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VOLUNTARY EUTHANASIA:

TOO HOT TO HANDLE?

graham adams Is NORTH & SOUTH s chIef subedItor.

A decade after his Death with Dignity Bill was defeated in Parlia-ment, former NZ First MP Peter Brown still

sounds mystified by how the vote went against him.

Right up to the debate on his mem-bers bill in July 2003, we had the num-bers to get it across the line by two or three, he tells me on the phone from Tauranga.

But, on the night, One guy whod promised to support the bill didnt turn up. And one woman [MP] who had prom-ised support changed her mind. He thinks someone with influence in her electorate had leaned on her.

Certainly, Brown says, if the parlia-mentary vote had reflected opinion polls which were running above 60 per cent in favour even in 2003 his bill should have got enough votes to at least send it to a select committee for public dis-cussion. But it was defeated 60-58.

The past 10 years havent dimmed Browns passion for the cause, however. It is a long time since my involvement in the voluntary euthanasia debate, he says, but this is still an issue where I strongly believe people are entitled to have their chance to express their view.

Fat chance, you might think.

It is 10 years since Peter Browns Death with Dignity Bill was narrowly defeated in

Parliament. In September, another members bill to legalise voluntary euthanasia was

suddenly withdrawn. Graham Adams asks why the topic is such a political hot potato

when public opinion polls repeatedly find a strong majority in favour.

Health

get

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terms of pledging a national discussion and referendum is particularly hard to understand given we are a nation known for our pragmatism rather than our religious fervour.

Contrast a deeply Catholic nation such as France, where President Franois Hol-lande made publicly discussing the issue of voluntary euthanasia a campaign pledge in 2012, and said he would intro-duce a bill to legalise it. This despite a proposal to legalise assisted suicide hav-ing been defeated in the French Parlia-ment in 2011.

And France, you might remember, saw street protests when same-sex marriage another of Hollandes campaign pledges was voted into law this year.

the suicide of his wife, Rosie, who had advanced multiple sclerosis, which meant she could not feed herself, was incontinent and had trouble walking. She had made a video that was present-ed to the court, in which she explained her decision to die.

To prove her husband was not present when she died, she asked him to go out and buy something from a shop.

As these and other court rulings show, attitudes to voluntary euthanasia are changing Street says the conversa-tion has moved on a lot in the past 10 years but still no major political party has been willing to make it official cam-paign policy. Or even to propose its own bill when in government and allow its members, and those of other parties, a conscience vote, which is how National dealt this year with the question of giving SkyCity more pokie machines in exchange for building a convention cen-tre in Auckland.

Peter Brown agrees such an approach would be a good way of presenting vol-untary euthanasia for debate in Parlia-ment. Also, he says, it could be subject to a binding referendum as a further check to make sure what Parliament decided was, indeed, what the public wanted.

When John Key was asked his opinion in October after a coroner had com-mented at an inquest into an elderly womans suicide that voluntary euthana-sia was a topic Parliament would have to address again he said: Its hard to be-lieve the government would put it on the agenda any time soon. Fundamentally, the government has to be confident its got the numbers, and I couldnt be at all confident weve got the numbers. There would be quite a considerable portion of the National caucus that would vote against that. It is something best man-aged through that members process.

(In the case referred to by the coroner, an 85-year-old widow in Lower Hutt had waited for her family to leave from a visit then used a homemade device to kill her-self in what was described as euthanasia by suffocation. On the stuff.co.nz news website, a poll alongside the story drew 4269 votes, with two-thirds favouring the legalisation of euthanasia.)

The reluctance of our po-litical leaders to deal with voluntary euthanasia as party policy at least in

a similar proposal. Street cited to North & South the results

of a 2012 Horizon Research poll which showed a huge majority in favour of her bill, with 62.9 per cent approving it and just 12.3 per cent opposed.

In October this year, Nationals Phil Heatley an avowed moral conserva-tive found to his surprise that 66 per cent of 977 respondents he polled in his electorate of Whangarei favoured some form of assisted suicide.

