the law in place, 88 percent supported it, 6 percent weren't sure and 7 percent opposed. It is difficult to imagine such high levels of support in a civilised democracy if the law was not safe.

New Zealanders express overwhelming support for the choice of assisted dying and this law because of their real life experiences. Too many of us have seen bad death.

The End of Life Choice Act will give choice and allow people to end their lives in peace and dignity, surrounded by loved ones.


Voting 'no' in the euthanasia referendum

Renée Joubert - executive officer of Euthanasia-Free NZ, a non-profit organisation that opposes the legalisation of euthanasia

Renee Joubert.
Renee Joubert. Photo credit: Twitter

Many of us have watched loved ones die. But we're not voting on whether people should suffer, or on whether assisted dying should be legal. We are voting on the specific details of the End of Life Choice Act. 

Unless we're absolutely certain that this Act would protect vulnerable Kiwis from wrongful deaths, we need to vote 'no'. It's too late to make changes to it. 

We are concerned that the End of Life Choice Act leaves out safeguards that are in US, Australian and Canadian assisted dying laws; this Act requires no cooling-off period, no independent witnesses to protect against abuse and no mental competency test when receiving euthanasia. 

An eligible 18-year-old could request a lethal dose and die as early as four days later, without telling their parents. They don't need to have physical pain or try treatment first. If they also have depression or a mental illness, they could still be eligible.

Only one doctor needs to "do their best" to check whether the person was pressured, and only by speaking to health professionals and family members approved by the person. But many Kiwis don't live with family, and relationship abuse can easily remain hidden.   

A review committee would assess whether this Act is working well, but without checking the forms completed before the deaths. It's also concerning that the committee would be allowed to assess the cases in which they were personally involved in. 

Polling found that most Kiwis think this Act is about choices that are already legal. This Act is not about turning off life support, do-not-resuscitate requests or stopping unwanted medical treatment.

It's also not for people in pain. It's already legal for a doctor to give a terminally ill person as much medication as needed to be pain-free, even if this may hasten death as a side effect.

Spokesperson for Care Alliance, a body of organisations that believes euthanasia is unsafe, unwise and unnecessary

Euthanasia referendum: Four experts explain which way you should vote on the End of Life Choice Bill

The referendum question for each voter is not about the idea of euthanasia, but about the robustness of this particular End of Life Choice Act. A group of more than 200 lawyers, some of whom support euthanasia, are opposed to the Act because it is badly drafted and dangerous. It's broader in its scope and riskier than similar laws overseas. 

It will expose many New Zealanders to the risk of a premature death at a time when they're most susceptible to pressure and coercion from either their own feelings of being a burden, or from uncaring relatives. People with disabilities, mental illness or depression are not excluded if they have a terminal illness and will be particularly vulnerable to the suggestion they would be 'better off dead'.

Medical professionals are overwhelmingly opposed and have stated that pressure/coercion will be virtually impossible to detect. A caring society has a duty to protect these people. 

There are significant dangers associated with introducing euthanasia in the current social context: a healthcare system under pressure, high and climbing rates of elder abuse and unequal access to palliative care. Overseas, people have chosen an assisted death when they don't really want it because of a lack of other care choices. 

The Act is deficient because it’s not just for the exceptionally hard cases; it doesn't require that a person first use available treatments or palliative care. Neither does it require a person to talk about their decision with a trusted family member or friend. There is no mandatory cooling-off period as in other countries - a person could be dead less than four days after diagnosis. 

Recent advances in palliative care make it highly effective in dealing with extreme pain and other suffering. Euthanasia is old 'technology' and unnecessary.

Vote no - it's just too risky for too many.