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Telegraph
12 hours ago
- Health
- Telegraph
Everywhere assisted dying is introduced, the safeguards never prove effective
The emotion of watching the progress of the assisted dying Bill through Parliament will differ for every person watching it. For some, it will elicit grief or perhaps fear. For others, hope. For me, watching from afar, it's déjà vu. Before assisted dying was legalised in New Zealand three and a half years ago, it was me speaking in Parliament against its passage. And the debate here is all too spookily reminiscent of what we saw. We, like British MPs, were promised that the eligibility criteria would be tight and that claims of a slippery slope were a 'fallacy'. My work on this issue began when I chaired the New Zealand Parliament's Health Committee inquiry into assisted dying. It was the largest inquiry ever undertaken by the New Zealand parliament and was our nation's most detailed public discussion on this topic. Again and again, I asked questions and probed for the details of how proposed safeguards, which promised to ensure no mistakes were made, would in fact do so. Each time, I was assured that the laws would function to ensure horror cases simply could not occur, that the criteria would never be relaxed, and that this law would be the safest in the world. Listening now to the UK debate, the lines from supporters here are redolent of what I heard back then. Kim Leadbeater, were it not for her broad Yorkshire tones, could well play a Kiwi parliamentarian, breezily dismissing the concerns voiced by my Committee and me. And, if the language matches closely, the proposed 'safeguards' are near-identical. Central to the safeguards in the Kiwi law was the introduction of a body called: 'The End of Life Review Committee'. It broadly mirrors Leadbeater's proposals for a supervisory review body following the removal of the High Court safeguard. In New Zealand, three experts – two health practitioners and one medical ethicist – sit on this Committee. Their role was to review assisted deaths and to scrutinise complex cases where something may have gone wrong. But things did not work out as they were supposed to. One of the Committee's original members resigned over serious concerns about its ability to supervise the implementation of assisted suicide and euthanasia. Another member was pushed out, it is thought, because she was raising too many concerns about the operation of the new law. Two out of three members were gone. Both subsequently went public and stated that the Committee's oversight of the law was so limited that wrongful deaths could go undetected. They said they were 'extremely concerned' about how little information they received relating to patients' deaths, leading to them feeling 'constrained to the point of irrelevance'. In one deeply troubling case, the Review Committee was able to establish that a dementia patient, who did not speak English, was approved for assisted dying despite not having an interpreter present for their assessment. The New Zealand experience is closely mirrored in every country where similar laws have been introduced in recent years. In our Antipodean neighbour, Australia, several states have legalised assisted dying in the last few years. Queensland's law was said to have taken extra time to progress through parliament to make sure the law would guarantee that every death was 'truly voluntary', 'without coercion', and with the strictest safeguards. In fact, patients there have killed themselves with others' drugs and, in a scathing judgement, a coroner ruled that it was in fact 'not a well-considered law', but rather had 'inadequate' safeguards that had taken just '107 days to be exposed'. In another case, a woman appeared in court last week, charged with her husband's murder, having admitted to her family that she had administered him three lethal doses of drugs after he told doctors he wanted to 'go on' rather than die via assisted dying. She denies murder, and the case continues. Meanwhile, Oregon – one of the first jurisdictions to legalise assisted dying – has seen its eligibility criteria stretched to include patients with anorexia, diabetes, or arthritis. Around half of those opting for assisted suicide now cite feeling like a 'burden' on others as a motivating factor. None of the parliamentarians voting for those laws did so believing that they were dangerous. In New Zealand, my colleagues certainly did not do so. They had repeatedly been assured that the safeguards were absolute, inviolable, and complete. But, if the experience of those who have passed these laws is anything to go by, British parliamentarians should think very carefully before passing the assisted dying Bill. Safeguards so often promised have proven so rarely effective. If British MPs are not certain that they will work here, my urgent advice, having seen this play out before, would be to reject this Bill today.