Whats more, the courts reflecting public sentiment often adopt a lenient position when sentencing those who help hasten the deaths of loved ones who are dying. In a widely reported case in late 2011, Sean Davison, a South Africa-based microbiologist, was sentenced to five months home detention in Dunedin after he pleaded guilty to a charge of inciting and procuring the attempted suicide of his 85-year-old mother, Patricia, in 2006. (He gave her crushed morphine tablets in a glass of water, at her request.)

In September 2012, Evans Mott was discharged without conviction in the High Court at Auckland after he assisted

prostitution are very exposing for MPs, she says. Opposition to these things can be very vociferous and po-larising, if people want to make it so.

Suddenly, MPs cant hide behind a manifesto. They have to make up their own minds and they usually dont have the cover of a party position. They have to have the courage to nail their colours to the mast, or not.

In election year, that is a riskier activity than in a non-election year.

Yet should it be seen as so risky when opinion polls over two decades have shown that a clear majority of New Zea-landers want the right to choose assis-tance to die if they are terminally ill?

In 1995, a One Network News-Colmar Brunton poll found 62 per cent of par-ticipants approved of voluntary eutha-nasia, with 27 per cent opposed and 10 per cent undecided.

In 2003, a Massey University survey showed 73 per cent of respondents want-ed assisted suicide to be made legal if it was performed by a doctor (support dropped to 49 per cent if performed by others); a Voluntary Euthanasia Society survey in 2008 found 71 per cent backed

Labour list MP Maryan Street withdrew her members bill in September because she didnt want the question of legalising voluntary euthanasia to be treated as a political football in an election year. getty

Its one of the great mysteries of a modern democracy a proposal that a majority of the public repeatedly approves in

opinion polls finds no major political party will present it as official policy. And when a members bill to legalise it is lodged, its sponsor withdraws it be-fore it can be drawn from the ballot be-cause she doesnt want it to become a political football in an election year.

Labour list MP Maryan Street lodged her members End of Life Choice Bill in July 2012 then withdrew it in Septem-ber 2013 even though it is a topic she feels very strongly about. It was widely speculated that senior party members had pressed her to drop it, but Street maintains it was entirely her decision. She says she intends to re-present the bill after the next election, and with-drawing it was purely for pragmatic rea-sons, not least because she didnt want it tainted by election-year dynamics after she had bent over backwards to make sure it wasnt seen as a partisan measure.

Conscience issues such as volun-tary euthanasia, alcohol, abortion or

Despite its long Catholic history, how-ever, France also has a tradition of per-sonal liberty and secularism, in which church and state are clearly separated. And, obviously, French politicians are a lot braver than ours.

In New Zealand, our parliamentarians have preferred to leave the question of voluntary euthanasia to the lottery of a members bill, which means any bill might not be picked to go before Parliament for weeks, months, years or never at all.

Brown says that although he was re-luctant to continue pursuing the issue after his bills defeat, he was persuaded by the many people contacting him in support to re-present it in 2004. But when he retired from politics five years

Professor Sean Davison was sentenced to five months home detention in Dunedin on charges of assisting his mothers suicide after she had tried to starve herself to death.

mike white / north & south

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Parliament, after a short debate, again decided against allowing it to progress further.

Who exactly, you may wonder, is so keen to make sure the public never even gets the chance to officially discuss that most fundamental of human questions: should I live or should I die?

In 2000, Labour MP Chris Carter blamed a vociferous moral minority wielding undue influence. Brown says the principal opponents of his bill were the Catholic Church and the New Zea-land Medical Association, which pub-licly announced its opposition in the run-up to the parliamentary debate.

Nothing much has changed in 10 years. In September, Ken Orr, spokesman for Catholic advocacy group Right to Life New Zealand, wrote on its website that the organisation had written to all the Labour MPs on July 24, lobbying them to use their influence to have this de-structive and controversial bill removed from the ballot.

Orr claimed its withdrawal was due to the lobbying, and said: Right to Life now requests [Street] finally discards this bill and makes a commitment to the com-munity to refrain from placing this con-tentious bill back in the ballot. This bill has no place in our Parliament.

