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Voluntary Euthanasia

Responses to Kim Hill's interview with Sean Davison on 20 June 2009.

Feedback has been edited for brevity and sense, and to preserve listeners’ anonymity. To contribute to the discussion, please email saturday@radionz.co.nz or send a text message to 2101.

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There can be only compassion for Sean Davison, but I'm still left queasy. As a minister, someone who fought Michael Laws' Death with Dignity Bill, and with an aunt who committed suicide in a ghastly way, isn't there something about this to do with the modern convenience of life, with keeping it clean and simple?

Those who work with death understand the profound depth and humanity of it all. Elisabeth Kübler-Ross talks about the seven stages of death; aren't individual deaths inextricably linked to family, friends and wider families and therefore not just about us? Isn't this a shared experience, as much as birth is?

Are there not people dying lingering slow deaths by starvation, or suffering terribly in torture chambers? Does a modern, clean, convenient attitude to death mean we should bomb these centers and end it quickly?

Death seems to me to be too profound, contradictory and too mysterious (like the oxymoron of "living will"). Is it not a journey that we should walk together with those around us?

John

 

I am very saddened listening to the chap talking about his Mother’s death and euthanasia and all the drama that went with it. When you believe, know and trust in God and your future with Him, you can die well and in peace. All this anguish is gone as you know that God is in control, therefore you have nothing to fear. He gives you a peace and comfort that surpasses all understanding.

Maureen

 

I agree with much of your interview this morning but I have to take umberance with the description of hospices as sterile places. As with everything until you have experienced it, it is easy to make such judgements but my father died earlier this year at the Mary Potter Hospice in Wgtn and I feel very blessed with the care the hospice gave us all - my father and those of us who, unfortunately, were waiting for him to die. The memories I have of our time there are very peaceful and special. The hospice took care of all the medical stuff and we were able to just "be" with him - talking, singing and just sitting quietly.

My father stopped eating and left us just six days later - it seemed a very long week but in retrospect he let go very quickly. This is an important book and I know my father would want the debate to continue, as do I.

Pauline

 

I have no idea how the assassination market works in New Zealand. If enough people used it in order to euthanise themselves, would it create a need to regularise the situation?

James

 

I have just returned from the US supporting my mother in her passing. She too chose to stop eating and I felt this was a wonderfully courageous decision on her part and supported her - after we all talked to her and tried to make sure that it was a clear decision. I was always so clear when I was in the US that NZ would not try to sterilize the natural process of death and yet listening here I am not sure if I was right.

My mother's death was as peaceful as they come. She too chose not to take any pain meds as she wanted to be clear and conscious in her last moments. She did take some at the very end (about 20 minutes from her passing) but at that point she was not making any decisions. My mother was living in her own home in a supported living apartment (which makes my process different than Sean's as she had nursing care but I was there for everything) which was wonderful however, she was ready to go. She was 87 and was no longer happy with the quality of her life. I applaud her and in no way feel that euthanasia is the right word as I understand it that word means someone did it for you or to you versus what my mother did was to herself. I loved being with my mother and felt that I was there to advocate for her and to make sure that her passing was as beautiful as it could be and as much HERS as her life had been. I felt honoured to be able to support her in that way. It wasn't always easy, but it wasn't hard either. I had to make her death less about me and more about her.

The state of Washington has a 'Death with Dignity' Law they just passed. It is a rigorous process in order to be allowed to participate.

I can't wait to read his book.

Sarah

 

It seems to me that;

rampant superstition

god-botherers

absolutely gutless pollies

And some anti-journos

are still the mainstay of NZ culture in this respect!

David

 

Great interview - I very much agree with you that it is only when you think briefly about it that you can come to an easy decision. There are many points of view, and the problem with legislation is that it solidifies one particular point of view.

Those who advocate euthanasia have a materialist view (which is nihilism): death is extinction, so why should anyone continue to suffer when they can end it? Shakespeare knew a thing or two: "What dreams may come when we have shuffled off this mortal coil?" (If I've remembered it correctly!) This has the wisdom to know that the body dies, but the mind goes on - and actually we don't know what is coming and shouldn't assume that it will be better than what we are experiencing at the moment.

