"Every person matters… always! He mea nui te ora o nga tangata katoa... i nga wa katoa!" So reads New Zealand's Support Life Sunday tagline.

Inspired by the Vatican document Dignitas Infinita (On Human Dignity), the day reaffirms "the indispensable nature of the dignity of the human person in Christian anthropology" says Bishop Steve Lowe, president of the NZ Catholic Bishops Conference.

Dignitas Infinita reflects on what this means for individual human rights, how this impacts on our freedom in the moral and social spheres and ways it can be violated - through poverty, war, human trafficking, sexual abuse, abortion and euthanasia, Lowe says.

"We see Support Life Sunday as an opportunity to reaffirm a central and ubiquitous teaching of the Church and we hope it can be imprinted in our hearts and our minds as a daily [not just a Support Life Sunday] calling."

Dr John Kleinsman, director of the Nathaniel Centre, puts it this way - each person's value and worth "calls us to work tirelessly for justice for the weak and needy, the poor and afflicted, the vulnerable, the most insignificant, the marginalised and those downtrodden by the powerful".

Support Life ... how in a country that enables euthanasia?

New Zealand's End of Life (euthanasia) practice is the subject of an ongoing review, says Simon O'Connor MP.

The Minister in charge of the review is David Seymour.

Palliative care specialist Dr Jane Greville and ethics expert Dr Dana Wensley were inaugural members of the three-person review committee in 2021, just before the End of Life Choice Act came into force.

That committee assesses clinicians' reports on each assisted death and checks the law is being complied with. In cases where the law may have been breached, they must alert the End of Life Choice Registrar.

In a letter to Health Minister Shane Reti in March, Greville said that while the new law's introduction had been very smooth, the committee had been "constrained to the point of irrelevance".

Information lacking

There's a lack of information from the Ministry of Health, Greville and Wensley say.

Illustrating this, Wensley says she was denied access to requested data on assisted dying statistics.

Information for the reviewers about the patients was sparse or absent, she and Greville stated.

There are no records about the time patients had their lethal dose of medication, so reviewers could not consider cases where death might have taken longer than expected.

Nor did they have access to "basic material" including a patient's diagnosis, prognosis, assessment of capacity, or information which could help detect any suggestion of coercion.

Wensley and Greville say reports about patients and their doctors' recall of their cases were inconsistent. Greville wrote to Minister Shane Reti about this.

The Ministry's response was the same as when the pair also discovered incomplete and blank patient reports - they were told to "just assume nothing is wrong".

Greville and Wesley also discovered a case where a patient was approved for assisted dying, then died, while having no common language with the medical team and no interpreter provided.

When they raised their concerns about this, the Ministry of Health told them it was not within their remit. Nor did the Ministry acknowledge that the law might be faulty.

They have since had their contracts with the review committee cancelled.

Review underway

The Ministry says there are multiple safeguards built into the law. It will examine the review committee's scope in a review which is now under way.

Source

• NZ Herald
• Substack
• NZ Catholic Bishops Conference

Those concerns have been aired in a series of just-released video interviews, as the Ministry of Health says it's impossible to quantify how many people are living with the post-viral condition today.

A constellation of persisting symptoms thought to accompany 10 to 20 per cent of infections, Long Covid can affect nearly every organ system in our bodies - yet there remains no universally-established treatment or cure.

A major study published earlier this year found that one in five participants reported Long Covid symptoms after their initial infection - and that many patients were still struggling to get help.

Read More

He's concerned about ACT Party leader David Seymour's desire to widen the End of Life Choice Act criteria. Seymour argues the change is necessary, as many who want assisted suicide are "missing out".

Seymour says this is mainly because those people don't have a terminal illness likely to end their lives within six months.

The six-month terminal prognosis requirement prevents those with chronic conditions or disabilities from being eligible.

Betty argues broadening the eligibility criteria would not improve equitable choice for those facing end-of-life decisions.

It should not progress in light of the current palliative care climate in New Zealand, he cautions.

