BSA Decisions Ngā Whakatau a te Mana Whanonga Kaipāho

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Summary

Euthanasia, as practised in the Netherlands, was the subject of a programme entitled

"Death on Request" broadcast on TV One on 25 March 1996 at 10.05pm. The decision

to end the life of a terminally ill man was examined from the point of view of the

patient, his wife and his doctor.

Mr D A Armstrong complained to Television New Zealand Ltd that the presentation was

biased and factually incorrect and thus in breach of broadcasting standards. He also

objected to the use of Paul Holmes to introduce the programme, suggesting that it was a

technique used by TVNZ to enhance the status of its message.

TVNZ responded that it had received reliable information from the Embassy of the

Netherlands which supported the statement that euthanasia was tightly controlled by law

in that country. Because the documentary was the experience of one person and his

family, TVNZ did not consider it was necessary to debate the moral issues surrounding

euthanasia, and declined to uphold the complaint. Dissatisfied with that decision, Mr

Armstrong referred the complaint to the Broadcasting Standards Authority under

s.8(1)(a) of the Broadcasting Act 1989.

For the reasons given below, the Authority declines to uphold the complaint.

Decision

The members of the Authority have viewed the item complained about and have read the

correspondence (summarised in the Appendix). As is its practice, the Authority

determines the complaint without a formal hearing.

The Programme

A programme on euthanasia, as practised in The Netherlands, was broadcast on TV One

on 25 March 1996 at 10.05pm, without advertising breaks. The programme, entitled

"Death on Request", dealt with the decision of a terminally ill man to end his life, and

the implications of this decision on his doctor and wife. It was introduced by Paul

Holmes, who outlined the legal situation in The Netherlands regarding euthanasia, and

who also emphasised that the focus of the story was the decision of an individual. The

decision, made while he was still able to communicate, was taken in the knowledge that

his illness was progressing rapidly and was incurable. The ethical and medical

implications of the man's choice were explained by his doctor, who also put into

context the legal background to the availability of euthanasia in The Netherlands.

The programme reported that in The Netherlands, euthanasia was available only in the

terminal stage of an untreatable illness and only after informed requests had been made.

The doctor described his anguish in preparing patients for euthanasia and the impact his

involvement in that decision had on his own personal life. As the documentary

progressed, the patient's health deteriorated rapidly, as predicted, and preparations were

made for performing the euthanasia. The doctor fulfilled his legal obligations by

referring the patient to another doctor for a second opinion and by ascertaining that the

patient intended and understood the outcome. The inevitability and finality of the

decision made by both the patient and his wife was poignantly portrayed. It was made

apparent that in this case, euthanasia was a preferable outcome for the patient to the

painful and lingering suffering of his illness.

The Complaint

Mr Armstrong complained to TVNZ that its presentation was biased in favour of

euthanasia and accused TVNZ of trying to influence the outcome of a petition circulating

in New Zealand at present, seeking a referendum on euthanasia. Critical of its decision

to use Paul Holmes to introduce the programme, Mr Armstrong suggested it was an

attempt by TVNZ to give the programme status. He questioned the statement in the

introduction which explained that the practice of euthanasia in The Netherlands was

very strictly controlled and not performed without the express wish of the patient. He

also questioned the source of funding for the programme since it was screened without

advertising breaks, and claimed the programme breached broadcasting standards

because it was biased and factually incorrect.

Mr Armstrong provided a document which suggested that a high proportion of

euthanasia deaths in The Netherlands were not voluntary, and he contended that in spite

of an apparently strict regime regulating the practice, it was incorrect to suggest that all

deaths by euthanasia met the legal and medical criteria. He asserted that the depiction of

euthanasia in the programme as the compassionate response to a terminal illness would

influence many people's views about euthanasia and affect the outcome of the petition.

Because euthanasia was both controversial and topical, Mr Armstrong argued that a

balancing view should have been given.

TVNZ's response to the complaint

TVNZ advised that it assessed the complaint under standards G1 and G6 of the

Television Code of Broadcasting Practice which require broadcasters:

G1  To be truthful and accurate on points of fact.

G6  To show balance, impartiality and fairness in dealing with political

matters, current affairs and all questions of a controversial nature.