Peter Brown is a Christian. Not a devout one, he says, but I try to live my life according to Chris-

tian principles. He notes that among the hundreds of

letters he received about his 2003 bill were many supportive messages from Christians, but some of the most un-pleasant were standard letters from religious people with comments scrawled at the bottom. Some were very unChristian-like, he says. And the worst letters I got were from people who identified themselves as Catholics.

Like Brown, Maryan Street is quick to emphasise that not all Catholics are op-posed to voluntary euthanasia: Theres no monolithic view on this by any group in society, she says.

Nevertheless, whatever the rank and file think, the Catholic Church hierarchy vigorously opposes assisted suicide, which is hardly surprising given its prohibition on taking another humans life; that it regards life as a gift from God and its natural course should not be

Reviewing attempts to le-galise voluntary eutha-nasia over the past 20 years, you could be ex-

cused for thinking most politicians dont really want the public to be given the chance to discuss the topic at all.

In 1995, then-National MP Michael Laws presented his Death with Dignity Bill, jointly drafted by former MP Cam Campion, who was dying of cancer. It was proposed that the bill would become law only after a binding national refer-endum, to be held with the general elec-tion in 1996.

The purpose of the debate was to de-cide whether the bill should be introduced to the House and then discussed at select committee hearings. That proposal was defeated 61-29, with many abstentions.

When Parliament discussed the matter next in 2003, Brown emphasised he was not asking anybody here in the House to make the final decision.

This bill should it pass all stages will go before the public of New Zealand, so that the public can make the decision by means of a binding referendum.

later, his bill still hadnt been drawn from the ballot.

After its defeat in 2003, he had discussed with Helen Clark the pos-sibility of presenting it as a govern-ment measure. Shed voted for Browns proposal, but told him a members bill was still the best means of addressing the issue.

Why our most promi-nent politicians wont front the issue seems even stranger

when the leaders of our two biggest par-ties voted for Browns 2003 bill to proceed to a select committee. And John Key not only voted in favour, in August last year he told Newstalk ZB he broadly sup-ported the principle of voluntary eu-thanasia and would consider it himself if he were terminally ill.

Labours leader David Cunliffe also voted in 2003 for it to proceed to a se-lect committee, but when I emailed him in October to ask what he thought about voluntary euthanasia personally, he replied coyly: I have a clear per-

interfered with; that suicide is a mortal sin; and that suffering is integral to the churchs teachings about salvation.

This last point is often overlooked in the debate about voluntary euthanasia, but was made vividly apparent to me in 2007 after my sister died in a Brisbane hospital tied to a bed, screaming in agony from cancer in her lungs, breasts and spine.

A few days after her death, a devoutly Catholic relative rang to say she had heard my sister had died in horrific pain and

Lake Kaniere.

sonal view on this issue. However, at this time, given my new responsibili-ties, I am refraining from stating it so as not to unduly influence any future conscience process that might arise.

Green Party co-leader Russel Norman wasnt an MP in 2003, but he told 3 News in 2012 that hed be voting for Maryan Streets End of Life Choice Bill, adding: I think it should go to select committee. I think we should have the debate about it as a country.

But when I asked him in October if that was still his stance on the bill and whether he would vote for it when it is reintroduced [by Maryan Street], he didnt answer but passed the email on to Kevin Hague, who describes himself as the partys spokesman on healthcare issues, including end-of-life ones.

Hague said he was disappointed that Maryan has withdrawn her bill, but understand her reasons for doing so.

The Greens have a process under way to develop policy [on assisted dying], but it has been moving slowly and is now very unlikely to be finalised before the next election.

Dr John Pollock, an Auckland GP, wrote a paper in 2010 calling for the legalisation of voluntary euthanasia. Suffering from terminal cancer, he died peacefully at home with his family two months after this photo was taken.

PressPix / Paul estcourt

In 2007, Pope Benedict XVI signed an apostolic exhortation at the Vatican in which he decreed celibacy remained obligatory for priests. He also urged Catholic lawmakers to oppose laws favouring divorce, abortion and euthanasia.

arturo mari / osserVatore romano/aFP/getty images

SUffERINg IS INTEgRAL TO THE cATHOLIc cHURcHS TEAcHINgS AbOUT SALVATION.

