Pleading case for death with dignity

By Nicola Shepheard

EXCLUSIVE: Sean Davison watched his mother try to starve herself to death to escape the cancer ransacking her life.

Patricia Davison understood her body's collapse, having practised as a GP and psychiatrist.

At 84, she was still acutely intelligent, but multiple cancers had robbed her of her joys - painting, reading, her ability to engage in the world she loved.

Determined to die, she summoned Davison from his South African home and asked him to help her.

The hunger strike, which she kept up for 35 days, backfired. It ravaged her body further but did not provide the lasting release she sought.

In his diary, Davison detailed the three months he spent at her side. He wrote about the old hurts and tensions that surface when family and friends gather, the appalling experience of watching someone you love diminish and suffer.

Finally, Patricia, who practised under the name Fergusson, died in her Dunedin home on October 25, 2006. It was not the self-imposed starvation that killed her - but her son will not detail how she did die.

This month, an edited version of his diary entries will be published as Before We Say Goodbye.

Auckland-born Davison, a professor of biotechnology in Cape Town, is arriving back in New Zealand today ahead of the book's launch. While he's here, he will publicly press for the legalisation of voluntary euthanasia.

In a note prefacing the book Davison says: "against my desires, much has been removed". It's clear he resents the deletions. Davison is used to shining a light on things others would rather remain obscured. At the University of Western Cape, he heads the forensic laboratory that specialises in DNA identifications to resolve human rights cases in South Africa.

"I'm a free-thinking man ... I have nothing to hide," he says on the phone from Cape Town, where he lives with his wife and baby. "There's nothing in the book to incriminate me. And I won't be implicating myself when I'm in New Zealand. It's actually irrelevant whether I did or didn't; that's not the point. The point is, I should never have been in that situation."

He'd never thought much about euthanasia before his mother's death. "It only crossed my mind afterwards: this should never have happened, the way she died."

Davison seems bemused at the media anticipation his book and calls for law change have already created. "It's a low-key book, it's not sensational" he insists. "It's an old lady; possibly her son helped her die. I don't think it should be controversial. If this happened in South Africa, it wouldn't even make the papers. It's such a right thing to do."

LESLEY MARTIN warns that by speaking out, Davison may be "making himself a target for a huge hidden wave of grief and despair that is out there".

A former nurse, Martin martyred herself to the euthanasia cause through her book To Die Like a Dog which describes how she gave her mother an overdose of morphine and smothered her with a pillow to release her from painful cancer complications. Found guilty of attempted murder, she served half of her 15-month sentence in 2004.

Now she's studying psychology and heads Dignity New Zealand, a lobby group that seeks to legalise assisted suicide, and to develop the expertise and an alternative hospice network ready to ensure the practice is safe.

The group is courting MPs to sponsor legislation after a 2000 private member's bill for voluntary euthanisation was defeated by two votes.

Martin points to a recent survey by Massey University that found 70 per cent support for physician-assisted suicide for someone with a painful, incurable disease. "For the majority of people it is that loss of sense of self," she says, "that feeling that they believe profoundly they should have the right to make decisions over their deaths."

Something is wrong, she argues, when people aged 85 or older are committing suicide at a rate of 20.7 per 100,000, the second highest among all age groups; and when an unknown number of people are resorting to the euthanasia underground.

The law change would have to be "contained, accountable and legitimate," she says.

Martin has distanced herself from a prominent underground figure, Australia's Dr Death, Philip Nitschke, who is famous for peddling his DIY suicide kit around the world.

"He refuses to be held accountable for the fact that more and more [his methods] are falling into the wrong hands."

Last year, two women were found guilty of manslaughter and being an accessory to manslaughter after administering veterinary sedative Nembutal, the euthanasia drug Nitschke advocates, to 71-year-old Alzheimer's disease sufferer Graham Wiley. The women were his partner and his friend, aged 51 and 75 respectively. It emerged that he had changed his will the week before his death.

Euthanasia opponents argue cases like this illustrate the potential for abuse by grasping, selfish or malicious relatives.

They worry about the risk of dreadful mistakes from simple ineptitude on the part of the doctors and psychologists supposed to provide checks and balances. A law change, no matter how carefully circumscribed, they say, could set us upon a slippery slope towards "death on demand".

Sociologist Tracey McIntosh believes the euthanasia debate tends to polarise people. On the "for" side, arguments broadly come down to a concern for individual rights; while the "against" side focuses on collective consequences, or collective values like religious morals.

All of us can understand the need to want to ameliorate the dying process and to stem the suffering of those we love, she says. But legalisation may have some collective consequences: "A reduced capacity to care and nurture the sick and suffering; reduced ability to accept death as part of our natural life process, and for the sick or elderly to feel that they are a burden on the living both economically and socially."

Mainstream Western culture tries to banish death to the margins, observes McIntosh, a senior lecturer at Auckland University. Death has been called the "biggest scandal" to our modern sensibilities; it is the ultimate slap in the face of our desire to control life. At one level, she says, the shift towards acceptance of assisted suicide reflects this desire.

Many who deal with death daily believe if medical professionals were trained to be up front with patients, and if palliative care was properly funded and practiced, the demand for euthanasia would greatly subside.

As an intensive care specialist at Auckland Hospital, Stephen Streat is used to seeing people dying "under the most ugly circumstances".

But he prides himself in ensuring they die well, by being straight with the patient (if they're able to communicate) and their family about the likely course of their condition, and supporting them medically, practically and emotionally to die they way they want to.

"People respond incredibly well to simple human honesty," he says.

He gives the example of a patient who arrived with a breathing difficulty, and was diagnosed with advanced cancer of the airway. He and his family wanted him to die at home, so Streat and a nurse escorted him home, where he was placed in the lounge.

"There were about 30 people over. They had a party and sang songs. We gave him a bit of morphine and took his ventilator tube out. He had a bit of breathing difficulty and it wasn't terrible and he died peacefully three or four hours later. We had a wine and said our farewells."

Every day, he says, intensive care specialists withdraw active treatment with the consent of family, and, where possible, the patient.

Davison hopes his book will get more of us thinking, and talking, about how we want to die.

"We talk about other things - abortion, gay rights - but we haven't really talked about death. It's the next big thing to talk about."

- Herald on Sunday

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