The Spirit in Tonga

I spent much of last week in Tonga at the invitation of a ministry based in the Southern Presbytery called 3D Disciples. This is a magnificent disciple making ministry planted by John and Heather Gullick of Riversdale. John has been the Presbyterian minister there for over 30 years and has maintained a lively and active parish for all of that time. He and Heather are a wonderful team and they have continued to bring people to Christ and disciple them through all of those years.

The 3D model is similar to other models which use a mix of classroom based teaching with practical field based experience usually in a place which is quite different from their home background. This both removes distractions and allows students to experience the dislocation of a cultural shift which creates space for them to rely on God more.

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My hosts Tapani and Lele’ana Kauvaka (left) and Foliaki Tauofa.

 

I went up as Moderator to both visit the base they have in Tonga and to make contact with various church leaders up there to highlight to work of 3D. It was, frankly, a God-moment for me.

Tonga is still a world immersed in a Christendom model. From the royal family to many of the government ministers, the public servants and so on down – acknowledgement of God’s role in their lives is a top priority. I spoke twice at the two prisons on Tonga. On both occasions the prisoners welcomed us by bursting out into a beautiful Tongan hymn in perfect 4 part harmony sung with magnificent voices and significant emotion and meaning. It was an incredible display of how deeply the Christian faith has been allowed to mold and shape the character of the nation and, frankly, it is good.

Are there the usual signs of normal human inconsistency and hypocrisy; of syncretism and shallow faith? Of course. But these are significantly outweighed by the incredible fruit a deeply Christian up bringing provides the majority of Tongans. Prayer is second nature. Scripture is referred to and woven into the fabric of their behaviour at every level of life. Love of neighbour is practiced even on the verdant battlefields of Rugby League over there where the hits are ferocious and tempers clearly become frayed yet… after the battle is over both teams will often pray together and thank God for the ability to play the game and enjoy the battle.

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Another very full church on Sunday.

I was asked to bless a new car given to the Minister of Internal Affairs for use by an officer charged with the care of people with disabilities. Every speaker began by saying something to effect that he/she would like to start by giving thanks to Him from who every good gift comes… There is a deep and abiding reverence for God in this nation and it starts at the very top.

The Royal family are committed Christians but not simply as Church goers. The Queen organizes and attends a 5am prayer meeting on the first Sunday of every month to pray specifically for the nation and to seek God for guidance in national affairs. I spoke at this meeting and it was a wonderful experience to see people weeping as they prayed for their own nation.

 

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A car is blessed.

I can imagine some asking or thinking ‘how long can it last?’ One certainly notices that things are changing and this is having an influence on the young but I believe that Tonga will weather many of the storms and contribute significantly to a renewed Church throughout the Pacific.

The nation was once known as the warriors of the Pacific. They are now warriors for God. They have turned their energies towards building the kingdom and I think they will be used in marvelous ways.

God Bless Tonga!

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The famous blow holes.

In the City…

“The city is not to be regarded as an evil invention of… fallen man… The ultimate goal set before humanity at the very beginning was that human culture should take city-form… There should be an urban structuring of human historical existence… The cultural mandate given at creation was a mandate to build the city. Now, after the fall, the city is still a benefit, serving humankind as refuge from the howling wilderness condition into which the fallen human race, exiled from paradise, has been driven… The common grace city has remedial benefits even in a fallen world.[1]

Chicago-02 Thus says Meredith Kline reflecting on the nature and role of the city in call of the Gospel. Quoted in Timothy Keller’s insightful book ‘Center Church.’

Keller builds the case for the Christian community to intentionally target cities in its missional strategy for it is there that we can have the greatest influence over the greatest variety of peoples and cultures.

Keller is not naïve about the challenge. As he says, “The earthly city is a metaphor for human life structured without God, created for self-salvation, self-service, and self-glorification. It portrays a scene of exploitation and injustice.[2]” At the same time however, the critical reason cities are so important to our mission is that “… God “has compassion on all he has made” (Ps 145:9). But of all the things he has made, human beings have pride of place in his heart, because they were made in his image (Gen 9:6; James 3:9). Cities, quite literally, have more of the image of God per square inch than any other place on earth.[3]

Furthermore the pattern of evangelization set in Acts reflects precisely this priority. “The Dictionary of Biblical Imagery in its article on “City” states the following:…There is a sense in which the city is vindicated in the history of the early church — not in the sense that the city is mainly good or cordial to the gospel but in the sense that the city is where most people now live and where the influential power structures exist… It is easy to see that the mission strategy of the early church was to evangelize the city. It is no exaggeration to say that in Acts the church is almost exclusively associated with the city.[4]” This the city sets the pattern for the early spread of the Gospel by informing the shape of how the Church will function within the city.

Paul’s pattern of working within cities proved that, “…if the gospel is unfolded at the urban center, you can effectively reach the region and the surrounding society. Stott cites J. A. Alexander’s insight that Acts shows the spread of the gospel “by the gradual establishment of radiating centres or sources of influence at certain salient points throughout a large part of the Empire.”[5]

In his bookThe Rise of Christianity  Rodney Stark offers a very clear picture of how the Church both used cities to further the cause of the Gospel and was influenced by the structure of cities in shaping its missional task. “To cities filled with the homeless and impoverished, Christianity offered charity as well as hope. To cities filled with newcomers and strangers, Christianity offered an immediate basis for attachments. To cities filled with orphans and widows, Christianity provided a new and expanded sense of family. To cities torn by violent ethnic strife, Christianity offered a new basis for social solidarity…”[6]

The need for Christian influence in our cities has hardly diminished over the last 2000 years but the means by which they are influenced has changed I believe. People today are used to single stop multichoice environments in cities and, to a certain extent at least, churches need to reflect this in the way they structure themselves. That we have something to offer is not in question but how we offer it is. We need again to be influenced by the structure of cities in the offering of the Gospel and frankly this means shaping ourselves to deal with the problems of larger churches.

The mission, essentially, hasn’t changed. There is still a clear need to care for the poor and under-resourced people in cities; there is still a need to address the results of immigration both legal and illegal and there is still a need to provide pathways to better socialization but the general style of living has changed from one centered on communal living and large multi-generational family groups to much smaller, nuclear family or even single generational groups who tend to be much more isolated from their neighbours and other family members. For this reason among others the style and shape of effective Church communities has had to change. This means that in general people are more comfortable in large and anonymous community settings where there is an emphasis on freedom of choice and the ability to take what one wants from an experience without necessarily buying into the whole package.

Interestingly enough this can and should include boutique experiences because this is exactly how the city works. No city would be complete without the small eateries, cafes, boutique fashion shops and dairies. They offer a special experience, very different from the large malls and department stores, which appeals to many. The buying power and efficiency of the larger stores is attractive to most but the smaller shops provide something important as well.

To leverage the efficiencies of a larger group of people with greater buying power Churches in cities now need to be at least 200 strong and be able to grow a group of support staff around the senior minister. This doesn’t so much replace volunteers as provide a structure to more effectively motivate and utilize voluntary labour. And it also shouldn’t preclude the offering of the boutique experience; the contemplative worship experience or the celtic worship experience or the age specific worship experience or the liturgical worship experience. These should be supported and provided by the larger church and they will need support. They seldom can find enough support to remain stand-alone just as the small boutiques shops require the foot traffic of the larger stores to bring customers to their door fronts.

