Louisa Wall championed the right of everyone to marry. The MP has now tabled a Bill that sets out a process for a terminally ill person to legally end his or her life. She tells Phil Taylor how she was inspired by Lecretia Seales.

"What captivated me with Lecretia's case," said Louisa Wall, "is she knew exactly what she was asking for."

Others, such as general practitioner John Pollock, in their dying days, used their situation to prompt debate.

"From the patient's point of view, from those I've seen dying, it's the nausea," said Pollock, 61, a few months before he died in 2010 due to metastatic melanoma. "It's the feeling of helplessness as you lie there, the feeling that you know you are going to die."

Pollock didn't want his family's last memories to be of him wasting away, and suicide would have been a solitary option because of the risk of others being accused of complicity, and because it risked a premature death in that the person still had to be physically capable.

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Lecretia Seales, 42, a Wellington lawyer and the Herald's 2015 New Zealander of the Year, took the step of asking the High Court to change the law with a ruling that gave her the legal right for a doctor to help her end her life. She died of her illness not long after learning her application had failed.

To do as Seales asked would have changed the effect of the offence provisions of the Crimes Act, changes that Justice David Collins decided could be made only by Parliament, such were the "complex legal, philosophical, moral and clinical issues raised".

A subsequent petition by MP Maryan Street and 8974 others led to Parliament's health select committee hearing submissions - 1800 of 21,000 want to be heard in person - as part of its examination of the public's views on euthanasia.

It was at yesterday's session that Wall tabled her Authorised Dying Bill.

Wall tried to see Seales before she died - "because I had this crazy idea" - but it wasn't possible, she told the Herald.

"I respected her strength. She put herself out there. She used her context to help promote something that she was never going to be a beneficiary of."

As an MP, Wall said she found herself in a position to do something. "There is an obligation to do something, especially when you have an idea that might work."

The bill, drawn up with Wall's wife, human rights lawyer Prue Kapua, and Otago University Dean of Law, Professor Mark Henaghan, proposes an ethics committee be set up to vet applicants and work out the details of the authorised death.

"The bill is tight and restrictive and only caters for people who, like Lecretia, have a terminal illness."

What may set it apart from previous bills about euthanasia is that it is based on the ethics committee system used with fertility practises.

"We were using ACART [Advisory Committee on Assisted Reproductive Technology] as a model. We thought, well if we do that for the beginning of life, why wouldn't we for the end of life?"

"We're really clear that it has to be incredibly tight. The claim ... is always the slippery slope."

Wall is confident the committee (to include people with expertise in diagnostic medicine, psychiatry, ethics, Maori customary values, and knowledge of the special interests of the elderly and disabled) would be able to detect applicants who might be under pressure or were influenced by feeling they had become a burden.

Applicants would have to have a diagnosed terminal illness with a reasonable expectation of death within 12 months, display free, uncoerced and informed consent, be competent to make the decision and be 18 or older. The committee would hear from the applicant in person or by video-link.

As well as medical records of diagnosis and prognosis, the ethics committee could seek its own medical advice.

Lecretia Seales in Aitutaki, Cook Islands, 2011. Photo / Lea Antigny
Lecretia Seales in Aitutaki, Cook Islands, 2011. Photo / Lea Antigny

Where approval was given, the committee and the person would work out the who, how and when of their death, which would be carried out by a willing and authorised doctor.

An aspect is balancing informed consent with doctors' ethical obligation to do no harm. "The philosophical question is can you do harm to somebody by allowing them to choose how and when they die, within the context that they have a terminal illness anyway?"

Henaghan, whose professional interests include medico-legal issues, is a former member of the advisory committee on assisted reproduction. He made a joint submission with Wall to the health committee yesterday.

He didn't think Seales' legal challenge could succeed. "It did need legislation rather than a court ruling," Henaghan said.

"I can understand why people fear this. I was brought up in a good Catholic environment where anything that interferes with the life process is seen as a threat."

Having read and thought about it, he thinks there comes a point in certain circumstances where we should recognise that choice.

"We have to make sure there is no pressure on them, they are not being forced by family and there is total accountability for those who carry it out."

The bill requires all authorised deaths to be reported to Parliament, providing a picture of how it is working.

Louisa Wall in her office at Parliament in Wellington. Photo / Mark Mitchell
Louisa Wall in her office at Parliament in Wellington. Photo / Mark Mitchell

The two areas society gets very anxious about are the end of life and beginning of life, he says. "What people don't like is giving anyone the power of life or death over anyone, whether a foetus or a human being."

What is known as the Double Effect Doctrine, where painkilling drugs are increased knowing it will hasten death, is widely accepted. "That is where society is at now. Once you move to that next level of actually authorising someone to take someone's life, it is a big step for society to take and I can understand the fears and moral concerns that people have. There are always risks involved.

"The person's health, mental wellbeing, dignity, recognition of the sanctity of life, of personal autonomy - they are the values we are balancing up and they are not easy. I think we have, as much as possible, taken all the different values into account. The bottom line is giving people autonomy in the last moments of their life."

