Sunday July 1, 2012

Greg Boyed interviews Maryan Street and Alex Schadenberg on euthanasia.

Q+A, 9-10am Sundays on TV ONE.

Thanks to the support from NZ ON Air.

Q+A is on Facebook, http://www.facebook.com/NZQandA#!/NZQandA and on Twitter, http://twitter.com/#!/NZQandA

Q + A – July 1, 2012

EUTHANASIA DEBATE –
MARYAN STREET AND ALEX SCHADENBERG

Hosted by GREG BOYED

GREG First of all, Alex, having seen that piece, are you really in the position where you’ve got an intelligent, strong, independent woman who wants to die – are you in a position to say, “You’re not able to do that”?

ALEX SCHADENBERG – Euthanasia Prevention Coalition
So, we have a situation at this time with euthanasia or assisted suicide, and the problem with any of these laws is what you’re actually saying is in law we’re going to allow someone to be involved or to actually cause the death of another person. So this is the whole crux of the issue. We’re not actually talking about suicide, where you do it yourself. We’re talking about somebody else being involved. And so you have a serious situation here where, you know, you’re actually then saying, can we actually divorce the attitude of the person who’s doing the act from the person who might be even requesting the act? And then you have to also consider the very fact that often the person requesting the act is possibly going through depression or having other significant problems connected to that. And you can’t separate all these issues. It’s not that simple. It’s not a simple issue at all. And when you look at other jurisdictions where this has been occurring, there are significant signs of abuse that are going on, and that’s the other things that are happening. So you say to yourself, “How do we protect everybody in such a situation?” And the answer is you really can’t.

GREG In the case of Sean Davison and his mum Pat, I’ve read the book, and she made it clear from a long way out that’s what she wanted. Shouldn’t she be allowed to make that decision when she’s clear and lucid and have that happen?

MR SCHADENBERG OK, but there's a difference here. If she were wanting to commit suicide, that’s one question Then we’re not having society or others involved in the act. But when we’re talking about euthanasia or assisted suicide, you’re saying others can be involved in the act I have serious problems when we say in law that person A can be involved in taking the life of person B. You cannot control that in such a way that you’ll always be able to say that was done without coercion, effect of the other or situations where somebody else might have lost their life without request or consent. You cannot separate these issues in such a way and say, “It’s that simple. We’ll be able to do this.” We don’t live in a perfect world.

GREG Maryan, what's your response to what Alex is saying?

MARYAN STREET – Labour MP
This is a profoundly complicated issue, and I’ve deliberately called my bill End of Life Choice, particularly shown to us in Pat Davison’s situation. For people who have been vibrant, self-determining individuals throughout their life not to be able to be self-determining in their death seems to be lacking in compassion, particularly when they are, as the situation in my bill would require, terminally ill or suffering from an irrecoverable condition and their quality of life has got to a stage where they can no longer bear it.

GREG What about when a situation can go wrong? And it could go wrong. There is scope for this to go wrong. Most people aren’t going to be like Pat, so well informed – she was a doctor – so well prepared. There is a possibility of this going horribly wrong.

MS STREET Well, there needs to be protection built in to any legislation in this area.

GREG And what's the protection in your legislation going to be?

MS STREET The protection has to be that first of all there have to be two medical practitioners who, quite separately, attest to the mental competence of the person. They have to be of sound mind. They have to either have a terminal illness or an irrecoverable condition, but be of sound mind or have put down in writing an end-of-life directive that says, “Should this situation occur and I become mentally incompetent, then I would like these things to happen.” Now, protections need to be built in to stop people being coerced into that situation. I absolutely agree with that point. And medical practitioners should not be coerced into it, either. They have to be free to follow their ethics and their world view and their morality. Neither should any family member be coerced into assisting. There should be no coercion, and so it’s got to be the person’s request, and there has to be protection also from criminal liability.

GREG Alex, what is your issue with this? If you’ve got somebody who’s of clear mind and before it gets to the point where they’re no longer of clear mind, be it with morphine, any sort of pain relief, and they say, “This is how I want to end. I want it done this way. I want it done properly.” What's your issue with that?

MR SCHADENBERG So, I got involved in this issue because I have a child with a disability. So that’s the first thing. And I’ve been involved with the disability community. Very clearly, the disability community in Canada is very opposed to this for the very reason that they already feel that their lives are not treated with equality within the context of our social life and everything in Canada. And they say, “Well, once you impose euthanasia into that, are we going to be treated fairly, equally? Will our lives be taken without our consent?” But secondly, when you look at the research – there's recent research that came out of Belgium in May of 2010. There was a study published on the Flanders region of Belgium showing— And they have these safeguards. They say there must be two doctors approving. They also say it must be by request or consent, and they looked at that region, and they found that there was 32% of the euthanasia deaths were done without request or consent. Now, that’s in a highly educated population who had these laws in place. So what I’m saying is, you know, you get these things going off in the other direction. Can you be sure it won’t happen in New Zealand?

GREG OK, then, I want to put to you – what about the other 70%-odd who perhaps did want that, were in immense pain and because the laws are what they aren’t able to—?

MR SCHADENBERG Why should they be in immense pain? See, now you’re throwing that out there—

GREG OK, OK—

MR SCHADENBERG That is an issue that we agree on—

GREG Let’s go down the palliative care road, then.

MR SCHADENBERG …that they shouldn’t be in immense pain.

GREG If somebody is to the point of palliative— They’ve said before that this is what they want. They’re to the point of being so full of morphine, so full of painkillers that all they’re doing is breathing. Who’s that for? The living or the nearly dead?