Commenting first on its decision to use Paul Holmes to introduce the programme,

TVNZ explained that it wished to emphasise that the documentary was the story of one

man rather than a debate about euthanasia. It also wished to reassure viewers that the

practice of euthanasia was strictly controlled in The Netherlands. It advised that it had

taken the precaution of seeking documentation of the current state of legislation in The

Netherlands from its ambassador some ten days prior to the screening. The document

provided by the Embassy supported the programme's description of euthanasia in The

Netherlands as being strictly controlled and being available only after carefully

considered and persistent requests had been made. Moreover, the patient's suffering

must be unbearable and without prospect of improvement. There was also an obligation

for the attending physician to consult with at least one other physician who also

assessed the patient's prognosis.

TVNZ emphasised that the documentary was the story of one man's request for

euthanasia.

To Mr Armstrong's contention that a high proportion of euthanasia deaths were

involuntary, TVNZ reported that, according to the report received from the Embassy,

the government of The Netherlands required strict adherence to the guidelines regarding

the practice of euthanasia. To the complaint that the item was unbalanced because it

failed to show the other side of the euthanasia debate, it responded that the programme

recounted a human reality as experienced in one part of the world, making it clear that it

was a personal decision dictated by the circumstances of the man's illness.

TVNZ acknowledged that had it been a documentary about the moral issues involved in

euthanasia, a view opposed to the practice would have been appropriate; however, it

argued, in this context debating euthanasia would have detracted from the personal

experience of the couple and the doctor involved.

With respect to the screening of the programme without advertising breaks, TVNZ

acknowledged that this was an unusual departure from normal practice, but asserted that

its decision to screen the documentary without interruption was because of the sensitive

nature of the subject matter.

The Authority's Findings

The Authority finds "Death on Request" a very moving account of the medical, ethical

and personal dilemmas experienced when making the decision to end the life of a

terminally ill patient. The decision, made by the patient and his wife in consultation

with their doctor, was obviously an extremely difficult and emotional one. When

viewers were first introduced to the patient, he was able to communicate by speech,

albeit in a limited way, and the couple still held out hope for a cure to the illness. As the

documentary progressed and the patient's condition deteriorated, the option of choosing

euthanasia became compelling.

The Authority notes that all of the legal and medical requirements of euthanasia were

satisfied in this case. The patient was informed about the consequences of his decision,

knew that his illness was terminal, and the doctor had had his diagnosis confirmed by

another physician, and had advised the patient of the full implications of his choice.

The Authority agrees with TVNZ's description of the documentary as the story of one

man's decision. The decision to die in this manner was made with full knowledge and

understanding of its consequences and satisfied the strict criteria laid down by the

legislation in The Netherlands.

The Authority considers it was clear that the facts were confined to the particular

circumstances portrayed. It notes that euthanasia is legal in The Netherlands, provided

that certain criteria are met. The example of euthanasia as portrayed in this programme

accurately reflected the legal and medical environment existing in The Netherlands

today.

While the Authority accepts the possibility that some deaths by euthanasia do not meet

those legal requirements, it was not relevant to discuss that matter in the context of this

particular programme. The Authority emphasises TVNZ's point that this documentary

focussed on the death of one man and how it impacted on his wife and the doctor who

was treating him. Clearly the decision to die in this way was not an easy one.

The Authority concludes that because the programme was confined to the matter

identified in the introduction – the decision of one patient, an incurably ill man, to end

his life – no balance was required. While it agrees that euthanasia was a compassionate

solution for a terminal illness in this situation, it does not believe that the solution was

glamorised or made so appealing that it would be regarded as an easy solution. The

moral and ethical dilemmas and vacillations experienced by the patient's wife and his

doctor were uncompromisingly portrayed.

To the complaint that the item was inaccurate the Authority responds that it was only

intended to portray the circumstances of this particular patient, and not to provide a

discussion about the breaches of the law in The Netherlands. As the experience

depicted did comply with the current legislation, the broadcast did not contravene the

requirement for factual accuracy.

With respect to the argument that the item lacked balance the Authority, as noted above,

acknowledges that although the wider issues of euthanasia were not debated the

programme contained its own balance in that the ethical and moral questions confronting

the couple and their doctor disclosed a wide range of perspectives on the issue. The

Authority concludes that no standards were breached.