It had felt like the right decision, back at the rest home, when her elderly mother signed a form declining medical intervention if she

became critically ill. But as Rebecca sat by the hospital bed watching her die, and the days stretched into a week, the reality of what that choice meant left her shaken.

Unable to swallow, her mother had been given no food or fluids, and the restlessness that saw her plucking compulsively at the bedding gradually diminished as her body weakened. By the sixth day, it was clear she would never regain consciousness from the massive stroke shed suffered in her sleep.

That would have been a good time to let her go, says Rebecca, who wanted to be with her mother when she died. I knew she wouldnt want to continue in a vegetative state. It felt cruel, as if she was sort of trapped. But you cant choose to be gently swept away on a cloud of morphine. That seems like a more humane scenario than allowing her to dehydrate to death.

Even if voluntary euthanasia were legalised, what would happen in situations like this, where the dying are unable to communicate their wishes? And is there really a difference between withdrawing the necessities of life and stopping someones heart with a lethal injection?

Thats a common misconception, says Anne Morgan, practice adviser for Hospice New Zealand. Shes worked in oncology and palliative care for more than 30 years, and sees Rebeccas experience as an example of how poorly end-of-life care is sometimes communicated to the family and how ill-prepared we are to deal with the process of dying.

After a massive stroke causes

severe brain damage, or when a terminal illness reaches a critical point, the bodys organs are no longer able to function and naturally begin to shut down, Morgan explains. The kidneys are often first to fail and would be unable to cope if fluids were given intravenously.

There are very clear indicators that any treatment is no longer useful, but would be a burden on the body and cause distress, she says. After a major medical event, such as a stroke or advanced disease, thats what the person dies from not dehydration.

Its like a motor shutting down. The breathing slows and finally the heart stops and comes to rest.

Hospice New Zealands official position is that it does not support a change in the law to legalise assisted dying in any form, but follows the World Health Organisations definition of palliative care neither to hasten nor postpone death.

Individual end-of-life plans are talked through with each patient, including where they want to be cared for, their spiritual needs and the choice to refuse treatment. Most commonly, people want reassurance they wont be in pain, to have their family around them, and not to be kept alive by artificial means.

The debate that needs to be happening in the public arena is about having those good conversations with your family before you get sick, Morgan says. An acute situation is not a good time to be making such decisions. There are formal ways to do that, with advanced care plans, but it can also just be a dinner-time conversation.

I think the reason the euthanasia debate has reared its head in a way is because medical technology has gone ahead so rapidly that we can now keep people alive. And a lot of the conversations around it are quite emotive. But dying is actually a normal process for the body. It knows how to do it. With good support, it will do it very well. For the family, its a very sad time, but theres a beauty in that sadness and a lot of honesty. JoaNNa WaNe

As well as regarding killing another person as a mortal sin, Catholics believe humans shouldnt stand in the way of fulfilling Gods plan for them, which is one of the reasons the church forbids anything but natural methods of con-traception such as the rhythm method or abstinence (even when condoms, for instance, can help prevent the spread of the HIV virus). Dying is another nat-ural process, governed by Gods will, that shouldnt be interfered with.

The strength of the churchs opposi-tion was made clear in the Vaticans Declaration on Euthanasia in 1980, which states: Intentionally causing ones own death, or suicide, is equally as wrong as murder; such an action on the part of a person is to be considered as a rejection of Gods sovereignty and loving plan; and no one can in any way permit the killing of an innocent human being, whether a foetus or an embryo, an infant or an adult, an old person, or one suffering from an incurable disease, or a person who is dying.

Furthermore, no one is permitted to ask for this act of killing, either for him-self or herself or for another person entrusted to his or her care, nor can he or she consent to it, either explicitly or im-plicitly. Nor can any authority legitimately recommend or permit such an action.

No one, of course, disputes the right of religious people to live life to their last possible breath and suffer excruciat-ing pain along with it if that is their wish. But why try to force that viewpoint on others?

As Zurichs voluntary euthanasia clinic Dignitas says in its manifesto: No one has the right to impose or even attempt to im-pose his or her individual ideological, religious or political beliefs on another. Muslims should not do it to Christians, Jews or Buddhists. Christians should not do it to Jews or those of other beliefs, and a believer should not do it to an unbeliever not even using the indirect method of a governmental regulation.

