Dr Mark Peterson | Chairman
New Zealand Medical Association (NZMA)
Thank you for your reply; needless to say, I find the NZMA and WMA’s position inhumane and – for reasons I shall give in the following - outdated, so given the Association, and yourself, get to frame this debate, I despair. The NZMA's policy against euthanasia is the briefest of documents given the importance of the topic, quote:
1. Has the NZMA polled its members on the issue of whether individual members see euthanasia and assisted suicide services as unethical? What were the results of that polling? This is important given the Association’s policy statement gives no guidance on the nature of ethics, or why euthanasia is unethical.
2. If the NZMA has not polled its members, then why not? Social mores are always changing; the ethical debate here will be evolving over time. Indeed, there are few fields outside medicine where ethics can afford to be less rigid, less debated, yet the simplistic WMA and NZMA statements on euthanasia are basically unchanged.
3. The above two points are further relevant in light of your final 'defence', quote, 'We [NZMA] are not out of step with the rest of the world' ... whereas to the extent you are saying there is a consensus against euthanasia, you are wrong. There is not the world consensus you imply, and hence there are differing interpretations of the Hippocratic Oath. And I’m at pains to point out none of this changes the principle of the individual right involved - I'll deal with that next because you, the NZMA and WMA, avoid it: but first to the matter at hand, how do you explain legal euthanasia in Belgium, Netherlands and Luxembourg, and legal assisted suicide in Switzerland, Germany, Colombia, Japan, plus the US states of Washington, Oregon, Vermont, New Mexico and Montana? These represent large populations, large professional bodies, and indicate there is no 'world consensus' that you would have me believe from your email. To sum up, is the NZMA merely slavishly following what it sees (erroneously) as some type inane consensus that ignores completely the humanity of every individual health services user, their uniqueness, and the sovereignty they hold over their own bodies, without continually working this issue through with its members? What is the evidence that you have consensus even within your own Association, given many doctors are unofficially, illegally, aiding voluntary euthanasia, per the original article of my first email, and my previous quotation of Professor Mike Ardagh, who has a PhD in bioethics, that "active voluntary euthanasia was at times the right thing to do", indicating there is plainly no more consensus amongst Association members, than there is world-wide.
And so to that crucial clarification regarding the central principle here: this debate is about an indivisible individual right - the ownership of one's body: just because there may be a 'consensus' here, either in your mind, or in the form of a 'tyranny of a professional majority', if that right of an individual to live and die as they wish, so long as they do no harm, is ever breached by the supposed consensus, then the consensus is always wrong. Whatever a world body says, if it overrides my right to die in the manner I wish, with whom I wish present, that world body will always, in every individual applicable case, be wrong, and hiding behind such a consensus is lazy and/or irresponsible. This proposition is unarguable, (plus the more years I put behind me the more I have come to understand that truth in numbers and consensus is a very dangerous assumption, especially in this case where the NZMA and WMA ethical assumptions are never stated or explained so members are in no position to critically evaluate the Association’s position.)
To my further two unanswered questions I would like to repeat and expand on.
Secondly, my initial question for yourself, and because you personally will be, whether you like it or not, fronting the coming debate, and this issue revolves entirely around individual responsibility, the human right involved attaching to the individual, this is relevant: do you subscribe to any form of religious belief, and religious practice, that influences your interpretation of the Hippocratic Oath, and thus your anti-euthanasia views? Noting your rather sensationalist ‘throw away’ quotation in the article which set this correspondence off that you ‘wondered where euthanasia would end up, killing the mentally ill, et al’ puts you squarely, personally, in the anti-euthanasia camp. Given the importance of your position in this debate as the mainstream media's first 'go-to', I think it important religious affiliation is put on record, and not just for you, but all parties involved in the debate. (Are statistics available on the religious make up, or not, of NZMA members?)
And a final line of questioning, with troubling implications, that arises from Chief Coroner, Judge MacLean's, recent workshops mooting changing the way deaths are certified in a manner that those (compassionate) doctors who have and do effectively provide, albeit illegally, voluntary euthanasia in specific family cases, can be discovered and convicted. Both in your capacity as Chairman of NZMA, and personally as a human being, how are you going to feel about your members being hauled through the legal system and losing their careers, perhaps their freedom, for the only crime of caring? Quite apart from the undesirable situation this will give rise to, when doctors protecting themselves have to stop their 'past humane practice', meaning every individual at the last stages of their life, if unlucky enough to be trapped in the medical system, will have no hope of mercy. And even with the current unsatisfactory situation I have had friends and acquaintances die of cancer over recent times, the last over April gone, and know from this that pain and severe discomfort is not wholly solved by morphine or any existing pain relieving regime; some of those friends had long periods of pain, for no purpose - their lives were over - and that's before we get to relevant individual preferences regarding dignity and how they would have chosen for their lives to end. (Pity also the idiot consensus against cannabis based pain killers; for one of my friends it proved the best ‘medication’.)
Please note that I write a blog, and all this correspondence is now in the public domain. I look forward to your further reply.