The best way through to the end of life

Conscience and consultation are good paths through the mire of emotional and controversial policies such as euthanasia. But referedums are key to ensuring voters are heard

The End of Life bill has been read a second time and is now heading for the House for further debate. Personally, I support the proposal. I don't ever epect to take advantage of the Bill's provisions myself, but as I see this is it my life – inasmuch as it is possible, how I end it should be my decision and mine alone. 

An end of life experience is something we all face sooner or later. And it can be tough and horrible. Willie Jackson made an interesting comment about his mother. My generation of politicians well remember June Jackson – she was a tireless, feisty, uncompromising and strong advocate for her people. From Willie’s account she would be horrified if she saw herself now.

I can understand what he means. Quality as well as quantity is important. My dad had an end that stopped him after a relatively short period of increasingly serious illness, fortunately before he was too racked with pain. He still ‘had his marbles’ as they say, but he could feel his quality of life ebbing away.

If he could talk to us now he would say he was glad he didn’t hang around when his quality of life had gone. He was a southern American, spoke with a drawl and had lots of pithy statements – he always said he wanted to “wear out not rust out”. That is a good guiding principle. 

One frequently raised concern during the debate was elder abuse.

A number of MPs cited the fear that subsequent generations would feel empowered by the new law to push their seniors into killing themselves off to avoid the cost or the hassle of caring for their demands. Some disability advocates feel apprehensive and uneasy about the potential impact on those with physical or intellectual disabilities. Any such pressure and abuse should be utterly unacceptable. Protections to stop that happening should be included.

A number argued that palliative care can manage pain. My own family experience demonstrates the limitation of available pain management – it cannot manage all pain. Neither can palliative care manage many of the other horrible symptoms of the final stages of terminal illnesses. It can help, but only to a certain extent.

I found myself unable to agree with Nick Smith’s argument that the Bill was out of step with a core part of Kiwi culture – respect for human life. On the contrary I think that is what it is all about. One may not agree with the proposals in the Bill, but the motivation of people like Lucretia Seales is not to show any lack of respect for humanity but, as she put it, to die (which she knew was happening) on her own terms. 

During the debate Mark Mitchell explained the consultation process he had delivered to ascertain his constituency voters opinions. He had organised well attended public meetings and a poll. Good on him for taking the initiative.

That bouquet noted, the numbers in the poll (about 1300), while significant, were still only a small proportion of the total voter numbers in that electorate. Public meetings tend to attract the activist element. There are many voters – the great bulk in fact – who don’t attend such meetings. They too have a valid opinion.

“Conscience issues” are always difficult for MPs. A number of MPs made that point. But they are difficult, maybe more difficult, for voters too.

A dedicated supporter of End-of-Life Choice in the electorate of an MP with a well known view – North Shore for example – is going to have to end up having no choice but to vote for one of the strongest opponents of this reform if they prefer National (as a large majority do in that electorate).

Our system is party-based. Voters choose their MP generally by their party preference – not their conscience choice.

The dilemma is how in a democracy we deal with the problem of reflecting the people’s opinion on the range of issues parties as a matter of principle do not take a stand on. New Zealand First has the correct answer – refer those decisions to a public referendum. They are a good solution to the question of conscience votes. Then the whole population will determine the questions parties by their nature cannot.