Unitarians and New Zealand’s Choice to Die

Sunday Talks / Random Musings
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Speaker:- Mary Panko
Worship Leader:- Barbara Thomborson

Unitarians and New Zealand’s Choice to Die
Listen, or download the MP3

Mary Panko, immediate past president of New Zealand’s End-of-Life Choice Society, is guest speaker on the End-of-Life Choice Act and its upcoming Parliamentary review.

Barbara Thomborson, service leader, will share Unitarian Universalist background on this controversial topic. This service is a call to action.

Follow this link to download information on how to make a submission to the End-of-Life Choice Act review, closing date 26 September 2024.

Mary’s slides to accompany this talk.

The End of Life Choice Act 2019 The first two years
Legal Background To be eligible, a person needs to be ALL of the following: 18 years or older, AND A citizen or permanent resident of NZ, AND Suffering from a terminal illness that is likely to end the person’s life within six months, AND In an advanced state of irreversible decline in physical capability, AND Experiencing unbearable suffering that cannot be relieved in a manner that the person considers tolerable, AND Competent to make an informed decision about assisted dying.
MoH data In the first two plus years since the Act came into force, 1,870 people have applied for assisted dying, out of which 775 people had an assisted death. All other people either died while applying, changed their minds or did not meet the eligibility criteria. This means that fewer than 1% of deaths in New Zealand were medically assisted.
The Doctors’ legal constraint Under the current End of Life Choice Act, 2019, no doctor is permitted to mention the option of Assisted Dying to any patient. The patient is the only person who may raise the issue of Assisted Dying. However, patients are required to be fully informed about all other avenues of treatment as part of their informed consent to treatment.
People who requested Assisted Dying Approximately 90% of people who applied for assisted dying were European/Pākehā and 5.5% were Māori. Just over 55% were female, 75.8% were 65 years or older, 77% were receiving palliative care at the time of the application. The majority – 67.9% – were diagnosed with cancer.
People found ineligible during year 1: The applicant is Not a New Zealand Citizen/Permanent resident, 5 Ineligible at 1st assessment, 0 Ineligible at 2nd assessment. The applicant is Not aged 18 or over, 0 Ineligible at 1st assessment, 0 Ineligible at 2nd assessment. The applicant is Not experiencing unbearable suffering in a manner that the person considers tolerable, 42 Ineligible at 1st assessment, 11 Ineligible at 2nd assessment. The applicant is Not in an advanced state of irreversible physical decline, 40 Ineligible at 1st assessment, 11 Ineligible at 2nd assessment. The applicant is Not suffering from a terminal illness that is likely to end their life within 6 months, 67 Ineligible at 1st assessment, 13 Ineligible at 2nd assessment.
What are some of the difficulties with the current Act? 1. The Gagging Clause Allow medical practitioners to raise the topic of assisted dying with end-of-life patients or with patients experiencing unbearable suffering that cannot otherwise be relieved, provided they explain the full range of other end-of-life options at the same time.
And … The 6 month Rule Extend eligibility clause from 6 months to 12 months. And, Allow non-terminal patients whose severe and irreversibly progressive medical condition causes them to experience ongoing, increasingly unbearable suffering and decline in physical capability to access assisted dying. This particularly relates to neurological disorders.
To date, the MoH state that there have been: No breaches of the law, No evidence of coercion or abuse, No evidence of “vulnerable” groups featuring prominently in the assisted dying statistics. 
Currently Parliament is reviewing the 2019 Act. Your input can make a real difference. Thank you.

From Barbara Thomborson:-

On July 1, 1988, at the Unitarian Universalist Assn’s annual general meeting, they adopted the following resolution:-

UUA Resolution on End-of-Life Choice. BE IT FINALLY RESOLVED: That Unitarian Universalists, acting through their congregations, … inform and petition legislators to support legislation that will create legal protection for the right to die with dignity, in accordance with one’s own choice.

How farsighted were those UUs to make this resolution 36 years ago!

Never mind that New Zealand is 33 years behind the UUA Resolution. in 2021, our End-of-Life Choice Act came into effect and is up for review at the end of this year. Mary gave you details about the Act. Now let’s consider the Unitarian values behind supporting the choice for medically assisted death. They’re in our first four principles:

Unitarian Universalist Principles:- Principle 1. inherent worth and dignity of every person; Principle 2. justice, equity, and compassion in human relations; Principle 3. acceptance of one another and encouragement to spiritual growth in our congregations; Principle 4. a free and responsible search for truth and meaning.

The word dignity in our first Principle relates to one term for self-euthanasia – death with dignity. My previous neighbour has been in the dementia ward at a retirement village for almost 3 years. After about 6 months of being there, he told his wife that he wanted to die then. He knew what was coming and dreaded it. Currently, because his brain can no longer send messages to his muscles, he cannot sit up, so is strapped up in a chair for most of the day. His flaccid muscles make it impossible for someone to carry him, so he’s taken to the shower by a machine like a small crane – it’s quite a production. He has worn a catheter for over two years and because of it, has had multiple urinary tract infections. He can open his mouth for someone to feed him and for drinking from a straw. He drools, and his nose runs most of the day. Where is the dignity in such an existence?

Principles 3 and 4 relate to spiritual and meaningful aspects in contemplating death, especially one’s own death. Principle 3 asks us to encourage spiritual growth in our congregation. I’ve read stories describing the thoughts and events of some who chose when and how to end their life. It was a spiritual experience in understanding their spiritual relationship to life through contemplating their suffering and death. Principle 4 has a related philosophical dimension. The experience of searching for the truth and meaning in contemplating their death brought them to seeing a broader truth to “death in life” and a new understanding of life’s meaning.

Our Principle 2 has the word ‘compassion’, which I think is the most relevant reason for expanding our End-of-Life Choice Act. 10 years ago, I knew a man who threw himself off a six-storey building because of suffering for many years from unbearable back pain. Elderly in failing health and abilities sometimes resort to voluntary stopping eating and drinking (VSED). I live in a retirement village and have met people, all in their late 80’s or 90’s, who wish their lives were over, yesterday. Some had tears just speaking about their agony; their anguish was palpable. One spoke of her despair at waking every morning and ruing that she was still alive.

If your pet had dementia or an extremely low quality of life, would you prolong their suffering by refusing euthanasia? At least that is legal for other animals who can’t tell us when they want it. As Unitarians, we have the chance to act on our principle of compassion in human relations by asking our government to expand the criteria for choosing medically assisted death. Information on making a submission is on the paper on your seat. Please act with your heart and make a submission on the review of the End-of-Life Choice Act. You never know from those you know who might benefit and thank you for your compassion.

Meditation / Conversation starter

  • Has today’s service changed your view on end-of-life choice? What is it now?
  • Will you make a submission to the Ministry of Health on End-of-Life Choice Act review? What would you put in it?