Nor should it happen without careful analysis.

Despite its supreme importance to New Zealand's health system, palliative care is not well catered for, says Betty.

"There's no strategic plan as to what is going to happen with palliative care, there's fragmented services, lack of funding… the list goes on. It's not a situation we can allow as a first-world, caring society."

The contrast and imbalance of palliative care vs assisted suicide and euthanasia is sizeable and cause for concern, he says.

"We have one part of the system fully-funded and overseen in an apparently coherent way by the Ministry of Health (assisted suicide and euthanasia), and the other sector that doesn't even have a strategic plan in place, that is inequitably funded, and has no coherent overview of how to develop the service.

"Why don't we have the exact focus on palliative care, so anyone making the biggest decision of life can make an equitable, informed choice?"

It's remiss of the Government, politicians and the Ministry of Health, he says.

Betty says New Zealand's 5,500 GPs, specialist GPs, trainees and rural hospital doctors often provide palliative care to their patients free of charge.

That's because there is no funding available for end-of-life care - a serious failing of the system, he says.

"Palliative care is so dependent on local funding, which is traditionally done by DHBs, but there's a total lack of funding, resourcing and a national approach."

This, coupled with a growing workload and an increasing complexity in clinical patient needs, adds pressure to palliative care practices.

"The question becomes - why don't we have that exact same focus on palliative care," Betty says.

The Assisted Dying Service Data and Report from 7 November 2021 to 30 September 2022 says only about 80 percent of those choosing assisted suicide or euthanasia have access to palliative care.

Betty cautions against this analysis.

"It doesn't show perceptions of what is going on or the quality of care they are receiving," he says.

The data's effectiveness should be questioned when the Act is reviewed, he adds.

"Everyone is affected by death and dying. That is part of health. Good dying and having equitable choice is a fundamental part of the healthcare system we set up. It has to be given space and focus at this point."

Source

• Scoop
• NZ Herald
• 1News

Statistics New Zealand today released its year-on-year update on births and deaths between September 2021 and September 2022.

It showed a "sharp" 10 per cent increase in the mortality rate, with 38,052 registered deaths up from 34,578 in the previous 12 months.

Of these, 5 per cent - or 2025 deaths - were attributed to Covid, according to the Ministry of Health data. Read more

The Assisted Dying Service which came into force last November has just released its first annual report for the period from November to March.

By the end of June, 400 people had applied for an assisted death, 143 had died and 68 were deemed ineligible.

John Kleinsman, a bioethicist at The Nathaniel Centre, is particularly concerned that the Ministry of Health has six full-time positions dedicated to assisted dying - and there is no dedicated team for palliative care.

"There is an action plan for palliative care developed after a review in 2017 but many health practitioners working in the palliative care sector are not seeing any action," he says.

"Proponents of the End of Life Choice Act promoted its introduction as being all about choice, but it's a 'Clayton's choice' (no choice) if palliative care, which we know is effective, is not accessible."

Kleinsman says that end-of-life "choice" is heavily weighted in favour of assisted dying, because of the increasing demands on New Zealand's underfunded palliative care sector.

"Demand is projected to rise 50 per cent in the next 10-to-12 years and access is uneven depending on where you live," he says.

"It has been well documented that palliative care is grossly underfunded in Aotearoa.

"The idea that assisted dying will become a solution to a lack of quality end-of-life care is extremely distressing and frankly unethical and undermines the notion of it being a choice."

The Assisted Dying Service's report also notes many want the threshold for accessing euthanasia lowered - they complain the End of Life Choice Act is too restrictive.

"The legislation is not as enabling as some people were hoping for with the criteria making an assisted death more restrictive than overseas jurisdictions," the report says.

Kleinsman says this is precisely the pattern that has unfolded in other countries and something that many warned about.

He says he hopes the Ministry will collect a broader range of data on assisted dying, including people's reasons for choosing the service.

