Alpha personalities, humility of death & Jenny Shipley – 3 reasons I don’t support euthanasia in NZ

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I don’t support euthanasia in NZ.

I’ve heard the arguments, I’ve listened to the debate, and I just don’t support it.

“If you were an animal you wouldn’t let it suffer” – Yes but we aren’t animals are we. We are self-conscious free thinking human beings.

“Letting people live in pain is wrong”. Yes it is, and we have incredible pain management these days, only very rare cases are left to writhe in agony.

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“People have the right to end their life”. No they don’t. They may have the right to commit suicide if you want to go that far, but the right to ask another to end their life? That’s not been agreed to at all!  This is a decision whanau and the wider community are all party to because of it’s ramifications upon the very fabric of our society.

I have 3 main reasons I disagree with euthanasia in NZ.

The first is the type of person and the reasons they push for euthanasia. It always seems to me to be alpha type personalities. Over achievers, people of deep independence who pride themselves on that independence. People who would consider the embarrassment of being unable to control their body functions worse than death itself. Their demand for death revolves around their inability to control the process of death. That doesn’t warrant allowing another to administer a medical cocktail that ends life.

Which brings me to my second reason, the humility of death. Dying as a process isn’t supposed to be clean and efficient. It’s painful, it’s human, it requires the family and friends you’ve built in a  lifetime to nurse you through your final moments. It is a deeply emotional time, a journey where the journey is far more important than the destination. The process of letting go, of saying goodbye is a deeply personal and intimate part of the human experience. To deny that is to deny one of the most important rituals of human life.

But the biggest reason I would never want euthanasia in NZ is Jenny Shipley.

One of the most important pieces of journalism investigative reporter Selwyn Manning ever wrote was in the mid 1990’s when he single handedly managed to expose a secret program by then Minister of Health Jenny Shipley to begin a defacto state euthanasia policy…

Back in the mid 1990s Jenny Shipley (then Minister of Health in the Bolger National Government) established a governmental body called the Core Health Services Committee (CHSC) which was chaired by former broadcaster Sharon Crosbie.

The CHSC was known to exist, but no one paid much attention to it, and also getting information out of it was problematic as it would cite commercial confidentiality as a reason for withholding information. So a lot of its work went under the radar.

Back then, National had created a commercial model that replaced health boards with Regional Funding Authorities (RHAs) and hospitals became Crown Health Enterprises. It wasn’t until 2000, that the new Helen Clark-led Labour-Alliance Government disestablished the RHAs and CHEs and reestablished publicly elected health boards, and, hospitals became public hospitals once again.

But back in the early to mid-1990s the Core Health Services Committee was accountable directly to the Minister of Health, Jenny Shipley, and was tasked with creating health funding frameworks, protocols, criteria that the then RHAs would rely upon when deciding what health services the government would pay Crown Health Enterprises (CHEs) for – when providing health ‘services’ to ‘clients’ (patients).

The Core Health Services Committee was tasked to evaluate a way of reducing the cost-burden on the Government for health services and come up with a set of criteria that CHEs and doctors would have to abide by when deciding which ‘clients’ (patients) would get treatment and, importantly, who would not.

In August 1994, I became aware that the Core Health Services Committee had been evaluating the most costly procedures, including renal dialysis treatment for people with end-stage renal failure. I was told by sources that the CHSC had drafted a document that included a framework for how expensive treatments would be handled, and that the Minister of Health had approved the plan.

Generally, there are two types of criteria:

inclusion – (meaning patients that met certain criteria would be eligible for treatment)

exclusion – (meaning those that could be labeled as possessing or exhibiting specific criteria would exclude then from being offered treatment.

In August 1994, I was leaked documents that displayed how the Minister had approved the CHSC protocols that used exclusion criteria and that the protocols had been presented to doctors and the exclusion criteria enforced.

What this meant was people who presented with end stage renal failure, and who required dialysis to stay alive, would be excluded from getting this life-saving treatment if they were deemed:

* to be blind

* to have an intellectual disability

* had a history of mental illness

* exhibited or expressed anti-social behaviour

* had a history of imprisonment

* had an unrelated health condition that may cause complications

* were over the age of 65-years…

The set of exclusion criteria continued on.

Without a public debate having ensured, CHE doctors were required to administer the changes and CHEs were required to report back to the RHAs with details on how the exclusion criteria was being applied.