So the issue of how to manage and maintain larger churches is, I believe, a key issue for us today. Cities require much more sophisticated management ability to run smoothly. They require specialist skill to remain livable and large churches require a quite different approach to continue to flourish and gain momentum.  We need to be providing this and training for it in order that we might remain effective in the city.

 

[1]Keller, Timothy. Center Church: Doing Balanced, Gospel-Centered Ministry in Your City (p. 150). Zondervan. Kindle Edition.

[2]Ibid p.141.

[3]Ibid p.141.

[4]Ibid p.148.

[5]Ibid p.149.

[6]Ibid p.149.

Committed

I’ve spent some time pondering the great theme of commitment this Easter. It is, of course, a central theme of evangelicalism but if we scratch a little below the surface it is also a theme of the left as well. Liberalism has always supported an agenda of justice and equality and it is clear that neither of these are possible without some significant commitment from individuals to both behaviours and policies which support them. Commitment, it would seem, is necessary for the realization of any hopeful future.

However, we don’t travel too far down this path before we strike the rather turgid note of moralism or even legalism. It is a mere step to the side from the valid observation that for most good things to persist they require good people to be committed to them to the deathly notes of condemnation poured out on all who will not bow the knee or sign the petition. Salvation by works is writ all through this music.

So how do we strike a balance. Christ calls for commitment to Himself and to the Kingdom in multiple places throughout the Gospel. (Take for example the ‘follow’ motif  in the NT. Jesus uses this word to call for commitment on multiple occasions and it is expanded in many other places to summarise the whole of a disciple’s duty and, indeed, to call for greater commitment to the cause of the Gospel.) There can be no doubt that we are to commit to both him and to his kingdom and that the decision to commit is both worthy and required on more than one occasion. (Rev 32) Recommitment is, in fact, another significant theme in the NT. I suggest the balance is struck in this way…

We should not shy away from both the notion of commitment to God and to the needs of the kingdom of God but this should always be tempered by an even greater emphasis on the commitment of God in Christ to us. Always and on every occasion it is the commitment of Christ which is the greatest theme of the NT and which also acts as the truest motivation for commitment to God by the individual. Every individual commitment should reflect that in committing to God what we are really doing is offering a small (but necessary) token of thanks for the enormous commitment God has shown to us.

So on this Easter morn I rejoice in Christ’s commitment to us all and I am reminded that this commitment calls forth a renewed commitment from me to all that Christ would have me be and do.

Sermon for Easter Sunday 2018

He Is Risen!

John 107-13/ Phil 26-11 / Ruth 41-6

Today we celebrate with all our might the commitment of Jesus – the man who faced down death and won!

Christ is Risen! He is Risen Indeed!

Empty tombThe only people who truly commit are those who believe. Without belief, commitment is either fake or it is fleeting. It is either pretend commitment or it is  passing commitment. Passing commitment is commitment that looks good to begin with but is withdrawn when it becomes inconvenient. But Christ’s commitment to us is unquestionable because He gave all that He had to give – He gave His life!

Christ is Risen! He is Risen Indeed!

Commitment proves itself largely by staying in the game, by remaining faithful; by finishing the job and by paying the price. And there’s always a price friends for without a price there’s no need for commitment. Without a sacrifice there’s no work to do and without an exchange of goods our commitment is an empty promise.

Today of all days we celebrate commitment but not ours. Rather we celebrate One who was committed to us! We celebrate One who stayed in the game till the very highest price was paid. Today we celebrate the commitment of Jesus!

 Christ is Risen! He is Risen Indeed!

We need to ask ourselves what the essence of this commitment was however. We all know He died but His death is really just the top of a mountain of commitment. Underneath that is the bulk of the mountain upon which the top rests and for Christ this bulk is the greatest mountain that ever existed.

You see Christ’s commitment begins with a terrible wrenching away from His home in eternity with God. Christ has left His home and His comfort and all that was familiar to Him to commit to us – very much as Ruth left her home and people and everything she had known to support her mother-in-law Naomi.

And this is a commitment that is counted daily in grief and loneliness as we exist without those whom we love. Christ choose to leave His loving relationship with God and to commit to us

Christ is Risen! He is Risen Indeed!

Secondly it’s a commitment to the cause of a separated and barren people; the same kind of commitment Boaz was willing to make to Ruth. Naomi had nothing left in the world except a property she could not manage and a daughter-in-law who had no future. So her future was blank; her present was one of desperate poverty and her past one of complete loss. However, Boaz was willing to buy into that bloodline in order to revive it and bring hope to it. He was willing to bear that risk in his own flesh.

Christ does the same for you and I today. He buys into our checkered past and our barren future and he says to each one of us – through me you shall prosper again; you shall rise again; you shall rejoice again! I shall bless your bloodline and restore it to its intended glory. You shall live again.

Christ is Risen! He is Risen Indeed!

Finally Christ is not only willing to restore our bloodline but he is willing to invite us into His bloodline; to make us inheritors of what was only His. His future has become our future; his possession our possession; his glory our glory; his place in heaven our place in heaven! We get to share in all that was his just as Ruth and Naomi get to share in all that belonged to Boaz.

It’s a double whammy. Christ restores our inheritance and He makes us to share in His inheritance. Christ saves us and he give us a new future which was wholly His.

Christ is Risen! He is Risen Indeed!

I wonder, are we prepared to receive these things? We can only do so when we realise that our futures are nothing without Christ. We can only do so when we realise that what we have is ashes. We can only do so when we desire health more that we desire  comfort and security.

The surgeon promises healing but only if we’re prepared for some discomfort. We cannot be operated on at home. The ground promises a crop but only if it will yield to the plough first. The grain will give us bread but only if it is crushed first to make the flour. We have to leave behind the body of death if we are going to receive the gift of life and, frankly, some people prefer certainty so much that they will not open their lives to Christ and to His uncertainties. Come Lord – help us to let go of the past.

Christ is Risen! He is Risen Indeed!

Today Christ is Risen but not so that we may stay at home – rather so that we may enter into a new home with Him; a home we could barely imagine – a home where pain and grief are gone and where we may find true joy and true comfort.

What we experience today is but a shadow of the things to come. What we are addicted to today is but a shadow of the comfort and joy Christ has won for us today but – we have a choice to make. Shall we stay with the old and let Christ hang on the Cross or shall we make the swap; rags for riches; pain for pleasure; grief for fulfilment.

Are we prepared to listen to the Good Shepherd and follow Him into the good pasture or will we prefer our old inadequate joys instead? He longs that we should listen. He longs that we should follow. He longs that we should enjoy the blessings of a life committed to following His call.

He is committed to us. Are we now to be committed to Him?

Christ is Risen! He is Risen Indeed!

I appeal to you today. Don’t stay at home! Don’t stay in your comfortable but sad existence. Take a risk with God! God risked everything for us – will we not take a risk with Him? Choose today whom you will serve. Choose today whose future you will take. He will not force us but He continually calls to us as the Good Shepherd to open our hearts to His voice and to say to Him, ‘Yes Lord, I will follow you.’