At present, statistics are collected on applications, numbers accepted for assisted dying and those who don't qualify or died before being able to make use of the Service.

Additional statistics could help safeguard against wrongful deaths by helping to identify whether people felt a "duty to die" because they were a burden on family or caregivers, he says.

The Assisted Dying Service's first annual report says patients and family members say they are happy with the Service, the support from doctors and the "peaceful" and "dignified" deaths of their loved ones.

Sources

• NZ Herald
• Supplied - Nathaniel Centre

After a decade of falling numbers, the Ministry of Health says 13,246 abortions were performed last year.

This number compared to 12,857 in 2019 and 16,630 in 2010.

The mean age of those having an abortion last year was 28; 40 percent of all abortions were for those aged over 30.

The report says the changes decriminalised abortion, allowed self-referral to abortion services and created provisions for abortions to occur in a range of settings, including primary care.

It also notes a big spike in women having their pregnancies terminated in the Southern District Health Board area. It says there was a 12 percent increase in abortion numbers between 2019 and 2020 - up from 847 to 956.

The increase was largely driven by an increase in abortions at The Women's Clinic in Invercargill. Four hundred abortions were carried out at the clinic in 2020 compared with 235 the year before.

Elsewhere in New Zealand, two facilities started providing abortions for the first time last year — Timaru Hospital and the Family Planning Clinic in Whangarei.

The report writers consider it positive that access to abortion services had not decreased due to the Covid-19 pandemic.

They also note changes to the timing of abortions. Last year 45 percent were accessed before eight weeks' gestation, up from 27 percent in 2019.

The Abortion Law Reform Association of New Zealand president Terry Bellamak said early abortions were better for people. They did not have to remain pregnant for as long and the earlier the abortion, the safer it was, Bellamak says.

‘‘Reducing delay was a key benefit of removing abortion from the Crimes Act and treating it like all other healthcare."

‘‘Actual reduction in delay, as expected, shows the new abortion system is working much better than the old one."

Pope's advice

Pope Francis has some advice for healthcare workers caught between abortion law changes and their employment.

Legislation legalising abortion makes no difference to it being wrong, he told a group of pharmacists and other medical professionals who met him at the Vatican last weekend.

All healthcare professionals have a right to conscientious objection, just as they have a right to denounce unjust harm inflicted on innocent and defenseless life, he said.

"I have been very clear — it [abortion] is homicide and it is not licit to become complicit.

"Abortion is still morally wrong and healthcare workers should refuse to be part of it."

The "ethical dimension" of healthcare workers' and pharmacists' professions must be supported and protected, he said.

As individuals, all pharmacists handle "medicinal products that may, however, turn into poison."

Francis advised them to be vigilant to make sure their goal always is to protect "the life of the patient in all of its aspects," he said.

"You are always at the service of human life, and this may, in certain cases, lead to conscientious objection, which is not disloyalty, rather the opposite, (it is) loyalty to your profession, if validly motivated."

Source

• ODT
• UCA News
• Image: Otago Daily Times

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Ministry of Health officials have highlighted "complex and sensitive elements" to the End of Life Choice Act and incoming assisted dying regime in a briefing paper to Health Minister Andrew Little.

The paper had been given to Director-General of Health Dr Ashley Bloomfield in January, highlighting numerous unresolved questions and risks surrounding assisted dying services.

Among the "elements" include "uncertainty" over how many people will seek assisted death, terminally ill patients having to travel for services when the law comes into effect, competing pressures in the health system, and a possible need to rewrite parts of the law to resolve "legislative issues".

A statutory body, Support and Consultation for End of Life in New Zealand (SCENZ), will include up of 11 medical experts who will manage the incoming assisted dying regime.

SCENZ will develop and oversee the standards for terminally ill patients should receive when they seek an assisted death.

Although the ministry says work to implement the new Act is "well underway", legal action over assisted dying services is considered "almost certain", due to the "strong views from sections of the public in favour and against assisted dying".

