Euthanasia: an interview with David Seymour

Exploring the moral and legal aspects of assisted dying
by Gordon Campbell

The End of Life Choice Bill being promoted by Act Party leader David Seymour is the latest in a series of attempts down the years by individual MPs to amend our laws on assisted dying. Michael Laws, Peter Brown and Maryann Street tried before. Since this is a conscience issue, Seymour’s Bill will be voted on by MPs according to their conscience, and not along party lines. The first vote in Parliament will determine if the Bill survives to the select committee stage, where its merits/demerits can be debated and the Bill amended, if need be.

The declared aim of the Bill is to allow the terminally ill to die at a time, and in a manner, of their choosing. This is evidently a popular cause that – reportedly – about two thirds of New Zealanders support. The tragic death of the Wellington lawyer Lecretia Seales in 2015 has served to bring the issue back into the public eye.

Several overseas jurisdictions have already legalised various regimes for assisted dying – notably Oregon, the Netherlands, Belgium, Switzerland, Colombia and Canada. These precedents have added fuel to the fire, on both sides of the debate. A useful summary of the various rules and processes in other countries can be found in the recently published report by a Health Committee set up to respond to a petition on assisted dying.

Many of the concerns raised about any regime of assisted dying have focussed on the potential for legislative creep. Once the procedures were in place, would the narrow access envisaged by Seymour’s Bill then gradually expand to encompass other categories of people? Inevitably, concerns of this sort are speculative. Most of the cautionary evidence on this point has come from two countries – the Netherlands and Belgium. In the Netherlands, in particular, the categories of people with access to doctor-assisted dying has expanded considerably since the issue was first debated, and the initial enabling legislation passed.

Certainly, there is no basis for assuming that New Zealand would follow the route taken by the Dutch. The example is purely cautionary. Initially, the Dutch advocates of assisted dying had claimed that the related procedures would be used only as a last resort, and would be limited to only a few people suffering from terminal medical conditions that had been strictly diagnosed. Even by the time the initial legislation was passed, the situation had evolved considerably.

To be brief : since 2002, not only the terminally ill have had access to legal euthanasia in Belgium and the Netherlands. The wording of the Dutch law is inherently subjective, in that a person must only be ‘suffering hopelessly and unbearably.’ Reportedly, this suffering can be either physical or psychological ; and as a result, assisted dying is also available to those with mental illnesses, such as dementia or severe depression. The wording in the Belgian law states that the person “must be in a hopeless medical situation and be constantly suffering physically or psychologically.” By 2006, the Royal Dutch Medical Association had declared that “being over the age of 70 and tired of living” should be an acceptable reason for requesting euthanasia. By 2016, the Guardian reported on this Netherlands example:

In 2015 euthanasia was administered to a young woman suffering from post-traumatic stress disorder and anorexia nervosa who had been sexually abused as a child.

The criteria also now includes the young:

Until 2001, the Netherlands allowed only adults access to euthanasia… However, the 2002 law allowed for children aged 12–16 years to be euthanised if consent is provided by their parents, even though this age group is generally not considered capable of making such decisions. The law even allows physicians to proceed with euthanasia if there is disagreement between the parents. By 2005, the Groningen Protocol, which allows euthanasia of newborns and younger children who are expected to have “no hope of a good quality of life,” was implemented. In 2006, legislators in Belgium announced their intention to change the euthanasia law to include infants, teenagers, and people with dementia or Alzheimer disease.

In Oregon by contrast, the criteria and procedures have not significantly changed. The cautionary tales of legislative expansion have mainly come from the Netherlands and Belgium:

In 30 years, the Netherlands has moved from euthanasia of people who are terminally ill, to euthanasia of those who are chronically ill; from euthanasia for physical illness, to euthanasia for mental illness; from euthanasia for mental illness, to euthanasia for psychological distress or mental suffering—and now to euthanasia simply if a person is over the age of 70 and “tired of living.”

