John Roughan: Did Lecretia Seales really die in pain?

The question matters because unendurable agony is the reason we are asked to legalise euthanasia.

It is not the happiest of subjects for New Year, but it is one that could make the year memorable. Some time in 2016 we are going to have a serious discussion about life and death. If it feels like we've already had one since the Herald made Lecretia Seales its New Zealander of the Year, wait until Parliament's select committee starts hearing carefully argued ethical submissions on the right to die. Thinking-people are going to be moved.

When I first wrote on this subject last year, just after Ms Seales' case was in court, I admitted that I found the idea of euthanasia repulsive but I didn't know why. Gordon McLauchlan sent me a note saying anybody who thinks this issue of human rights is a simple one is very foolish. He also referred me to a recently published monograph in the Australian Quarterly Essay series.

It is a beautifully written work by an Australian doctor and writer Karen Hitchcock, and it is not about euthanasia at all. It is about assisted dying, a phrase euthanasia advocates are trying to co-opt for their own purpose, but it really means helping people to a natural death. It means all possible pain relief, of course, but much more.

For palliative care specialists such as Karen Hitchcock, it means an attitude to the frailties, needs and often the indignities of near death that treats the person with care, honesty and genuine respect for this phase of life that will come to us all.

Reading the discussion on these pages over the past few weeks, I have often wondered whether those who claim to have witnessed agonised, excruciating deaths are really being honest with us. In response to one such letter, a Ngaio doctor, Sinead Donnelly, wrote, "In more than 23 years as a doctor caring for the dying I have never witnessed what [the correspondent] has experienced. Such distress for the patient and the family can be avoided by excellence in palliative care."

I am old enough to have been at the bedside of several dying relatives. Their pain, as far as I could tell, was gripping at times but bearable with the medication they had. None of us really know, of course, we rely completely on what dying people tell us, which is why Ms Seales' gift to public knowledge is so valuable.

Her husband, Matt Vickers, sent a surprising letter to the Herald last week. "Contrary to claims, my wife's death was not peaceful nor pain-free," he said. "The last few hours were tough and if we could have spared her from them, we would have."

This was surprising because everything I'd read and heard on radio at the time, including a tribute written by Mr Vickers himself, made no mention of it. Quite the opposite. Back then he wrote, "In the end, Lecretia was fortunate that her death happened quickly, and that she was cared for by some very fine health professionals from hospice and DHB. Others are not so lucky."

I might be partly to blame for his latest account. Shortly after his first one appeared in the paper I was one of those who noted Ms Seales' death had clearly not been as drawn-out and dreadful as the death predicted for her by her lawyers just a week previously. Six months on, Mr Vickers is being true to his wife's fervent wish that her death might advance the case for euthanasia but I believe him the first time.

Well, what does this matter, you may ask if you subscribe to the view that you should simply have the right to die at a time of your own choosing? It matters because you are asking for a doctor to do it for you. Unendurable pain in the throes of imminent death is the only possible pretext on which the law could allow it without simply sanctioning suicide.

The practical legal problems in defining at what point a person is capable of making a free choice and at what stage a doctor could act on a request, will all be hard issues for the select committee's inquiry, and for David Seymour's bill if it is drawn for debate in Parliament this year. But I have come to the view that the reason we should not legalise voluntary euthanasia is not so much these difficulties. It is that euthanasia would not remain truly voluntary.

In too many cases it would be an option frail old people would think they ought to take.

Nobody wants to be a burden, nobody wants to depend on help for intimate needs. But those provided with help have dignity in the fact that they know, and their helpers know, they have no choice. Let's not take that dignity away.