Euthanasia: The case for and against assisted dying

by Julie Jacobson / 08 August, 2017
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 David Seymour's End of Life Choice bill will force MPs to vote on the issue.

Act MP David Seymour’s controversial bill is motivated by compassion but it has divided many Kiwis.

It’s been 13 years since former intensive care nurse Lesley Martin was sentenced to 15 months jail for the attempted murder of her terminally ill mother, Joy.

Mrs Martin had rectal cancer. A police investigation followed her death, but no arrests were made until three years later when Martin published her book To Die Like a Dog in which she described administering morphine to her mother.

The case attracted international attention, and also sparked a national debate about voluntary euthanasia and assisted dying. It’s a debate that’s been reignited many times over the years.

Then-National MP Michael Laws sought to introduce a Death with Dignity bill in 1995, but it was roundly defeated.

In 2003, New Zealand First’s Peter Brown saw his Dying with Dignity bill defeated by three votes, and in September 2013, Labour list MP Maryan Street withdrew a similar bill due to nervousness around the following year’s election.

Now, Act Leader David Seymour’s End of Life Choice bill has been drawn from the ballot, meaning MPs will have to vote on whether or not euthanasia should be legal.

Perhaps the most high-profile case since Lesley Martin’s has been the case of Wellington lawyer Lecretia Seales, who went to the High Court in 2015 to argue for the right to choose to end her life, surrounded by her husband and family.

Just hours before her death from brain cancer, she heard the court had ruled against allowing a doctor to help her to die – that only parliament could give her what she wanted by passing a new law.

Lesley Martin, left, and Lecretia Seales both fought their case in the courts and lost.

Her case prompted a petition to parliament calling for an investigation into attitudes towards a law to allow medically-assisted dying in the event of a terminal illness or an irreversible condition that makes life unbearable. The petition asked for a change to the existing law.

The Health Select Committee has finished hearing evidence from almost 22,000 people who made submissions – the majority against changing the law. The Parliamentary Committee’s report was released in early August.

One of those who made a submission was former Commonwealth and Olympic runner Anne Hare. The mother-of-two spoke of her sadness at seeing her father-in-law stop eating and drinking to hasten his death.

Rene Hare had been an outspoken campaigner on everything from workers’ rights to racism all his life, protesting against the Vietnam War during the ‘60s and the 1981 Springbok Tour. He was also a prolific newspaper letter writer.

He died two years ago, in his early 90s, following a battle with cancer.

Anne (53) says, “My mother-in-law looked after him for a long time, but it got to the point where he needed more care, so he went in to Riverleigh Rest Home in Lower Hutt. They did a great job of looking after him. He enjoyed it there to start with – there would be trips out in the van and school kids would come in and sing – but towards the end, he decided he didn’t want to keep going."

Rene also lost his eyesight – there was no joy any more in reading or writing, or even watching television. He had no quality of life, tells Anne.

“He was wasting away, really. He never talked about feeling sorry for himself, but he talked about not wanting to be around many times. He would often say, 'If I was a horse, they would’ve shot me by now'. He was very pragmatic, he wasn’t emotional about it. He’d had a really good life, he had an amazing life.”

While Anne is pro-choice and a supporter of David Seymour’s bill, she stresses she is not advocating “assisted suicide”, nor is she knocking palliative care, which she describes as outstanding even if lacking in government funding.

“A lot of people seem to think what we’re saying is that it’s black and white – here’s a doctor who will assist you to die and that’s it – that there’s no place for anything else, like palliative care. I actually think there’s a place for both. This is about assisted death – you are already dying, you are not choosing to die or to live, you are actually going to die.

“When I was growing up, people would never admit to being gay and now we’ve got gay marriage. It doesn’t mean you have to have one. This is the same thing – if you’re allowed to have an assisted death, you don’t have to have one – you are not being forced to.”

Catherine Hallagan is a Wellington doctor with 33 years’ experience as a general practitioner. The 62-year-old has cared for countless patients with terminal and chronic debilitating illnesses, and is opposed to any relaxation of the laws around euthanasia, as is the New Zealand Medical Association to which she belongs. 

“I’ve cared for many patients in the dying phases of their illnesses, I’ve sat at their bedsides, I’ve visited them in hospices and on a personal level. I have had three family members die having received excellent palliative care.

“I had a baby who died of a rare genetic syndrome when she was only two days old. My daughter was nursed with palliative care all her life, not given doctor-assisted death.”

She believes doctors have no role in taking patients’ lives and that euthanasia is not a medical treatment. She says “assisted suicide” completely contradicts what the medical profession stands for and undermines the resources that are currently being pumped into suicide prevention campaigns.

Catherine also has concerns around coercion of the frail elderly, and pressure on those with disabilities to ask to die prematurely, if David Seymour’s bill is passed. It is fanciful to say that safeguards can be made to work, she argues.

Doctors don’t always get predictions right either.

“Doctors predicting when death is imminent can be wrong up to 80 per cent of the time, so forecasting life expectancy in terminally ill patients is a very imperfect process. In fact, one friend told me recently that her sister was given six months to live and that was 18 years ago!” said Catherine.

“I have had patients say that if they were to have a cardiac arrest while they were in hospital with a very serious illness, then they didn’t want extraordinary means taken to keep them alive. That’s a perfectly reasonable attitude. Some patients have signed documents to put in their notes with an advanced plan as to what they’d like done if they enter the terminal phase of their life. I’ve never had a patient say that they wanted to be ’put down’.”

Like Anne, Catherine believes palliative care needs better resourcing. “I care about people who are suffering, but changing the law against euthanasia is not the solution. The provision of more and better funded palliative care is what is necessary.

“I tell my patients that they are worth my working hard for them, that they deserve my trust. There’s no evidence that the current law is oppressive or dysfunctional and we shouldn’t normalise people asking for assisted death. That stance implies that there’s such a concept as a life not worth living and I don’t believe that. 

A Horizon poll last month found 75 per cent of the 1300 people surveyed favoured a law change to allow the terminally ill and people with irreversible unbearable suffering to be helped to end their lives peacefully with 11 per cent opposed. The largest support group was those in the 65 to 74 age range, with 82 per cent in favour of a law change.

David Seymour’s The End of Life Choice bill

It would allow mentally competent New Zealand adults, aged 18 and over, who have a terminal illness likely to end their life within six months, or have a grievous and irremediable medical condition, the choice to ask a doctor to help end their life at the time of their choosing.

It requires the Director-General of Health to establish a group of medical practitioners who would maintain a register of health professionals willing to participate in assisted dying.

A new process would require two medical practitioners to be satisfied a person meets the required criteria. The second would be independent of the patient and initial doctor.

It defines a person eligible for assisted dying as someone who:

  • Is aged 18 years or over
  • Has New Zealand citizenship or is a permanent resident
  • Suffers from a terminal illness likely to end their life within six months or has a grievous and irremediable medical condition
  • Is in an advanced state of irreversible decline in capability
  • Experiences unbearable suffering that cannot be relieved in a manner that he or she considers tolerable
  • Has the ability to understand the nature and consequences of assisted dying

 

This article was originally published on Aug 3, on Now to Love

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