To repeat: there is nothing to say that we would necessarily go down the same path. The Netherlands and Belgium are not New Zealand. In order to explore Seymour’s thinking about the issues raised by his Bill – and the cautionary tales from Europe and lessons to be drawn from them – Werewolf editor Gordon Campbell conducted a 40-minute interview with David Seymour on Tuesday 1 August in his Bowen House office.

Campbell: When it made its ruling on the Lecretia Seales case two years ago, the courts virtually implored Parliament to change the law on doctor-assisted dying. Why do you think National and Labour have ducked that invitation?

Seymour: I don’t think they’re alone in that. Most governments, at most times, have ducked most conscience-type issues [like] marriage equality. I stand to be corrected, but [also on] prostitution law reform, homosexual law reform. I stand to be corrected, but abortion law reform as well. I think these were all conscience issues. I think the one notable exception was when Helen Clark took on civil unions. I think she took that on as a Government bill.

So it usually requires an individual MP to step into the breach?

Yep, by and large.

Why you?

I asked around my colleagues, and I observed that Labour wouldn’t be able to do it. Ian Lees-Galloway had been kiboshed by Andrew Little. Maybe [with Labour’s leadership change] that will change now, I don’t know. I spoke to people in the Greens and they said that they all believed in it, but it wasn’t one of their priorities as a party.

So, amongst the MPs you have lobbied, what are they looking for from you, by way of reassurance?

Can I just say, and it’s a bit long-winded… But, basically, I spoke to every other party and realised that if not me, then nobody. That’s why, me; after that implorement by the High Court.

To repeat: when you have lobbied other MPs, what have they most wanted from you?

They want to know if it’s possible to do safely. Just now – and I’d prefer not to name him – I had an MP here who basically wasn’t convinced it can be done safely. The best argument for that is that the Supreme Court of Canada, that has marshalled all the rules and evidence and decided that a complete prohibition on assisted death would be, “over-broad” for the purpose of protecting people’s lives.

Michael Laws, Peter Brown and Maryann Street all tried before to get parliamentary traction on this issue. What does your Bill contain that Street’s bill lacked?

My Bill is actually more modest than Street’s. Street’s Bill allowed an ‘advanced directive’ whereby you could effectively nominate, at some future time, in some future condition, another person who could decide that your life should end. I felt that was politically very difficult. And I was uncomfortable with it, ethically. So I said that this Bill should only allow people to end their life if they were making the decision.

And the relevant time frame, as I understand it, requires a diagnosis of impending death within six months, rather than the 12 months that Street was recommending.

Yes. Or, a grievous, irremediable condition in an advanced state of decline. And that wording is critical, because people will say: I’m in a wheelchair, and are you going to say that is grievous and irremediable and that I should be able to end my life, because my existence is unworthy? I’d say absolutely not. Because, with a person in a wheelchair – their condition is not in a state of decline, and certainly not in an advanced state of decline. An advanced state of decline captures things such as Huntington’s Disease, where we know from everyone in history who has ever had it, that it only gets worse, progressively.

To go back to what you said before – your Bill will not allow someone with power of attorney to volunteer someone else, who may be comatose or demented, for this process?

No.

Your critics would say that suicide is always an alternative to a doctor-assisted process. What’s your response to that?

Again, I’d quote the Supreme Court of Canada, who called that a cruel choice between violent, amateur suicide, and suffering to the bitter end. I’d also quote the High Court here in New Zealand who accepted the argument that a prohibition on legally-assisted dying can actually shorten people’s lives.

By people bringing forward the suicide, before they lose their faculties?

Yep. And, the closest I’ve come to a personal connection to someone on this issue is Martin Hames who was an Act Party staffer with Huntington’s Disease and he attempted to kill himself with a gas bottle and a plastic bag. And the only good thing about it is that he actually failed, and so he was able to have all his friends visit him in hospital and say goodbye over the last two days. If he’d succeeded he wouldn’t have been able to say goodbye to anybody – because he was required to do it without anybody’s knowledge, because they could be implicated.