Dr John Kleinsman, the director of The Nathaniel Centre for Bioethics sees "a tragic irony in the fact that the Ministry of Health is able to put so many resources into enabling assisted death, and fully funding it in our country, when palliative care is not equitably available and also not fully funded.

"Advocates of the law change campaigned for change on the basis of choice, but for too many people they won't have the choice to access quality end of life care.

"I am not surprised by the prospect of further legal action. On the one hand, the Act is a terribly weak piece of legislation and I and many others, including lawyers and health practitioners, pointed out its many problems when the Bill was being considered.

"Too many MP's chose not to listen."

"Many proponents of the new law made it abundantly clear at the time it was passed that they thought it too restrictive! So they will be pushing hard for the law to be expanded. It is what has happened in every other jurisdiction and it will happen here."

Although Little has been approached by media about the Act in recent weeks. he has not been available.

The three "key risk factors" health officials identified in the briefing paper given to Little and Bloomfield are that: parts of the health sector are refusing to be involved in assisted dying; competing resources and pressures in the health system; and inadequate or insufficient engagement with "stakeholders" within the short timeframe to enact the law.

A "key question" is whether assisted dying should be fully government funded, or a "mixed-model". How a mixed-model could work was not detailed.

The legislation, which was a members' bill, may need to be rewritten "to ensure that the Act functions as intended", the paper said.

Source

• Stuff
• Supplied: The Nathanial Centre for Bioethics
• Image: Stuff

He has a twitter account and tweeting his memes and a fan base dubbed "Bloomers".

He has had a song written about him; hand towels bearing his image have sold out, but you can still get the T-shirts and tote bags.

Colleagues describe him as "measured, methodical, calm and sensible".

Former health reporter Tess Nichol, writing for the American online magazine Slate, described him as "New Zealand's current obsession, an unlikely heartthrob, a mild-mannered health care hero".

It is Dr Ashley Bloomfield, New Zealand's director-general of health.

At 1 pm each day, offering a steady and sure message for a country in lockdown with a lifetime's worth of experience, skills and training geared towards the crisis we are now experiencing.

"There's an incredible congruity between what he thinks and how he lives his life. He's a person of incredible integrity, with regard for others, and humility," says Damon Plimmer.

Plimmer grew up with Bloomfield in Tawa and went to school with him at Scots College.

More recently had contact with him again when the Bloomfields moved to Eastbourne; Plimmer was the vicar at Eastbourne's Anglican church, St Alban's.

"He was able to balance work life and home life so well for someone whose job makes such demands."

The Bloomfields' connection to the church was a path to faith but also to community.

It's a link both Plimmer and former Presbyterian vicar Reuben Hardie recall.

There's no hidden agenda with Ash," Hardie says. "He's in that role for the right reasons. He's very easy going, gets on with everyone."

Plimmer watches the 1 pm updates and sees the Bloomfield he recognises from Eastbourne, "with a sense of humility and service".

"This isn't about him. It's about the wellbeing of this country".

"I have a huge amount of confidence and trust in Ash".

"I can't think of a better person to be Director-General of Health at this time," Plimmer says.

Bloomfield and wife Libby, who is also a doctor have raised three children. They are either nearing the end of secondary school or studying at university.

The Bloomfield family's faith connection continues through St Alban's Church, where Libby Bloomfield is a member of the vestry.

Source

• nzherald.co.nz
• nzdoctor.co.nz
• stfabiola.co.nz
• thebold.nz
• tvnz.co.nz
• slate.com
• thecoast.net.nz
• Image: thecoast.net.nz

"Should there be a need for restrictions on receiving Communion or the exchange of the Sign of Peace, these will be immediately notified to parishes throughout the country," said the acting director of New Zealand's National Liturgy Father John O'Connor.

O'Connor noted some churches have taken it upon themselves to stop giving holy communion from a communal cup because many of their members had recently come back from China, for example."

President of the NZ Catholic Bishops Conference, Patrick Dunn says the current advice of health professionals is there is no need to take further precautions.

