Lisa Owen interviews Matt Vickers

Vickers says scope of select committee inquiry into assisted dying needs to be “quite tight”, focusing on adults with terminal illness

“So it’s not a question of wanting to die; it’s a question of them facing their death and having a choice about how that actually happens.”

Says Canadian study of NZ suicide statistics show 5-8% of all annual suicides were people with terminal illnesses

“I think that as people gauge public opinion or as MPs gauge public opinion and see how people feel about this, they will begin to take a position and will feel secure in doing so.”

Lisa Owen: Well, Matt Vickers is with me now. Good morning.
Matt Vickers: Good morning, Lisa.
Lecretia’s situation – it really struck a chord with people, and they followed this, and they’ll want to know how you’re doing. What can you tell us?
It’s been a tough few weeks, so the last few weeks I’ve been privately grieving, along with Lecretia’s family. It was a huge loss to us, of course. Lecretia was a wonderful, exceptional human being, and her absence has been felt keenly. I guess, though, with this petition being raised and the issue still live and being discussed, it kind of feels in a lot of ways that she’s still with us.
Has having this campaign, has it helped in any way in what is an incredibly difficult time? Or do you look back and wish that you hadn’t spent the precious time on that in the days leading up to your wife’s death?
Well, it was always very important to Lecretia. She really felt very strongly about this, and I think I actually tried to talk her out of taking this High Court case, I think, when she first raised the idea, but she was so committed and wanting to do it that ultimately I got in behind her and supported her.
Well, if you’re going to succeed in this, you’re going to have to convince MPs, the MPs that you saw then and others. Can you get them to take that political risk of backing you on this?
Yeah, I think so, and some already have. It was really heartening to see when the Voluntary Euthanasia Society petition was presented at Parliament the other day, we had four MPs come down and actually accept the petition, and they all spoke and spoke in support of this. And, of course, David Seymour from the ACT Party has already said that he wanted to drop a bill into the ballot, and he did that almost immediately after Lecretia’s case or High Court proceedings ended and we got the judgement, which was a really brave thing for him to do. I think that as people gauge public opinion or as MPs gauge public opinion and see how people feel about this, they will begin to take a position and will feel secure in doing so.
Well, you’ve got the first step, haven’t you? You’ve won a select committee inquiry, so how would you want that to work?
The terms of reference of the select committee inquiry are really important and this problem definition that they need to come up with. I think they need to keep scope quite tight. I think they need to focus on people that are in situations like Lecretia’s, where they are facing a terminal illness and impending mortality and just focusing on that specific scenario and saying is assisted dying justified in those cases?
Yeah, so just to be clear on that, would it be fair to say that you want a law sort of like Oregon’s, which is only for terminally ill, only for people in the last six months of their law, they have to get two doctors’ and it’s where the person is, they say, of sound mind and settled opinion?
Yes. Yes, I think those sorts of safeguards are important to have. I think we should focus primarily on those people that are dying and are clearly dying and it’s not a question of whether they will recover, et cetera – they’re in that process. So it’s not a question of wanting to die; it’s a question of them facing their death and having a choice about how that actually happens.
I just want to look at some of the arguments around this, and I’m going to put the criticism to you because you do want to engage in this and you do want to address those points. So first off, many disabled people, they live with limitations and they live with pain in their lives and a lot of them find the prospect of this legislation insulting. They worry that they will come under pressure to choose death too.
The people affected by this legislation are terminally ill and whether they’re disabled or not, and it’s about respecting the wishes of a person that is in a situation where they are dying. Yes, disabled people may be suffering from some of the symptoms that terminally ill people suffer from, but those two people are on two different trajectories. One, the disabled people are living their lives and living productive and full lives, and people that are terminally ill are facing their mortality and having to deal with that – a very anxious and scary situation. And having choices and a sense of control over how that plays out I think is a tremendously powerful thing for people to be able to have.
Because it is a slippery slope argument, isn’t it? You say only terminally ill adults, but the fear is that, well, what about terminally ill children? What about those people who fear that they will become a burden? Because Belgium has just extended its laws to include terminally ill children as well.
I think we should look at countries like the Benelux countries and learn from them. There’s no reason for us to copy them outright. We can see what works for New Zealand and what New Zealand is willing to accept as appropriate for our citizens. My personal view is that terminally ill competent adults are really who we’re talking about with this legislation.
So people over the age of 18?
Yes.
Okay. What about people who could face the pressure to end their own lives? You know, someone wants Mum and Dad’s inheritance or they don’t want the burden of looking after a parent or someone in the family?
Yeah, this is the vulnerability argument – that vulnerable people are affected. The Canadian Supreme Court in their decision – what they did is they said that there’s anecdotes on both sides. There’s anecdotes that vulnerable people are going to be affected and there’s difficult cases, and then on the other sides there’s examples of things working well. But when they actually looked at the evidence, and they said that specifically in their judgement, and they looked at the evidence, there is no statistical significance around vulnerable groups being affected. So I don’t buy that argument at all.
What about people who put pressure on themselves? They feel that they’ll be a burden, both emotionally or financially, on someone, so they decide to opt out. It’s a different type of pressure. It’s internal pressure.