The state should be the guarantor for a pluralistic society and must forbid anything that would restrict this plural-ism or lead it in a certain direction in the interest of a specific ideological viewpoint.

In fact, we are so used to politicians shutting down the official debate, its easy to forget that what advocates of voluntary euthanasia are proposing is an action that takes place between two consenting adults.

Why the NZMA op-poses voluntary eu-thanasia is an abid-ing mystery to

many, just as it was to Dr John Pollock. In 2010, Pollock a 61-year-old Auck-land GP facing death from metastatic melanoma wrote an open letter to New Zealand Doctor, which was also pub-lished in the New Zealand Herald. He noted that the associations official po-sition didnt tally with his experience of talking to fellow doctors (and, for that reason, he had resigned as a member several years earlier).

The New Zealand Medical Associa-tion is against euthanasia. To me this is unfathomable, he wrote. I have dis-cussed it with many, many of my col-leagues over the years and have found that the vast majority are for it. Indeed, I have met many who, at great risk to themselves, have succumbed to a pa-tients begging for a merciful release.

Is it really likely that the profession that sanctions the termination of the lives of thousands of healthy unborn babies each year would criminalise the shorten-ing of the lives of suffering, dying patients who ask for that last merciful service?

tried to console me by saying the good news was that her suffering hadnt been pointless because she wouldnt have to spend much time in purgatory.

She went on to explain that enduring suffering patiently on Earth is one way to cut your time in purgatory.

If you read around the topic, youll find that, according to the Catholic Church, anyone who isnt going straight to hell has to be purified of unforgiven venial sins in purgatory before facing God.

Catholics advocate suffering as a way of sharing in Christs sacrifice of his life on the cross. In fact, it is so common to see a cross in the Western world that its easy for the unreligious to forget it is an instrument of torture, or that Cath-olic worship often takes place in front of a representation of a man being tor-tured to death on a cross. Suffering as a means of sanctification is fundamental to Christianity, and to Roman Catholi-cism in particular.

And not only experiencing suffering, but watching it as well, apparently. As Bill English, a practising Catholic, said in arguing against the 2003 Death with Dignity Bill in Parliament: Pain is part of life, and watching it is part of our humanity. Many of us have become more human for watching it, whether or not we liked doing that.

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Even in countries where voluntary euthanasia is legal, it can be difficult to arrange. In 2009, 93-year old Amelie Van Esbeen went on a hunger strike in Belgium after her request for euthanasia was denied by her rest home. Medical staff felt she didnt qualify under a law authorising doctors to help patients die only if they are suffering from a serious terminal illness and constant and unbearable pain that cannot be relieved. The decision was reviewed by another doctor and she died the following month, surrounded by family members. aFP Jorge Dirkx/aFP/getty images

ENDINg A LIfEIs withdrawing the necessities of life simply euthanasia by another name?

THE kIDNEYS ARE OfTEN fIRST TO fAIL AND WOULD bE UNAbLE TO cOPE If fLUIDS WERE gIVEN INTRAVENOUSLY.

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such desperate sub terfuge for those in unbearable agony or distress would not be necessary.

Peter Brown says he was very disappointed by Mar-yan Street withdrawing her bill. He thinks she may

have done so because Labour didnt want to risk further antagonising middle New Zealand after same-sex legislation came into effect last August as a result of La-bour list MP Louisa Walls members bill being drawn from the ballot.

Or is the reason much simpler that Street knows Labour will put forward a government bill if it wins the next election?

She has said publicly that is her hope, while denying a deal has already been done with party leaders. I dont have a cast-iron undertaking from anybody that that will happen but I will certainly agitate for it.

She is keen to promote it to her cau-cus colleagues, but still as a conscience vote, obviously.

Asked if she would like it to be a govern- ment bill, Street replied: Ideally, yes, because it would take the capriciousness out of the situation.

When I emailed David Cunliffe and asked: If Labour is in a position to form a government after the next general elec-tions in 2014, will such a bill be proposed by your government? he replied enig-matically, This has traditionally been dealt with as a conscience matter. There is no bill currently before us at this time.