"Following discussions with health professionals about the implication of COVID-19 Coronavirus on Catholic gatherings for liturgy, our advice is that the current standard procedures for safeguarding health continue to be followed and there is no need for churches to take further precautions at this stage", Dunn said.

The position follows current literature and expert medical advice that concludes sipping the communion chalice and sharing a handshake represents minimal risk of transmission of COVID-19.

It is also advice provided to members of the Anglican Church in New Zealand.

However, Hilary Babcock, an infectious disease specialist at Washington University, suggests people do not share food utensils, glasses and cups.

"I think that's higher-risk than if there is a way to allow people to have individual cups or individual containers that they are using and either disposing of or having cleaned afterwards."

Caitlin Rivers, an infectious disease specialist with the Johns Hopkins Center for Health Security, says that although communion wine does contain alcohol, it's probably not enough to kill the coronavirus that causes COVID-19.

Sources

• facebook.com
• nzherald.co.nz
• anglicanlife.org
• nzherald.co.nz
• npr.org
• chchcatholic.nz
• Image: www.telegraph.co.uk

The ministry was responding to a request from the Government and Administration Select Committee for a written submission on a petition it is considering which was presented in June 2017 by Family First's Bob McCoskrie.

The petition containing 22,334 signatures requests "that an expert panel be appointed to investigate the public health effects and societal harms of pornography to both children and adults, and to make policy recommendations to Parliament."

The Ministry has now submitted a research proposal for the consideration of the cross-government Sexual Violence Prevention Advisory Board.

The Ministry's Service Commission acting director, Keriana Brooking, says it wants to understand the scope and amount of pornography usage by New Zealanders, as well as the issues encountered by schools, young people and health providers.

In its submission, the Ministry states that violence towards women and girls is depicted in 80% of online content.

"This has a variety of harmful impacts on children and young people's sexual expectations, attitudes and behaviour.

"European research showed an association between regular viewing of pornography and initiation of sexual violence."

Australian gender and violence research Associate Professor, Michael Flood, has been recently been quoted as saying "If we're genuinely concerned about sexual harassment and abuse, whether at work or on campus or in school, then we have to address pornography."

The ministry in its submission, however, pointed out that Flood has also said that simplistic deterministic claims about the effects of viewing pornography were unhelpful.

He said the effect varies depending on the amount and nature of pornography used, and characteristics of the viewer.

Flood said a broader focus on social and public health effects of pornography would be more useful.

Source

• tvnz.co.nz
• echildhood.org
• familyfirst.org.nz
• radionz.co.nz
• familyfirst.org.nz
• Image: familyfirst

"The way to interpret this is that the laws are still in effect, but the judges and the policemen have all been fired," said Wang Feng, director of the Brookings-Tsinghua Center for Public Policy in Beijing. "Soon the laws will also change."

In a move that may signal a future weakening of the policy, the State Council, China's Cabinet, said it proposed to merge the existing Ministry of Health with the National Population and Family Planning Commission.

"Saying that there is no change is a measure to save face and a recognition that they can't announce all the change in one day," said Wang.

"The National Population and Family Planning Commission was created for a single mandate of controlling population growth and now they no longer have that, those powers have been dissolved.

"What the government is doing is a major political move and they cannot make or announce all the policy changes that go along with it in one day. They know they can't dismantle everything all at once. It's going to take some time.

"It will not take long, however, for change to come. Leaders are aware of the changing demographics. The one-child policy has taken a toll on the labor force and has jeopardised the future economy….

"The family planning commission employs more than 500,000 people and it will be difficult to change this bureaucracy and what it has done for so many years.

"The people employed within the system are going to be redundant and many of them will likely leave, enabling a shifting of resources to the Ministry of Health. Those resources can be used to invest in reproductive health," Wang said.

"This is going to be an extremely difficult process."

Sources:

Xinhua

Wall Street Journal

Image: China Mike