Christ is Risen! He is Risen Indeed!

Easter Sunday is, in fact, a day of decision for us all because it’s the day that God’s decision for us becomes clear. With Christ’s rising it is clear that God has conquered death and crossed the last barrier between us. God has come to us and we are now faced with this incredible offer… ‘Come with me now and walk with me.’ ‘I give you honour for shame; peace for hostility; joy for sadness; riches for poverty and passion for apathy. I have come, says Jesus, to bring life, life in all its abundance. But we need to say yes to God! Are we willing to say ‘Yes’ to God today? Are we willing to open our hearts to Him again. Are we willing to take a risk with God because essentially faith is a risk in that it is always a step into the unknown.

Christ is Risen! He is Risen Indeed!

This is not a foolishness risk. It’s not an unwise risk. It is, rather, a step of trust and, wherever trust is involved there is an element of risk. Marriage involves risk. We cannot know what the future will hold. Our promise at the alter isn’t to guarantee the future of the one we are giving ourselves to but to guarantee our love in that future. When we have children we take a risk. When we play sport we take a risk, when we invest we take a risk but these are usually not foolish risks. God calls us today to take risk with Him – to put our lives into His hands and to trust Him.

Christ is Risen! He is Risen Indeed!

If you’ve never made that commitment before I invite you now to say yes to this prayer I am about to pray and then to tell one of the people you know is already following God and we will help you grow into this wonderful inheritance.

Dear God, I see you died and rose again to give us all a wonderful inheritance. I want to be a part of that. Help me to receive all that you have for me today. Help me to open my heart to you and to become your follower. Help me to say ‘Yes’ to you today and every day from now on. In Jesus’ Name. Amen.

 

 

 

Easter Break

The Easter Break in New Zealand is somewhat unique in the Western world. We get both Good Friday and Easter Monday and have done for a long time. Australia doesn’t make Easter Monday a break though South Africa calls it ‘Family Day’ and so they effectively get it as well.

In this we follow Britain which does call both Easter Friday and Easter Monday a holiday but neither Canada or the USA take both days off. In Canada all of the country bar Quebec take Easter Friday and only Quebec takes Easter Monday – go figure? In the USA neither are holidays. Frankly I think we’ve got it right.

Easter is early this year coming as it does on April 1st. In Western Christianity, using the Gregorian calendar, Easter always falls on a Sunday between 22 March and 25 April inclusive, within about seven days after the astronomical full moon – according to Wikipedia. Usually we’re about half way through the school term and families are needing a break, to say nothing of teachers and everyone else!

family-on-beachMy memories of Easter holidays spent at my grandparents small crib in Alexandra are still bright with joy and adventure. Swimming was still possible and so long as the weekend wasn’t too drab much of the time was spent outdoors with cousins and others. It was a great weekend. Yes we experienced the odd really bad weekend but even cooped up in a small but different space for a weekend where books could be read and card or board games played it was a special time.

Of course it is the true high point of the Christian calendar and much is made of it in Churches but typically many are away on Easter Sunday and so whereas in the States it becomes a time of immense activity in church as congregations gear up for an influx of annual Easter going visitors here, we simply don’t get that response and we are used to many of our best volunteers being away.

Again, I think this is healthy largely because this western culture we’re in simply doesn’t stop and, frankly, it’s killing us. I would much rather have a large group within my congregation return from a good Eater rest ready to serve well for the rest of the semester/term than have a group of stressed and over-worked volunteers drag themselves back to church after a busy Easter with very little in their gas-tanks to take us any further.

For goodness sake – don’t feel guilty about taking a break this Easter. The Sabbath, said Jesus, was made for humans not the other way around. Easter is our greatest Sabbath but it too, was made for us, not we for it!

God bless you all this Easter.

Richard D. (Moderator)

Who is my neighbour?

Neighbours Day 2018:

It’s Neighbour’s Day on both the 24th and 25th of this month (March). I wondered how you are going to celebrate this special and valuable day? I wonder if you’ve asked the question at the heart of Neighbour’s Day “Who is my neighbour?” This question, which was asked of Jesus by a teacher of the Law no less, has echoed down through the ages and is, perhaps, more pertinent now in this day and age than at any other time.

In this day of refugee crisis, growing international tension and shocking civil war; in this day of homelessness and of breakdown of community identity throughout the Western world, surely the one major question we must ask is who is my neighbour.

neighboursday18-page-001.jpg I find there are two aspects to this question which must be answered – one which is essentially political and one which is far more relational.

The first political question simply asks who should we consider is on our side – who believes as we do – who sees the world as we see it and, further, who will help us when we need help.

This is a deeply problematical way of putting the question because the essential thrust of the question is to separate the world into those we will accept and those we will reject. It is very much the same question in the same spirit which was put to Jesus. “Who can I rule out so I don’t have to be neighbourly to everyone?”

It’s the question which is now finding political sympathy across Europe with the rise of deeply worrying separatist and exclusivist parties in France, Germany, Britain and other nations.

The second way to frame the question is to emphasise the relational aspect of it so that the question is really asking us to get to know our neighbours. It therefore asks us not to exclude anyone but to get to know them better. It asks not so much, “Who is my neighbours”? but “Do I know my neighbour?”

In many ways this was how Jesus chose to answer the question put to him. He did not offer any clue about how to make a decision as to who was ‘in or out’ but instead he showed through the story he told what it meant to be a neighbor, and how to get to know one’s neighbour.

Who is my neighbour? You are the one who: needs my help, needs my protection, needs my open heart, needs my understanding…who doesn’t need my judgement, my prejudice, my suspicion, or my lack of generosity.

On this special Neighbours Day 24 to 25 March, let’s return to this key value of Kiwi society – we are all cousins – we are all that person who is in need of welcoming, and a helping hand. We are all neighbours!

Richard D

A Road Less Traveled

Right_Rev_Andrew_NortonThe Very Rev Andrew Norton officially resigned from ministry last Saturday at the regular meeting of the full Northern Presbytery. He spoke of his passion for the church and his struggle to let this part of his life go but of a growing realisation that this was what was required of him at this stage of his life. As was so often the case with Andrew it was through poetry that God had spoken to him and, as usual, through him to us. I have seldom met a man more passionate about the Church and more committed to Christ. But this man always came with the uncomfortable Presence of God.

Scott Peck was a psychologist who found God while resting from a writing assignment in a convent. The discovery completely turned his life around and for the next 20 or so years he gave himself to writing about the confluence of psychology and faith. In his ground breaking publication ‘The Road Less Traveled’ which was an anthology of love from a psychological perspective Peck wrote this…

Human beings are poor examiners, subject to superstition, bias, prejudice, and a PROFOUND tendency to see what they want to see rather than what is really there.

The Church is no exception but what I found with Andrew was that his ministry to us as a people prone to self-deception was precisely a corrective – Andrew spoke the truth to a people so often unprepared to accept it.

We are still in that place unfortunately – we are still offering old wine skins to new wine and the risk of losing it all is still great.