RTÉ News
2 days ago
- Health
- RTÉ News
Health committee to hear CHI apology over practices
Executives and senior clinicians from Children's Health Ireland are appearing before the Health Committee this morning to update politicians on spinal surgeries, the recent hip surgery review and other governance issues at CHI. Chief Executive Lucy Nugent will apologise to the children and families impacted by recent revelations about CHI's culture, governance and practices, which she says have "led to great pain being inflicted upon some of those who were in our care". Ms Nugent is in her current post five months, having started her career as a nurse in CHI Temple Street. In recent months, members of the opposition have detailed what they called "unnecessary" hip surgeries from an unpublished report into practices at three CHI hospitals. The review into Developmental Dysplasia of the Hip, or DDH, found that the majority of children who had pelvic osteotomy surgery at CHI Temple Street and the National Orthopaedic Hospital in Cappagh did not meet the threshold for surgery based on the criteria used for the audit. Children who had surgery at Crumlin were found to have met the threshold. Ms Nugent will tell the committee that the family of one child they identified who experienced complications due to surgery has been contacted and supported through an open disclosure process. She will also say that all families have now been contacted about the next steps, and if their child was part of the audit. Multidisciplinary team review clinics have begun seeing patients, with 60 seen so far. CHI has said the aim of the review clinics is to assess complications only, and it hopes to have all children seen within six months. Ms Nugent will say she does "not underestimate the stress and anxiety that families are rightfully feeling throughout this audit process." "To one family in particular, whose child experienced complications during their care in Children's Health Ireland, I extend my heartfelt apology. I would like to give my assurance to all of the families affected, that they will be directly supported and are being contacted with follow up information and the next steps." Separately, the HSE is currently developing an independent review into hip surgeries going back to 2010, to determine if harm has occurred for any child, as the original audit does not establish this. Going forward, any child who is listed for hip surgery with CHI will have their case discussed at multidisciplinary team meetings. On the recent report into culture and governance issues at CHI and the use of the National Treatment Purchase Fund, Ms Nugent will apologise for not being at liberty to publish the report, saying it is her legal duty not to do so, despite media reports. Executives at CHI will also update the committee on progress in paediatric spinal surgery services. At the start of June, 48 patients were waiting over four months for surgery, a decrease since the start of the year. CHI will also say that 223 spinal procedures have been completed in the year to date, up on 196 such operations at the same point last year. An additional Consultant Orthopaedic Spinal Surgeon is due to start in August, with recruitment under way for a further three consultant orthopaedic surgeons.
RNZ News
12-06-2025
- Health
- RNZ News
Health Committee backs bill to extend hospital stays for new mums, but how much will it cost?
The bill also requires the lead maternity carer to let the mother know what she is eligible for. Photo: 123RF Parliament's Health Committee recommends the Pae Ora Amendment Bill - which would offer mothers and newborns a minimum three-day postnatal hospital stay - be passed without any changes. However, the committee's report also notes the cost to add capacity to the system could be over $100 million, plus up to $38.3 million in annual operational costs. The Pae Ora (Healthy Futures) (3 Day Postnatal Stay) Amendment Bill proposes the 48 hours of funded inpatient post-natal care currently available, be upped to 72 hours. The bill also requires the lead maternity carer to let the mother know what she is eligible for. In the report, the Health Committee said they had "no issues regarding the legislation's design to bring to the attention of the House". But the report said the Committee were "advised" that 175 additional beds would need to be added to the nation-wide system to manage the increase of inpatient care. The capital expenditure - the initial amount needed to set-up - was estimated at $100 million, while annual operational costs could range from $31.9 million and $38.3 million, the report said. The costs are based on 100 percent demand. As not all mothers would use the 72-hour entitlement, the overall cost would be lower, the report said. The majority of submitters were in favour of the bill. But the report said regardless of stance, submitters agreed that a 72-hour stay alone will not solve broader issues in the maternity sector. "They sought wider reforms , including resourcing, alongside any change to postnatal care entitlements," the report concluded. Labour Health spokesperson Ayesha Verrall. Photo: VNP/Louis Collins Labour's health spokesperson Ayesha Verrall called on the government to provide the funding needed to implement the changes. "Anything less is a cynical attempt to look like it cares about women's health while actually doing nothing," Verrall said. National MP Catherine Wedd - who put the bill forward - said funding decisions were yet to be made. "If the bill progresses, our focus will be on making sure any changes are realistic, well-planned and sustainable - so they can truly deliver for families and for our health system," she said in a written statement. National MP Catherine Wedd. Photo: RNZ / Angus Dreaver "Investing in postnatal care through this bill will yield long-term benefits for the health and wellbeing of mothers, babies and whānau across New Zealand." She said the government "absolutely" supported the goal of ensuring women have access to safe and high-quality postnatal care. The bill is set to go back to the House for further debate. Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday .
New York Times
11-06-2025
- Health
- New York Times
Party Politics Is Said to Have Played a Role in Kennedy's Firing of Vaccine Advisers
Health Secretary Robert F. Kennedy Jr., who has promised to make decisions rooted in 'gold-standard science,' fired an entire committee of vaccine advisers in part because all were appointed by a Democratic president and some had made donations to Democrats, according to a White House official and another person familiar with Mr. Kennedy's thinking. When he announced the firings on Monday, Mr. Kennedy cited the members' financial ties to industry and their 'immersion in a system of industry-aligned incentives.' But according to the White House official and the other person, both of whom spoke on the condition of anonymity to discuss an internal matter, Mr. Kennedy was also concerned with 'political conflicts.' The mass firing was another example of the unusually muscular — and sometimes chaotic — way that Mr. Kennedy has exercised his authority, often while setting vaccine policy. Like President Trump, Mr. Kennedy inserts himself in policy matters ordinarily left to underlings, and sometimes announces new policies on social media, with scant or no evidence to support them. Delegates to the American Medical Association, the nation's largest doctors group, which is holding its annual meeting in Chicago this week, adopted a resolution on Tuesday calling for Mr. Kennedy to immediately reverse his decision, and directed its leadership to ask the Senate Health Committee to investigate it. Two public health law experts said on Tuesday that Mr. Kennedy had the authority to fire all 17 members of the Advisory Committee for Immunization Practices, or A.C.I.P., which gives guidance to the Centers for Disease Control and Prevention. But both said that federal law required him not to act in an arbitrary manner. 'The secretary has ultimate authority, but he can't exercise that authority arbitrarily, casually, haphazardly — he actually needs to use a deliberative process,' said one of those experts, Lawrence O. Gostin, a professor of global health law at Georgetown University. 'I think he's very vulnerable to a judicial challenge.' Want all of The Times? Subscribe.
