Jay Kuten: Dying with dignity a must - and so is choice

BEFORE I attended a meeting in Whanganui on end-of-life choices advertised as "informational", I had not concluded an opinion.

I attended, anticipating I would hear both sides of the issue. It's not "informational" when only one side of a controversy is permitted, and it becomes deception when the presentation seems designed to frighten or negatively influence attitudes towards the End of Life Choice Bill.

There was certainly misinformation presented.

It was alleged that physicians would be criminally prosecuted if they refused to participate, which is simply false. The term "euthanasia" was used to promote the idea of a "slippery slope" from voluntary to involuntary euthanasia. Hitler's euthanasia of "undesirables" was even mentioned.

That meeting set me on my own course of research into the facts of the End of Life Choice Bill, as well as the law in the US state of Oregon upon which it is based.

I also interviewed National MP Maggie Barry who is adamantly opposed to the bill. I called to afford her an opportunity for clarification of remarks quoted in the Dominion Post that seemed heartless.

Deriding the suffering of patients electing physician-assisted suicide, Maggie Barry dismissed the suffering of the dying patients. Taking a quote out of context from a study in the Journal of the American Medical Association, she repeated: "Pain is not the main motivation for physician-assisted suicide ... the dominant motives are loss of autonomy and dignity and being less able to enjoy life's activities."

Dismissively Barry responded: "That's more about social rather than medical reasons."

Ms Barry admitted she had not read the whole study and, like any politician, evaded answering when I quoted the study showing the opposite of her contentions predicting abuses of physician-assisted dying. Read it here: https://bit.ly/2Guptf2

Ms Barry's alternative bill requires provision of palliative care. That seems reasonable and even compassionate - until the real goal is revealed in Dr Hartfield's "recommendation"(Chronicle, March 31).

It is to make palliative care mandatory for three months before anyone is deemed eligible for assistance to die. That is a real slippery slope from voluntary palliative care to mandatory palliative care designed, because of its duration, as an impediment to patient choice.

At the heart of the bill on medically-assisted dying is the word "choice", and the importance of choice cannot be over-estimated. It's what characterises succinctly our adult human uniqueness; it's what you get for "putting aside childish things"; it's the essential reward for assuming adult responsibilities, our unheralded, quiet daily heroism.

At the end of a hopefully long life, or one shortened through catastrophic illness, with the prospect of imminent death, an untreatable illness, and unbearable or intolerable suffering, a competent adult ought by right to have the choice of the means, the time and the circumstances of ending of that life.

That's what the End of Life Choice Bill does. It imposes no sanctions on unwilling physicians; it simply gives the power of life's ending to the patient.

The consistency of the opponents' talking points suggests an organised campaign by a minority bound by ideology. It is one where the individual's integrity is less important than a closed belief system.

Minimising respect for individual choice, the opposition seems willing to ignore or distort the facts, promote predictions of dire outcomes already disproven by research elsewhere, apparently in order to enshrine and enhance the present patriarchal system that permits a doctor - but not a patient - to determine the time and means of dying. All without the requirement which the End of Life Choice Bill contains - the consent of a dying person.

On any contentious matter of public policy I wish for a debate that is robust, fair and fact-based.

But we're in a universe in which the facts no longer matter - at least to those vehemently and dogmatically opposed to our having a choice as we near our deaths, a choice to die with the last vestiges of our humanity intact, the dignity that comes with making our own decisions.

■Jay Kuten is an American-trained forensic psychiatrist who emigrated to New Zealand for the fly fishing. He spent 40 years comforting the afflicted and intends to spend the rest afflicting the comfortable.