For the reasons set forth above the Authority declines to uphold the

complaint.

Signed for and on behalf of the Authority

Judith Potter
Chairperson
27 June 1996

Appendix

D A Armstrong's Complaint to Television New Zealand Ltd - 26 March

1996

A programme about euthanasia, as practised in the Netherlands, was screened on TV

One on 25 March 1996 at 10.05pm. It was introduced by Paul Holmes, who explained

at the beginning that in The Netherlands the practice of euthanasia was very strictly

controlled.

Mr Armstrong of Timaru complained that the presentation of this controversial subject

was biased in favour of euthanasia and that it could be said that TVNZ was attempting

to influence the outcome of a petition calling for a referendum on euthanasia presently

circulating within New Zealand. He also suggested that having Paul Holmes introduce

the programme was evidence of an attempt to give the programme status.

Mr Armstrong stated:

The statement at the beginning of "Death on Request" which said in effect that

the practice of euthanasia in The Netherlands was very strictly controlled and in

no circumstances done without the expressed wishes of the people to be killed

was quite at odds with the truth. The Remmelink Report, commissioned by the

Netherlands Government, showed quite clearly that about half the people killed

by euthanasia had not requested it.

Mr Armstrong asked whether the Voluntary Euthanasia Society or any other group with

the same aims were involved in the screening of the programme. He also asked what

agency had made the tape available and who paid for the screening of it, since there

were no advertising breaks during the programme.

TVNZ's Response to the Formal Complaint - 18 April 1996

TVNZ noted that the programme told about a case of euthanasia in Holland and that it

followed the event through the eyes of the patient, his doctor and his wife. It observed

that the programme recounted a human experience and that euthanasia was legal in some

parts of the world.

TVNZ strongly objected to Mr Armstrong's assertion that Paul Holmes was used to

give the programme status. It advised that he was used to introduce the programme to

emphasise that it was the story of one man - not a debate about euthanasia - and to

outline the conditions in The Netherlands, where the death occurred. TVNZ reported

that 10 days prior to the broadcast it had sought from the Ambassador of The

Netherlands documentation of the current state of legislation regarding euthanasia there.

TVNZ quoted extracts from the report which outlined the criteria used when considering

euthanasia. It noted that the document stated:

The request to the doctor must be voluntary, explicit and carefully considered

and it must have been made repeatedly. Moreover, the patient's suffering must

be unbearable and without any prospect of improvement.

TVNZ also referred to the work of Professor Remmelink (referred to by the

complainant) and suggested that it presented a different perspective than the complainant

described. It reported a quotation from the report:

It was extremely difficult to estimate the number of cases of termination of life

without a recent explicit request from the patient, but the committee estimated it

at about 1,000 cases a year (out of 2,300 cases of euthanasia). These were

patients who were terminally ill and who were suffering but who were no longer

able to express their wishes. Either the doctor and the patients had discussed the

matter at an earlier stage, or the patient had previously expressed a wish that his

or her life be terminated in such a situation.

TVNZ noted that the report described this form of termination of life as part of normal

medical treatment in those circumstances.

However, TVNZ observed, according to the report provided by the Embassy, the

government of The Netherlands did not accept this and required that all forms of

termination without an explicit request from the patient should be reported and

reassessed, and become subject, when necessary, to prosecution.

Answering Mr Armstrong's specific questions, TVNZ advised that there were no

groups such as the Voluntary Euthanasia Society involved in purchasing the

programme. It had been extensively screened in other countries, where it had received

enthusiastic reviews. The film was purchased by TVNZ in the usual manner.

With respect to the lack of advertisements, TVNZ advised that because of the sensitive

nature of the documentary it made a decision to show it without advertising breaks.

Turning to the standards nominated, TVNZ advised that it was satisfied, on the basis of

information received from the Netherlands Embassy, that the information was both

truthful and accurate.

As far as standard G6 was concerned, it considered the programme was a

straightforward account of one person's experience and was not an appropriate vehicle

for the debate on euthanasia. It declined to uphold the complaint.

D A Armstrong's Referral to the Broadcasting Standards Authority - 26

April 1996

Dissatisfied with TVNZ's decision not to uphold his complaint, Mr Armstrong referred

it to the Broadcasting Standards Authority under s.8(1)(a) of the Broadcasting Act

1989.

