Assisted dying: When staying alive is the best option

A visiting expert on palliative care wants New Zealand to think twice about adopting a Bill that would legalise doctor-assisted suicide.

Ilora Finlay, professor of palliative medicine and former president of the UK Royal Society of Medicine, is in New Zealand to take part in a panel discussion at Parliament on ACT MP David Seymour's End of Life Choice Bill.

She told RadioLIVE on Monday New Zealand's palliative care and hospice services are so good, no one should ever have to consider taking their own lives.

"They are there to try and do everything to ensure people do have a peaceful, dignified death when they die at the end of their disease - not cut their life off by months or years".

Since 2001 Dr Finlay has been a life peer in the UK's House of Lords, and has argued against past Bills that would have legalised assisted suicide in the UK.

She has first-hand experience of patients who once wanted to take their own lives, but came to be glad they didn't - including her own mother, who had advanced breast cancer.

"She was in a hospice at the time, and thought to die within weeks - or even days," she told host Mark Sainsbury.

"Because she couldn't have assisted suicide and because she had the care that she needed her pain became under control, she got going again and she lived for four years independently at home, would go out shopping. She said they were the four richest years of her life, and she never thought she'd have them."

She also cites the case of a man in 1991 who was seen by four doctors, including herself, who agreed he had no more than three months to live. He was "desperate" for help ending his life.

"He fit all the criteria of every bill I've ever seen, but he is still alive today," said Dr Finlay.

"We managed his pain, we managed his disease. He had a little bit more treatment. His request vanished."

And just as well - 11 years later his wife died unexpectedly, but their children still had their dad.

"You can't predict with any accuracy how long someone has to live. It's guesswork."

History repeating

Dr Finlay was last in New Zealand in 2012, offering her expertise when Parliament debated former MP Maryan Street's euthanasia Bill. After his Bill was drawn from the ballot in early June, Mr Seymour told Newshub it has more restrictions on what circumstances a person can be granted an early death than previous Bills.

"A previous Bill that Maryan Street had in the ballot would allow someone with say, dementia, to have another person, perhaps a power of attorney or family member, make that decision for them after they'd lost their own ability to decide," he told The AM Show.

"I didn't put that in my Bill. One of the principles of my Bill is that only the person concerned can make the decision for themselves."

But Dr Finlay says it'll still result in the sick and elderly coming under pressure to call it quits well before their time is up.

"You've got elder abuse, coercion going on. Not all families are loving families, I'm afraid."

Then and now

Many people's fear of pain and suffering stems from a misunderstanding of just how good palliative care can be, says Dr Finlay. Many elderly have memories of what their parents and grandparents went through in the past, not realising how much has changed.

"I think it's really important to realise we are now less familiar with dying and dying naturally than perhaps we used to be, but we're very good at managing death.

"If you're going to change the law to licence doctors to give lethal drugs to patients, you have to be sure it will be better and safer than what you've got in place. Looking at the international evidence, that's just not the case."

Three-quarters of Kiwis back some kind of assisted dying, according to recent polling.

Why is this Bill needed?

Mr Seymour introduced the Bill to address "anguish faced by a small but significant minority of people with terminal illness or who are grievously and irremediably ill, as they anticipate the prospect of intolerable suffering and the indignity of the final few days and weeks of their lives".

He says it's better than "the alternatives people right now - starve themselves to death, commit amateur suicide, or their doctors give them a bit too much morphine".

It will be a conscience vote, meaning MPs don't have to stick to party lines.