Dr David Robins says he will vote in favour of the End of Life Choice Act referendum. Photo File
As a retired doctor with many decades of experience in various branches of medicine, I should commence by stating that I will vote in favour of the End of Life Choice Act Referendum.
I can understand those who have reservations, among whom will be friends and colleagues.
I would ask voters to read carefully the provisions of the Act, which is very restrictive in access for medical aid in dying ( www.referendums.govt.nz). Only adult New Zealand citizens and permanent residents in sound mind, with fewer than six months of expected life and in severe stress unable to be relieved by palliative measures, will be considered.
The benefits of assisted dying to such people seem so obvious to me that I do not believe that a humane person could deny them. May I then address some of the concerns of opponents to the Act?
The "slippery slope" argument, beloved of opponents, is that there will inevitably be loosening of the criteria for assisted deaths, such that minors, the elderly and the disabled will be encouraged, if not coerced, into requesting such intervention.
Firstly, this would clearly necessitate amendments to the Act and these would have to pass Parliamentary scrutiny and receive a majority vote. Such amendments are certainly possible - though not inevitable - at a future date, depending on public opinion and the will of Parliament.
Secondly, under the present Act, evidence of coercion by relatives or others would disqualify any person requesting assisted death.
Some opponents of assisted dying claim that medical ethics forbid it. Such ethics are thankfully not engraved in granite, and have changed over the years in response to changes in medicine and in public attitudes.
In the 19th century, psychiatric patients were chained and exhibited for the amusement of the public, and Queen Victoria was criticised for her use of pain relief in childbirth.
When I qualified, many doctors would not, on ethical grounds, prescribe the contraceptive pill to unmarried women - who often then became mothers.
Abortion, even in cases of rape, incest, severe maternal illness or foetal abnormalities incompatible with life, was a criminal offence.
Babies for adoption were routinely separated from their mothers at the moment of birth. It was unusual and distinctly frowned upon for fathers to attend the births of their children.
Ethical views have changed, and this clearly now applies to medical aid in dying, which is now available in many countries and states in Australia and the US, where assistance in dying is not considered unethical by most people.
I pay tribute to my medical and nursing colleagues involved in palliative care, and would recommend more public funding for their services. My support for the Act in no way devalues their diligence and professionalism, for which I have great admiration.
However, on some occasions, palliation may not be sufficient to prevent suffering at the end of life. I believe that with excellent palliative services very few people will request assisted deaths, but many of us, particularly as we age, will be glad that with the passage of the End of Life Choice Act we will be able to receive medical help at the end of our lives should fate present us with a nasty prolonged and painful demise.
For those who, faced with the circumstances that would allow an assisted death, choose to submit to God or nature's will, I have respect and a somewhat bemused admiration.
However, I strongly resent their efforts to deny me the right to self-determination at the end of my own life, on the basis of their personal perceptions of morality, ethics, or philosophy, not to mention their assessment of the value of my life, which only I can make.
To quote Greta Thunberg "How dare you?" I would never think of trying to influence their decisions, nor to evaluate the quality of their own lives.
I again ask voters to read the Act and vote on what it proposes, and not on some possible slippage that would require amended legislation, or ethical views that may well be outdated.
• Dr David Robins, Napier