 He said his mother's death was ghastly, but they didn't know that beforehand - exactly: we think we know and make decisions based on that delusion. Another thing which I remember from the interview is that his mother chose not to take morphine in order to stay sharp, but therefore experienced pain and sadness. Here again I see the lack of a spiritual dimension to life - pain and sadness are to be avoided at all costs, they have no use. But actually they are helpful if we remember that others also experience pain and sadness and use our experience to generate compassion for others. That way our suffering is meaningful.

 But if you have the attitude that after a full life, at the age of 85 or 90 there are few pleasures left so you might as well end it - that is such a limited view of life, the only point being pleasure seeking, that I would not like a person with this attitude to be having an influence over our laws.

Marion

 

Very moving topic! Having lost a mother in law to cancer, spending her last 4 weeks in an amazingly beautiful hospice, located on a lake in Canberra, makes me think, instead of spending millions on a debate, how about spending millions on building hospices in amazingly beautiful places, with harbour or lake or mountain or garden views with accommodation for visiting families.

Glynis

 

Perhaps we could look at what we have presently arrived at in the other debate about how we relate to each other as family members. And that is, it's illegal to assault your child, but in some instances, the police won't prosecute. So, maybe it's illegal to murder your parent, but in some instances the police won't prosecute. Yes it's all very grey, but sometimes black or white doesn't allow us to do the loving and responsible thing.

Jane

 

I'm listening to your interview with Sean Davison and immediately I'm back in 2002 in the 10 weeks I lived with and cared for my father when he was dying of terminal bowel cancer. It is one of the most profound and most loving times I have experienced in my life so far.

There was never any question of interfering with the process of his dying - it took the time that it took. My dad was kept comfortable with an array of medication including morphine. He couldn't eat, his digestive system was riddled with cancer. We were supported by family members and friends, a wonderful general practitioner and the fantastic hospice nurse service provided to us in his home. My father was surrounded by loving care and he felt safe and nature took its course.

It was enormous help to me that I had trained as a nurse in the early seventies but more importantly, have spent 30 years as a practising midwife so I have a very good understanding of natural processes and the time that they can take! My lasting impression is of his life force - whatever it was that made him, him; whatever it was that kept him alive and the part of him that stays with me still. At the moment of his death, I was beside him on the bed, looking into his eyes and despite the cancer that he had, despite the fluid that filled his lungs, his organism still struggled to get the air into his lungs to keep going. I watched the light go out of his eyes and he was dead. It was shocking and traumatic and it was the way it was.

I now live with the knowledge that I was able to meet my father's death head on and deal with it. I am pleased that I was able to look death in the face. I no longer feel frightened of it coming for me. So nothing is surer - we will all die; the majority of us will not 'want' to and it is, as Sean said, a matter of timing. I don't want to 'control' it, and as Sean's mother demonstrated, even stopping eating doesn't necessarily speed the process up.

How can each of us be brought to the point of approaching the matter of our dying as yet another rich life experience that we can still learn things from? As long as I am physically comfortable and hopefully, surrounded by loving care, I want to live until the moment of my death.

Bronwen

 

Enjoyed the discussion this AM. The basic issues were precisely what Leslie Martin encountered and led her with many others to set up Dignity NZ which is committed to changing NZ law, having a major public debate in the process, and setting up Dignity Havens as a place where people could elect to die in lawful and compassionate circumstances if they wish.

I am a retired intensive care doctor and have many time withdrawn life support care in hopeless situations knowing that rapid death will result ( as happens every day in NZ). The difference between passive and active euthanasia becomes theoretical in such circumstances. The issue becomes - is death worse than life? We seem to act on a basic instinct that life is always better than death. This is manifestly not true.

Jack

 

Your speaker took me right back to my Mothers death 12 years ago. She was unconscious from a brain blood clot, the life support taken off and after a struggle with health authorities we took her home to die - why not?? She was on a morphine drip, and her family gathered from round NZ It was lovely Spring, her garden glorious, the sun shone and the birds sang.

We had a week of total anguish yet celebration of her life and the family she created. But she just went on and on and on and showed no signs of dying and we had no idea how long she would continue. We were emotionally drained and anxiety set in about our lives outside her home - careers, university and school exams.

