Concern for expansion and normalisation
Internationally euthanasia laws have very consistent trends, and pressure is on for New Zealand to follow suit.
Expansion Pressure is Inevitable
International trends in euthanasia law all show the same thing: an increase in those using it, and pressure to loosen eligibility criteria and liberalise the outworking of the law.
Expansion of assisted dying in New Zealand is no longer theoretical — it is already underway.
Proposed legislative changes are pushing for change that will dramatically expand euthanasia in our country.
Areas targeted include broadening who can be involved in delivering assisted dying, reducing the already feeble legislative safeguards, shifting the role of clinicians toward actively raising it as an option, and eroding the ability for conscientious objection.
These changes reflect patterns already seen overseas, where initial limits are progressively widened through legal and policy shifts. Proposals include expanding practitioner roles beyond doctors, loosening procedural safeguards, and increasing integration of euthanasia into standard care pathways.
The impact is significant: as eligibility and delivery expand, pressure on vulnerable patients and healthcare professionals increases, and the distinction between good end-of-life care and euthanasia becomes less clear.
The international precedent: Canada
Canada’s Medical Assistance in Dying (MAID) programme has grown rapidly in both scale and proportion of deaths since its introduction in 2016.
Since legalisation, more than 76,000 Canadians have died through MAID, accounting for 5.1% of all deaths — roughly 1 in every 20 deaths nationally, reflecting how quickly the practice has become embedded within the healthcare system.
Alongside this growth, eligibility criteria have expanded. Initially limited to those with a “reasonably foreseeable death,” the law was broadened to include people with chronic, non-terminal conditions, with further expansion to mental illness repeatedly debated and delayed.
Beyond formal legislative changes, the interpretation of suffering and eligibility has also widened in practice, contributing to both the scale and trajectory of MAID in Canada.
Terminal no longer a requirement
Canada’s MAID law was significantly expanded in 2021 with the passage of Bill C-7, which created two distinct eligibility pathways, often referred to as Track 1 and Track 2.
Track 1 applies to individuals whose natural death is “reasonably foreseeable,” with fewer procedural safeguards and a more streamlined process.
Track 2 was introduced for those who are not terminally ill, allowing people with serious and incurable conditions to access MAID even if death is not imminent, but with additional safeguards such as a 90-day assessment period.
This shift marked a major legal change — moving MAID beyond end-of-life care into broader categories.
Since then, Canada has seen a notable increase in horrendous MAID cases where patients have been woefully unprotected, particularly those living with disability, chronic illness and unmet social need.
Neighbouring Nation Australia’s demand rises
In Australia, data in 2025 shows more than 7,000 deaths since legalisation in 2019, with around 40% growth in a single year (2024–25) and assisted dying now accounting for around 2% of all deaths nationally.
Alongside this growth, there are ongoing calls for further reform and expansion, with reports arguing laws should “evolve” to meet demand and remove barriers to access.
Taken together, these trends reflect a broader international pattern: once legalised, assisted dying does not remain static — numbers increase, systems expand, and pressure builds to widen access over time.
Minority of Doctors Actively Participate
Internationally, euthanasia is delivered by a small minority of clinicians, while the majority of doctors choose not to be involved. The result is healthcare environments marked by ethical division and deepening pressure points across the workforce.
While there is strain on those who choose to participate, there is also ongoing tension for those who do not — as they navigate legal obligations, referral pathways, and proximity to a process they may fundamentally oppose. This dynamic can contribute to burnout, moral distress, and division within healthcare teams.
New Zealand is already showing this pattern, with euthanasia reliant on a limited pool of clinicians. In many cases, the assessing doctor is not the patient’s regular GP, but assigned practitioners meeting them for the first time — reducing the depth of understanding around their circumstances.
Several doctors have come forward, exposing the reality of moral distress and division within healthcare settings. Ultimately, this reflects a deeper issue: a lack of broad professional consensus and growing strain on the culture of care within the health system.
Ultimately, it reflects a deeper issue: a lack of broad professional consensus and growing strain on the culture of care that predominantly rejects euthanasia within the health system.
Society Begins to Normalise Early Death
Over time, countries that have had euthanasia in place longer are now seeing far higher levels of tolerance — and far broader use — than originally intended.
In Oregon, where assisted suicide has been legal since 1997, usage has steadily increased, with the most common reasons now being loss of enjoyment of life (94%) and fear of being a burden (63%) — not purely medical necessity.
In Europe, the shift is even more pronounced. Belgium has no age limit, and cases have included non-voluntary euthanasia. In the Netherlands, practice has expanded well beyond initial boundaries — including euthanasia for children, newborns, and a growing number of people with mental illness or psychological suffering.
There are now active discussions about extending access to otherwise healthy elderly people who feel “tired of life.”
These developments show how, over time, what was once tightly restricted can evolve into far broader and more normalised use.
What we tolerate today shapes tomorrow — We cannot accept euthanasia as normal in our country.