As New Zealanders prepare to cast their vote on whether to legalise assisted dying, health reporter Emma Russell speaks to former Whanganui nurse Lesley Martin, who went to jail for the attempted murder of her terminally ill mother in 2004.
As Lesley Martin sat in a cold dark prison cell, she reflected on whether helping her mum die was the right decision.
It was May 28, 2004 or, as she remembers it, the fifth anniversary of her "beautiful, humorous and warm-loving" mum's death.
More than 170km away from Wellington's Arohata Women's Prison, a theatrical version of her book To Die Like a Dog was being performed in her hometown of Whanganui.
Martin's book was about her reasons for helping her terminally ill mother Joy die with 60mg of morphine. The book led police to open a homicide inquiry into Joy Martin's death, which eventually resulted in Lesley Martin being sentenced to 15 months in prison. She served seven and half months.
Martin says she knew her book could lead to jail, but says prison didn't scare her as much as knowing someone could die a cruel and painful death.
During the theatrical performance, two candles were lit - one for Martin and another for her mum. It was the only time the book was acted out in a play.
"I knew the play was being performed that night and I was at my lowest then," Martin told the Weekend Herald in a phone interview from her home in Hereford, England.
"I really deeply soul searched to find whether I had any remorse or any thought 'had I done the wrong thing', 'did I deserve to be in prison' and I kept coming to the conclusion: morally I had done the right thing for my mother."
More than 16 years later, Martin says she still "with all my heart" believes that.
The now 57-year-old says she will be voting "yes, without a doubt" in support of the End of Life Choice Act referendum. If a majority vote in favour, voluntary euthanasia will be legal after October next year.
"This is long overdue, it's a natural progression of the social reform and it's important that New Zealanders have their say at grassroots level because it is an issue that affects each one of us."
Martin, though, was critical of the legislation for a lack of support and information available to patients and their families.
"I personally have always said there should be 'dignity havens' that were separate from hospice."
The havens would have specified doctors willing to assist patients with dying, as well as support and counselling to avoid people being pressured, Martin said.
She said that for her, 20 years ago, there was no support.
"I remember my lawyer telling me not to talk to anyone but her. I went to a priest and he wouldn't even talk to me. I couldn't believe it, it really hurt."
If the proposed law was in force back in 1999, Joy Martin would have been eligible for assisting dying.
At the time, the 69-year-old was dying of bowel cancer, a "horrible disease" that had already claimed Joy Martin's mother - Lesley's grandmother.
Martin said from the time Joy had surgery in January 1999 to the day of her death on May 28, 1999 she lost 40kg.
"She never stepped a foot outside the house again once she came home hospital because she nearly died after surgery from multiple-organ failure. She was ventilated and on life support and we thought we were going to lose her back then."
Martin said she made a promise to her mother to help her die with dignity.
"My mum said to me 'it was better to die like a dog than a human being'."
"It's a very common thing when people are in good health and could, for example, be watching a movie with a very horrible death unfolding, and you look to each other and say 'if ever that's me you'll switch the machine off or shot me or whatever', you agree and make these promises and then get a cup of tea and biscuit and watch the rest of the movie and life goes on."
The mother-of-two said during her time as an intensive care nurse at Whanganui Hospital many suffering patients had asked for help to die.
"Whenever that happened I emotionally and almost physically took a step back and would say 'no I can't do that but I can do everything I can to make you comfortable' but in my mind when you go home from those night shifts you think 'would I help someone I love'?"
Martin said she believed if her mother had been able to make use of assisted dying, they would have had that significant goodbye.
"You know, I can't remember the last thing I said to my mum."
New Zealand is voting on whether it wants voluntary euthanasia to be legalised.
Before you cast your vote, here are five things you should know.
1. You have the final say.
The referendum is binding, and a majority "yes" vote will mean voluntary euthanasia will be made legal exactly a year after election day (October 17). A "no" vote will mean we keep the status quo.
2. We've been here before - sort of.
Parliament has twice voted against laws to legalise euthanasia in New Zealand. Former National MP Michael Laws' Death with Dignity Bill was heavily defeated in 1995. And NZ First MP Peter Brown's bill by the same name was narrowly defeated - by just two votes - in 2003.
On the latest attempt, Act Party MP David Seymour's End of Life Choice Act has already been passed by Parliament - but relies on a public vote to get it over the line.
3. If legalised, euthanasia would not be available to anyone.
It would be limited to NZ citizens or permanent residents who are 18 years or older and suffer from a terminal illness which is likely to end their lives within six months.
They also need to be:
• In an advanced state of irreversible decline in physical capability.
• Experiencing unbearable suffering that cannot be relieved in a manner that they consider tolerable.
• Competent to make an informed decision about dying.
They also cannot be eligible on the basis of age, mental illness, or disability alone.
4. Opponents are concerned, however, that legalisation might create risks for a broader group.
Some countries have broadened their euthanasia laws. This is being considered in Canada, which New Zealand's law was partly based on. A law change there could soon make euthanasia available to non-terminal patients.
Supporters of the End of Life Choice Act say that doesn't foreshadow what could happen here. Those changes were specific to Canada's constitution and law-making. Any further changes to New Zealand's law would need to get through Parliament.
5. Euthanasia generally benefits the most privileged people in society.
Analysis of deaths in the United States, Canada and Europe found those most likely to access assisted dying were old, white, well-educated and relatively wealthy.
This is mainly because this group is more likely to be able to have better access to the healthcare system, and are better able to navigate the medical and bureaucratic hurdles to assisted dying.
