Barry MaggieHon MAGGIE BARRY (National—North Shore): Thank you very much Mr Chair. I spoke at both of the previous readings and I've outlined many of my concerns in a general and philosophical sense against euthanasia and assisted suicide. I have been the deputy chair of the Justice Committee and have read and listened to many thousands of submitters and it is my intention in this call tonight to focus on some of their voices in relation to Part 1. But I would say to colleagues in the Chamber how important it is that we do retain a respectful dialogue here and that we debate things and listen to each other—qualities which are not always seen when we debate bills in the House.But I as a member of the select committee was involved in the gathering of the evidence and the material. The select committee process has come under a lot of criticism unfairly so. I would like to commend the staff and the people who have worked extremely hard to do their very best with 39000 submissions and the logistics of it have been extraordinary. This document here which is our report from the Justice Committee really details and summarises some of the people who have made submissions so I urge members to read it and also to understand that we were unable to agree that this bill be passed. Eight people had different views on this matter. It was very appropriate that it comes back to this place and in this process that we all argue through the various points and have our say and reflect and channel and advocate for the people whose voices are not always heard in this place and the people who have strongly submitted to us that they feel that this is a very dangerous bill and with many risks. The proposals that have been put forward in the Supplementary Order Paper (SOP) in the name of the sponsoring member David Seymour number 259 do not change that. They do not make any material difference to the risks and the dangers that people feel about this bill.So I would like to start by looking at some of the aspects of this bill the purpose of the Act: to give persons who have a terminal illness the options. So how do you define terminal illness"? How do you understand what that means and for many occasions when we were at the select committee process we had a variety of people who came forward to us and told us that the prognosis is not an exact science that doctors on their own admission get this sort of thing very wrong very often. In particular I'd like to draw the attention of members here tonight to the New Zealand Medical Association's submission. They talked about "While advances in diagnostic tools and improvements in knowledge [generally] regarding the progression of disease continue it is still an inexact science." It is something where "Errors occur and individuals can still prove all of the experts wrong. According to The American Journal of Medicine and [The British Medical Journal] Quality and Safety11 published studies indicate misdiagnoses occur anywhere from 10-15 percent of the time." So the idea that anyone would rely on a doctor's diagnosis of a terminal illness with six months—it is an arbitrary figure. It's not used internationally. It is one that has no particular application and really does not give anyone any real safeguards.So I think that while the member has pretended really—or has attempted perhaps would be a kinder way of putting it—to make the safeguards better by determining that a terminal illness should apply I think it is still deeply flawed and there is not anywhere near enough detail involved in that process.I have looked at a number of elements in Part 1. I've put a couple of SOPs in. I'll talk about the competency one in this call but I would like to draw attention to Chris Penk's Supplementary Order Paper 207 which looks to replace the name "End of Life Choice Act 2017" with "Euthanasia and Assisted Suicide Act 2019." I support that as a Supplementary Order Paper because I believe it tells it like it is. Words are important and definitions are important and the euphemisms that the member has applied in refusing to use the exact terminology I think has really clouded a lot of the important issues that we need to discuss and embrace.So from the point of view of Supplementary Order Paper 262 I have put in around competency it looks very much at the Victorian model which the member has drawn on for his amendment but it goes into a lot more detail. I think part of the issue—and we heard this from the Alzheimer's society who made several submissions to us on this subject and it's part of the major issue for them—is the issue of competency and how on earth you tell that somebody has reached the point where they are no longer able to decide. The pressure on vulnerable people to end their lives—[Bell rung]CHAIRPERSON (Adrian Rurawhe): The Hon Maggie Barry.Hon MAGGIE BARRY: Thank you Mr Chair. The competency issues that they drew our attention to include four main points and I would like to spell those out in some detail because I think that they are not well served within this bill. It is a weak piece of legislation and the new definitions don't change that. They've talked about a lack of a cooling-off period. So in other jurisdictions—and remembering there are only 5 percent of the world's jurisdictions that have gone down the euthanasia path; many billions of people manage to live very safely without it. And by the way if we do bring it in there's no going back so that's another reason why we need to pay particular attention to this.But the nature of the tests for mental capacity Alzheimer's New Zealand told us were very inexact. The tests are either open to question or they really don't exist. This is from the body of experts. So psychogeriatricians typically would have a half a dozen episodes and appointments with people. I know with my own mother who had dementia it was a very long slow process to reach a diagnosis. It's not something that can be done in one or two sessions with a doctor. So good and safe decisions currently are not capable of being done under one or two appointments. That is a very clear point from Alzheimer's New Zealand.Also people's ability to understand can vary over time from complete to non-existent and it depends on the day. These are the factors and the sorts of details that need to be incorporated if we want to have any sense at all that this is safe for people with dementia conditions.Competence as a definition may provide little protection for vulnerable individuals was another point that the dementia groups made to us—that a small number of physicians making euthanasia their core business could result in people or families seeking out doctors to facilitate that easy path.And I come back to the point the Rt Hon David Carter and others have made about coercion. Elder abuse in this country has far too many victims. Many of the people that perpetrate it are from within their own families—something like 75 percent of the people who are abusers are family members. When it comes to dementia and the subtleties around that and the easy ability to confuse as we see from the Alzheimer's society there are no genuine ways in a very short appointment where doctors will be able to make use of what is a very low threshold for competence in this bill. In fact as has been pointed out it is easier to open a bank account than it is to get euthanasia under the provisions that exist in this bill.The other point that they make: temporarily or partially impaired individuals are also at risk. So for those of us who know about people with dementia we know that from time to time from day to day where their mood varies and where they might be upset with infections and so forth their competency flies out the door and it is apparent. Then they go back to another state where it becomes extremely difficult to gather whether they really do understand what is being put to them or not. So in the Supplementary Order Paper I've put forward I want to emphasise that practicable and appropriate support really does need to embrace all of the information and the formats to give it the time to really process the information: to go back to the patient to get psychogeriatricians to get the right people in there to make decisions around whether somebody is competent or not to make an informed decision.So the jurisdictions that have dealt with euthanasia and have had tests around dementia have not come up with particularly good ones. I know that in places like Holland for example they grapple with this all the time. The likelihood of people arriving on the right side of the ledger and determining whether somebody wants to actually have assisted suicide or not is an extremely difficult thing to do. So I believe that it is very important that when we are doing the competency tests this bill is still not in any way appropriate or thorough enough to do the job and to do the people who have perhaps dementia but in an early stage justice.So if the person is assessing whether someone is competent to make an informed decision for the purposes of this legislation they must make reasonable steps and that assessment of time and the environment. So they need to actually go to the person's home. They need to be alongside them and they need to understand their needs. This is not somebody who is on a group of doctors on this committee that the bureaucracy in the ministry would set up. They are not in a position to know—they already; what do they call it? These are the doctors who are "willing to act". Those are not the sorts of doctors who should be working with people with dementia and other mental health injuries. So that is why I would like to do the SOP."