I want to honour this man who has literally bled for the Church because he and his family, especially his wife Sue, have suffered greatly over the last 18 months as illness forced him to lay aside a unique call to lead the Church for a second term as Moderator. Few if any other person have inspired such confidence that they have been nominated a second time to this position. Andrew did. The truth He spoke was intoxicating and yet hugely releasing. It gave all of us a sense of hope; a glimpse of a remarkable future and a desire to travel again with the Church.

Andrew was incredibly kind and helpful toward me as I traveled the road to Moderatorship. He included me in so much of what he was doing and thinking and I felt tremendously thankful for this. I helped me form a much better idea of how to handle the position.

None of us have any idea of how much the recovery from his illness cost Andrew but I can tell you that theSpirit of God was still shining brightly in him as he laid down the reigns of both St Columba’s Church and ministry at that Presbytery meeting. His final speech produced again a ‘thin place’ where the Presence of God was palpable.

We will miss you Andrew but we are so much the better for your leadership. May your journey be sweet and…

Arise today
Through the strength of heaven:
Light of sun,
Radiance of moon,
Splendour of fire,
Speed of lightning,
Swiftness of wind,
Depth of sea,
Stability of earth,
Firmness of rock.

Richard D.

Billy Graham is not here…

Billy Graham has died.
His influence can hardly be measured and though some still like to point out his inadequacies I for one am sure I will see him in heaven. I have a distinct and clear memory of his visit to Dunedin.
Photo of Graham Reverend BillyIn 1969 Bill Graham came to Dunedin. I was 10 years old at the time and my sister was 8. I’d never heard of the man and so it was somewhat of a surprise that my father took us to his rally on Carisbrook the famous, now gone, Rugby ground. He seemed a long way away to me and I hardly listened to what he said. But my sister did and when it came time to go up the front and give our lives to Jesus she wanted to. I didn’t! The last thing i wanted to do was to go up the front but Dad insisted I take my sister and so dutifully I held her hand and we went up the front together and I dutifully said all that I was told to say and prayed all that i was told to pray.
BGraham1It took a little longer to bear fruit in my life than in my sister’s but today I am a minister of the gospel – a place i never expected to be in my youth – but there’s no place I’d rather be.
Thank you Billy…

Fasting Fridays…

Lent 2018

Lent, in the Christian calendar, is defined as a period of spiritual preparation for the highlight of the Easter celebration.

Easter is the highpoint of the Christian calendar. Arguably it is from this point that all liturgy and Christian worship begin.

One of the most common approaches to Lent was the practice of fasting – largely from food or specific food types. Why fasting?

hqdefault  In the Old Testament (OT) perhaps the ‘top quality’ of a follower of God was humility. All things in maturity came down to a fundamental humility which enabled the believer to live a life of obedience before God and a life of friendship towards others. The key practice in developing humility was… fasting. So, in James 4 we have this passage:

But he gives all the more grace; therefore it says, ‘God opposes the proud, but gives grace to the humble.’”

In the OT we find that Moses, the key figure of the OT, was “more humble than anyone else on the face of the earth”. Again, in Psalm 149 we read:

For the Lord takes delight in his people; he crowns the humble with victory”.

But how is this humility obtained? Again in both testaments one of the key answers to that question is… to fast.

Psalm 35v13 says, “13But as for me, when they were sick, my clothing was sackcloth; I humbled myself with fasting”.

And again, in Ezra 8 we read:

21 Then I proclaimed a fast there at the river of Ahava, that we might humble ourselves before our God, to seek from him the right way for us and our little ones and all our possessions”.

The notion of both the importance of humility and the link to fasting is clear. Today we need to retrieve this spiritual gift because we live in an age so dominated by the glory of technology that we have become almost allergic to proper reflection and meditation.

Let me reiterate my initial claim that Christian maturity is dependent upon the development of a deep reflectiveness which grows out of humility.

So come, fast with me that we might know again that humility which should be the mark of all Christians and of the Church. We have six Fridays before Easter. How about we do our best to miss a meal, or even two, on those Fridays? I will give you a run-down on how I am going on my blog https://moderator.presbyterian.org.nz. Let’s see where God leads us together.

 

Richard D.

Remember Tonga… Manatua a Tonga

Dear Friends in Christ,

I bring to you at this time an opportunity from within one of our churches in the south. For some time now a Discipleship training School has been run from a base in Riversdale Presbyterian Church in Southland. This school is run through a sister organisation called Global Disciples and the one in Riversdale has focused on helping people to draw closer to Christ and to share the Gospel in both New Zealand and Tonga. The schools usually involve some teaching time in Riversdale (11days) and then three weeks working in Tonga.

The next school begins in mid-June and will go to mid-July and will focus on the rebuilding effort in Tongatapu. The DTS base in Tonga has suffered significant losses but these pale into comparison with those the people of this small Island nation. At this stage a team member is assessing how best a team can be used and this information will be used to guide the team when they enter the country.

Usually the cost of the DTS is $2650 which includes flights and all meals. This may have to be changed if flights become more expensive.

Team leaders John and Heather Gullick are looking for people who can be a part of the DTS and come to Tonga to assist with the clean-up. Could this be you?

Please contact the team if you are interested or have questions.

Contact numbers and email are…

jgullick@xtra.co.nz

or Globaldisciples@gmail.com
website:3Dtraining.weebly.com

Yours in Christ,

Richard D

No Place for Killing

The ICBC released its submission today on the assisted death bill called the ‘End of Life Choice’ Bill. It is implacably opposed the the bill on multiple grounds. It is poorly written showing evidence of real naivety in regard to the implications of the bill for the future both of suicide statistics and medicine to say nothing of the plight of those whose lives are a cost on their families and society. Here is the submission in full.

 

12/2/2018

InterChurch Bioethics Council Submission to the Justice Select Committee:

On the End of Life Choice Bill:

 

The InterChurch Bioethics Council (ICBC) is an ecumenical, cross-cultural body supported by the Anglican, Methodist and Presbyterian Churches of Aotearoa, New Zealand (www.interchurchbioethics.org.nz).  Its role is to increase the knowledge and understanding of church members and the wider community, of the spiritual, ethical and cultural issues connected to biotechnology and related issues, and enable and encourage citizens to take action on their own behalf on these issues.  ICBC members have between them considerable expertise and knowledge in science, ethics, theology, medicine and education.

 

In writing this submission against the proposed End of Life Choice Bill introduced to the House by David Seymour, the ICBC recognises that we do not represent all Anglicans, Methodists and Presbyterians, but that as a designated committee, we are providing our “expert” opinion following our own discussions, research and reading over the past 3 years and some limited wider consultation.  Our submission will follow 8 areas that we would like to bring to the Justice Select Committee’s attention.  We would like to appear before the committee to talk to our submission should the opportunity arise.