The other main criticism is that currently, modern pain relief and palliative care enable the majority of people to die peacefully. Given that, why do you think your additional measure – which is fraught with unintended consequences – is necessary?

Well, I’d challenge the premise that it is fraught with unintended consequences.

I’ll go through them with you later.

Why it is necessary is that people are not always able to be helped with palliative care. You’ll notice the people who claim that are always the providers of palliative care. Its not up to them to decide that their product is perfect, its up to the people who are affected by it. And again, to go back to Seales v Attorney General, the court again accepted in evidence that not everyone can be [sufficiently assisted]. Lecretia herself felt that her pain could not be ameliorated by palliative care. But I just want to stress that I have great respect for the hospice. My Mum died in a hospice. I understand that they’ve come a long way over the last 20 years, and palliative care is a lot better than it used to be. But that doesn’t mean people don’t suffer, and that those people shouldn’t have choice.

One thing I’m a little fuzzy about – will your Bill create a legal right to doctor-assisted dying?

No. I don’t know who you would sort of… charge with having the duty to deliver on that.

Exactly. The question is really one about provision. As Baroness Hale once said, you can have a right to marry but that doesn’t mean the state is required to provide you with a mate. Similarly, are you envisaging a user pays system, or one where doctor-assisted dying is delivered via the public health system?

Um… that’s really a matter for the budgeting and administration of the government of the day. I’m just creating the legal mechanism. The simplest way to describe my Bill is that it exempts those sections of the Crimes Act – I think its 177 and 178 – from the penalties of assisting in a death, or of providing the means to assist in a death. [The relevant parts of the Crimes Act are actually section 160(2)(a) and (3) on culpable homicide and section 179(b), which deals with aiding and abetting suicide.]

I’m aware of your intentions. But if you render a process lawful, doesn’t it then become difficult to see the compelling legal argument for excluding other categories of people from having access to it?

Some people will make that argument. I think the distinctions we’ve drawn are quite sound. The clearest distinction that people like to raise – maybe we’ll end up with a Groningen Protocol like they have in the Netherlands that allows those under 18 –

Or depressed people?

Well, I don’t think so, but I’ll address that one next, if you like. Under 18, it’s quite clear. There are some things that you don’t allow someone who isn’t a legal adult to do. This is one of them. Of course you could make that argument that all of the things that are currently illegal below a certain age will be allowed, but that’s absurd. Having an age of consent doesn’t mean, all of a sudden, that sex will be legalised for younger people.

So, again, to clarify… under your Bill, it won’t be legal, as it can be in the Netherlands, for a custodial parent to authorise this process for someone under their care?

Again, the critical criteria is choice. It’s all about freedom of choice. We would argue that people who are not legally adults – and there are arguments in the Bill – that if you’re not legally an adult, you can’t make a choice and no-one else can make it for you. Secondly, on the depression… again, any condition has to be irremediable, in an advanced state of decline. You would have to prove that you were grievously, unfixably depressed. See, there’s two basic streams or pathways if you like; one is for terminal, the other is for degenerative.

Does ‘intolerable’ also come into that, as a qualifying factor?

Well, intolerable is an additional condition for both streams.

If I said I had intolerable depression would that qualify?

No. Depression is not terminal.

But it can be intolerable.

Yes but it’s an ‘and/and’ process not an ‘or’. Let’s say you were so depressed you were out of your mind. You would then have a very difficult time persuading any doctor that you understood the nature of assisted dying and the nature of the decision you were making. Which is also a requirement of the Bill. It’s sort of a Catch 22, with mental illness. Either you’re not ill enough to have a problem that justifies you accessing this Bill, or you are so ill you don’t know what you’re doing. One way or another you don’t know what you’re doing.

Current medical practice

I want to ask some questions about current medical practice, in order to see where your Bill differs from it.

Currently, doctors can prescribe drugs that may hasten death, provided that is for the purpose of alleviating pain and suffering along the way. This is the concept known as ‘double effect.’ To be clear: doctors can claim the ‘double effect’ defence, but nurses can’t. Is that right?

