Euthanasia referendum – the case for ‘No’

As well as choosing a new government, October’s election gives us the opportunity to support or oppose the legalisation of euthanasia and recreational use of cannabis. Here, Sinéad Donnelly of the Care Alliance argues for a ‘No’ vote in the referendum on the End of Life Choice Act.

The referendum question is not about whether a case can be made for euthanasia in New Zealand. It’s about the robustness of a particular law – the End of Life Choice Act 2019.

The Act is wider than many assisted death laws because it allows both assisted suicide and euthanasia. By contrast, Victoria – with a small exception – and states such as Oregon and California only allow assisted suicide.

The Act poses a significant risk of wrongful deaths. There are too many uncertainties involved, including the difficulties of accurately predicting how long someone will live, the possibility of a wrongful medical diagnosis, and the difficulties of determining competence. Neither is it designed as a measure of ‘last resort’ for ‘difficult cases’ because people do not have to be in pain and nor do they first have to try treatments or palliative care, even if they would be effective.

There is a high risk that persons will feel coerced into an assisted death, whether from their own feelings of being a burden or because of an uncaring family or uncaring society. The wording in the Act simply states that the attending doctor should “do their best to ensure that the person expresses their wish free from pressure from any other person”. This suggests an acceptance that coercion will happen, indicating a lower standard of professional behaviour than is normally expected of doctors. As the NZMA has noted: “The provisions in the Bill will not ensure that a decision to seek assisted dying will always be made freely and without subtle coercion.”

Under the Act, terminally ill persons are not necessarily excluded if they are suffering from depression or an underlying mental illness. No mental health screening is required of a terminally ill person who asks for euthanasia. Depression is very difficult to detect, and even mild depression can seriously skew a person’s judgement.

There is no requirement that a person be competent at the time the lethal dose is to be administered, unlike overseas jurisdictions. Incredibly, there is also no mandatory cooling-off period before the administration of the lethal dose, as with overseas laws. The only timeframe specified in the End of Life Choice Act 2019 is a minimum of 48 hours between the writing of the prescription and the chosen time of death. That means the process from request to death could happen in four days.

In 2019, a group of New Zealand researchers and mental health practitioners, having looked at the overseas evidence, wrote an open letter stating it cannot be ruled out that legalising assisted dying won’t lead to further increases in our already tragically high suicide rates.

Finally, the Act fails to provide a corresponding right to receive palliative care. In Canada, with a similar law, there is evidence of patients choosing assisted death because they could not access quality palliative care. There is not yet uniform access to palliative care in New Zealand.

It’s not compassionate to vote for this dangerous and flawed law. Even those who favour the idea of euthanasia will vote No to this Act.

  • What’s your view? Contribute to the debate through the ‘Comment’ box below.

About Sinead Donnelly

Sinead Donnelly
Dr Sinéad Donnelly is a specialist in palliative medicine with 30 years' experience in Ireland, Scotland, USA and Aotearoa. Sinéad leads the Doctors Say No open letter expressing 1,700 doctors’ concerns about the legalisation of euthanasia in Aotearoa New Zealand. Sinéad is also a founding member of Care Alliance, a network of organisations in New Zealand promoting excellence in palliative care and opposing the legalisation of euthanasia.


  1. Avatar

    Opposing the EOLC Act has nothing to do with religion. In my view it is mischievous and misleading to bring in the religious aspect. I seek answers to whether there are adequate safeguards and whether there can be deaths that people did not consent to or want. Would the following questions provide a ‘YES’ response?

    1. Are independent witnesses required at key stages of the process?

    2. Is there is test of mental competence prior to the lethal dose being administered?

    3. Is there a cooling off period?

    4. Does either of the two doctors need to have specialist medical knowledge of the person’s illness?

    Shockingly, the answer is ‘NO’ to all the above questions.

    In addition there are a number of other reasons listed in the article above.

    Hence the only logical and safe response is a loud ‘NO’ in the referendum.

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    Every country compassionate enough to adopt Voluntary Assisted dying/ Voluntary euthanasia legislation has met strong opposition from fundamental conservative Christians and their organizations, inclusive the Roman Catholic church, the one with the deep pockets! One of the arguments that are used presently as “flavor of the month” is:” we are not against euthanasia in principle, but we don’t want this bill”. After 2.5 year of scrutiny in our Parliament, the Bill has been approved with a big majority by our elected Parliamentarians, and received Royal Assent, and is now called: the “End of Life Choice Act 2019”. ALL leaders of our major political parties support the Act. Many Christians inclusive Roman Catholics support the Act. Don’t take my word for it, but google: “Ian Wood Christians supporting Choice for Voluntary Euthanasia”. And/ or read the Act on line: Please VOTE YES for compassion, vote YES for Voluntary euthanasia.

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      There are many reasons to oppose the EOLC act without resorting to criticising anyone’s religious beliefs. If people oppose (or support) the act due to their religion, their arguments for their choice are still worth looking at, especially if supported by non-religious evidence. Otherwise, you end up having to say that anyone with a perceived ‘vested interest’ in a particular topic has no valid opinion – e.g. should Greenpeace members’ opinions on environmental matters be discounted because they might be biased? Of course not. In any case, you correctly point out that there are people of faith who are supportive, which actually weakens your argument that opposition arises from religious people.

      Reasons to oppose the act are numerous, but particularly because it is not as safe as overseas laws and lacks provisions many of them have.
      There is no waiting period to allow people to come to terms with a bad diagnosis (15 days in Oregon, 9 in Victoria, 10 in Canada).
      There are no independent witnesses (2 required in Victoria). In fact, someone can sign for the person without any adequate check of their intent.
      There is no requirement that either of the doctors have any expertise, experience, or training in the disease the person has (unlike Victoria or Oregon). A person with cancer need not even have seen an oncologist.
      There is no specific requirement in the act that the person be assessed as fully competent at the time of lethal medication administration – only in the earlier stages – and this is important because we know that many people do become delirious at the end of their life.

      I’m afraid I don’t have the same faith in the parliamentary process that you do, as amendments along these lines to make the act safer were voted down in parliament, despite clearly being of benefit and seen fit to be part of overseas laws.

      Remember that the vote is not about euthanasia or assisted suicide in principle, but about the specific act as it stands now.

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      Goodness me Allan you must not have been paying attention to the fact that almost every medical body is opposed to this dangerous Act. Spreading falsehoods that it is only religious people who oppose this act are simply not going to cut it with readers. Maybe you should have a look at the NZMA’s latest publication which definitively shows that most of its members oppose the EOLCA. Yes you may be right that the majority of our Parliamentarians voted for this bill but how many of them bothered to be properly informed about it? I’d call readings of the Bill in Parliament where the vast majority of those that voted for the Act never even bothered to attend a telling sign.