 

We would also like to remind the Justice Select Committee that over the past 2 years the Health Select Committee has undertaken a comprehensive process to determine public attitudes towards legislation permitting medically-assisted dying following the petition of “Maryan Street and 8,974 others” that sought to determine the public opinion on assisted suicide.  Their report was presented to Parliament in August 2017, received 21,000 unique submissions and heard from 944 oral submission.  The key finding was that “80% of submitters were opposed to a change in legislation that would allow assisted dying or euthanasia”.[1]

Before addressing these issues, we believe it is important to clarify terminology in this current debate.  The term “assisted dying” we believe is inadequate as this confuses scenarios where the intention of the medical practitioner is actively to cause death with those where the intention is to relieve suffering.  Where the intention is to cause death, this may be either through prescription of drugs which the patient takes (assisted suicide) or where the doctor administers a lethal dose of drugs (euthanasia).  Where the intention of the medical practitioner is to relieve suffering, this may include withholding or withdrawal of treatment and administration of appropriate treatment through which “nature” is allowed to take its course and death is allowed to occur.  This is not defined as euthanasia and is currently legal.  For the purposes of our submission the term “euthanasia/assisted suicide, EAS” will be used.

We acknowledge that there is a small but significant population for whom the conditions of their death are horrendous and unacceptable. We would advocate for funding for research and access to resources that helps to alleviate this suffering. We acknowledge also that there will sometimes be family and even medical assistants who will quietly hasten death in these circumstances. However tragic these situations are we do not think the appropriate response is to give everyone the “right to die” or the “right to be assisted in dying”. The cost is too great – for the other vulnerable populations mentioned below, for doctors who have always seen their calling as maintaining life, not taking life, and for all older people who might begin to wonder if they have outstayed their welcome on earth. The enshrining of this right in law would have widespread and deepening repercussions for the way we understand life, and the callings and duties of life.

Indeed, much of the current debate centres on a patient’s right to choose when and how to die in the face of a terminal illness.  But the right to self-determination does not take place in a vacuum – no-one is completely free, we are embedded in family and society involving critical relationships, including a debt to future generations.  Our personal freedom is always held alongside the rights of others, and from a Christian perspective, our personal rights must be considered alongside our responsibilities to others that reflect our love of God as indicated in the command to love both God and neighbour (Mark 12:28-32).  In the face of suffering, the Christian and humane response is to maximise care/compassion for those in most need.  Killing, however, is not a part of the arsenal of care/compassion for the dying.

 

Reasons for opposing the End of Life Choice Bill.

 

In acknowledging that euthanasia and assisted suicide have significant moral and ethical objections, there are also significant discrepancies in this legislation that we suggest make the End of Life Choice Bill untenable.

 

  1. We believe the scope of the Bill is too large.
    The purpose of the Bill: “gives people with a terminal illness or a grievous and irremediable medical condition the option of requesting assisted dying” (part 1 clause 4).
  • Provides “assisted dying” for NZ citizens 18+. This criterion is too arbitrary and open to legal challenge. As seen overseas, over time minors (those under 18) have also been granted permission for assisted suicide.[2]  If death is a good/right for some it ultimately becomes seen as a good/right for all.
  • with a terminal illness likely to end his or her life within 6 months – Medically speaking this is difficult to determine, and overseas evidence shows some people being given permission for assisted suicide living longer than 6 months. In Oregon 2014, the range of days between first request and death was 15-439 days.[3] Even Lecretia Seales was initially given only weeks to live and survived 3½ years.[4]  Furthermore, significant discrepancies between clinical diagnosis before death and post-mortem findings suggests that misdiagnosis in up to 39% of cases is possible.[5]  The problem here is that euthanasia/assisted suicide is a non-reversible ‘solution’, and the 6-month criterion (or any time frame) cannot be provided with absolute certainty.
  • or grievous and irremediable condition. The Bill is not just about persons with a terminal illness but embraces anyone with a grievous and irremediable condition. This criterion includes those with: depression and mental illness; physical disability; long term illness; or the increasing frailty of old age (as seen in the Netherlands).[6]
  • and in advanced state of irreversible decline and experiences unbearable suffering that cannot be relieved in a manner the person considers tolerable. In this context, ‘Unbearable suffering’ is self-defined and is effectively euthanasia/assisted suicide on demand.  This criterion would allow for euthanasia/assisted suicide even if the patient rejected effective treatment on the basis they deem it intolerable.
  • Although this bill is framed to provide an Option for euthanasia/assisted suicide, we believe “option” is a loaded term, and one that is not simply a clear rational perspective. Our society projects certain values, including what we value in people – productivity, intelligence, physique – so that people can be made to feel a burden on relatives or society, or feel devalued by not fitting the social stereotype.  For example, in the Netherlands there are moves to extend euthanasia/assisted suicide laws with a “completed life” bill.[7]  The danger in the suggested law change provided by the End of Life Choice Bill, is that we may be providing a threshold beyond which a person’s life is seen as having little or no value instead of addressing how society hold and value people, especially the vulnerable.

 

  1. The Bill does not properly characterise the current NZ situation (pg 2-3)
  • It prioritises the Lecretia Seales case. Although Justice Collins remarked that “The complex legal, philosophical, moral and clinical issues raised by Ms Seales’ proceedings can only be addressed by Parliament …” all three petitions to the court based on the human right to die/choose death were rejected on legal grounds.[8] Ms Seales herself stated that she may not have used assisted suicide even if it was legal or the Judge had found in her favour.[9]

 

  • As evidence for a required law change, it is argued in the background to this bill, that the current law has treated with leniency those who have assisted terminally ill family members to end their life (Background pg 2). This however is evidence that the current law works, not that the law needs changing.

 

  • New Zealand First has asked for a binding public referendum on this issue. However, even if a referendum identified a majority position for euthanasia/assisted suicide, this would not mean that the public were suitably informed about the difference in terminology or the significant issues involved.

 

  • As previously mentioned, the claim that there is strong public support for a law change (background pg 2) is incorrect given the Health Select Committee 2017 finding was that “80% of submitters were opposed to a change in legislation that would allow assisted dying or euthanasia”.[10] This figure contradicts previous surveys indicating support for a change (2012, 2969 people 62.9% support; 2015, 2800 people 66% support).[11]  These previous survey results reflect the level of public confusion about what the terms euthanasia/assisted dying mean.  Significantly, 63.6% of all submissions to the Health Select Committee, equating to 82.5% of all submissions opposed to a law change, used no religious argument in their opposition to change.[12]  The Health Select Committee process was an open process, with no leading questions but simply asked for public opinion.  The scope of this report, the number of respondents, and the significance of the findings, means that the Health Select Committee report should have significant weight in the Justice Select Committee deliberations.
  • Of great significance, the current discussion is largely a rationalist Pakeha conversation. Many cultures in New Zealand other than the majority Pakeha culture have traditional ways of managing death and dying in family/whanau settings.  Our conversations and research identify that euthanasia/assisted suicide has no equivalent in language or practice in Māori and Pacific people practices.  Therefore, the current debate risks imposing on New Zealand culture a largely individualistic worldview without adequately considering other perspectives.  Within Māori and Polynesian communities, euthanasia/assisted suicide is not part of everyday reality or something readily discussed.  For many Māori the tribal custom of karanga aituā means that talk about death will ‘call it down’,[13] which could further limit discussing the issue of euthanasia/assisted suicide.  However, the Bill now brings this issue into the open for us all, and the result of this Bill may affect any one of our whā That is why there is a call for Māori and Polynesian families to discuss this Bill, and its impacts on whānau, hapu and iwi.[14]  As Tess Moeke-Maxwell and colleagues state, “the dying and their whānau are proactive in doing whatever they can to ensure a high quality of life is achieved to enable the individual to live for as long as possible and as comfortably as possible” – “They do not give in easily to death”.[15]