He pointed to the introduction to the programme which stated that in The Netherlands

there were very strict regulations about euthanasia and outlined what they entailed. The

clear impression, he noted, was that only after persistent requests by a person in a

terminal illness and after careful consideration by two doctors was euthanasia

performed.

Mr Armstrong suggested that the Remmelink Report revealed that the list of criteria

supposed to be followed (and stated in the introduction as fact in The Netherlands) was

inaccurate. He considered it quite misleading that viewers were told that this was a real

story about real people living within the framework of the law in The Netherlands when

the data in the Remmelink Report showed that over 50% of people killed by euthanasia

there had not requested it. He suggested that obtaining information from the Embassy

was similar to a person requesting information on abortion in New Zealand and being

given an extract from the Crimes Act and concluding that abortions in New Zealand are

only done for certain serious reasons. In fact, he claimed, the reality was that we have

virtual abortion on demand.

Mr Armstrong maintained that it was wrong to imply that the programme portrayed

accurately the situation regarding euthanasia in The Netherlands.

With respect to standard G6, Mr Armstrong noted that the subject of euthanasia was

both current and controversial. As such, he asserted, TVNZ should be cautious in its

choice of programming. In Mr Armstrong's view, the showing of a programme on

euthanasia which gave the impression that it was the compassionate response to a

terminal illness, was likely to influence some people's attitude and lead them to support

euthanasia.

Mr Armstrong stated that he did not know of any other programme about euthanasia

which balanced "Death on Request", although he recalled a programme on TV3 which

had favoured euthanasia and had been the subject of a successful complaint.

Finally Mr Armstrong contended that the programme had gained additional impact by

being introduced by Paul Holmes and by being allowed to run without advertising

breaks. He suggested that immediately put it into a "very select category". He

concluded that because it misrepresented the true situation in The Netherlands regarding

euthanasia and because it was presented while a petition was circulating in New

Zealand, TVNZ had breached the requirements of the Code of Broadcasting Practice.

Mr Armstrong included an article entitled "The Report of the Dutch Governmental

Committee on Euthanasia" by Dr Richard Fenigsen and an extract from an article

entitled "The Truth about the Netherlands" by Dr John Fleming.

TVNZ's Response to the Authority - 2 May 1996

As is its practice, the Authority sought a response from TVNZ to the referral. TVNZ

described the difference between its position and that of the complainant was that the

complainant saw the programme as propaganda designed to promote euthanasia, while

TVNZ saw it as a moving story of human experience in The Netherlands, where

euthanasia is legal.

It described the film as being about emotions and the bonds between the people

involved as well as the torment of the doctor. It agreed that had the documentary been

about the moral issues involved in euthanasia, it would have been appropriate to include

a view opposing the practice. In the context, it considered such comment would have

detracted from the programme and belittled the real emotions which the film reflected.

It noted that Paul Holmes was used to introduce the programme to emphasise that the

film was about one man and that the practice of euthanasia was strictly controlled in The

Netherlands. In response to Mr Armstrong's accusations of inaccuracy, TVNZ stated

that it had sought advice from the Embassy of The Netherlands, and enclosed a copy of

the article the Embassy provided entitled: "The Termination of Life by a Doctor in the

Netherlands" which contained material drawn from the Dutch Ministries of Foreign

Affairs, Justice and Health, Welfare and Sport. This, TVNZ asserted, confirmed its

statement that euthanasia was tightly controlled by law in The Netherlands.

Mr Armstrong's Final Comment - 14 May 1996

Mr Armstrong noted that TVNZ, in its response, stated that the material obtained from

the Embassy of The Netherlands confirmed its statement that euthanasia was tightly

controlled in The Netherlands. He considered that it would be more correct to say it

was controlled by agreed regulation than by law.

He maintained that the Embassy material did not answer the statistical analysis of the

Remmelink report.

In conclusion, he wrote:

My complaint remains, that either consciously or unconsciously, TVNZ has

broadcast an inaccurate programme that is likely to persuade some people to a

particular view of euthanasia, while a petition on the subject is being circulated,

and that no balancing programme, either before or since, has been