Dawn Picken: Voting 'yes' for the End of Life Choice Act is an act of mercy

People have the chance to vote on an End of Life referendum this year. Photo / Getty Images

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Picture yourself in the cockpit of a fighter jet. In addition to an anti-gravity suit, helmet and oxygen mask, you're also wearing a parachute and harness connected to an ejection seat. Pull a lever, and rocket boosters blow open the aircraft canopy before the entire seat explodes, propelling you up and out of the jet. The move is risky. It can be painful.

The last thing a fighter pilot wants to do is eject.

While the manoeuvre is designed to avoid certain death, the ejection scenario is analogous to someone facing terminal illness. A person with a life-threatening condition doesn't want to eject. Like the fighter pilot, they've tried evasive manoeuvres to stay alive. Instead of screeching into the sky at twice the speed of sound, the terminally ill have gone quietly into chemotherapy and surgery or screaming into the night at the injustice of their body's betrayal.

No one wants to pull the escape lever when there's a chance another treatment, potion, prayer, good thought, crystals, eye of newt (aka, colloidal silver) or other interventions, panaceas and talismans have failed to stop their perilous plunge.

Voting "yes" for the End of Life Choice Act next month is an act of mercy for those facing certain death. And it won't be used frivolously.

Humans fight for life. We want one more conversation, another hug, another sunrise, a walk, a book ... We allow medical professionals and even quacks to poison and carve our bodies in hopes of getting to say "I love you" one more time. Few people of sound mind pull the ejection lever prematurely. A person would not be eligible for assisted dying under the new law if the only reason they give is they're suffering from mental illness, are disabled, or old.

Life expectancies are higher (around 82 years in NZ in 2020 versus 75 years in 1990) mainly due to modern medicine. We're surviving years with cancer and other conditions that 30 years ago would've killed us within months. We've become victims of our success. We gain more time. We also find it increasingly difficult to refuse treatment.

Disease spawns metaphorical war. We tell people they must "fight" to "win the battle". Sick people spar each day - they take the drug, get the IV, have the surgery, drain the fluid ... Patients become pincushions with a duty to continue interventions that make them sicker and more tired than they were before. Some continue scuffling in the medical arena because they want one more day. Others do it because their loved ones want them to have one more day.

People opposing New Zealand's End of Life Choice Act imply Kiwis will start suiciding because they have a hangnail or haemorrhoids. I say life is too precious to call it quits - until our hours become intolerable. The vast majority of pain can be managed. But some of us towards the end of life will need to be stupefied with narcotics for pain control, rendered inarticulate, incontinent, mostly unconscious. Technically, we'd still be alive.

Sometimes the duty to care for our most vulnerable is conflated with duty to live no matter the physical and emotional toll. A doctor once told me caregivers benefit when they can help someone at the end of life. True. But if the end is inevitable and unbearable, I won't be your service project. The world offers plenty of other bums to wipe.

The End of Life Choice Act has safeguards to prevent what many opponents fear: that greedy family members would pressure elderly relatives to sign a death warrant so they could collect an inheritance. A person would only be able to make an informed choice about assisted dying if they understood and remembered information about it and were able to communicate their decision. A doctor or nurse practitioner would have to do his or her best to ensure a person's choice was their own. If the health care professional thought someone was being pressured, they'd have to stop the process.

Friends who've cared for loved ones at the end of life have recounted how medical professionals provided lethal doses of narcotics with instructions about how to use them. The wealthiest among us have always had the option to schedule a dignified death by accessing private doctors or travelling to places where assisted dying is already legal.

Who else opts into assisted dying? Minorities, the disenfranchised? In New Jersey, United States, where assisted suicide became law last year, 12 people out of a population of nearly 9 million accessed it in 2019. Nine had cancer. Three had neurodegenerative diseases. Patients were between ages 50 and 93. Eleven were white. One was Asian. New Jersey's governor, Phil Murphy, signed the law, even though he said his Catholic faith might lead him not to end his own life if he were terminally ill. Murphy said he wouldn't deny the choice to others.

Here in New Zealand, a man with motor neuron disease is running for an ACT party seat in Whangarei. Despite his support for the End of Life Choice Act and his terminal illness, David Seymour (not the Act Party leader of the same name) says he's not sure he'd use assisted dying when his health deteriorates if it were legal. He told NZME, "I've lived a full and active life, but I believe that when my time comes, I should have a choice about how I go. It's my life and my choice."

Seymour doesn't want to eject himself from life's cockpit today and doesn't know if he ever would. For him and for many of us, knowing we could exit on our terms would be like a hidden escape hatch, providing strength and courage to fly one more day.