Up until then, doctors and clinicians had decided on whether a patient would get dialysis treatment – the assessment was based on what health benefits a patient could expect, and were not required to consider exclusion criteria that were determined by the State.

The doctors silently rebelled and, as a journalist, as I mentioned above, I was leaked the CHSC protocols and exclusion criteria documents.

…the National Party were actively and secretly looking for ways to disqualify the sick and vulnerable from state health care. If they were prepared to do it when euthanasia was illegal in the 1990s, imagine how quickly they will begin to pressure hospitals to start euthanasia as a cost cutting measure if it becomes legal?

We know how poorly Corrections look after the welfare of prisoners. We know how badly CYFs looks after children in their care. We know how damaging Housing NZ, WINZ and the Ministry of Development treat beneficiaries.

So what would stop Government agencies applying the same disregard for the poor and sick if euthanasia is passed?

The demands of those too proud to die needing others, denial of our humility in death and a hard right Government who see euthanasia as a cost cutting mechanism are not good enough reasons to legalise euthanasia.

Mountain climbing lawyers might consider ending their life on their own terms a victory, but the real losers will be the poor and voiceless in state hospitals being pushed into ending their expensive treatment of a life.

30 COMMENTS

  1. +100 yes I agree Martyn…I also have reservations…just think how much they would save in pensions if the elderly were euthanaised?

    …many elderly are living into their 90s and are living on with the help of relatives

    …others are pushed into corporate old peoples homes with the profits of their life times work sucked out and going to overseas investors coffers

    …doctors/nurses already administer painkillers which if required in the high enough doses will shorten a person’s life at the end…this is done in the name of pain relief not euthanaisia

    • Basically I don’t think NZ is a civilised country! It’s quite barbaric and cruel in many ways! Just look at child poverty and homelessness and making people destitute off benefits and the stupid pot laws and the bigots that infest everywhere.

  2. I agree with you 100% Martyn, and find it astonishing that so many people cling to the idea of euthanasia as a progressive move, while neglecting the social conditions that would determine just what it would mean in practice. And “Oh but there will be strict safeguards” cuts no ice in a society that cannot safeguard such fundamental rights as the right to a roof over your head.

  3. So that’s why my father was left to die of kidney failure in 1998; he was over 65.
    He may have chosen not to have dialysis but it wasn’t offered.

    They are very salient points you’ve made Martyn, and until we get a government we can trust I think I’d agree with you.

  4. The more you look into it, the more complex the issue becomes. A couple of interesting things I found out recently were:

    When people are taken off life support they don’t die immediately, it can still take a long time before they die. I learned this from a woman whose parent went through this. She’s a believer in euthanasia now.

    A friend whose father was found to have an incurable illness of some sort and took his own life. Obviously, there are already people who are choosing to end their own life prematurely before they will die anyway from an illness. So Euthanasia is already occurring whether legalised or not.

    • +1

      I don’t understand the article. It seems to be about withholding healthcare, rather than assisted suicide. Euthanasia is about the person having the choice to end their life when they want to, rather than having to suffering for months or years until their body gives up.

      • They already have that right, it is called suicide. People no matter how incapacitated can decide not to eat or take fluids and die.

      • I agree with HEMEBOND.

        In response to the posting (and no disrespect to the author of the article intended)

        “Yes but we aren’t animals are we. “

        Well, sorry to disagree, but yes we are.

        Put it this way: Humans are living organisms. Scientifically speaking, that makes us either plants or animals – at least on this planet and given the current definitions of “living organism”. Personally, I’d prefer to be lumped in with the animals. (OK, ok, the bacteria and viruses may be an “intermediate” exception.)

        And, yes, overall, i’m guessing that you want an “emotional” argument, not a “Scientific” argument.

        “ . . . only very rare cases are left to writhe in agony . . . “

        Well sorry to disagree again, but IMO those heart-wrenching cases (if you want an emotional; argument) are more than enough to justify the right to choose to terminate one’s own life with suitably qualified assistance from the MEDICAL PROFFESSION”. Certainly, I would want that right to choose, with or without suitably qualified assistance, when and if the occasion ever arises for me at my soon-arriving end-of-life experience.

        The two paragraphs beginning “The first is the type of person and the reasons they push for euthanasia. “

        My reply: “Pop psychology.” ’nuff said.

        “…the National Party were actively and secretly looking for ways to disqualify the sick and vulnerable from state health care.”

