Thursday, 24 May 2018

Otago University-led Citizens’ Jury highlights complexity around euthanasia debate

A University of Otago-led Citizens’ Jury on euthanasia could not reach agreement about whether it should be legalised, highlighting complexities around the debate.

A group of researchers at the University recently conducted the Citizens’ Jury whereby 15 people randomly selected from the South Dunedin and Te Tai Tonga (the Māori) electoral rolls met together over three days to decide whether they thought the law should be changed to allow some form of euthanasia or assisted dying.

New Zealand is currently considering an End of Life Choice Bill. If the bill (or a modified form) passes the next two readings, it would allow people with a terminal illness or a grievous and irremediable medical condition, the option of making a voluntary choice over the timing of their death if they meet certain criteria.

One of the jury organisers, Emeritus Professor Charlotte Paul from the University of Otago’s Department of Preventive and Social Medicine, explains the jurors listened to seven experts presenting on key aspects of the debate, questioned the speakers and deliberated together.

Despite the contentious nature of the topic and the clear disagreement that emerged amongst the group, the jury was able to deliberate in a respectful and productive manner throughout the process, Professor Paul says.

At the end of the process the jury could not agree because of a difference in how people weighed up the argument from compassion and individual choice versus potential community harm, she says. Ten of the jurors believed these risks could be adequately managed and were in support of a law change, while five believed the potential harms could not be managed and were opposed.

Through the process, four jurors had changed their position to strong opposition, while six had moved from uncertainty or moderate support to strong support.

“This outcome suggests that informed deliberation will not produce agreement on the issue. Indeed, it may lead to more people opposing a law change, but it may make people who are supportive more sure of their position,” Professor Paul says.

The jury members were asked before and after whether they thought the issue should be addressed through a national referendum. Although a majority of citizens supported a referendum, this proportion fell after deliberation. The main reason people changed their minds was that they considered the issue to be too complex for a referendum and that the public did not have enough information.

Based on the experience, the University of Otago researchers’ Dr Richard Egan, Dr Simon Walker, Ms Jessica Young, Dr Chris Jackson and Professor Paul made a late submission to the Select Committee on the End of Life Choice Bill outlining their findings. They neither support nor oppose the intent of the Bill.

A Citizens’ Jury is a form of democratic deliberation. It is a forum in which citizens can become informed about and then discuss and debate issues of public interest, often related to social policy.

Professor Paul has helped organised two earlier juries on different topics and says the strength of this approach compared to public surveys, is that people are given the opportunity to become informed on all sides of an issue and to reflect and deliberate with others.

In this case the 15 jurors discussed the following question: Do you think the law in New Zealand should be changed to allow doctors to provide or administer a medicine to a person, at their voluntary and competent request, that will bring about their death, under certain circumstances?

The wording of the question and appointment of experts is overseen by a steering group, who ensure the various issues and perspective are covered and that the process is not biased.

The jurors who supported a law change cited several reasons, including preventing people having to endure unbearable pain, respecting individual choice, protecting loved ones from witnessing suffering and a scepticism about whether the New Zealand health system could sufficiently address the needs of all New Zealanders who are dying.

Those who were opposed to a law change were concerned it would devalue the lives of vulnerable people, raise ethical issues for doctors, erode the care of older and disabled people. They considered a law change would benefit a minority but adversely affect the majority and that sufficient care already existed for a “good death”.

Those supporting a law change recognised the importance of these concerns, but believed they should be addressed through safeguards. Both groups recognised the need for more investment in palliative care.

Radio New Zealand has interviewed some of the researchers and jurors involved in the panel and their views will be shared on ‘Our Changing World’ at 9.06pm this evening.

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