Physician Assisted Dying in New Zealand: A Qualitative Analysis of Submissions to the End of Life Choice Act

Abstract

Physician-assisted dying (PAD) is a contentious issue, with increased recent interest given the efforts and success of the legalisation of PAD in numerous parts of the globe. New Zealand has now legalised PAD with the End of Life Choice Act 2019 (EOLCA), a legislative bill for PAD that received the most public submissions in New Zealand’s history. Despite this, there has not yet been a methodologically transparent and robust qualitative analysis of the submissions to ascertain central themes and concerns contained within these. This thesis aimed to thematically analyse the contents of a sample of 100 of the total submissions for the EOLCA to identify key themes and concerns that submissions raised. Secondary to this is the aim to contextualise these themes, concerns, and central arguments within national and international research to provide an educative stance. Qualitative thematic analysis, specifically a mixed approach using inductive and deductive methods primarily focused on semantic themes was utilised to conduct this research, accompanied by using the software NVivo 12 Plus. A total of 40 themes were identified. Of these, 16 themes were outlined in the results section, with a further discussion of the top 5, while 24 were excluded due to a master’s thesis' scope. They top five themes are: (1) PAD and the EOLCA puts vulnerable populations at risk; (2) the EOLCA enables undue pressure, misuse, and an undesirable sense of obligation to seek and provide PAD; (3) PAD and the EOLCA condone suicide; (4) The EOLCA is inadequate; and (5) PAD and the EOLCA violate the intrinsic value of life. The concerns and arguments made towards PAD and legalising it largely mirrored international research and literature. Submissions’ concerns or assertions were mostly unsupported by the contents of the EOLCA, literature, or data from overseas jurisdictions where PAD is legal. The limitations and strengths of my thesis, including implications of utilising submissions, were outlined. Suggestions for future research were identified, primarily regarding exploring four different potential associations and relationships between specific variables, for example, between risk-aversion and attitudes (e.g. support or opposition etc.) for PAD and the EOLCA.