        I can’t (and don’t want to ) disagree at all with any of this. I take my hat off to you for “bringing this to our attention” and leave it to others to comment. I was never a JS fan by any stretch of the imagination.” Nevertheless, this is all news to me.

        “We know how poorly Corrections look after the welfare of prisoners. We know how badly CYFs looks after children in their care. We know how damaging Housing NZ, WINZ and the Ministry of Development treat beneficiaries. “

        All of this is completely irrelevant if the decisions are fairly and squarely left in the hands of the individual, assisted or not as the case may be, by the medical profession. What it comes down to, in the end, is the capacity of the medical profession to resist government encroachment upon their areas of expertise (not to mention Gov’t encroachment upon the Hippocratic oath).

        So far, IMO, the NZMA have been reasonably effective at resisting previous attempts at “Government encroachment”.

        Which is NOT to say that all members of the medical profession have the appropriate expertise to counsel people approaching death and seeking advice from either their patient or his/her relatives on euthanasia. IMO, some of them are woefully lacking in the appropriate areas of psychology – but that is a different story.

    • Surely what you are saying here is that the father of your friend committed suicide. Well there is no law stopping him doing that, let’s just not involved someone else in anyone’s choice of death. There will never be enough safeguards to satisfy me. Birth is a messy business and so is death. We can’t have everything tied up in a neat little bundle – life is just not like that.

    • Especially as I have a young 24 year old type 1 Diabetic as a friend who has to use the private hospital more often than not because the public hospital isn’t funded for some of his needs. Under that model above he would have been dead long ago if it wasn’t for me helping with his health costs even though I am 65 myself. Health funding under this government is a joke and it would not surprise me if this underfunding is how Dr Johnathon Coleman is achieveing exactly the same effect as you mention above.

  5. “the National Party were actively and secretly looking for ways to disqualify the sick and vulnerable from state health care. If they were prepared to do it when euthanasia was illegal in the 1990s, imagine how quickly they will begin to pressure hospitals to start euthanasia as a cost cutting measure if it becomes legal?”

    Yes I am in 100% on board with Martyn here.

    AS IT SEEMS NOW THAT A DEEP DARK SINISTER PLAN IS AFOOT UNDER NATIONAL.

    TO REMOVE THE AGED AS FAST AS POSSIBLE FROM VOTING!!!!

    AS OVER 75% PERCENT APPARENTLY VOTE FOR ANY OTHER THAN A TORY PARTY’.

  6. But do Neoliberal Free Market Governments want premature, preplanned death??
    The Government funded privatisation of health care thrives on the tragedy of artificially prolonged life.
    Premature births, down to considering 21 weeks as being viable, are a prime example.
    I wonder how many Americans are kept alive in a vegetative state as part of some sort of Medical Insurance Business plan. There are many many cases of families fighting to end ‘treatment’ of their loved ones, and the courts seem to side with the hospitals most times.

    Privatised Hospitals and Medical services..It’s like private prisons…the business model would collapse without customers.

  7. Which brings me to my second reason, the humility of death. Dying as a process isn’t supposed to be clean and efficient.

    Dying isn’t “supposed to be” anything. You’re entitled to your opinion, but you’re not entitled to decide what kind of death a person is “supposed to” have.

    But the biggest reason I would never want euthanasia in NZ is Jenny Shipley.

    You do know that withholding medical treatment is a separate issue, right? It’s called “voluntary” euthanasia for a reason.

  8. “voluntary” euthanasia …really depends on the psychological state of the individual….and this depends on the support and love they have around them…

    ….so how does one define “voluntary”…apart from a social environment ?

  9. I agree Martyn, if one is determined to die because of terminal illness, then they should make sure they can carry it out themselves before they get too ill to be able to carry it out themselves. I find it disgraceful that anyone should have the arrogance to ask another person to do it for them. Doctors are trained to save lives, not to terminate them. Even if they can opt out, no doctor should be placed in a position to put people down.

    Dying need not be traumatic time for the family or the terminally ill person. Hospice is well trained and compassionate at making sure patients are comfortable and I know from experience from nursing dying patients and my own family that euthanasia is a clinical and godless solution. Death does not have to be a trial.

    Today everybody it seems wants to have it all including a booked in appointment to die – dying is part of the life cycle and we should all just get over it and accept it – nobody escapes from it. Better we try to live good lives and gain wisdom and grace for our final hours – with good Hospice care lives pass peacefully.

    No elderly person should live in fear of being pressured to end their lives – believe me that will happen with this uncaring society we live in. Greedy relatives wanting to get their hands on their estate. Please do not let this law come into fruition in this country.