 

  1. Terminology within the Bill.
  • As defined in the Bill (Part 1:3) “assisted dying” means the administration by a medical practitioner of a lethal dose of medication to a person to relieve his or her suffering by hastening death.
  • The term “assisted dying” as defined above is inadequate as this confuses scenarios where the intention of the medical practitioner is actively to cause death with those where the intention is to relieve suffering. The Bill identifies 4 methods: ingestion or intravenous delivery by the person; or delivery through a tube or injection by a medical practitioner (part 2 clause 15). Where the intention is to cause death as outlined in the Bill this may be either through prescription of drugs which the patient takes and is correctly termed “assisted suicide”, or where the medical practitioner administers a lethal dose of drugs, is correctly termed “euthanasia”.
  • Where the intention of the medical practitioner is to relieve suffering, this may include the withholding or withdrawal of treatment and administration of appropriate treatment through which “nature” is allowed to take its course and death is allowed to occur. This is not defined as euthanasia/assisted suicide and is currently legal.
  1. The Bill claims that relief of suffering and compassion is the motivation for this legislation (Purpose pg 1 and Part 1 clause 3).
  • We acknowledge there are circumstances where individuals face unbearable suffering, however compassion is a societal value, not only for the individual. There are many arguments against assisted suicide that do not have a religious foundation, and there are some that have their foundation in religious values. One such shared value is our understanding of love and compassion. Care and compassion contained within the view of unconditional love is about doing good without doing harm and identifies the intrinsic value and dignity to human life regardless of abilities or situation.  Compassion is exercised in relationship with others so the ‘suffering’ of an individual does not happen in isolation.  Nor does its treatment, or the choices an individual may wish to make.
  • Respect for human dignity applies to everyone throughout life, and to humanity as a whole. In this context, the causing of death is seen as a harm, whereas compassion denotes walking alongside the other so as to not die alone, and where the relief of suffering can include not prolonging the process of dying.  Furthermore, there is also the preferential care for the vulnerable within society, so that our compassion and care extends to create conditions where all can flourish.  For those experiencing suffering, this includes the greater availability of palliative care; research into palliative medicine; and by listening to those who speak for the ‘disabled’ so that there is “nothing about us without us”.[16]
  • This bill identifies the relief of suffering as the major motivator for law change. However, “suffering” is too broad a term and needs further definition. Suffering can be understood as: 1. Pain – physical suffering which can be managed through medication, including terminal sedation near the end of life; 2. Distress – physical/psychological suffering in situations for example when a patient can’t breathe.  Again, this can be adequately managed through medication or medical interventions.  Suffering – existential, where people feel they have no place, no value, no hope, no autonomy or are a burden. It is this form of suffering that surveys identify as the major reason for people wanting to use euthanasia/assisted suicide.[17]
  • New Zealand is rightly concerned about the levels of suicide especially among young people, and men aged between 20 and 65 where the New Zealand rates are high compared with other OECD countries.[18] Suicide rates have reached their highest since records have been kept, and have risen three years in a row.[19]  “From June 2014 to May 2015, 569 people are officially listed as having died by suicide or suspected suicide – the highest number ever recorded in New Zealand.” Furthermore, it is recognised that the rates for suicide are under-reported.[20] Do we want suicide (whether physician-assisted or not) normalised as an option when a person is in distress?  Do we want to be a society that when someone takes their own life, our response is to say, “well that was their choice”? Furthermore, overseas studies show that allowing euthanasia/assisted suicide does increase the rates of unassisted suicide – in the Netherlands unassisted suicide rates have increased 35% over the 6 years up to 2015.[21]

 

  1. Safeguards for the Bill.
  • Part 2 clause 6 talks about conscientious objection and safeguards. Although a medical practitioner may refuse a request for euthanasia/assisted suicide, the Bill compels the medical practitioner to refer the patient to the SCENZ group – an appointed body that does not have an objection to assisted suicide/euthanasia [part 2, clause 7 (2), part 3 clause 19]. This overrides the professional autonomy of the health practitioner and forces him/her into colluding in the process.
  • This undermines the safety processes in that the SCENZ group will refer the patient to a doctor that has no long-term relationship with the patient and is in no position to assess coercion or other underlying issues. This is of concern in that depression, the commonest factor in requesting assisted suicide or euthanasia, may be difficult to detect even when the doctor knows the patient well.
  • In New Zealand the population at risk includes elderly people and people with disabilities. There is already concern about the level of elder abuse,[22] and older people have little or no power to resist subtle pressures that they should end their lives, and many worry that they may be a burden to other people.  As indicated by the US states of Oregon and Washington, 40-60% of those who used legally prescribed lethal drugs to end their lives cited concerns that they would be a burden on their families as a factor in their decision to end their lives.[23]
  • The Two-person safeguard (part 2, clause 10 and 11) has been shown to be inadequate in Oregon over time,[24] with one or both medical practitioners having no long-term relationship with the patient and evidence of “doctor-shopping”. Again, referrals to specialists provided by the SCENZ group does bias the process towards medical practitioners who are in favour of assisted-suicide/euthanasia and could constitute “doctor-shopping”.  In the Netherlands mobile squads have been established which provide access to such medical practitioners who may never have met the patient before.  Furthermore, in Oregon, there was a significant decline in people referred for psychiatric assessment over the first 5 years of legalising euthanasia/assisted suicide.[25]  Evidence from Quebec also shows a failure of safeguards after just 2 years of legalised euthanasia/assisted suicide.[26]
  • International evidence shows, wherever legislation is introduced to allow assisted-suicide and euthanasia, there is an incremental extension of criteria allowing euthanasia to more groups over time; including lowering the age limit – for example Belgium now allows euthanasia for minors of all ages, the inclusion of other conditions including non-terminal conditions such as depression and other psychiatric conditions. Recent examples are a 20-year-old sexual abuse victim in the Netherlands,[27] and a 17-year-old in Belgium.[28]  It has even been argued that euthanasia for prison detainees is permissible under Belgium law based on unbearable psychological suffering.[29]   Also there is a gradual shift from voluntary to involuntary euthanasia, for example dementia patients.  It is worth noting that in 2007, 32% of euthanasia events in Belgium occurred without request or consent.[30]  You might say – surely good legislation can prevent this expansion.  The reality is “No”! Legislation cannot stop this.  Why – because if death is now seen to be a right and to be a benefit worth having – then it is a right and a benefit for all, not just for some in society. Therefore, as seen overseas, any restriction on assisted suicide is open to legal challenge and over time the numbers increase.[31]

 