Yeah, and Lecretia – she talked about that, I think, on another programme where she felt she didn’t want to be a burden to her family, but it was only part of her thinking. And believe you me, her mother and I made it very clear to her that we were willing to take that on. I think what this is really about is giving people the ability to have discussions with their families about their wishes. You know, the scary thing about this is when— in Canada they drew a distinction between people that are suicidal and people that make a rational decision to die. When you’re facing an impending death, you can make this rational decision which is really not about— you want to live, but you’re making a decision about how you actually pass from this earth. And that’s quite different to someone who can be treated and seen to and helped to see that their situation is not one in which they should take suicide. But people get into this situation where they have this cruel choice between taking suicide in order to prevent future suffering, which may or may not happen, or having to go through this future suffering.
But don’t you think terminally ill people can still be pressured? You know, they may have a terminal illness, but they could still be open to pressure. And once you open that door with this law, isn’t it hard to push back?
I think it would be very hard to convince a competent adult to basically say yes to death if they didn’t want to.
You touched on suicide there. You would argue that people are killing themselves prematurely, wouldn’t you, to avoid uncertainty of not being able to have control so they choose to end their lives earlier.
That’s right. Part of the evidence that was presented in Lecretia’s case was some research that was conducted by a man named John Charles Weaver, who is a Canadian historian. He looked at about 100 years of New Zealand’s suicide records through the Coronials- the Coronial Office – the Coroner’s office. And he looked at the reasons why people were doing it, and he actually was able to determine that between 5-8% of all the annual suicides could be described as self-euthanasia; so people that had terminal illnesses and were actually choosing that option out of the two options.
So how many would that be, then?
That’s about 25 to 30 people a year.
That’s a lot of people who are ending their life prematurely.
Absolutely.
So you are arguing that this would mean that- Well, you’ve written about sitting with Lecretia and her final days. You talked about eating feijoas, playing with the cat, talking about your holidays and all those memories.
Yes. So those 25 to 30 people are forced, essentially, to not tell their family about it to go and do this in a very lonely and often quite violent fashion, whereas what assisted dying would allow is actually the families to deal with this as a family and provide an end stage of life that was pleasant, I guess.
So you’re actually saying that allowing someone to end their life could actually prolong it and the quality in the final days.
That was a key argument in Lecretia’s case. It was that by not having this legislation, it meant that there was a risk that a life would be shortened by not having that legislation. So if we have that legislation in place, it can actually prolong people’s lives.
But couldn’t that happen still when you talk about spending that time with your family? Palliative care is so much better these days; pain can be managed. Some people would say you can have that; you can- you can be in hospice; you can be looked after; you can have those final days with your family without taking your life.
Palliative care in New Zealand is wonderful, and we experienced that with Lecretia. But both the plaintiff’s evidence – Lecretia’s evidence – and the Crown’s evidence was almost a unanimous agreement that palliative care cannot deal with all suffering. It can do a really job with most, and most people, that’s all they’ll ever need. But some people fall outside of what palliative care is able to offer. And it’s really- this is- this legislation, if we get to that point, is for those people. It’s for if the pain becomes too much, they can actually make a choice to say enough is enough. And it’s just those people as well. It’s those people that fear that might happen to them. So Lecretia’s circumstances meant that the medical evidence she was getting was that she may end up being in that situation of having pain that couldn’t be managed by palliative care, and that created psychological suffering and existential suffering. But knowing that assisted dying legislation was there would- it’s like being able to swim to the side of the pool, right? You’re swimming out of this deep end, and none of us has been there yet except for those people in that situation. And she- by having this legislation, it would have been able- she would have been able to say if things got too much and palliative care got to a point where it couldn’t help her, she could say enough is enough.
Some people sitting at home will be thinking to themselves, you know, with circumstances they've experienced with their parents, grandparents, friends; doctors are actually doing this in an ad hoc way; that's what they might be thinking at home. It's happening already.
Yeah, and that's the thing. It's happening, and it's not being reported. So, another piece of evidence that was presented in Lecretia's case was a doctors survey — I think it was from the year 2005, possibly — where doctors were queried anonymously about end-of-life practices, and some of them, you know, actually admitted to the fact that they were doing— they were actually hastening death — and not outside of the principles of the double effect, which is where they ease suffering and hasten death — hastening death without the explicit request of the patient, and, not only that, this report also said that it was happening at rates similar to the Netherlands. So, that's happening, and it's happening in a fashion that there's no real visibility over it. It's this grey area. They talk about this bright line that doesn't exist. So actually getting clear legislation and legislation around these practices and practices like terminal sedation would actually be a wonderful thing to do.
So tell me what is the next step for you now?
Well, with the select committee agreeing to look into this and to conduct an inquiry, that's a tremendous first step. We've never done this before in New Zealand. So with the two private member's bills that we had, they failed at first reading, so it never got to select committee, so this is wonderful. So what will happen now is the select committee will decide on the terms of reference and the problem definition, and I'd encourage them to keep that scope quite small on to terminally ill patients only — to look at people like in Lecretia's situation — and figure out what is the right sort of policy position to deal with those sorts of cases.
You're determined to deliver this legacy?
Well, I feel like Lecretia deserves this.
Okay, thank you very much for joining us this morning. We're going to keep watching with interest and hopefully we'll talk to you again.
Transcript provided by Able. www.able.co.nz

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