Taking the assistance out of suicide?

As a boy, my mother always told me that you should never ask your neighbour to do something that you wouldn't do yourself. I doubt she was talking about suicide, but if we had this conversation again in later life she could well be. And I would not disagree with her.

The recent call by Auckland GP, Dr John Pollock, has brought the issue of assisted suicide back into our lounge rooms. As the nation argues whether anyone of us deserves assistance in our dying weeks, days or hours, my long association with this issue has made me think a bit beyond the tabloid headlines.

In this respect I have recently re-titled the workshop program that I hold annually in New Zealand, Australia and around the world.

Whereas once our workshops focused on Assisted Suicide, these days the focus is on Safe Suicide. Information that equips the seriously ill to organise their deaths, should that need ever arise is my case in point.

Back on the 22 September 1986 I used my training as a doctor to help a terminally ill man to die peacefully and with dignity. That man was prostate cancer sufferer, Bob Dent.

Bob died in Darwin under the Northern Territory's Rights of the Terminally Ill Act. Three more of my patients followed in Bob's footsteps. All were terminally ill, of sound mind and desperate for relief from their suffering.

The ROTI Act is now long dead, pardon the pun. This ground-breaking piece of legislation lasted nine months before a vote in the Australian Federal Parliament barred the Northern Territory from making laws on voluntary euthanasia. The law promptly ceased to operate.

Back then, however, even though that law allowed me to administer a legal, lethal, voluntary injection I did not do it.

The reasons are varied.

Firstly, I did not want to be sitting right by the patient in their final moments. While doctors can often become confidants and even friends with their patients in the majority of cases, we are just doing our job. Call it professional distance.

On the other hand, I have always believed that the personal space of a dying person belongs to their nearest and dearest. That is what I would want. That is overwhelmingly what the patients also want.

Secondly, I did not want to be the person to make the final decision about when that person's life should end.

My training at Sydney University medical school left me with important standards to uphold. One of the most important of these is what it means to empower a patient with the knowledge necessary to make the decisions which best suit them.

As a doctor, I have never considered it my role to kill. Under the Northern Territory's law, however, I did consider it my duty to make the choice of voluntary euthanasia aka suicide available to those patients who qualified.

I had no qualms about inserting the canula into a patient's arm. I had no concerns about mixing the lethal solution of drugs which, if the patient elected, would be administered into their veins with a peaceful death following a few minutes later.

The point of the Deliverance Machine that I built to enable this process to take place made the suicide of Bob Dent safe. To call those lawful deaths assisted suicides' is, at least to me, a misnomer.

I did not press the buttons on the laptop. The patient did that. The patient could equally have abstained from pressing any buttons.

The point of the Machine was that it was the patient who was taking responsibility for their life, and their death. Not me, as their doctor.

So when a terminally ill GP calls for legislative change for doctors to be able to assist their patients to die, I do sit on the fence.

As his doctor I would not want the responsibility of killing him. He can do that, and take the responsibility onto his own shoulders.

The claim that legislative change would allow sicker patients to live longer isn't my experience. The sickest lucid patients can take the small drink or press the button. And we should not assume those who have passed this point, unable to make any meaningful gesture, still want help to die.

I would also support what can be the only humane response in a civil society such as ours, that the laws of conspiracy and assistance be clarified.

All dying people should have choice in who is with them in their dying days. My own worst fear would be to die without my wife with me, holding my hand.

On this count I fully support Dr Pollock's call for legal clarity. What I would be more concerned about, though, is that a rational, well considered decision to terminate one's life one's suicide is not one for delegation.