Seymour DavidDAVID SEYMOUR (Leader—ACT): Thank you Madam Chair. I take this opportunity to answer some of the questions as best I can that have so far been raised.We had the first speech other than mine from Chris Penk who queried whether the use of the word persons" would imply that all persons with a terminal illness were eligible for assisted dying under this law. And the answer to that is: of course not. One of the central concepts of Part 1 is eligibility and having a terminal illness is but one of those potential criteria a person has to meet in order to be eligible. We were asked if terminal illness was defined. Well yes it is; if the member cares to continue reading after the word "illness" it says "likely to end [their life] within six months". So you've got a definition there. He asked about the words "Lethal dose of medication"; he asked why that had been removed. It simply is a matter of efficient legal drafting. If he cares to look at the interpretation section which is part of Part 1 it gives the definition that medication is a lethal dose of that medication. As I said in my opening remarks people should look very carefully at that interpretation section because words defined in the interpretation section have the meaning given in the interpretation section for the remainder of the bill.We were asked if the Code of Health and Disability Services Consumers' Rights—what happens when that conflicts with the bill? Well statute law overrides that particular code. I will have to check but I understand the code itself actually says that. We were asked why one medical practitioner the independent medical practitioner must have five years of experience. The fact is that the bill as introduced didn't require either of the medical practitioners—either the attending or replacement medical practitioner or the independent medical practitioner—to have a given length of tenure in the medical profession because the fact is that the medical practitioners as you also see in the interpretation section are defined as a doctor who is registered with the Medical Council of New Zealand. That is not a low bar and I think members of this committee should be very careful about how they describe the experience of medical practitioners. Those who are doctors registered with the Medical Council are already extremely highly trained and experienced people. I think stating that the independent medical practitioner must have five years of experience is a useful reassurance that that medical practitioner will be even more experienced than the other medical practitioner that's examined the person.We were asked about nurse practitioners and how they have been included as capable of undertaking a role under the bill. Well first of all I think it's worth talking a little bit about what a nurse practitioner is. It's somebody who has had 300 hours of supervised clinical experience who has a master's degree who specialised in an area of nursing for four years. These are highly skilled and experienced nurses who routinely carry out procedures such as filling out death certificates for patients who have died. I see no reason why under the supervision of a doctor they should not be able to carry out certain procedures that they are used to carrying out in every other area of medicine under this bill. Particularly for those New Zealanders who live in remote areas where it can often be difficult to get access to a medical doctor being able to have a nurse practitioner who is perfectly qualified to carry out a role seems like an appropriate thing to do.We then had a very well-appreciated contribution from Louisa Wall. Louisa I want to acknowledge that you are giving this speech a week after your loss and only a day after a funeral. I know that people talked a little bit about courage; that takes courage very few members would have. I want to thank you for your support of the concept. I also want to thank you for your industriousness along with Lawrence Yule in bringing an amendment that really is an alternative bill. It gives an alternate way of achieving the overarching objectives of the End of Life Choice Bill of alleviating suffering and giving choice to those who want it while protecting those who want nothing to do with it. So I want to thank you for that and commend you.I want to say with some difficulty that I can't support that amendment. There's a few reasons for that—one is that all around the world where assisted dying has been put in place the question of whether the two-doctor model is superior to various judicial models that have been investigated has been asked and answered in a number of courts and select committees around the world. People have said look on balance you are better to have two medical practitioners—the reason being that they have medical knowledge; they understand the medical conditions. To introduce a judicial officer would add inevitably some delay although I accept Lawrence Yule's word that it won't be as big as it's sometimes made out. But on the other hand the judges are still relying entirely on the expertise of the medical officers anyway. I'm just not convinced that it will introduce the greater comfort that's been promised. I'd further say that there are some other issues with the amendment that in my view are problematic. One of them for instance is that judge is effectively making the decision about whether the person has carried out the other possible terms of treatment that might be available. It's very clear in this bill that it is important—and several members who are opposed to the bill have raised this; I think it's one thing we all agree on—that it is the person in question who makes the decision. It shouldn't be a judge deciding whether or not the person should have other types of treatment. So I want to thank Louisa Wall.The other issue Louisa raised is the 12 months. Around the world six months is the time period that has been used. I agree that for the purposes of insurance for the number of preparations that people may make when they are ill they want to be able to have 12 months or even longer to prepare for their departure from this world. However I'm not convinced