MR SCHADENBERG That’s not effective palliative care, anyway. Effective palliative care doesn’t have you in such a situation where—

GREG Yeah, but everybody reaches that—

MR SCHADENBERG …you’re just treated like that.

GREG Everybody who’s got an irrevocable disease is going to reach that point at some point If they then want to die with some dignity, shouldn’t it be up to them to decide that?

MR SCHADENBERG Well, wait a second. But it’s not about suicide. You’re giving me a suicide argument. If it’s about my right to decide—

GREG No, I’m not giving you a suicide argument. I’m not giving you a suicide argument.

MR SCHADENBERG …that’s me killing myself. But if you’re going to get involved it, if it’s my right to cause your death—

GREG But many people— Again, with the case of Pat, she simply wasn’t able. She couldn’t speak, her tongue was so swollen. She couldn’t stand. She couldn’t do anything.

MR SCHADENBERG So if it’s—

GREG This is what she wanted. She couldn’t do it by herself. What about the people like Pat?

MR SCHADENBERG If the law says it’s my right to be involved with causing your death – and there’ll be rules involved, yes – you cannot then take away the fact of what my attitude might be. See, so now you’re imposing— You have the whole attitude of the doctor, the person involved in it. There's no safeguards that will ever protect you from that.

GREG But you’re already imposing your attitude. You’re already imposing your attitude by saying—

MR SCHADENBERG Actually, no, I’m not.

GREG No, your standpoint – and to a different degree, Maryan’s standpoint – imposes another point of view already.

MR SCHADENBERG It’s all about how do you protect everybody in society. You see, I’m in Canada, and in Canada, we don’t have capital punishment. Why do we not have capital punishment? Because we found that there were several people who were on death row who were innocent, and so they had to say, “We can’t go this way any more. We can’t consider this.” And it’s the same here. How can you justify if there's going to be some deaths without request or consent? So you said, “What about the 70%?” Well, what about the 32%? What about those people who die without request or consent? And how many of those died in a situation where the doctor made the decision?

GREG Maryan, what about the coercion side of it? You’ve got an older person who perhaps is feeling a burden, is sick, but may have six, eight months to live and thinks, “I don’t want to be a burden. I’m going to take the road of this bill” that you’re hoping to introduce. How do you safeguard against people like that?

MS STREET For me, it is about compassion, and it’s about dignity, and it’s about these people being able to choose their moment of exit. And this is not anything to do with disability. It’s nothing to do with capital punishment. It’s nothing with those other arguments, with respect, Alex.

MR SCHADENBERG Well, actually, it’s everything to do with—

MS STREET No, it’s not.

MR SCHADENBERG …how we protect all vulnerable people.

MS STREET Well, you have—

MR SCHADENBERG That’s what it has to do with.

MS STREET You have different ways of protecting vulnerable people. What we’re talking about is self-determining people being able to choose the moment of their death and the method of their death. Now, in some illnesses, terminal illnesses – for example, neurological deteriorating illnesses – people become unable to lift a cup to their mouth and unable to apply a lethal dose of anything, and so asking somebody to assist is perhaps the most unthinkable thing that a relative could contemplate, but in the end, it may be the best thing for that person, and it is their wish, as long as it is their wish. And if the safeguards in my bill are not strong enough, then let’s put it to a select committee—

GREG Let’s— I want to ask—

MS STREET …get some submissions—

GREG I want to ask you both a question quickly—

MS STREET …and let’s make it stronger.

GREG First of all, Alex, have you been in the position where a loved one or a relative has been that sick, there was no way out, they were in pain, palliative care or not?

MR SCHADENBERG Yes, absolutely without a question. But you see—

GREG And at no point did you think—

MR SCHADENBERG No, I would never consider killing somebody.

GREG …something like this might be the answer?

MR SCHADENBERG No, that’s not the way to go. The way we go is we provide proper care for our citizens. You can’t separate this issue from the possible depression that might be involved in it. You can’t separate it from the decision of the few. And there are also some physicians who will not be as careful as others. So when we’re considering this, we’re saying, “Well, we’re going to set up a whole bunch of safeguards. These are the – how would you say? – the hurdles we must jump in order to accomplish an end.” And when someone is really in favour of that end, they’re less likely to consider the hurdle as being so high. “We’re going to just find our way through that.”

GREG Maryan, have you been in that position?

MR SCHADENBERG Certainly, in my family, yes, there have— Both my mother and sister have died of terminal illnesses. But I have to say that neither of them would have availed themselves of this legislation, had it been in place. My mother fought to the very end. And it was— Neither of them would have taken up the choice, so I’m not driven by my own stories, but I am informed by them.

GREG Just finally, let’s talk the politics. What stage is this at? What next with your bill?

MS STREET I’ve got one more legal check to do with it. I think I’ve got it in the shape that I want it now. I’ve consulted with people about it. One more legal check, put it through to the Office of the Clerk for getting into the right format, and then it’ll be ready to go into the ballot.

MR SCHADENBERG There are no level of safeguards that will ever be safe for all people. It’s simply not— And when you consider conditions people get into and a very difficult circumstance where they become vulnerable and dependent, you can’t protect against that, especially when you consider what's happening in our area around elder abuse. You just can’t get through that.

GREG Alex, just one thing I do have to ask you – are you coming at this from a moral point of view, a medical point of view or a religious point of view?

MR SCHADENBERG Actually, none of them. I’m coming from a social point of view. I’m suggesting that this is simply not safe within a society. We just don’t go there because what you're doing is you’re allowing person A to cause the death of person B, and you can’t assume that those people will share an ethical perspective of maintaining safety. It’s just not going to happen.

GREG Alright, Alex Schadenberg and Maryan Street, thank you both very much for your time.

© Scoop Media