When a bill is eventually presented either as a members bill or as a govern-ment measure Street has no doubt that a well-resourced, vocal minority, whose position is informed more by their theology than anything else, will pull out the big guns.

But she has been working steadily over the past 20 months, organising meetings to discuss voluntary euthanasia and getting turnouts of 300-400 in the big cities and 50-120 in provincial centres such as Hamilton, Nelson and New Plymouth.

Street says she is trying to create a solid groundswell so that people are talking about the issue and coming out of the woodwork and lobbying their MPs.

And at every turn I am finding a ma-jority in favour, she says. In the end, the vocal minority will not be able to contest all of that. +

the manner of their deaths. Adrian, a local body politician, had terminal stomach cancer. Hand written suicide notes were found, but it was unclear whether they were parties in each others deaths or just their own.

Some voluntary euthanasia advocates now operate an underground movement with advice on how to kill yourself as painlessly as possible. But, as Dr Pollock noted, anyone suspected of having a hand in the suicide, including even pro-viding materials such as helium and plastic bags, risks being charged with aiding a suicide even if they are not pre-sent at the time of death.

If the nation developed a well-regulated and entirely voluntary euthanasia policy,

patients from around the world because its staff believe it would be discrimina-tory to exclude those unlucky enough not to be Swiss citizens.

Perhaps one of the most interesting les-sons comes from Oregon, where around 40 per cent of those given a lethal pre-scription dont use it. For them, the re-assurance they can have a painless death is sufficient.

Yes, you can always kill yourself or at least try but as Pollock wrote: The law wont be changed in

time for me and the only way that I can legally end my life before it is due to end is suicide and thats the cruelty of it not only suicide but suicide alone, because if I top myself with my family present then I put them at risk, and I think thats hideous. Its very cruel.

Maryan Street paints that cruelty in vivid terms: Why did Rosie Mott have to send Evans out to the supermarket and for him to have to wait until the texts stopped coming? Why couldnt he have been with her when she died?

Terminally ill people often end up using extreme ways to kill themselves too, although details of their final mo-ments are usually suppressed.

Last May, a coroner found that devoted Paekakariki couple Adrian and Marei Webster, both in their 70s, had died in a suicide pact, but banned publication of

A euthanasia kit available in Belgian chemist shops for doctors who want to carry out euthanasia at a patients home. Doctors in Belgium have complained of difficulties in practising home euthanasia in suitable conditions because of a lack of knowledge about products, doses or procedures.

etienne ansotte/aFP/getty images

Its worth noting that the NZMA is not the body that registers doctors. That or-ganisation is the Medical Council of New Zealand, which looks after standards, conduct and competence. It has a neu-tral stance on voluntary eu thanasia.

The NZMA is more like a union; it de-scribes itself as the countrys foremost pan-professional medical organisation, representing the collective interests of all doctors.

It also boasts on its website of being a strong advocate on medico-political issues, with a strategic programme of advocacy with politicians and officials at the highest levels and that our high profile and influence places us in a strong position to advance core health issues.

NZMA policy on voluntary euthanasia is not formulated in consultation with local doctors. The NZMA board and councils are representative bodies, elected by members, but its chairman, Napier GP Mark Peterson, confirms doctors arent polled individually about their views.

While the question of whether voluntary euthanasia should be made legal for a

dying person suffering overwhelming pain is easily agreed to by many when asked, it becomes a much more thorny debate once the net is widened.

Opponents of voluntary euthanasia quite rightly point out the difficult ethi-cal questions involved in deciding who exactly should be covered by legislation. Should it include those, for instance, without a terminal disease but who find life intolerable because of a mental ill-ness that medicine cannot control? Or should anyone be able to instruct close relatives, by way of an advance direc-tive, to ensure that they are euthanised when they get a disease such as Alzhei-mers and can no longer confirm that earlier choice themselves?

These are difficult propositions worthy of close analysis and debate, but it is the weakest (and sometimes plainly false) arguments against legalising voluntary euthanasia that are often the first deployed. A common one is asserting that palliative care has advanced to such a level that no one need feel overwhelming and uncontrollable pain.

