A Debate We Need To Have

A debate we need to have, Sep. 29, 2010.

Euthanasia could be compared to old-fashioned backyard abortions: sneaky, dangerous, and happening in spite of the law.
Dignity New Zealand campaigner Lesley Martin is holding a national conference next month to debate euthanasia. She talks about assisted dying to senior reporter LEE MATTHEWS.
Nobody is going to kill anybody who doesn't actually want to die. And people who ask somebody to help them to die will have to prove they're mentally competent, and have made the decision with full information. And yes, of course they can change their minds.
Dignity New Zealand campaigner Lesley Martin wants people to understand this. It's her vision for voluntary euthanasia in New Zealand.
She can't actually see what all the "but you're killing people" outrage is about with the euthanasia debate.
Since she was convicted of the attempted murder of her terminally-ill mother in 1999, and served a 15-month prison sentence, she's been the face for New Zealand's small but vocal right-to-choose assisted death lobby.
She's living near Ashhurst, 14km from Palmerston North, with sweeping views of the snow-dusted Ruahine Range, and daffodils and irises and damp-loving lettuces clustered in the rose garden.
Also outside is Zanzidini Arac, a 17-hands-high stud stallion she's having broken in for dressage. Her own twice-broken pelvis and arthritic hip notwithstanding, she's riding horses again, cautiously but loving it.
Talking about assisted death as your day job requires sound management of the work-life balance, or you burn out, big time.
That's because the job never stops. The issue doesn't go away, just because the law says it shouldn't happen. Assisted death is illegal in New Zealand – the law is implacable, it's murder – but Ms Martin says it happens frequently; underground, out of sight, too-often botched.
That's why she wants debate about whether it should be legalised, and clear, enforceable rules if people decide it's what's wanted.
People want to talk about it, she says. The politicians might not have "the bottle" to tackle the issue but, every day, somebody in distress and wanting help phones her, emails her, approaches her after speaking engagements, or taps her shoulder when she's shopping.
"I was in Farmers, buying underwear. I had the polka dots pair in one hand, the flowery one in the other, debating frills. A lady stops me and starts telling me her story, what had happened in her family. It's hugely important that we talk about it."
She lives her convictions. Ms Martin went to jail in March 2004, after she wrote and self-published a book To Die Like a Dog. In play format, it told how she had given her mother all the morphine she'd had on hand, trying to end her pain and suffering.
She published it deliberately, after seeking advice from lawyers and police. She wanted it to be a change catalyst, to open a grown-up debate in New Zealand on voluntary euthanasia. Do we want it, and if we do, what rules should there be?
The book's first print run of 3500 sold out. So did its second of 1000. And the police took it as a written admission of guilt, that she'd done what they tried to prove she did, and failed to prove, in the 1999 investigation of her mother's death. She went to jail.
"What a pointless exercise. Going to jail didn't change my views. It didn't rehabilitate me. It didn't make me remorseful, make me feel that I would never do it again. If one of my sons was suffering interminably and asked me to assist, I would."
Probably the most useful thing she achieved in jail was cataloguing Arohata Women's Prison's 4000 library books, and guiding some of her fellow inmates to better reading.
"When they first come in, they want books about crime and drugs and bulldogs and demons and dragons. Then you see the rehab start to work, and they'd read Maori culture and mana, self-help books, poetry, books about peace. Nice fiction."
In jail, prisoners sought her out to tell her about how badly and sadly their family members had died. Botched suicides, often, sometimes leading to irreversible brain damage.
A former intensive care nurse, Ms Martin believes jail actually gave her cause more credibility in the eyes of some. It doesn't matter, it's a past chapter of her life. But she says she's invested too much of her life into the issue of euthanasia to walk away from it.

Is she obsessed?
"No, no I'm not," she laughs. "I'm not obsessed. It's a job. It's my job."
Voluntary euthanasia is legal in the Netherlands and in Belgium. Ms Martin notes that it took the Belgian parliament 300 hours of solid debate, moving 680 amendments, to get the legislation right for the people of that country.
New Zealand had a crack at a voluntary euthanasia bill in 2003, but it failed. That came as no surprise to Ms Martin and, in hindsight, she's pleased that version didn't make it.
"I was gobsmacked at how superficial and unfocused and irrelevant the debate was in our Parliament."
She believes that countries that allow voluntary euthanasia have to have to a support infrastructure so people can access the service.
Put bluntly, that's somebody and somewhere to finish things off.
No use having the right if it can't be exercised by people who want it.
Ms Martin says it would have to be controlled, safe, and legal, with decisions made properly and competently. No coercion.
The right to change your mind.
Her Dignity New Zealand Trust is working to set up what she calls dignity havens; places where people can get expert palliative care for the last stages of terminal illnesses, and where they can also choose the right to die.

Expert and outstanding palliative care in terminal illnesses is what hospices do in New Zealand. The hospice philosophy is to neither hasten nor postpone death, and Hospice New Zealand last year said in response to Ms Martin's calls for dignity havens that improvements in palliative care have taken the sting out of the voluntary euthanasia debate. Proper palliative care means keeping the dying supported and comfortable; ending life prematurely therefore isn't necessary.
Hospice New Zealand doesn't support a law change to allow voluntary euthanasia, and it doesn't support the development of dignity havens where legalised euthanasia could be done.
So are hospices, right? We don't need to bother with this debate because everything's under control? Many would agree.
Ms Martin doesn't agree. She has a huge respect for the work hospices do; 40 years ago at their inception, they broke the ice on the difficult subject of the specialist needs of the terminally-ill person.
"But when the conversation stops short of whether assisted death is the specific wish of the dying person, to my mind that means there are still things to talk about."
She sees a major problem with the euthanasia debate is that most people, in the comfort of everyday good health, don't see the subject as something they need to know about or talk about.
"The subject's taken quite lightly, initially. People might promise to look after families' members, saying nobody's going to suffer. But it's different when it becomes pertinent, when the suffering is happening, when someone you love is drifting in that zone between living and dying."
People who have been there, in extremis, know what she's talking about. They might not want euthanasia; they don't have to agree with it. But Ms Martin says they should have the right to choose if they want it.
"People who say `I wouldn't choose that, therefore I think you should not have the right to it either', are not helpful. That's just restricting personal choice."
Palliative care has improved, she agrees, and for the majority of people it will be sufficient. But she's also got the 2007 Nathaniel report on her mind. That stated that hospices and palliative care could control pain in 90 per cent of cancer patients.
"And the other 10 per cent? About 9000 people die of cancer each year in New Zealand. Let me tell you, if 900 people were dying in public view out in The Square, in uncontrollable pain, we'd have that legislation today, now, already."
What upsets her is underground euthanasia.
"Legislators need to understand this. It's already happening. People have been doing this since the year dot. There are some parallels with the illegal abortion debate, we need to learn from that debate."
The problem as she sees it is that everyone always wants somebody else to do their social reform for them.

From The Manawatu Standard, New Zealand