Herald political editor Audrey Young on what you need to know about David Seymour's End of Life Choice Bill.

Act: The leader of the Act party and Epsom MP, David Seymour, is the sponsor of the End of Life Choice Bill, legalising assisted suicide.

Bill: The bill allows people with less than six months to live or with a grievous and irremediable medical condition to have a lethal dose of medication to cause death, although Seymour has said that if the bill passes its second reading, he will put up an amendment to ensure it applies only to people to people with six months to live.

Criteria: To be eligible, the patient must meet the above conditions and be in an advanced state of irreversible decline in capability and experiencing unbearable suffering, be aged at least 18 and be a New Zealand citizen or resident. The patient must initiate the request to their attending medical practitioner who must seek an independent second opinion and, if either of them doubt the competence of the patient, get a third from a psychiatrist or psychologist.

Disabililty sector: The bill has been a big issue in the disability community with Disability Rights Commissioner Paula Tesoriero saying it undermined years of work to change perceptions of disabled people and put them at significant risk especially from the risk of coercion. Seymour accused her of wading into the debate in an unprofessional way.

Effect of death: Under the bill, a person who dies as the result of assisted dying would be deemed for all contractual purposes to have died as if assisted dying has not been provided, meaning that life insurance, which is often voided by suicide, and other contracts held by the patient would not be affected. But the death certificate would have to record the assisted death, and the underlying illness.

Faith-based submitters: Many oppose the bill on religious grounds, believing that life is sacred, although by no means all opponents fall into this category.

Dr Mary English appeared before the select committee alongside her husband, former Prime Minister Bill English, both opposing the bill. Photo / Mark Mitchell.
Dr Mary English appeared before the select committee alongside her husband, former Prime Minister Bill English, both opposing the bill. Photo / Mark Mitchell.

Many oppose it on the grounds it could normalise suicide, that the vulnerable could be subtly coerced by being made to feel like a burden. Many doctors believe it is unethical. Former Prime Minister Bill English and his GP wife Dr Mary English have been strong opponents.

Geoffrey Palmer: Former Prime Minister Sir Geoffrey Palmer and Family Court Judge Paul von Dadelszen propose that the Family Court be the final authority, not two doctors. The suggestion has been picked up in an amendment promoted by Labour MP Louis Wall and National MP Lawrence Yule.

Health sector: Opinions on the bill in the health sector are mixed with the New Zealand Medical Association and Hospice New Zealand opposing any form of medically assisted suicide. The NZ Nurses Organisation advocate for patient choice but the bill is silent on conscientious objections for nurses.

Immunity: Under current law it is a crime to assist someone to commit suicide. The bill would give doctors immunity from criminal or civil action, so long as they acted in good faith and without negligence.

Former Prime Minister Sir Geoffrey Palmer is proposing that the Family Court make the final decision on each case of assisted dying. Photo / Mark Mitchell
Former Prime Minister Sir Geoffrey Palmer is proposing that the Family Court make the final decision on each case of assisted dying. Photo / Mark Mitchell

If it passes its second reading, it is likely to be made clearer that the doctors could still be subject to complaints to the Health and Disability Commissioner and complaints under the Health Practitioners Competence Assurance Act.

Justice committee: Raymond Huo (Labour) chairs the committee which heard submissions on the bill. Other Labour members were Ginny Anderson, Greg O'Connor and Duncan Webb. National members were Maggie Barry, Chris Bishop, Mark Mitchell and Nick Smith.

Kith and kin: Many supporters of the bill are friends and family of people who have witnessed loved ones suffer a painful death. Many submissions also argued that the right to die in dignity is a human right.

Lecretia Seales: More than any other person in recent years, Lecretia Seales who died of brain cancer, raised awareness of assisted dying when she unsuccessfully sought a court declaration to protect her doctor legally from helping her commit suicide. A lawyer, she had studied the Canadian Supreme court case allowing assisted dying. Her husband Matt Vickers has continued the campaign.

Methods: Under the Seymour bill, the patient would choose the method of assisted dying - ingestion or intravenous delivery triggered by the person, ingestion through a tube, or injection - and the time of it to be administered. The doctor would need to order the prescription at least 48 hours before the nominated time to give them sufficient time to change their mind.

New Zealand First led by Winston Peters could make the difference between the bill eventually passing or not passing. The party position at present is that it will support the bill at third reading if an amendment is passed making its commencement conditional on a referendum. It has not decided its position if a referendum is voted down in the committee stages.

Overseas: Victoria in Australia was the most recent state to adopt euthanasia. Its law came into effect on June 19 this year. Switzerland has had it since the 1940s, Oregon in the United States since 1998, Belgium and the Netherlands since 2002 and Canada since 2017.

Previous bills: Michael Laws' Death with Dignity Bill in 1995 failed to at its first vote by 61 to 29. Peter Brown's almost identical Death with Dignity Bill came close in 2003 but was voted down at its first reading by 60 votes to 58 with one abstention. Maryan Street drew up a End of Life Choice Bill in 2012 but withdrew it in 2013 ahead of the 2014 election. Seymour's bill was entered into the Ballot in October 2015 and drawn out in June 2017.

Quantity of submissions: Parliament's justice select committee received 39,159 submissions, including from 199 organisations, said to be the largest number of any select committee previously. They heard oral evidence from 1350 submitters in 14 cities.

Registrar: The Director-General of Health must appoint a ministry employee be the registrar of assisted dying to administer the law such as receiving the required forms from doctors and specialists, and co-signing prescription for lethal drugs.

Support and Consultation for End of Life in New Zealand (SCENZ) is the group of medical staff under the bill, including doctors, psychiatrists and pharmacists willing to take part in assisted dying.

Terminology: Although it is not clear in the bill, the term "assisted dying" covers both "assisted suicide" in which a patient takes a dose of lethal drugs which he or she has requested, and "euthanasia" when someone else administers a lethal dose of drugs.

Unresolved: Among the unresolved issues is whether the list of doctors who are willing to assist patients to die early would be a public or private list.; whether other health professionals would be able to conscientiously object to take part; whether private profit-making assisted-dying clinics could be set up.

Voting: The second reading debate on the End of Life Choice Bill will begin on Wednesday June 26 but if the business ahead of it on Parliament's agenda takes up its maximum time, voting on the second reading will be delayed until July 31, the next members' day.

What happens next? If the bill passes its second reading, Parliament will begin considering the bill in its committee stages, when supplementary order papers (amendments) will be considered.

Debate on the second reading will begin on Wednesday evening and probably be voted on, but if the debate has not concluded the vote will be on July 31. Photo / Mark Mitchell
Debate on the second reading will begin on Wednesday evening and probably be voted on, but if the debate has not concluded the vote will be on July 31. Photo / Mark Mitchell

Opponents of the bill are promising to draw up hundreds of amendments which could extend debate for months and possibly into next year.

XXXII: Thirty two is the majority by which the bill passed its first reading, 76 to 44. It would take 17 MPs to move from support to oppose for the bill to fail.

Young people: People aged 16 and 17 are not eligible for assisted dying, something the Attorney General declared was inconsistent with section 19 of the Bill of Rights Act, under which every person aged 16 and over has the right to be free from age discrimination.

Zealots: They probably call themselves passionate rather than zealots but the bill is creating some interesting bed-fellows. Those who passionately oppose the bill include Chris Penk, Simon O'Connor, Maggie Barry, Alfred Ngaro, David Clark, and Phil Twyford. Those who passionately support it are David Seymour, Louisa Wall, Iain lees-Galloway, Amy Adams, Nikki Kaye and Ruth Dyson.