RNZ News
05-06-2025
- Health
- RNZ News
Health Committee hears submissions on Medicines Amendment Bill
The Medicines Amendment Bill will continue to be considered by the Health Committee over the next two months. Photo: 123RF MPs on Parliament's Health Select Committee were told by the public this week that, while the government's Medicines Amendment Bill is a step in the right direction, changes are still needed to ensure it balances safety with efficiency. The bill, which amends the Medicines Act 1981, received its first reading in April, and is a component of a wider push by the government to loosen burdensome regulation across sectors. Under current settings, prescription medicines can take a long time to be approved, funded, and made available to the New Zealanders that need them. Historically, we have ranked well below the OECD average for access to medicines. In his oral submission on the bill, New Zealand Initiative chief economist Dr Eric Crampton suggested that New Zealand simply wasn't a desirable target market for medicine companies. "We are a small, relatively poor country at the far end of the world that will not be at the top of anyone's agenda in getting their regulatory affairs team to deal with paperwork… It can take years after a drug has been approved by at least two markets overseas before anybody puts it into the New Zealand approvals process." In his submission, Crampton mentioned the concept of an "invisible graveyard," referring to the people who may have died or been harmed as a consequence of not having access to unapproved medicines. The Medicines Amendment Bill seeks to shake up the status quo, improving patients' access to medication by doing three things. Primarily it would introduce what has been dubbed as 'the rule of two', whereby if a medication has been approved for use in two recognised overseas regulators, Medsafe (New Zealand's medicines regulator), can bypass its usual, often lengthy, assessment process. The government hopes this will reduce the time it takes for new medicines to reach patients. The recognised overseas regulators are those from Australia, Canada, the EU, UK, USA, Switzerland and Singapore. As well as these fast-tracking medicine approvals, the bill also expands the power to prescribe medicine to a wider range of healthcare professionals, such as nurse practitioners, midwives, dentists, and optometrists, so long as the medication falls within their scope of practice. Thirdly, the bill updates some of the settings around the Medicines Classification Committee, which makes recommendations to the Minister of Health around how new medicines should be classed. This week the Health Committee also heard from Dr Graeme Jarvis, CEO of Medicines New Zealand, which represents pharmaceutical companies. While in support of the bill's intent, he told MPs, it needs refinement in order to better achieve its goal outcomes. When asked by Labour's spokesperson for Health Ayesha Verrall, why he was sceptical of the automatic approvals that Dr Crampton had suggested to the committee earlier, Dr Jarvis suggested that doing so would create "unintended consequences around parallel importing and other activities". "People flood the market, and the product may not necessarily be what you think it is, you may end up with counterfeit products coming in. There is no clawback for the regulator to go after a sponsor who has been acting in an unsatisfactory manner." When New Zealand lawmakers look outward for policy inspiration, they tend not to just throw a dart at a map on the wall and hope for the best. There are generally agreed comparable countries, commonly drawn on as case studies for good lawmaking here, which vary depending on the topic. The Medicines Amendment Bill's 'rule of two' provisions reflects this tradition, using a familiar set of jurisdictions in its list of recognised overseas regulators. Members of the Wellington Community Justice Project, a volunteer group made up of Victoria University law students, suggested to the Health Committee that while these overseas regulators have been historically reliable, that does not mean they always will be. "While the bill allows the minister to make rules for verification through secondary legislation so they can be refined to reflect changes in best international practice, we feel as though there needs to be something within the text of the bill itself, ensuring that the regulatory authorities themselves are regularly assessed and upheld to the standards of best international practice," the students told the committee. They went on to cite the current changes being made to the United States FDA, which has long been the world leader in approving medicine. "The FDA's placement on this list, most notably for the reason that the FDA is currently headed by RFK Jr, a health secretary who has been described as a conspiracy theorist, and relevant to this bill, has cancelled or frozen billions of dollars of research grants for the development of the medicines. Clearly, this bill [will outlast] RFK Junior's appointment. However, this example illustrates the need for a process to review the regulatory authorities in Section 22A, so when the questions arise about jurisdictions' suitabilities to be on the two-step verification process, these are able to be addressed." The Medicines Amendment Bill will continue to be considered by the Health Committee over the next two months, before being reported back to the House by the 9 August. You can listen to the audio version of this story by clicking the link near the top of the page. *RNZ's The House, with insights into Parliament, legislation and issues, is made with funding from Parliament's Office of the Clerk.
