DECIDING ON DEATH:
An Introduction to Euthanasia Evoked
by New Zealand’s Case
While the world was jittering at the clamour of the 2020 US Presidential Election, across the Pacific Ocean New Zealand had its low-key bout of General Election drawn to a close. Without much suspense, incumbent Prime Minister Jacinda Ardern won her second term in office with Labour Party.
Exceptionally, two referenda concerning whether the proposed Cannabis Legalisation and Control Bill as well as the End of Life Choice Act 2019 should come into force respectively were initiated to the public alongside the election. The historic final results turned out on Friday November 6th after more than 2 million of votes counted: with 65.1% 「Yes」 cast, End of Life Choice Act 2019 will be enacted after 12 months. To wit, New Zealand citizens just had their DECISION ON DEATH made.
「To be, or not to be?」 The ultimate question about life had been echoing long before Shakespeare made this ringing statement. To give a glimpse of what are the cornerstones of a decision on death, in the following sections, firstly a precise definition of euthanasia will be distinguished. Secondly, the prolonged controversies over euthanasia will be scrutinised on a vertical scale drawn from Ancient Greece. Thirdly, New Zealand’s bill will be analysed from its legislative procedure and key initiatives. Finally, our thoughts about the crux behind the rising legalisation tide contemporarily will be introduced.
Euthanasia means the act or practice of killing or permitting the death of hopelessly sick or injured individuals (such as persons or domestic animals) in a relatively painless way for reasons of mercy.
Usually, there are some differences in euthanasia between passive and active ones, voluntary and involuntary ones. What is legalising in NZ, for example, hinges on voluntary and active euthanasia.
A. Passive & Active
Passive euthanasia is the intentional ending of one person’s life by another, motivated solely by the best interest of the person who dies, through the deliberate withholding of a life-preserving substance or procedure.
Active euthanasia is the intentional ending of one person’s life by another, motivated solely by the best interest of the person who dies, through the deliberate administration of a life-ending substance or procedure.
B. Voluntary & Involuntary
Voluntary euthanasia is to bring an end to a person's life with the explicit consent of that person.
Involuntary euthanasia is always considered as the obverse of voluntary euthanasia, which is carried out at the request of the guardian or a relative of the incapacitated person. Sometimes involuntary euthanasia is against the will of the person himself/herself.
Euthanasia dates back to ancient times. In Sparta, children with physical defects were put to death in order to maintain health and vitality of the population. Although they didn’t ask for children’s permission, this practice met the essential condition of euthanasia, which was to accelerate the process of dying with other’s assistance and the executors wouldn’t take any responsibility for doing so. As a result, it can be deemed as the origin of Euthanasia.
Aristotle, Plato and Pythagoras all expressed support for Euthanasia in their works. They considered it morally reasonable to help the vulnerable volunteers go to their death. This point of view was widely affirmed throughout Ancient Greece, when social productivity was on an extremely low level. Euthanasia won acceptance because it could release the burden of the society and limited resources could be concentrated to develop the state.
In the Middle Ages, Euthanasia was widely banned under the coercion of Churches and emperors. According to the Christian doctrine, the life of man is endued by God, so is man’s death. Only emperors could decide one’s life or death on behalf of God and suicidal behaviors were considered as usurping the power of life decision. Although the productivity in the middle ages were much developed than that in Greek times, manpower was still the major contribution to social wealth. For popes and emperors, manpower was an important source of fortune; thus, they eliminated any form of population loss in order to plunder as much interests as possible.
2.3 Renaissance & Enlightenment
After the Renaissance, discussions on Euthanasia made a gradual comeback. Some scholars objected to it because they believed human should not abandon their rights given by nature, in light of natural rights. However, British philosopher Jeremy Bentham thought euthanasia could be a way to reach maximum happiness, considering reason and social efficiency. This thinking, namely utilitarianism, later found a wide range of recognition from philosophers such as Francis Bacon, Immanuel Kant and David Hume. Nowadays, it still features as an important theoretical basis for euthanasia supporters.
Jeremy Bentham, 1748- 1832, British Philosopher
The concept 「Euthanasia」 was again brought out and put into practice by Nazi Germany. In fact, it was just an excuse to carry out Nazi’s genocidal policy. Therefore, it has left great negative effect on the world’s opinion about euthanasia. After World War II, most countries became very cautious while making suicide-related policy, in case such crimes as murder and fraud happen again.
3.1 Legislative Procedure: The Parliament and the Referendum
Given its birth after 3 prompts since 1995 were aborted within the parliament, NZ’s End of Life Choice Act 2019 had its preparation from 2015 by Davis Seymour, a politician from the party ACT NZ. Before the decisive referendum was released to the public, the bill had undergone 3 successful parliamental-readings from 2017 to 2019.
