Fear, Uncertainty and Doubt: David Seymour and the Experts
I recently attended a Health Central debate in Wellington on the End of Life Choice Bill (full debate online). Among the panellists were David Seymour and a visiting Canadian doctor, Dr Leonie Herx. Dr Herx, President of the Canadian Society of Palliative Care Physicians, had come out to New Zealand to describe her experiences with the Canadian euthanasia legislation that was passed two years ago. And, frankly, to warn us off doing the same thing.
Dr Herx detailed serious concerns about her ‘on the ground’ experience of euthanasia. These issues include failed/ignored safeguards (similar to those in the NZ Bill), limited data collection, coercion of doctors and institutions, expanding eligibility, and the use of palliative care funding to facilitate euthanasia.
Mr Seymour’s routine response to overseas documented failures has been to brush them off as ‘fear-mongering’, and the ‘spreading of lies and misinformation’, or ‘fear, uncertainty, and doubt’. It’s patronising and dismissive. Of course he’s not going to agree with all of their concerns. But he tends towards broad-sweep rebuttals, glossing over the complexities and nuances that make euthanasia a complex issue.
In the face of well-documented problems in jurisdictions such as the Netherlands, Belgium and Canada, he also continues to claim that ‘it is possible to to design legislation that gives safety and protection to those who want nothing to do with it and choice to those who do’, without engaging with practicing physicians who say that euthanasia looks far different in practice. ‘The answer from the Canadian Supreme Court is yes’, he said at the debate. “The lived experience is not that’ said Dr Herx. It’s the difference between the neatness of things on paper, and the messiness of human activity; theoretical possibilities versus the realities.
One of the central issues is the widening of the criteria for euthanasia over time; it has occurred in every jurisdiction with laws similar to what is being proposed in Seymour’s Bill. The Canadian debate about allowing euthanasia for mature minors is a case in point. Why would New Zealand be any different? It is, in the words of Dr Herx, a question of logical progression rather than ‘slippery slopes’. We can’t just avoid the fact that the widening of criteria will happen here, too.
When Mr Seymour does quote figures, one has to check them carefully. He has repeatedly said that 3.2% of people were euthanized without their consent in Belgium in 1998 but only 1.5% in 2013, pointing to the decrease as the result of improved regulation brought about by the legalising of euthanasia. However, academics such as Professor Emeritus David Richmond point out that the decrease in euthanasia without explicit request occurred by 2001, the year prior to the legalisation of euthanasia. Legalising euthanasia had nothing to do with it. It is totally disingenuous for Mr Seymour to - as Professor Richmond says - ‘misinterpret the data for the benefit of naïve audiences as a fall in rates and a triumph for legalisation.’
Mr Seymour also glosses over the rise in the numbers of people accessing euthanasia across all jurisdictions. In a lengthy online interview in August 2017, Mr Seymour asserts that the numbers of people accessing euthanasia are flatlining or stabilising; but, in fact, as the interviewer points out, the official figures indicate a steady rise. Mr Seymour’s response is, somewhat vaguely, ‘In any case, you kind of know there’s a ceiling on it, and you’d expect it to flatten out; with those conditions to qualify, it is going to be limited.’ The whole exchange is vague on Mr Seymour’s part, and there are a number of editorial insertions to correct Mr Seymour’s statements, and point out his errors. Mr Seymour quite simply does not know the facts or does not want to engage with them.
So let’s return to Dr Herx and ask ourselves why she came to NZ. Option One: She came to fear-monger and spread lies and misinformation. To impose fear, uncertainty, and doubt. Why would she do that?
So let’s move to Option Two: She
genuinely had serious concerns. And those who listened
closely to Dr Herx would have all come away well aware of
these serious concerns, which deserve a serious response.
But all Mr Seymour’s could say in his eagerness to ignore
Dr Herx’s professional experience was, ‘I lived in
Canada for five years, and I know many Canadian friends, and
if you were to ask them about the version of events you have
heard from Leonie [Herx] tonight, they would wonder what on
earth you were talking about.’
That is, under the circumstances, an astounding thing to say.
Avoidance of the hard questions and dismissal from David Seymour is irresponsible and patronising. At the end of the Health Central debate, he said ‘tonight we’ve had endless speculation, fear, uncertainty, and doubt which collapses as soon as you go to the hard evidence of what happens overseas.’ The laughter of the audience exposed the fact that the reality of Dr Herx’s Canadian experience actually pointed to the opposite conclusion. Highly experienced clinicians don’t say ‘do not make our mistake’ on a whim. Let’s at least offer them the respect of paying attention to the facts.