Maryan Street Out lesbian Labour List MP Maryan Street is under pressure to withdraw her End of Life Choices Bill private members bill, given that the Labour Party is concerned about alienating more social conservative voters from the party. How should we view this? As I've said beforehand, there seems to be comparatively little discussion of voluntary euthanasia and/or physician assisted suicide within New Zealand's LGBT communities, apart from these columns and a recent interview between Andrew Whiteside and Street herself about the End of Life Choices Bill. What was interesting about that interview was that if the title had been removed, there was virtually nothing within its content to indicate that this was an LGBT interview. Part of this is attributable to developments within our communities. In the case of HIV/AIDS, protease inhibitors and other new pharmaceutical options and combination therapies have considerably extended HIV+ peoples life expectancy and relative health, due to advances in microbiology and scrutiny of HIV and cellular metabolism. Rather than death with dignity, HIV+ lobby groups seem to be more concerned about issues of more immediate relevance like Pharmac and Medsafe's pharmaceutical regulation, approval and funding concerns, HIV prevention and the Trans Pacific Trade Partnership, with reported US animus against Pharmac's subsidisation of many HIV treatment pharmaceuticals. Much the same situation exists when it comes to the lesbian community and breast cancer. While breast cancer is not an exclusively lesbian medical problem, lesbians and bisexual women are as likely to inherit genetic risk factors as straight women, and then there are other risk factors like alcohol consumption and environmental toxicity which may affect some groups of lesbians and straight women compared to others. More Maori women die from breast cancer than pakeha women, as well. The National Cancer Registry statistics seem to be indicating early detection and intervention is improving women's cancer outcomes when it comes to breast cancer, but this isn't the case when it comes to ovarian cancer and other women's cancers- as well as lung cancer. The latter raises some questions about LGBT smoking and consequent possibly poorer respiratory and cardiovascular health outcomes. For these reasons and others no doubt, LGBT New Zealanders tend not to view debates about voluntary euthanasia and physician-assisted suicide as particularly relevant to our communities. We might have an abstract libertarian commitment to personal autonomy in this context, and animosity to perceived Christian Right impairment of it, but do we need to take a more nuanced view? Voluntary euthanasia and physician assisted suicide seem to be beyond LGBT identity politics, although it may be questioned whether the same is true about feminism. Street has stated that the experiences of her mother and sister galvanised her to introduce this legislation to Parliament. Many euthanasia law reform advocates seem to be women, possibly because in western societies, women live longer than men and are more susceptible to degenerative diseases as a result. Still, feminist opinion seems either noncommittal, neutral or sometimes actively opposed when it comes to euthanasia or assisted suicide. When it comes to the disabled community, the opposition is far more evident and articulate. Many people with disabilities oppose euthanasia and assisted suicide for reasons that have nothing to do with religious social conservatism. They oppose the idea that due to physical "impairment," some lives are "less worth living" than others and therefore should "not" receive medical treatment or insurance coverage, compared to others. Within New Zealand's Human Rights Act, insurance providers are exempted from having to deal with disability discrimination concerns. Their perspective is that oppression and discrimination occur because their "impairment" is constructed as a "social problem" by ablest political philosophies and institutions. They do not want to be seen as weak, pathetic and vulnerable "charity objects" and argue that euthanasia law reformists tend to repeatedly depict people with disabilities in such a manner. They conclude that rather than obsessively attacking "dependency," rather we should stress interdependency and relationships between others instead of an unrealistic emphasis on personal autonomy. For these reasons, disability rights groups tend to oppose moves toward euthanasia law reform and assisted suicide, and actively oppose it. So do organised medical practitioners groups, and it is their professional reputation and influence that carries weight within current debates over euthanasia and assisted suicide. They question the need for euthanasia and assisted suicide and argue that pain relief can alleviate the onset of some medical conditions, as well as the intensive care practises of hospices in the same context. The New Zealand Medical Association and its constituent organisations take such a stance. If not for their opposition, it is probable that any such reform would pass. Indeed, this has been the situation in the Netherlands, Belgium and Luxembourg, where voluntary euthanasia has been decriminalised and is regulated, and in Switzerland, Oregon, Washington state, Montana and Vermont, all of which have decriminalised physician assisted suicide. In those societies and individual US states, national and state medical associations have either declared neutrality, are divided on the issue, or actively assist in decriminalised and regulated service provision. What about the Christian Right? When medical groups withdraw their opposition, religious social conservative anti-euthanasia groups have little to draw upon, unless they are able to align themselves with anti-euthanasia disability rights groups. There are some disabled religious social conservatives, but many people with disabilities distrust the Christian Right and suspect that their stance against voluntary euthanasia and assisted suicide has more to do with absolutist prohibitionism than with any nuanced comprehension of disability, citizenship and social inclusion. This is an "unmarked" issue. If Street does decide to withdraw her End of Life Choices Bill, it may be simply because it is several decades too soon. When climate change makes its presence felt more markedly, there is every prospect of new pandemic diseases overwhelming medical equipment, pharmaceutical, staffing levels and other public health safeguards. At that stage, decades from now, unless a contingency plan has been worked out to deal with the spread of epidemics from tropical areas, it may well be time for the decriminalisation of voluntary euthanasia and assisted suicide. We should not be complacent about the future need for such legislation. Craig Young - 24th July 2013