New Zealand's human rights watchdog has given the "orange light" to assisted dying, saying that the Government should proceed with caution and only if strict safeguards are in place.
These safeguards should include a minimum age limit, a prognosis that a person will die within 12 months, and an opt-out clause for doctors who do not want to be part of the euthanasia process.
The Human Rights Commission gave its position on the hugely contentious issue this morning before Parliament's Health Committee.
The committee has been tasked with investigating public attitudes towards legalising medically-assisted dying in New Zealand, in response to a petition by former Labour MP and right-to-die campaigner Maryan Street.
The Human Rights Commission's chief legal adviser Janet Anderson-Bidois said the commission's position was unanimously backed by all commissioners after "a very robust discussion".
"In summary, the commission's agreed position is that a legal framework permitting assistance to be given to a competent, adult, terminally ill person, if he or she autonomously chooses to do so, could be acceptable with the following provisos: that the system must be delivered in a manner consistent with core human rights principles; the process must be accompanied by adequate legal and procedural safeguards; and appropriate palliative care services must be available and accessible for all terminally all people."
Under questioning from MPs, she stressed that the commission's position was neither a "green light" or a "red light" for legalising assisted dying.
"It's very much an orange light. It's a 'proceed with caution if you can safely do so'."
Chief commissioner David Rutherford later added that his office's position was "as far as we're prepared to go".
Commissioners had not reached on consensus on whether assisted dying should be extended to people who were not considered legally "competent".
As a result, their position was that any law change should be limited to the terminally ill.
"One of the key human rights principles we've looked at here is autonomy," Anderson-Bidois said.
"If you are talking about people who do not have competency and capacity in the legal sense, such as young children or people who aren't able to make their decisions, it becomes a much more difficult argument to make.
"You're not talking about the exercise of personal autonomy ... you're talking about other people imposing what they think would be best for that person."
The watchdog recommended "essential" minimum components for an assisted dying regime, while noting that its list of recommendations was not exhaustive.
It suggested "clear and sensible thresholds" for assisted dying, including a minimum age of 18 years old for applicants and "likely death within 12 months".
Any law change should include a "conscientious objection" clause, the commission said.
Some medical staff and pharmacists would not want to participate in the process even if it was legalised, and "such views ought to be respected".
The commission also said potential legalisation of euthanasia should not come at the expense of palliative care.
"Assisted dying should not become a 'default option' or a choice that is made because of an absence of alternatives.'
The Health Committee is considering nearly 20,000 submissions on the petition. Once it has finished public hearings, it will make a recommendation to the Government.
- High thresholds: Minimum age of 18 years old and likely death within 12 months.
- No coercion or influence: System ensures decisions are competently and freely made.
- Medical backing: Appropriate medical advice to confirm prognosis and confirm absence of treatable condition which may affect any decision-making ability.
- Cooling off period: To prevent hasty and reactive decisions, especially after a recent diagnosis.
- Monitoring: Ongoing monitoring and independent review to prevent abuse of the system and give public transparency.
- Judicial oversight: To determine whether thresholds for assisted dying have been met.
- "Conscientious objection" clause: Make participation in the assisted dying process voluntary for medical professionals.
- Cultural considerations: Take into account cultural diversity of NZ in any legal framework, especially those for whom English is a second language.
- Alternatives: Make sure palliative care is accessible and remains a first choice, rather than making assisted dying a default option.