  1. Reporting of Assisted Suicide/Euthanasia Practice (Part 2 clause 17).
  • The Bill has an inherent contradiction in that it promotes assisted suicide and euthanasia as acceptable practice and a register kept (Part 3 clause 21), yet at the same time proposes an amendment to the Births, Deaths, and Marriages regulations (part 4, clause 28) so that any death through “assisted dying” is recorded as if no assistance has occurred [Part 4 clause 28 (2xiia)]. This clause would prevent an accurate assessment of assisted suicide/euthanasia events and runs the risk of “hiding” this activity.
  • The best legislation in the world cannot restrict this practice. To quote Professor Theo Boer, Professor of Ethics at the University at Groningen, and for nine years a Member of a Regional Euthanasia Review Committee in the Netherlands, “the very existence of a euthanasia law turns assisted suicide from a last resort into a normal procedure – don’t make our mistake”.[32]

 

  1. Effects on Medical Professionals carrying out euthanasia/assisted suicide.
  • A central aspect of the Bill is to provide immunity from criminal prosecution or disciplinary action for Medical Practitioners (doctors or pharmacists) involved in hastening death (unless provable that they acted in “bad faith”).
  • Throughout the Bill there is the assumption that euthanasia/assisted suicide will be administered by a medical professional (doctor). However, euthanasia/assisted suicide is not a medical issue, as seen in the fact that the Justice Select Committee is hearing submissions. Furthermore, it was noted in the Health Select Committee report, that for the NZ Medical Association and the World Medical Association, “assisted dying is incompatible with medical ethics”.[33]  The concluding statement of the Gillett report for the New Zealand Medical Association, summarises the caution that is needed in bringing about a legalisation of euthanasia/assisted suicide:[34]

The debate about the legalisation of euthanasia is complex and the medical profession should remain cautious about any change in law that would interfere with principles that have guided medicine and general healthcare to good effect for most people throughout the centuries. The WMA’s resolutions on euthanasia and physician-assisted suicide reflect this tradition; its clear opposition—to what would mark a departure and move towards a different ethos in an area where medical practice needs sound guidance and standards—is worthy of support because of the value it puts on human life. This stance does not prevent a physician from respecting the desire of a patient (or the patient’s guardian) to allow the natural process of death to follow its course in the terminal phase of sickness (where that may involve the withdrawal of life-prolonging treatment or treatment limitation because the treatment is properly deemed futile).

  • EAS effects on families and people involved. In countries where euthanasia/assisted suicide is legal, there is a web of people involved in each individual case – doctors, nurses, pharmacists, psychiatrists/psychologists, and often decisions of family members.  We note that the proposed bill does not name nurses amongst “medical practitioners” for whom the bill provides legal protection.  Also, overseas studies identify that those involved can and do suffer vicarious trauma from being involved in euthanasia/assisted suicide practices, as this quote from a study undertaken in Finland suggests:[35]

We can’t go that far and have this or that kind of criteria to let you kill another person. Nobody can cope with it mentally for very long. You have to think about the personnel. Everybody’s talking about the patient but nobody says anything about the one who has to do it and who also has feelings.

  • There is an assumption that doctors will be the ones to enact any law change. But doctors see their calling as maintaining life, not taking life.  Any law change would have widespread and deepening repercussions for the way we understand life, and the callings and duties of the medical profession.  These are fundamental roles within society charged with caring, healing, curing wherever possible.  At our most vulnerable times – when we face death – physicians (and others) have a considerable role in the care of people through a relationship in which the real questions are addressed with patient and family, unnecessary treatment is stopped or not started, relief is provided for physical, mental and spiritual distress, and the person who is dying is supported to the end.  The intention is a dignified, pain-free, natural death. Euthanasia/assisted suicide and would cut across this trusted relationship. There may also be pressures for doctor to conform to the wishes of families or patients.  As Margaret Somerville suggests;[36]

We also need to consider how the legalisation of euthanasia could affect the profession of medicine and its practitioners. Euthanasia takes both beyond their fundamental roles of caring, healing and curing whenever possible. It involves them, no matter how compassionate their motives, in the infliction of death on those for whom they provide care and treatment. Euthanasia thus places the soul of medicine itself on trial. We thus need to be concerned about the impact that legalisation would have on the institution of medicine – not only in the interests of protecting it for its own sake, but also because of the harm to society that damage to the profession would cause.

 

  1. Addressing issues preceding a request for EAS.

Rather than promoting euthanasia or assisted suicide as a ‘compassionate’ solution to unbearable suffering, critical factors that precede the requests could make a great difference to many more people and have a positive effect on society.  These include:

  • Palliative care services – improve access so all in this situation can receive care, as it has been shown that recipients of these services find hope and relief of suffering;
  • Mental health services – improve access to services, provide training for recognition and treatment of depression which is frequently a significant factor in a patient’s suffering and request for EAS;
  • Continue/enhance programmes to prevent suicide among all age groups and reduce its normalisation;
  • Address social isolation particularly among elderly people – this has been shown to be a cause of depression, and of the sense of being a burden;
  • Continue measures to address and prevent elder abuse
  • Providing funding and adequate resources so that society can support those in need at their most vulnerable times.

[1] Health Select Committee, Petition 2014/18 of Hon Maryan Street and 8,974 others.  Wellington: NZ Parliament, 2017, pg 6.  https://www.parliament.nz/resource/en-NZ/SCR_74759/4d68a2f2e98ef91d75c1a179fe6dd1ec1b66cd24

[2] http://www.abc.net.au/news/2016-09-18/euthanasia-17-year-old-first-minor-to-be-granted-belgium/7855620

[3] Oregon Public Health Division: Oregon’s Death with Dignity Act – 2014. https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year17.pdf, pg 6.

[4] Macfie, R. (2015, January 8). Dying wishes. The Listener. Retrieved from http://www.listener.co.nz/current-affairs/health-current-affairs/dying-wishes/

[5] Gavin D Perkins, Danny F McAuley, Sarah Davies and Fang Gao (2003).  Discrepancies between clinical and post-mortem diagnoses in critically ill patients: an observational study. Critical Care 7:R129.

https://doi.org/10.1186/cc2359. https://ccforum.biomedcentral.com/articles/10.1186/cc2359.  Also see The Sydney Morning Herald. (2004, June 8). Post mortem reveals euthanasia crusader clear of cancer. Retrieved from http://www.smh.com.au/articles/2004/06/08/1086460287366.html?from=storylhs.

[6] Simon Caldwell, Number of mentally ill patients killed by euthanasia in Holland trebles in a year as doctors warn assisted suicide is ‘out of control.  Mail Online, 2016 (First Published October 2014).  http://www.dailymail.co.uk/news/article-2779624/Number-mentally-ill-patients-killed-euthanasia-Holland-trebles-year-doctors-warn-assisted-suicide-control.html.

[7] https://www.theguardian.com/world/2016/oct/13/netherlands-may-allow-assisted-dying-for-those-who-feel-life-is-complete.

[8] https://www.stuff.co.nz/national/69112451/lecretia-seales-did-not-have-right-to-die-high-court-rules

[9] https://www.stuff.co.nz/national/69068898/Lecretia-Seales-lived-with-passion-determination-and-autonomy

[10] Health Select Committee, Petition 2014/18 of Hon Maryan Street and 8,974 others.  Wellington: NZ Parliament, 2017, pgs 6, 15, 47.  https://www.parliament.nz/resource/en-NZ/SCR_74759/4d68a2f2e98ef91d75c1a179fe6dd1ec1b66cd24

[11] ibid, 14-15.

