Jay Kuten: Trust and deception in the end of life debate

Pacific Island people during their rally opposing the End of Life Bill at Parliament, Wellington.

In 1924, when democracy was on the rise, not threatened as it is today, Tomas Masaryk, the founding president of what was independent Czechoslovakia, the strongest democracy in Europe, spoke of democracy this way: "Democracy is a way of life, it requires belief in human beings, in humanity. Democracy is a continuing discussion. But the real discussion is only possible if people trust each other and if they try fairly to find the truth."

Opponents of the End Of Life Choice (EOLC) have adopted a contrary view. We've seen how local politicians Harete Hipango and Ian McKelvie express their distrust of the democratic process and of the voters. They oppose the referendum on the EOLC, contending with no factual basis, that average voters - you and I - could not educate ourselves on the issues to make an informed choice.

Whanganui MP Harete Hipango and Rangitikei MP Ian McKelvie.

While I deplore the condescension of those anti-democratic views about the voters, the distrust of our common sense (which certainly reflects negatively on the electoral process by which these two were installed in their exalted positions) I have to acknowledge that there is some truth to the difficulty of voters to inform themselves properly about the EOLC. That's because the opponents, like Maggie Barrie and her fellow religious zealots in the National Party have done everything in their power to misinform and create fear about the bill and its potential.

Unfortunately for the trust we need to have in our institutions and in our professions, a small coterie of like-minded zealots on the board of the NZMA (New Zealand Medical Association) have had their anti-choice positions aired on TV (TV1, May 22 2019) by their head, Dr Kate Baddock. Dr Baddock made a number of outrageous statements unsupported by facts.

Sadly, the NZMA has a history of support of ultra-conservative positions, such as opposition to abortion and even to providing information on contraception.

Dr Baddock claims physician participation in the EOLC is unethical. To bolster this dubious contention, the NZMA commissioned Dr Grant Gillett, an ethicist whose conclusion is based on the principle of "sanctity of life", which he believes is perfectly illustrated by the words of Clint Eastwood's character Will Munny in the film Unforgiven: "It's a heluva thing killing a man; you take away everything he's got and everything he's gonna have."

The trouble is, Will Munny is an alcoholic serial killer bent on revenge killing for hire. Can we look to him for moral guidance?

In response to Dr Baddock's TV appearance, Dr Miles Williams, a Havelock North cardiologist, wrote a letter - to which I was one of 18 physician signatories - calling out Dr Baddock for her fear-mongering in place of dispassionate searching for truth.

Dr Williams' letter read (in part): "There is absolutely no contemporary evidence to support any aspect of your opposition to giving the people of this country the right to End Of Life Choice (EOLC). It has been successfully implemented in many countries, none of whom have reversed their legislation. It is not unethical, there is no evidence in the literature of coercion, increased suicide rates, distrust of doctors, exploitation of the vulnerable or of wrongful deaths."

Dr Williams concludes: "On this issue at least, despite being aware that there is evidence in favour of EOLC, disciplined, rational, evidence-based, scientific medicine has been abandoned (by the NZMA) in favour of conservative cultural and personal beliefs."

Here are a few facts from the two-decade old (1997) experience of end of life choice in Oregon, the model for our own bill.

In Oregon, the most recent figures show that just 204 people received lethal prescriptions under the scheme in 2016. By the end of the year, 56 per cent of those people had used their prescription to die. Nearly 18 per cent had died of other causes without taking the medication, 5 per cent had died of unknown causes, and 22 per cent were still alive.

Jay Kuten

If indeed there is a "slippery slope" as opponents claim, it's the potential erosion of trust through falsehoods by doctors and our public leaders and what that portends for democracy.