  10. So Martyn, you want to deny people the right to decide their own fate because you don’t like Jenny Shipley, and “the humility of death”? You want people to suffer through lingering terminal illnesses? You have reached a new depth of stupidity. Have a lingering terminal illness.

    • No. I wish to deny a right wing Government from using a law change to start pushing the poor and vulnerable into euthanasia and I believe that there is more at stake than a ‘clean’ ending.

      • Absolutely correct there Martyn. I feel the same of what legalized euthanasia is likely to lead to.

        A convenient form of state sanctioned genocide based on socio economic status, mental and/or physical disabilities, age, dissenters and the like maybe. Any excuse to “get rid” of those who do not fit the “accepted” perception of conformity, is the next step after humane euthanasia is enabled! All it will take is the stroke of a pen or the tap of a computer key to do the job.

    • Harry, people are not denied the right to decide their own fate, the stats show this regularly on the news with suicide. The only problem with euthanasia is that is passes the buck on to the medical profession to do the deed for the person so inclined. That is where it becomes repugnant. The medical profession are trained to save lives, not become legalized killers. Leave the doctors right out of it please. Suicide is an extremely personal decision for the person concerned and that’s where it should remain.

    • Harry;

      “Have a lingering terminal illness.”

      What a nasty little person you seem to be.
      No one should be wishing this on anybody and the moderator should have
      dis-allowed this comment. For an opinion?

      You (and others) seemed to have missed the ‘standout’ in Martyns article.
      ie That the exclusion criteria listed was not just a discussion but
      that the Minister of Health had approved the plan, Jenny Shipley!!
      This is almost a direct copy of the NAZI AGENDA!!

      I would have liked to have seen the complete list.

      I think you should apologize forthwith and commence deep reflection.

      I suspect you may be ‘youngish’.

      Martyn; Congratulations for bringing this ‘secret agenda’ to our attention.
      NZers were right to boycott the ‘billing system’. We have already paid in our taxes.
      In our parents time it used to be separate,but it would only be the ‘older’ that
      would remember that now.

      Cheers.

  11. There are many people who will die alone. They have no family or friends to gather around in the old Victorian way. Folk who live in flats. Who don’t know their neighbours. Who can lie dead for months before someone says, ‘Whatever happened to that bloke next door?’

    If someone can get the wee luvvies at Department of Statistics to add a question, or do one of their intrusive studies, and ask how many people actually have access to medical advice and services? And how many don’t…because there’s no practice close enough, or the charges are so high, or the hours they work mean they’ll pay a premium for ‘after hours’ attention.

    Take a casual wander into a pharmacy or so to see how many prescriptions have NOT been collected because the price is too high.

    It’s not euthanasia. It is denial of services and creeping death because health care is rationed and put out of reach of so many. Think ‘hernia operations’ so young-ish blokes can get back to work. Or timely cataract operations for both young and old. Basic stuff.

    If you’ve lived with that relentless, grinding misery for long enough, the power poles start to look inviting. A sturdy rail in a closet and a high enough stool. Or the back seat of the car and a hose from the exhaust, or simply scarfing down the whole bottle of pain killers you were given as ‘health care’.

    If people want to depart this life – they’ll do it, as they have done for centuries. If they want the whole weepy drama – fair enough.

  12. Great post Bomber. I and my extended family are totally opposed to euthanasia. This is not about someone taking their own life, everyone is free to do that whether we like it or not. This is about getting someone else to intervene to take your life. Giving the job to someone else is not assisted suicide. Recently a 28 year old woman in Belgium had her life terminated by a doctor. She had suffered horrific child abuse and a number of psychologists had agreed that this could happen. This is not a terminal illness at all but a psychiatric problem and how can anyone know the future about how this woman’s life might improve. To me it is the thin end of the wedge.

    People need to do some research on what has happened in the countries that have legalised it. In the Netherlands in 2012, fourteen mentally ill patients were euthanized by their psychiatrists. In 2013, that number tripled to 42.

    Could we stop talking about the issue of pain. Pain can and should be managed and if people are in terrible pain then they or someone else needs to help then out of the pain and that does not mean by knocking them off. We have fantastic palliative care in NZ and it can only improve. I have been with 3 people I was close to at different times in my life as they have died, 2 of old age and one of cancer, it is not pretty, but then neither is birth and both of these significant things are about the experiences we have.

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