[12] Care Alliance. Analysis of written submissions to the Health Select Committee’s investigation into ending one’s life.  May 5, 2017. http://carealliance.org.nz/wp-content/uploads/2017/05/HSC-submissions-analysis.pdf.

[13] Tess Moeke-Maxwell, Linda Waimarie Nikora and Ngahuia Te Awekotuku. “Māori End-Of-Life Journeys”. In Human Development: family, place, culture 2nd ed, W Drewery and L Bird Claiborne eds.. North Ryde: McGraw-Hill Education, 2014.pp. 382-383.

[14] Mamari Stephens. We need to hear the Māori and Pacific voices on the euthanasia debate, Feb 21, 2016. https://e-tangata.co.nz/news/we-need-to-hear-maori-and-pacific-voices.  Bishop Kito Pikaahu, Māori perspective needed in death debate, Dec 20, 2017. https://www.waateanews.com/waateanews/x_news/MTgxMzU/National%20News/Maori-perspective-needed-in-death-debate.  Alice Guy. End of Life Choice Bill sparks debate about euthanasia and Māori values. Jan 20, 2018.  http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11977365.

[15] Tess Moeke-Maxwell, et al., “Māori End-Of-Life Journeys”, pp. 382-383. Tess Moeke-Maxwell et al., “End-of –Life Care and Māori Whānau Resilience”. p. 145.

[16] Margaret Somerville, The Importance of Stories in the Euthanasia Debate: the risks and harms to vulnerable people outweigh any possible benefits.  https://www.mercatornet.com/careful/view/the-importance-of-stories-in-the-euthanasia-debate/19452

[17]https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year17.pdf (2014).  Also http://www.theguardian.com/commentisfree/2015/sep/05/assisted-dying-suicide-bill-justin-welby-archbishop-canterbury

[18] Glenn McConnell. The highest rates of teen suicide in the developed world.  Last updated October 16, 2016. https://www.stuff.co.nz/national/health/85305366/the-highest-rate-of-teen-suicide-in-the-developed-world. Andy Fyers. Unicef Report: New Zealand 34th out of 41 developed countries for child wellbeing. Last updated June 15, 2017. https://www.stuff.co.nz/national/93583589/unicef-report-wellbeing-of-kiwi-kids-languishes-behind-other-developed-countries.

[19] Tina Law. National suicide numbers rise three years in a row. Last updated August 28, 2017. https://www.stuff.co.nz/national/health/96217175/national-suicide-numbers-rise-three-years-in-a-row.  Jess McAllen. Suicide toll reaches highest rate since records kept. Last updated  July 3, 2015. http://www.stuff.co.nz/national/health/69920289/Suicide-toll-reaches-highest-rate-since-records-kept

[20] Amy Maas. The story of one woman, a suicide note, and blind justice. Last updated May 29, 2016. http://www.stuff.co.nz/national/health/80450197/the-story-of-one-woman-a-suicide-note-and-blind-justice

[21] Aaron Kheriaty, The dangerous contagious effect of assisted suicide laws.  Washington Post, November 20, 2015.  Also: Margaret Somerville, The Importance of Stories in the Euthanasia Debate: the risks and harms to vulnerable people outweigh any possible benefitshttps://www.mercatornet.com/careful/view/the-importance-of-stories-in-the-euthanasia-debate/19452

[22] Ministry of Health Guidelines, Elder Abuse and Neglect. See http://www.health.govt.nz.

[23] http://www.theguardian.com/commentisfree/2015/sep/05/assisted-dying-suicide-bill-justin-welby-archbishop-canterbury

[24] See http://dredf.org/public-policy/assisted-suicide/some-oregon-assisted-suicide-abuses-and-complications/

[25] Data retrieved from Annual Death with Dignity Reports, Year 1 – Year 17. https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/ar-index.aspx

[26] Aubert Martin, Two years of euthanasia in Quebec: the facts, 2017. https://www.mercatornet.com/careful/view/two-years-of-euthanasia-in-quebec-the-facts/20831

[27] Simone Mitchell Euthanasia debate reignited by 20yo sexual abuse victim.  Monday May 16, 2016. http://www.nzherald.co.nz/lifestyle/news/article.cfm?c_id=6&objectid=11639637

[28] http://www.abc.net.au/news/2016-09-18/euthanasia-17-year-old-first-minor-to-be-granted-belgium/7855620

[29] Katrien Devolder, (2016). Euthanasia for Detainees in Belgium. Cambridge quarterly of healthcare ethics : CQ the international journal of healthcare ethics committees. 25. 384-394. 10.1017/S0963180116000037.

[30] http://www.alexschadenberg.blogspot.ca/2013/09/euthanasia-is-out-of-control-in-belgium.html

[31] The Netherlands saw a 190% increase in euthanasia from 2006-2015.  In the 10 years to 2013, the number of euthanasia cases in Belgium has risen from about 1,000 to 8,752, according to official records.  http://www.abc.net.au/news/2016-09-18/euthanasia-17-year-old-first-minor-to-be-granted-belgium/7855620

[32] http://www.dailymail.co.uk/news/article-2686711/Dont-make-mistake-As-assisted-suicide-bill-goes-Lords-Dutch-regulator-backed-euthanasia-warns-Britain-leads-mass-killing.html#ixzz475CQjW5M.  See: Boer, T. Rushing toward death? Assisted dying in the Netherlands, March 28 (2016) at http://www.christiancentury.org/article/2016-03/rushing-toward-death.  Also see Theo Boer, I supported our euthanasia law, but I was terribly wrong: Dutch ethicist.  https://www.lifesitenews.com/opinion/i-supported-our-euthanasia-law-but-i-was-terribly-wrong-dutch-ethicist

[33] Health Select Committee, Petition 2014/18 of Hon Maryan Street and 8,974 others.  Wellington: NZ Parliament, 2017, pg 34.  https://www.parliament.nz/resource/en-NZ/SCR_74759/4d68a2f2e98ef91d75c1a179fe6dd1ec1b66cd24

[34] Grant Gillett. A Report on Euthanasia for the NZMA, 2017, pg 64.  https://www.nzdoctor.co.nz/sites/default/files/2017-11/NZMA-euthanasia-Gillett-report.pdf.

[35] Kuuppelomäki, M. (2000). Attitudes of cancer patients, their family members and health professionals toward active euthanasia. European Journal of Cancer Care, vol, 9: pgs 16–21. doi:10.1046/j.1365-2354.2000.00184.x.  Also see https://healingrefuge.com/life-issues/compassion-fatigue-and-vicarious-trauma/.  Fiona Cocker and Nerida Joss, Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review. Int J Environ Res Public Health. 2016 Jun; 13(6): 618. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4924075/

[36] Margaret Somerville, What would we lose by legalising euthanasia?. ABC Religion and Ethics, May 2013. http://www.abc.net.au/religion/articles/2013/05/24/3766685.htm.