That’s my understanding. I’ve always assumed the doctor would be the one with ultimate responsibility. But I’m not aware of there being a distinction as to who can claim it. It’s not really a legal thing, it’s within the medical community.

Another point – if it is therapeutically futile to continue treatment, do doctors currently have an over-riding obligation to prolong life?

I’m not sure about the answer to that. I wouldn’t have thought so.

My understanding is that if death is merely being deferred, the doctor is not under a duty to avert that death at all costs.

In practice, they certainly don’t.

Thirdly, does a terminally ill patient currently have the ability to refuse medical treatment that may prolong their life?

Absolutely.

So, to summarise the situation – a patient can currently choose to refuse life-saving treatment and a doctor can currently choose (a) not to prolong life-saving treatment and (b) can prescribe pain relief that will have the effect of killing the patient or shortening their life. Do you think, therefore, that a clear moral distinction can and should be retained between medical treatment that intends to cause death, and medical treatment where death is virtually certain to ensue?

Yeah. First of all yes, and that’s one of the things my Bill achieves. We’re bringing people who intentionally want to end their life into a regime that is above board, and safeguarded, rather than being informal as it is now. The construction I always use is: starve yourself to death, refuse treatment, commit amateur violent suicide, a doctor gives you a bit too much morphine. All of those things are accepted, even though they are basically, intentionally, hastening death.

Really? But surely that’s where the grey area exists – as to whether death is acceptable when it is an inadvertent consequence, rather than being intentional from the outset.

I think it clearly is denial, frankly. But what’s not allowed is for the person whose life it actually affects to take control and make a conscious decision for themselves. And I think that’s a real shame.

Insurance industry, Big Pharma issues

What do you think the implications of this Bill will be for the insurance industry?

I think, none. My Bill says that the cause of death should be recorded as the expected cause of death, absent assisted dying. Now, some people have criticised that as misrepresenting the cause of death. I don’t think it is. Statistics about the numbers of assisted deaths are kept as part of the Bill by the registrar – which is another position created within the Ministry of Health by my Bill. I’m creating a lot of bureaucracy for an Act MP. And yet, from an insurance point of view, they have to pay out a death certificate that says they died, of whatever they died of.

Right. So how much do you think the average doctor-assisted suicide will cost?

I don’t know the answer to that. But I imagine, in the context of the various types of end of life care that are available, it would not be an especially expensive option.

But most of the costs of the current modes of terminal care largely fall on the public health system. We’re talking about what will probably be a user-pays system, where we wouldn’t want cost to be a barrier to access, right? So should people be able to take out insurance cover for this process?

Well, I would certainly have no objection to them doing so. My Bill is silent on that question. I imagine it is something that health insurance providers would find attractive to provide, given the demand.

In some countries, there won’t be an insurance payout if a suicide occurs within two years of signing the contract. Obviously there’s potential for doctor-assisted suicide to be put on the same spectrum. Would that seem appropriate to you?

I think, generally speaking, someone who has a terminal illness or a degenerative condition wouldn’t be able to obtain the kind of cover you’re talking about anyway, because they’d be seen to have a pre-existing condition. One of the important things here is that assisted dying doesn’t make a great difference to someone’s life span or healthcare costs.

Would it be possible for a termination to be authorised if and when a pilot study for a new treatment for the condition in question is already under way? This goes to how reliable is the two-physician safeguard contained in your Bill.

Well, it always comes down to the professional judgment of the two physicians. And so they have to judge that… would the person have an obligation to whoever, if they’ve entered the trial? Absolutely not. Would they be in any way barred under my Bill, no they wouldn’t.

Be barred from what?

From accessing the Bill because they were involved in an experimental trial. My Bill would be silent on that. Would it affect the judgment of doctors as to the life expectancy being six months? I suspect that it wouldn’t. But I also suspect that someone who was trying new experimental drugs would feel unwilling to umm –

Advance down that path, because they haven’t exhausted their hopes?

Yeah. That makes it less likely. But it is still a valid question.