He says this bill is a transparent and explicit way of doing that and gives choice to people facing fairly imminent death, but before they reach the stage where they are so pained they are desperate.

"They want to say goodbye to people on their terms and not watch their family sitting by as their life dissipates away. Some people don't want to go to that final stage where they are hanging on by a thread."

Wall and Henaghan say it is important to ensure there is no obligation to go ahead once permission is given, and note that a third of the 150 people a year who gain authorisation in Oregon, which passed its Death With Dignity Act in 1997, go ahead.

"It may be", says Henaghan, "that they want the peace of mind of knowing they have control."

The weekend Herald front page.
The weekend Herald front page.

Seales' mother, Shirley, told the Health Committee last month that she doubted her daughter would have gone ahead.

"The choice was what was important to Lecretia," Shirley Seales said. "She could tolerate pain more than anyone I know. Though she also feared losing her mind and had drawn up a directive that in that case her directive should be exercised."

Wall has a strong commitment to human rights to the extent she finds herself regularly quoting Article 1 of the Universal Declaration of Human Rights: "We are all born free and equal in dignity and rights.

"With the marriage bill that was the principle and foundation of what I was trying to communicate. For me, this is the same issue.

"How do you define dignity? For me it is tied to self-respect. Lecretia had an awareness that because of the way her disease was progressing, that she was losing her dignity. That was her definition of it. She believed we all have the right to die with dignity."

Wall has met Seales' husband, Matt Vickers, a campaigner for law change. "Lecretia would have benefited from this kind of set up," says Wall. "It is for people like her."

Getting Wall's bill before the house will be tough. There appears to be no political appetite from the Government - or her own party - to promote it, should it win next year's election.

Prime Minister John Key this month said he thought the best process was a member's bill. National would treat it as a conscience vote and he and more than half the National caucus would likely support it.

Opposition leader Andrew Little said he too was likely to support a bill with adequate safeguards but putting forward legislation would not be a priority for a Labour Government.

Members' bills go in to a lucky dip, and as they are allowed only one each Wall would have to withdraw the one she put in the ballot last year about liquor sales.

Wall, however, seems ready to bang on doors to have the issue addressed by Parliament.

"The bill will be something I champion after the next election."

New Zealand cases - crime or compassion?

Lecretia Seales: In 2015 she went to court seeking a legal way to end her life. The change to the law was too big, the court said, the issue so multi-faceted, so far-reaching it was for Parliament to decide.

Evans Mott. Photo / Steven McNicholl
Evans Mott. Photo / Steven McNicholl

Rosie Mott: Evans Mott, 61, walked free from the High Court at Auckland in 2012 without a conviction after pleading guilty to assisting the suicide of his wife.

Sean Davidson. Photo / NZPA
Sean Davidson. Photo / NZPA

Sean Davison: In 2006, he came home to Otago from Cape Town and killed his ailing mother. It was what she wanted. He revealed this in a book, Before We Say Goodbye, admitting giving her a fatal dose of morphine. Initially charged with attempted murder, he pleaded guilty to inciting and procuring suicide. He was sentenced to five months home detention.

Lesley Martin. Photo / Wanganui Chronicle
Lesley Martin. Photo / Wanganui Chronicle

Lesley Martin: In her 2002 book, To Die Like A Dog, she revealed that she had killed her terminally-ill mother, Joy, prompted by the pain she was suffering. Martin, a former intensive care nurse, served half of a 15-month jail sentence for attempted murder.

Chris Simpson. Photo / David Hallett
Chris Simpson. Photo / David Hallett

Christopher Simpson: Found guilty in 2001 of the manslaughter of his terminally ill mother, Marjorie, 82. The court heard he administered drugs and tried to suffocate and then strangle her. He was sentenced to three years in jail.

Attempts at Legislation:

1995, Michael Laws (National). his Death With Dignity Bill was the first major effort in New Zealand to promote legalised euthanasia. It was jointly drafted by former MP Cam Campion, who was dying of cancer. Defeated 61 votes to 29.

2003, Peter Brown (New Zealand First). Introduced a Death with Dignity Bill. The bill was defeated 59 votes to 58. Brown became an advocate of euthanasia after his wife died of cancer.

2012, Maryan Street (Labour). Submitted her End of Life Choice Bill but withdrew it prior to the 2014 election in case it was drawn and became a distraction to her party's campaign.

2015: David Seymour, ACT. Submitted the End of Life Choice Bill to the member's ballot. It is waiting to be randomly drawn.

2016, November: Louisa Wall tables her Authorised Dying Bill.

Around the World

Euthanasia is legal in The Netherlands, Belgium, Colombia, Luxembourg. Assisted suicide is legal in Switzerland, Germany, Canada and the US states of Oregon, Washington, Vermont, California, and Montana.

South African courts have indicated physicians assisting terminally ill patients to commit suicide would not be held criminally responsible, but that decision has yet to be tested.