Lecretia’s dying wish denied

Lecretia Seales' dying which was denied but the battle for assisted death continues. Photograph: Supplied
Lecretia Seales' dying which was denied but the battle for assisted death continues. Photograph: Supplied

On Friday, June 5 at 12.35am, just hours after learning that her wish to die on her terms had been rejected, Lecretia Seales passed away from natural causes.

Seales, 42, was a senior legal and policy adviser at the Law Commission and was diagnosed with terminal brain cancer in 2011. In March of this year she filed a statement of claim in Wellington’s High Court. Seales wanted to have the choice to have her GP lawfully administer her a lethal dose of drugs should her suffering at the end of her life become intolerable.

She argued that under section nine of the New Zealand Bill of Rights Act she had a right “not to be subjected to cruel, degrading or disproportionately severe treatment”.

“It is my life that has been cut short,” said Seales in a statement last month. “So who else but me should have the authority to decide if and when the disease and its effects are so intolerable that I would prefer to die?”

Her darkest fear was that she would be “drugged to the eyeballs, virtually unconscious, breathing and that’s about all … I really want to be able to say goodbye well.”

Seales was in court for three days presenting her case, but in the end Justice David Collins ruled that a doctor could not assist her to end her life without the risk of prosecution.

Just hours after learning of this outcome Seales passed away in her home.

Although her claim was rejected, the topic of euthanasia has been put in the spotlight. Questions are now being asked about what the law says or should say about euthanasia.

Seales hoped to encourage a parliamentary review.

“I would welcome such a review as I believe this is a choice that should be made available to all New Zealanders who are suffering from painful, incurable illnesses, without needing to follow my example of going through the courts. And as a recent poll has shown, the public overwhelmingly agrees,” said Seales.

Research New Zealand-released poll results on April 9 showed that 74 per cent of New Zealanders support the law change to make euthanasia legal. The poll was carried out after the increase in media coverage over the Seales case.

Currently the law around euthanasia isn’t so straightforward.

If a terminally ill patient’s level of pain is so bad that their doctor needs to administer a vast amount of morphine to relieve it, but in turn would also have the effect of hastening their death, the physician would be deemed safe in the eyes of the law – because the intent was to ease suffering, not to cause death.

Doctors can even choose to withdraw treatment (including switching off a patient’s life support) – even if the patient and their family wanted it to be continued – if the doctors thought that continuation of treatment would be futile. This is legal, even if the continuation of further treatment could prolong life for a few more days or weeks.

Yet it is illegal to administer a lethal pill to a competent adult who is dying painfully from a terminal illness, although asking knowingly for their life to be put to an end.

University of Otago medical law expert Colin Gavaghan explains the current level of control a person has over their imminent death: while still fully able, they would need to prepare an advance directive, advising their carers that if they reach a self-determined threshold of pain and disability, they are not to be given food or fluids, or directing that they are not to be resuscitated if they become unconscious.

The Bill of Rights Act enshrines everyone’s right to refuse all treatment, provided they are competent to make the decision and regardless of the opinion of their physicians or family. New Zealand law holds that their carers would be obliged to follow their wishes.

Wellington woman Margaret Page, who had been debilitated for years by a brain hemorrhage, starved herself to death over 16 days in 2010. The law sanctions such a choice.

But the option that Seales believed should be “a fundamental human right” – assistance to end her life with dignity at a time of her choosing – is illegal.

“I am simply saying that I, Lecretia Seales, a human being confronted with the inescapable reality of my death, and the prospect of great suffering – for me and those who love me – must have the right to determine when I have reached the end of the road. This right belongs to me and none other.”

Seales’ lead lawyer, Dr Andrew Butler, said sometimes ethics drove the law and sometimes the law drove ethics.

Euthanasia abroad:

* In Oregon, in the United States, people with fewer than six months to live can access assisted dying through a prescription from their doctor. An expert said she believed simply having that prescription helped the patient live longer, and with a better quality of life, as they had control.

* Another expert told of a man who killed himself when told he might not meet the criteria for assisted death, that he would need to see a consultant to make sure he did; a woman who did meet it sought assurance from her doctor that she would get a prescription should she want it, then went home and concentrated on her husband, children and “writing inspiring poetry”.

* In the UK, former engineer Tony Nicklinson, who was paralysed from the neck down after a stroke and unable to communicate except by blinking, asked the High Court to allow doctors to end a life that he said was “miserable, demeaning and not worth living”. The judges refused, issuing a decision in 2012 that was applauded by the British Medical Association and anti-euthanasia groups. Nicklinson died a few days later.

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