The initial query was about the reliability of the safeguards. Yet, conversely, what would stop Big Pharma from recruiting the terminally ill known to be exploring your process, as a test group for their experimental drugs?

I guess we’ve got that problem whether my Bill passes or not. I’m not sure how my Bill will affect it. Other than I guess – and I’ve never thought about this before – people might be more willing to participate in experimental trials if they thought they had a way of getting out of it by having an assisted death.

I was thinking more of Big Pharma deciding these people are in an exposed position, mentally and financially, and the doctors involved have alerted the drug companies that they’re exploring this process. So, they’re recruitable.

Yep. But I think that’s a problem that you have in countries with assisted dying, and without assisted dying.

State intervention

Lets talk about state intervention. As you’ve said, the foundation for this Bill is autonomy on one of the most crucial decisions you can imagine. But currently, the state forbids us from paying a dealer in order that we can choose to shoot up heroin, and it says we can’t drive without a seatbelt – so why should the state allow us to pay a doctor, so that we can kill ourselves?

Well, in Portugal, they no longer prohibit people from shooting up heroin, and their level of heroin deaths has halved since they made that change. So, just because the state doesn’t, doesn’t mean it shouldn’t.

But we’re talking here about New Zealand.

Well, there are many New Zealand laws that I think are wrong. Give me some time, I can’t change them all. But in time…

So, given time, Act will get around to legalising heroin use?

Look, I think New Zealand right now needs to start looking hard at the overseas evidence. Lots of other countries are moving on these questions, and we seem to be dead in the water. If I can just go back to the seatbelt example, that’s there fundamentally because we’ve signed up to a public heath insurance system, and that insurance system says well, here’s our premium – if you pay your income tax, here’s the payout you can expect. But here’s how we expect you to behave in the interim.

Right. Yet, while your Bill says it’s based on individual choice, it has to turn someone else into an accomplice. Therefore, some have argued, this is no more a private act than a duel, or an agreement to sell yourself into slavery. How do you deal with that paradox – given that, by definition, your process has to involve someone else in the pursuit of their own death?

Well, I think people should be free to voluntarily associate and co-operate with others. What I’m opposed to is the state defining the nature of the voluntary consenting acts you can enter into. In a free society, there is lots of voluntary co-operation. That’s the great thing about it. Not everything has to be individualistic. I’m not Ayn Rand.

That’s a blessing. Under your Bill, a family doctor, say, that sanctioned the death procedure would still need backup, from a second opinion. Won’t this invite people to shop around for that second signature, thereby creating a market for ‘death doctors’?

That’s something we considered very carefully when we drafted the Bill. The first physician, unless they conscientiously object – which they are allowed to do – is your attending physician, the person responsible for your care at any given time. The second physician is someone who is selected at random from a register by SCENZ [Support and Consultation for End of Life New Zealand], which will be a department within the Ministry of Health established by the Bill, whose job will be to develop medical guidelines and also appoint – at random – the second physician. So you can’t get a coterie of, as you called them, ‘death doctors’.

Except that you would, as the procedure develops. Take out the conscientious objectors, and there will be a de facto residue of so-called ‘death doctors’, surely.

Yeah, you’re really just arguing about the concentration of them. They’re going to exist, regardless. The question is what percentage of the medical profession will be conscientiously objecting, and what percentage will be on call at SCENZ.

What’s your hunch?

I think probably about a third will be on call. Based on the fact that the latest research by Auckland Medical School shows that a third of doctors in New Zealand are in favour of the legislation.

So… is there anything in your Bill that would stop those SCENZ physicians registered at the Health Ministry from ratifying deaths because the relevant treatments were too expensive?

First of all, the patient has to be the one who asks for it. And you’d have to get two doctors to collude on it, and the patient has to ask for it at about four different times in the process. So the scenario in which that would happen you would have to have a doctor who was so diabolical that they would probably be doing harm under any legal system.

Not really. Medical care gets rationed all the time because its too expensive, doesn’t it?

It does.