that it takes more than six months to go through the process of applying to become eligible for an assisted death and having one of those. So I think six months is the best practice around the world and we should keep that.We saw Simon O'Connor ask why it is that we say that we're making a lawful process. I think it's important that legislation communicates to people outside this Chamber what the intentions of elected representatives are. It's very much the case that we make sure there is a process that is lawful. I guess some people might be pedants and argue about redundancy and drafting but frankly I don't think it serves the committee to have debates at that level. He also said that assisted dying is euphemistic and we should define the process as available. Well again I point the member—and I said this in my opening address and I knew it would come up—to the interpretation section where both the process where the person takes the medication that ends their life and the process where the doctor applies it to them are defined. Mr O'Connor again mentioned that term "Lethal dose of" which of course is defined in the interpretation section.I want to turn to David Carter who is someone I've enjoyed a very good relationship with and have had a lot of respect for over a long period of time. Look I just put two propositions to Mr Carter. One is that people always say that there's the potential for undetectable coercion. Two things about that: one is that when we look around the world we don't find evidence of it and second of all I don't believe that it's a standard that people apply to other aspects of law. They certainly don't apply it to any of the other medical decisions that people make and if they did the entire field of medicine would be unworkable. I think if the member's been prepared to preside over a set of statutes since 1994 that allow all of those things then I'd urge them to consider this bill by the same standards.Second of all the faith in palliative care. I'm a big fan of palliative care. I've got great faith in palliative care but I want to point out to the member that while there are many many successful instances of palliative care giving people good deaths—in fact those are by far and away the majority. In the Lecretia Seales court case it was accepted by both sides uncontested as evidence that palliative care is great for many but it does not work for all. Lecretia Seales of course was one of those very public exceptions.We then got to Alfred Ngaro who said that we should according to the parliamentary prayer lay aside all private and personal interests. I agree with him completely. He said that the Attorney-General had said that we were going to get possible litigation on the age because the Attorney-General section 7 report recommended an age of 16 rather than 18 according to the New Zealand Bill of Rights Act. I think we need to remind Mr Ngaro of why we're here: we're here because Lecretia Seales and her legal team took a case to the High Court calling on the Bill of Rights arguing or claiming that Lecretia Seales' rights under the Act had been violated by Parliament's laws. The judge said "I'm not going to make laws; you have to go to Parliament".Sitting suspended from 6 p.m. to 7.30 p.m.DAVID SEYMOUR: Thank you Mr Chair. I finished with a couple of calls just addressing some of the issues that had been raised by members in regard to Part 1 of the End of Life Choice Bill. In the first hour or so of the debate I addressed things that have been said by Chris Penk Louisa Wall Simon O'Connor David Carter and Alfred Ngaro. I was about to get to responding to comments made by Poto Williams.Poto Williams I think really made two important points. One is that death is very difficult regardless of how it happens. There's a paradox about it that Poto brought up which is that on the one hand you want to see one's relatives stop suffering; on the other hand as soon as they're gone you wish that they could come back. It's a very difficult and paradoxical process that is part of the human condition. One of the things I'd say to Poto Williams and people that listen to her comments is that it is undeniably true that people come to the topic of death with a variety of perspectives lived-experiences faiths and also a variety of practical situations—different conditions and different circumstances.What this bill is about is giving choice and safety giving people an ability to make a particular choice should it suit them. It doesn't take anything away from all of the other choices people might have; it gives an additional choice to some people who might want it. I would put it to Poto Williams that for some people in certain circumstances—people of certain perspectives on the world—this is a choice that makes this suffering that much less than it currently has to be.Poto Williams also said that we need to debate on the facts something that we heard in the second reading very strongly from Deborah Russell in her contribution. I completely agree. I'll make a quick comment that on all of the issues that are debated on this particular topic there is always speculation about what might happen were New Zealand to change its laws. But when we evaluate that speculation we should always have reference to the considerable body of empirical evidence that has been formed in countries around the world—countries that are inhabited now by some 200 million people; countries that in some cases have had assisted dying laws on their books in operation for 20 years. That is where we should look if we want to demystify or clarify what we might think the outcomes of an assisted dying law in New Zealand should be.Finally Lawrence Yule made a contribution in regard to the Supplementary Order Paper that he and Louisa Wall have jointly covered. I've already addressed that Supplementary Order Paper to some extent and that makes a response to Lawrence Yule's views. But Lawrence also acknowledged something very important: that there is considerable support and that we do owe it to think very carefully about the people at home and what it is that they might want especially those who want choice. Thank you Mr Chair."