Ian McIntosh, the Co-General Editor of Elder Law in New Zealand, has published an article arguing that the Bill fails to adequately protect victims of the pervasive and notoriously difficult-to-detect problem of elder abuse, who might be coerced into requesting assisted dying.
Around 10 per cent of elderly New Zealanders have suffered some form of abuse, and close family members are the most common elder abuse perpetrators: 79 per cent of abusers of the elderly are their family members; their children are the most common category of abuser (48 per cent).
“When inheritance comes into play, the risk of coercion of older people is greatly elevated,” says McIntosh. “Unscrupulous family members may be motivated by the prospect of inheriting property, getting their hands on the estate sooner or preventing its value from being eroded by the cost of rest home care or treatment.”
McIntosh explains that the due diligence provisions in the Bill do not provide adequate protection against coercion. “The due diligence process in the Bill is not fit for purpose,” he writes. “It depends on a flawed process that is open to abuse by family and others. A doctor assessing an elderly patient’s request for assisted dying will not necessarily know much about their circumstances, or whether abuse is actually driving their request. A victim of elder abuse, may well be so afraid of their abuser that they would be unable to voluntarily advise the doctor that they are being coerced.”
“The Bill is not fit for purpose,” he concludes.
However, advocates for the legislation argue that by allowing people to suffer is its own form of abuse.
At Health Central’s ChalkTalks discussion, retired ICU specialist Dr Jack Havill argued that the current practice of “slow euthanasia” is not acceptable and leads to “bad deaths”, something no one wants for themselves or their loved ones.
“I think one day we’re going to look back and think ‘why did we let so many people suffer?’,” said Havill.
This view is shared by Ann David.
“Even with the best of palliative care, some end-stage patients suffer severely,” she points out in Health Central.
David quotes Clive Deverall, former president of Palliative Care Western Australia who campaigned tirelessly for assisted dying legalisation before his death. Deverall maintained that palliative care was not the answer for between 4 and 8 percent of patients, those “very end stage patients where symptoms cannot be controlled”. He felt that patients in that distressed state should be offered euthanasia.
Yet, Richard McLeod, a spokesperson for Lawyers for Vulnerable New Zealanders, warns that the Bill presents significant risks to elderly New Zealanders, who will comprise by far the largest group of those finding themselves eligible to be euthanized or helped to commit suicide under its provisions.
“In the few jurisdictions where euthanasia or assisted suicide is legal, it’s the elderly who bear the brunt of these laws: reports show that between 78 and 83 per cent of those who were euthanised or assisted in their suicides in the Netherlands, Oregon and Belgium in recent years have been aged over 60 years”, McLeod says.