And if the treatment costs $100,000 a shot – which is what some of these new biologics medicines do cost – couldn’t the decision to terminate be influenced by the expense of the treatment?

By whom?

By both doctors. The point being, the check and balance you’re offering on the patient’s request comes down to the two doctor signatures – and I’m asking whether that safeguard would be susceptible to being eroded, or bartered away, because of the expense involved in pursuing the treatment for the medical condition.

If that’s true, there’s plenty of scope for it to happen now. The difference that my Bill will make, at the margin, is that it requires an explicit initiation of the process by the patient. Whereas the kind of informal euthanasia we have now – and it is estimated to be four percent of all deaths in New Zealand now, according to Auckland Medical School surveys – is far more susceptible to that economic rationing than my process, that requires the patient to pro-actively initiate it.

OK. This is the Hippocratic question: If patients felt that the symptoms they currently confide could eventually be used as potential evidence for a decision to terminate their lives, wouldn’t this be likely to change the doctor/patient relationship?

All the evidence from countries that have legalised and been surveyed on the basis of whether they might legalise, is that, if anything, patients become less suspicious of doctors once this is out in the open, and become more trusting… I can’t give you the causal mechanism as to why that has happened. But the public opinion research into the relationship between patients and doctors is that it has actually improved it.

Social pressure

Free choice made without coercion is the cornerstone of your Bill, according to its explanatory note. Yet the sick and the elderly don’t want to be a burden to their kids. And they won’t want to see the cost of rest home care erode the inheritance their kids would otherwise receive. Won’t such pressures propel people towards the exit your Bill will create?

That’s certainly a concern that people have. In other countries, what is the proportion of people who have taken this up, and who do they tend to be? Jurisdictions like Oregon – and I use Oregon a lot because it has had it the longest and it is the most studied – people who use it tend to be wealthier. If you thought it was about familial and economic pressure, you’d probably expect poorer people to make use of it.

Not necessarily. Not if there’s an inheritance at stake.

Yeah, hmm… Poorer people might not have an inheritance… Yeah, plausible hypothesis. Secondly, the proportions of them are between 0.3% and 2%. Or 3% in some of the Benelux countries [i.e. Belgium, Netherlands, Luxembourg]. Now, why might that be? If you think about it, you’ve got to have a terminal illness certified by two physicians that’s likely to kill you within six months, or a degenerative condition in an advanced state of decline. At any given time, the proportion of the population that could possibly fit into that category would be one or two per cent.

Yet, as you will also know, the percentage has been steadily climbing in the Netherlands and Belgium, at the same time as the criteria for access have been steadily widened.

Yes, but Oregon has gone like that [Seymour makes a flatlining gesture] and [elsewhere] you’d expect people when they first learn of it, there’s going to be a time when it accelerates but it appears to stabilise.

[In fact, the Oregon statistics do not support Seymour’s claim of flatlining. The Oregon death procedures became available in 1998. The figures for 2016 are available here.

Since the fatal dose is self-administered in Oregon, the relevant figures cite both the prescriptions written for the fatal dose, and the related deaths. Back in 2010 the two figures were 97 written prescriptions and 65 deaths. By 2016, the corresponding figures were 204 and 133.]

Sorry, but the evidence from the Netherlands is that it hasn’t reliably stabilised. Assisted dying became available as long ago as the early 2000s and the pickup in the rate has galloped ahead in the past few years.

I stand to be corrected, but my understanding is that it has flattened out. 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 opponents will always say it’s a slippery slope and the criteria will broaden.

There is evidence from Europe to suggest that slippery slope is, in fact, what has eventuated. [The Netherlands procedures were introduced in 2003. The figures for 2015 are available here.

They show a 50% jump over 5 years from 2010, to just under 4% of all deaths in 2014, dropping back slightly in 2015, which is presumably the basis of Seymour’s claim that the rate has flattened out. The 2016 figure is not yet available.]

Yeah, you’re talking about the political processes that have occurred really, in one country. That’s the Netherlands that has really broadened it out, with the Groningen Protocol and so on. Belgium, less so.