We have had no remorse or anxiety about our decision to help her die so peacefully - Morpheus - the Greek God of Dreams which became the god of slumber. It was a wonderful death.

A Listener

 

In the early '80s I was a Social Worker in the UK with special responsibility for elderly clients. Three stand out in particular, a well-educated spinster from a wealthy family, a high performing, retired, female executive & an ex self employed owner of a successful business. All at one point decided to take to their beds & give up on life. The head of the Home Help Service & I came to the conclusion that they were trying to commit suicide. This was the only means available to them to do this & that it was not a rare occurrence. Her comment was that sometimes she wished that she could just wrap them up, keep them warm & let them go. My husband died of cancer. He was paralysed & his speech was incomprehensible. His concern was not pain but the loss of dignity & the burden he was to his family & the effect on his then very young children. Why force him to linger? He died at home with his family as people should. I am a qualified Medical Lab Scientist & it appalled me that moribund, aged patients were put on anticoagulants to prevent heart attacks & had to be monitored with daily, invasive blood tests. Why couldn't they be allowed to go in peace - wrapped up & kept warm - in their own beds? Things haven't changed for those who want to have some control over the when & the way that they die. In fact it's got more difficult as we now have more ways in which we can interfere. More antibiotics & other drugs, bigger & better life support systems Bigger, clinical, less inviting hospitals & still the same arrogant opinion that everyone & anyone knows better than you when you've had enough. I'm with Sean Davidson on this one.

Marjorie

 

I saw my sisters go through all these things trying to care for our mother, and the fear of hospices and morphine. Our experiences of the awful effect on family trying to care for her are acute.

The difference was that Mum did not want to die and leave her family. I know what Sean means about taking over life. My sisters had the door open at night and were not sleeping, rushing out to Mum's room at any sound.

I think myself that hospice is still very misunderstood or just too awful to contemplate. Sean is right about not wanting it to be like that for ourselves. But I can't understand the morphine fear. Hospice staff say this is the greatest asset.

Thanks Sean for the debate and book. We never contemplated such an experience. I have told my sisters stay away from the doctors and nurses if it is me, as I do not want them having any reserve about morphine.

Mark

 

After listening to your discussion on the question of euthanasia, it saddens me that such intelligent people (son and mother) can get it so wrong. Where is the dignity of a long drawn out starvation? Obviously the poor mother wasn't as near death as they thought. I believe that might have had something to do with Sean's arrival back in his mother's life.

My understanding of the Hospice movement is that there is tremendous support for people to die in their own surroundings. Only acute situations often end up at the actual hospice itself. For Sean to call the hospice sterile made me wonder if he'd ever been in one. I cannot but have praise for the wonderful work of those dedicated to the care of the dying have to making a hospice far from sterile - it reeks of humanity!

Palliative care creates a shield of protection for one who is dying. That shield is made up of medicine, counseling, therapy, informed understanding of a situation etc. It sounds as if mother and son knew better and were not going to listen to advice. And when the death went wrong, those that were never listened to were then to listen to the son who has become an authority on badly managed dying.

My other concern about the mother's decision to starve herself was her son leaving not her death? Sounds like the pain of the leaving was too much for mum.

Emotions around death are very mixed and they need to be tempered with informed understanding. Sadly then, emotions got the better of this situation and the result was far from ideal.

I could write more. There is a lot to argue about with the dignity of dying. What I pray for is the courage of people to seek the help of others who are experts in the field so that informed decisions can be made rather than anguish experienced in ignorance.

Stephen

 

The logic of voluntary euthanasia as proposed by your guest is surely not contradicted by the kind of compassion that emphasizes the right to choose the timing of our death but by the kind that denies the core meaning: ‘com-passio’ = ‘suffering with’. A pragmatism that emphasizes choice practically reduces the choice: it denies families the chance to say goodbye together. Practically today’s ‘painkillers’ are not compassion-killers but actually allow time for family and friends to gather and say goodbye. Sure it’s possible to return ‘Euthanasia by starvation’ (Eskimoes breaking their teeth when no longer able to travel with the tribe) but today’s pain relief seems to be less stressful and more practical all round. Apparently, most of us do die in our beds, and surely advantages of this being our own are incalculable. The lack of a hospice movement in the Netherlands and Switzerland is telling, but to me not a compelling argument to reduce the choice available to families by hospices. Contrary to the puritanical solutions in the above countries and your guest’s honest grappling I believe humanizing hospices by making them more open-door, home-from-homes – and financing home-care and home-death preferable as a transition of choice.