John Pollock devoted part of his letter to identifying the arguments commonly

used against voluntary euthanasia. The first of the prevalent arguments he attacked was: Our medical services, par-ticularly the hospice organisation, have the skills to take the unpleasantness out of dying and so euthanasia is unnecessary.

Pollock didnt accept this. Break-through pain is common and its preven-tion requires constant medical attention, which is not often available, he wrote. We are not good with neuropathic pain.

He added: My cancer may kill me in a variety of ways, some very unpleasant and drawn out. There are several sce-narios which I would find intolerable and should be able to opt out of but for our old-fashioned, ill-thought-out, cruel laws which force me to suffer to the end or kill myself.

In fact, as journalist Jim Robinson pointed out in 2007 in his North & South article A Fiery End that focused on pain management for dying patients, break-through pain occurs in about 10 per cent of cancer cases, which means around 900 people a year die with pain that cannot be reliably controlled by available pain-killers. Yet, the website of the Catholic Nathaniel Bio ethics Centre states: These days, no one need die in pain.

And, of course, it is not just the problem of unbearable pain. People also die in other terrifying ways. Rodney Hide told Parliament during the 2003 Death with Dignity debate that his friend Martin Hames had watched his mother die a terrible death [from Huntingtons] a death where one loses ones mind and loses control, to the extent that one cannot swallow. Hames chose to kill himself in 2002 to pre-empt suffering that fate himself.

Hide, who supported Peter Browns bill, said: If Mr Browns bill had been the law, Martin Hames would still be with us, I am sure. He would not have needed to take his own life, as he did.

Last September, Canadian infectious diseases specialist Donald Lowe who came to national prominence steering Canada through the SARS crisis in 2003 made a video of himself a week before he died of a brain-stem tumour; it was posted on YouTube after his death.

Already debilitated, Dr Lowe spoke of his fears of being unable to swallow, eat, walk or control his bodily func-tions, and suggested anyone opposed to voluntary euthanasia who could live in my body for 24 hours would

change their mind.Why make people suffer for no rea-

son when theres an alternative? he asked. I just dont understand it.

Another tack commonly used to argue against legalising voluntary euthanasia is to shift the

debate from the use of voluntary eutha-nasia to its abuse. This is the thin edge of the wedge or slippery slope argu-ment, which often leads opponents to invoke the spectre of the Nazis killing victims such as the mentally deficient completely overlooking the fact the Nazis specialised in involuntary eutha-nasia. In fact, they were known for state-sanctioned murder.

This argument cut no ice with the dy-ing Dr Pollock. The thin edge of the wedge [argument] if we allow volun-tary euthanasia for the terminally ill, it wont be long before we are killing the mentally ill, the deformed and everyone over 70 is about as sensible as saying if we allow people to eat meat it wont be long before we are eating each other.

In fact, Pollock effectively reversed the argument, pointing out that under our present laws we allow people to die in most appallingly wretched states, some-times akin to those who died of starva-tion in Nazi concentration camps.

Brown says: The best argument against the slippery slope is good legislation sound, workable and totally voluntary euthanasia.

Its also worth pointing out that most nations, including ours, already have ex-perience in regulating how people kill and are killed. In war, for example, there are strict rules against killing non-combatants (particularly women and children), and severe penalties for those who do.

If the state can make laws for how people conduct themselves amidst the terror and chaos of war, why is it so dif-ficult to make laws that govern how we deal with those dying in the relative peace of a hospital ward, a hospice or at home?

And we are hardly going to be pioneers in the field. Internationally, there are plenty of models of legal voluntary euthanasia to study, including four US states Vermont, Oregon, Montana and Washington as well as Belgium, the Netherlands, Luxembourg and Switzer-land, where the Dignitas clinic accepts

PERHAPS ONE Of THE mOST INTERESTINg LESSONS cOmES fROm OREgON, WHERE AROUND 40 PER cENT Of THOSE gIVEN A LETHAL PREScRIPTION DONT USE IT. THE REASSURANcE THEY cAN HAVE A PAINLESS DEATH IS SUffIcIENT.