Doesn’t that indicate the potential for a problem?

But there’s potential for a problem now. If you want to look at some of the evidence I’ve been given by the anti side, they’ll tell you that 1.7% of Belgians are euthanised without their consent. And you think, Jesus Christ, that’s a bit of a worry! I don’t know if I should be supporting this thing. It turns out, prior to legalisation, it was 3.2 %. What has happened is that the majority of people have now been brought under the ambit of a process that’s legal and above board. In New Zealand, it’s currently 4.5%.

And just to repeat: no-one with a power of attorney will be able to euthanise someone else, under your Bill.

That’s right, and that’s why our numbers are likely to be lower. We don’t have ‘advance directives’. The North Americans don’t have advance directives. There are basically three binary decisions: one, is it self applied, or remotely applied, or by someone else. In Oregon, you’re basically given the stuff and you have to swallow it yourself. In the Benelux countries, and in my Bill, you can get someone else. The second binary is… is the condition terminal or degenerative? Mine is both, Oregon is just terminal. The third is, can you do an advance directive? The Benelux countries are all in, on all three.

For the benefit of readers, explain again what an advance directive is.

An advance directive is where you sign some sort of document that says that if I come to state X, then person Y can say… Freddy would have wanted to go if he was like this. Maryann’s Bill had that. My Bill doesn’t.

And finally, following the European precedent, what would stop the timeframe and other criteria for your Bill to be expanded, once the procedures are in place?

I guess that’s a decision for future people. I think my Bill strikes the best balance but, of course, I would say that. But, I think there is something terribly fallacious about arguing the ‘slippery slope’ argument – that says if things were different then things would be different. Well, if we were debating a different bill then I would be opposed to it. But we’re not.

No, the slippery slope argument is not about dealing in hypotheticals. It is about saying that familiarity will breed indifference, which will lead to expansion. That’s a reasonable concern.

And the rejoinder to that is that our customs evolve, over time. Now, does that mean the world we are familiar with today is worse than what we used to have? I don’t think it is. But I also look at the evidence of what’s happened, and the two Benelux countries have been quite expansionary.

But it won’t necessarily happen here? Is that what you’re saying?

Well, it’s certainly true that it won’t necessarily happen here. But the jurisdictions that are more like New Zealand i.e. the English speaking, New World, common law jurisdictions of the United States have not had any expansion [of the qualifying criteria.]

Timetable

What’s the likely timeframe for when this Bill will be put before Parliament?

That’s actually a hard question to answer. I can almost absolutely guarantee there is no way in hell it is going to come up before the election.

But before the end of the year?

That is 50/50.

If MPs could hold a conscience vote tomorrow would the Bill pass and get to select committee?

I think it would. I don’t know that for certain. As has been reported, I think we have about 40 onside, and about 27 we know are against, and about 50 are in the middle. Since the Bill was drawn, probably we’ve locked down about another four or five on our side. I think the antis have probably locked down a few more on their side, too. But I have not been lobbying as hard as I might have… [partly] because the other thing is that this Bill is going to be voted on by quite a different Parliament than the one we have now.

Which raises the final question. Shouldn’t the public know before the election just where the candidates that they’re about to elect, happen to stand on this Bill?

Yes, they absolutely should. I think it is reprehensible that people will be elected who have not made their position clear. I have more respect for the Bill Englishes of the world – who have made their position clear, even though he may disagree with me – than I have for the people who may duck and dive. Because I do think the public deserve to know.

Footnote : Further Reading

The text of David Seymour’s Bill is available here.

The compassionate High Court ruling on the Lecretia Seales case is available here.

Two New Zealand academic overviews, (one pro a regime of assisted dying, one against it) are also well worth reading. Last year, the Otago University law professor Rex Tauati Ahdar published “ The Case Against Euthanasia and Assisted Suicide” in the New Zealand Law Review, available here.

Professor Ahdar’s article has been responded to with similar insight and erudition by his Otago University departmental colleague Andrew Geddis, available here.