Decided until 2020 at a binding referendum, which means the democratic result of the referendum will be forceful to the Act’s implementation, End of Life Choice Act will be enacted on in November 2021.
NZ Ballot Paper, released by NZ’s authorities to citizens
3.2 Key Initiatives: Qualification and Execution
In prevention of 「something that could be interpreted in a range of ways」, according to Seymour, the leader of ACT NZ and the sponsor of the euthanasia bill in a TV debate, the NZ bill is designed to be 「much clearer」.
In terms of a qualified 「eligible person」, the Act defines s/he to be an 18+ years old NZ citizen or permanent resident who
suffers from a terminal illness that is likely to end the person’s life within 6 months and
is in an advanced state of irreversible decline in physical capability; and
experiences unbearable suffering that cannot be relieved in a manner that the person considers tolerable; and
is competent to make an informed decision about assisted dying.
(Part1, Section 5)
To check for competence, after an assisted-dying registration is made, a first opinion should be given by the attending medical practitioner, as well as a second one by independent medical practitioner. A third opinion should also be made by psychiatrist, if needed.
If qualified, the eligible person will choose the time for medication, and 4 methods to take medications will be introduced for s/he to choose from.
During the administration of medication, the attending personnel MUST be available with the eligible person until death. Before that, the attending practitioner MUST ask for the eligible person’s feeling at every stage, and further action MUST be stopped if the person rescinds the request to assisted dying or if there is any pressure suspected.
Additionally, the practitioner MUST destroy the prescription if medication is no longer required, for safety concerns.
Though praised as another monumental victory of NZ’s liberal democracy by its proponents, the legalisation of voluntary assisted dying on the other hand recurred a notable amount of bombard from doctors. Indeed, concerning general practitioners, Section 10 states that assisted dying must not be initiated by health practitioner. Besides, in Subsection 8(1), the bill does state that,
「A health practitioner is not under any obligation to assist any person who wishes to exercise the option of receiving assisted dying under this Act if the health practitioner has a conscientious objection to providing that assistance to the person.」
However, doubts are far from dispelled. According to Hospices in New Zealand, ethically, 「euthanasia has no place in palliative care」 as it hastens death. Doctors further argued that 「only when all New Zealanders have ready access to good quality end-of-life care」 can a balanced discussion begin.
Doctors are especially concerned that euthanasia legalisation will undermine their trusting relationship with patients and family.
OUR THOUGHTS & CONCLUSION
Throughout human history, people’s attitudes toward euthanasia vary from time to time. Nowadays, although the justification of euthanasia has been challenged and swiped by its opponents constantly, some nations have put the legalisation of euthanasia on the agenda and more of them are taking a wait-and-see attitude. Generally, people and nations these days tend to entertain a more open-minded attitude toward making decisions on death while dissent will probably persist.
Retrospecting the controversies over euthanasia on a historical scale, in times of low social productivity like Ancient Greece, euthanasia was acceptable as it could alleviate the burden on society as resources were limited and scarce. With the development of social productivity, people’s basic survival need was fulfilled and the population was attached great importance to at that time owing to the soaring need for labour resources. Moreover, the expansion and infiltration of religious influences in the Middle Ages restrained people from deciding their deaths on their own. Therefore, euthanasia was widely banned at that time. During the Renaissance and the Enlightenment, the emphasis laying on human’s natural rights made opinions diverged greatly on euthanasia as the two sides explained the innate rights of man in different ways. In WWII, euthanasia was promoted by Nazi Germany as an excuse to carry out genocide. In contemporary society, endeavors have been made to legalise euthanasia by some NGOs and individuals. The dispute over euthanasia is supposed to continue.
Then, what underlies people’s changing attitudes toward euthanasia? Three views are come up with here. Firstly, people’s opinions on euthanasia are rooted in certain social and economic backgrounds. People acquiesced to euthanasia when social productivity was extremely low. Nowadays, living in a society of affluent material resources, people tend to entertain a more open-minded view on euthanasia. Secondly, the secularization process led to a decline in religious influences, enabling people to repossess their rights to decide on their lives and their deaths. Further, the serenity and dignity in people’s dying moments are valued. In the third place, people’s misgivings have been somehow alleviated by the status quo of nations legally supporting euthanasia: according to the data of Switzerland and other nations, the suicide rate has indeed declined after the legalisation of euthanasia and the negative consequences of which are not as conspicuous as people once feared.
In conclusion, people these days are possessing a much more open attitude toward euthanasia as many proponents claim their rights to be allowed to die with dignity and decide when they want to die. However, the effects of the legislation of euthanasia including New Zealand’s End of Life Choice Act should be tested in practice as many people are worried about the abuse of euthanasia and subsequent ethical issues. There is still a long way for the humanity to go.
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