Steve

 

I remember reading many years ago of a tribe of native American Indians where the elders took it upon themselves to disappear when they were no longer able to be useful to the group. Also in the future in a more equitable society hopefully old people will not be weighed down with massive wealth that would elicit dark deeds by relatives.

Ron

 

A few years ago I read Denial of the Soul by M Scott Peck, a late book of his which I think is the true sequel to The Road Less Travelled.

Until I read it I didn't think much about euthanasia, but I guess my opinion would have been in line with my modern cultural upbringing, involving individual rights and the capabilities of medicine etc. The book though gave me cause for thought. In and amongst Peck poses the premise that we all think that, if nothing else is, our lives are our own so we should be able to do what we like with them. But he argues very convincingly that we are mistaken if we think that. I suppose that that is such a counter intuitive idea for me that I thought it must be worthy of serious consideration. Anyway, I strongly commend the book to anyone involved in the debate about euthanasia.

Of course, the right to euthanasia may not be a strictly answerable question, and regarding such questions, more particularly 'divergent problems' as distinct from 'convergent problems', another great writer, E F Schumacher, has some fascinating insights in his book, A Guide For The Perplexed.

Peter

 

Have you read Dancing with Mr D. by Bert Kaiser, MD? He's a doctor in the Netherlands, writing about his experiences in a hospice or hospital, with people requesting euthanasia. He raises a lot of the questions you mentioned in the interview today.

You were concerned about people feeling obliged to take that option so as not to be a bother to people, and I agree that that is possible. The interesting thing in Kaiser's book is that although people often ask him to 'finish them off' he is perceptive enough to try to understand whether their request is genuine or because of fear of being a nuisance, or fear of pain or indignity.

I think the deal is that as human beings with the ability to make requests such as for euthanasia, and to be able to fulfill those requests, we also have the responsibility to be very very thoughtful about complying with the request, to look into all the alternatives and motives.

After being with my mother when she died of cancer, in pain because she didn't know that hospice care doesn't have to include being IN the hospice, and then being with my 7 year old son when he died of leukaemia with superb hospice care, I know that for many, if not most people, having the right kind of medication makes it possible for people to 'let nature take its course', but I also know that if I were in my mother's or my son's position, I would also want to know that I COULD opt to finish myself at my own pace, in my own time.

I really don't think most doctors would take a request for euthanasia lightly. And the kind of people who would want to bump someone off for the inheritance are not likely to be put off by the lack of legality in doing so. Having the euthanasia option available will just bring the whole issue out into the open, because you can be very sure that there are many many patients who are 'helped' to die in their last hours or days anyway.

Kate

 

So far you’ve not got into the detail of euthanasia which i think provides the solution to all the objections to euthanasia

Method for Euthanasia:

1.an application is made to die in the applicants own hand or in the hand of a JP stenographer.

2. this application needs to be repeated and auto initiated 3 times over a period of not less than 18 months and no more than 3 years.

3. when the application is received an officer of the court is assigned to visit the applicant ASAP, and take tea with the applicant and listen (be in the company of the applicant )while communications are augmented in any way to assist in reflective conversation over the application.

4. This procedure is triplicated without rancour. It’s a process of full consideration to provide a humane, soft take-off for the spirit.

5.The medical profession would take part only in so far as making the prescription. They would take no further part.

After the second application has been received a court officer visits the applicant and informs on the method of euthanasia. This could be a combination of oral agents to deeply sedate followed by mask administered carbon monoxide for 15 minutes. The mask is removed and if death has not ensued the family stay close until the applicant’s death within 24 hours.

After the third application has been authenticated, an officer of the court sends a certificate that must be presented with the doctor's prescription, including the gas, for the agents to be dispensed.

A.A.