For Pacific people, the end of life legislation is a direct challenge to their basic beliefs about life and death. Dr Collin Tukuitonga explains why.

On October 17, New Zealanders will elect a new government. In addition to electing new leaders for our nation, New Zealanders will also be asked about the End of Life Choice Act 2019 and the cannabis legalisation and control referendum.

In the end of life choice referendum, New Zealanders will be asked if they support or do not support the End of Life Choice Act 2019 coming into force. This Act gives people with a terminal illness the option of requesting assisted dying.

In the Act, ‘assisted dying’ means:

– A person’s doctor or nurse practitioner giving them medication to relieve their suffering by bringing on death; or

– The taking of medication by the person to relieve their suffering by bringing on death

The End of Life Choice Act 2019 sets out who is eligible to request assistance to die and the process to follow to ensure choices are made freely and without coercion.

For Pacific people, the End of Life Choice Act 2019 is a direct challenge to their basic beliefs about life and death. The Act seeks to balance the need to avoid pain and suffering by people with terminal illness while safe guarding them against unscrupulous individuals and practices taking advantage of vulnerable people.

Pacific people in particular will be dismayed and disappointed by this seemingly callous and casual approach to the end of human life. The majority of the Pacific people are Christians and believe human life is sacred, a gift from God to be respected and protected at all costs. This is called the sanctity of life. The Bible teaches that human beings are created in the image of God, that murder is forbidden and only God can make decisions about life and death.

The health profession in Aotearoa New Zealand is capable of treating people with terminal illness effectively with care and compassion. Unfortunately, gaps in our ability to provide effective high quality end of life care reflects the funding situation in New Zealand – where a significant share of the cost of palliative care relies on volunteers and voluntary donations. We would do well to ensure that adequate public funding is provided for high quality palliative care at this most critical time.

Supporters of the End of Life Choice Act 2019 will argue that only a handful of people will be affected by the legislation and the Act if safe. Those opposing the legislation claim the Act is open to manipulation by unscrupulous health workers and others who stand to gain from assisted death of affected individuals. They state that legislation is not safe and it should not be supported.

The individual right to choose is central in the legislation. Choice has become a key aspect of modern life from deciding on breakfast cereals at the supermarket and the colour of the new car. Choice requires full understanding of the impact and consequences of the choices made and, in this case, the consequence is final and immutable.

The Pasifika Medical Association (PMA) is the largest NGO representing the majority of Pacific health professionals in Aotearoa/New Zealand and the Pacific region. PMA does not have a view on the End of Life Choice Act 2019. However, PMA encourages Pacific people to vote and to consider the advantages and disadvantages of the End of Life Choice Act 2019. It is an important addition to the legislative frameworks that exist in Aotearoa/New Zealand.

Dr Collin Tukuitonga is Associate Dean Pacific and Associate Professor of Public Health at the University of Auckland and a member of the Health Quality & Safety Commission Board

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