A Dunedin doctor's death is the subject of a poignant book being released today.
Dr Pat Davison, who practised as Dr Patricia Ferguson, was in her early 80s when she discovered she had terminal cancer in November, 2004.
After battling the disease for two years, during which she lost the ability to pursue her passions - painting and reading - she decided to end her suffering by starving herself to death.
In a shakily-written living will dated September, 2006, Dr Davison outlined her intentions to her children, Fergus, Philippa, Jo and Sean.
"I am ill with progressive cancer which can only get worse. My quality of life can only deteriorate. I do not wish to have a protracted, disagreeable death," she wrote.
"I have decided to die by inanition [starvation] and would like to make the following request: No resuscitation (or ECT), no antibiotics. No attempts to make me eat. I wish to be the one to decide when I stop fluids. I would prefer as few people to know about this as possible.
"It is what I call a `Bobby Sands'."
Bobby Sands was an Irish Republican Army activist who died on May 5, 1981, after a 66-day hunger strike in HM Prison Maze.
Her agonising end is detailed by her son, Sean Davison, in Before We Say Goodbye.
"Mum had terminal cancer. She was such a dignified woman and she had a very difficult and miserable death. She wouldn't have suffered if there had been an alternative."
Davison's book chronicles the last few months of his mother's life as a daily diary.
"I've always kept a diary in stressful situations. The situation I was in was very difficult and very emotional. I started recording day-to-day events, as they happened. It helped me to organise my thoughts."
Davison returned to Dunedin from South Africa to be with his mother as she died.
He says it was the most painful time of his life.
"I knew that she was going to die, which was very stressful. It was ghastly, really," he says.
"The hunger strike went on and on and on. It was a very difficult situation.
"You don't think about it till it happens. There has to be debate about this. Many people have elderly parents and, at the end, you just want to cut things short.
"Other people will be faced with similar issues to those I faced - when the pleasures of life are few and the end is very near. I think people have the right to decide how they want to end things; especially if they're in pain," he says.
"I question how many people die peacefully in their sleep. Probably a lot less than we would like to think. I think a lot of people would like the option to go their own way."
Davison (47) was born in Auckland and gained a doctorate in microbiology at the University of Otago in the 1980s.
"Dunedin's in my blood. It's a great place. It's a very arty place. It's also where Mum spent the last 10 years of her life and died."
He is professor of biotechnology at the Western Cape University in Cape Town, South Africa, where he heads the forensic DNA laboratory which specialises in DNA identifications in human rights cases in South Africa.
"Mum was an experienced physician and the family respected her knowledge.
She did not want her life prolonged by drugs and she was wary of using drugs to take her life in case something went wrong," Davison says.
"She knew about drugs and she knew that you had to get the dose exactly right. She was terrified of the possibility of administering the wrong dose and ending up trapped inside her body, possibly in a coma or something horrendous like that."
Davison says his mother did not want people to know of her decision to go on hunger strike and was determined in her refusal of medical intervention.
"She put forward a very reasoned and logical argument for her decision," he says.
"Mum was a very intelligent woman. She was a psychiatrist in Hokitika and at Seaview Hospital for many years and then carried on as a GP when she left psychiatry at 65," Davison says.
"She worked all around Otago as a locum for years. She finally retired as a GP at 72. She was a lovely lady. Everyone loved her. She was very popular as a GP.
"But, through her work, she understood death and didn't want to have a long and painful death. Art was one of the few pleasures in her life and, when she couldn't read or paint or enjoy food anymore, the time had come to take things into her own hands.
"If there was an alternative within the law she would have taken it."
On Saturday, September 23, Dr Davison's diary entry reads: "Day one of only water: four cups".
Davison believes the book raises important issues about voluntary euthanasia and the question of a change in law.
"I am sure this book will generate debate, as my mother was an experienced medical practitioner who had thought hard about the issues surrounding voluntary euthanasia," he says.
"I decided to publish the book of my experiences and the circumstances I found myself in to help others think about the issues surrounding death.
I hope the book helps people be less afraid of death.
Hopefully, people won't feel so alone when they're in the same position - both the person dying and those caring for them.
"It is good to think about these issues now, especially when you're younger, while we have the ability to look at changing the law rather than finding ourselves in a situation similar to my mother where she felt she had no alternative to going on a hunger strike to end her life.
"Her approach to dying may also create some interest, together with admiration for her courage and resourcefulness in choosing to stop eating, which she saw as the most uncomplicated method at her disposal.
Obviously, I feel voluntary euthanasia should be legalised and that our society should show some compassion in easing that distance between dying and death.
"The contradiction in the book, I suppose, is why did this wonderful woman have to suffer like she did?
"The situation became ghastly. I loved her very much. We were very close," Davison says.
Pat Davison died in Dunedin on October 26, 2006. She was 85.
Passive euthanasia is perfectly legal in New Zealand.
A clause in the Bill of Rights Act 1990 gives the right to refuse medical treatment.
The Code of Health Consumers Rights endorses that statutory right and also enshrines in law the use of an appropriate advance directive (defined as "a written or oral directive - a) by which a consumer makes a choice about a possible future health-care procedure; and b) that is intended to be effective only when he or she is not competent").
However, active euthanasia is illegal in New Zealand.
Aiding, abetting or in any way assisting suicide is also illegal and is subject to heavy penalties, although convictions are rare, according to the Voluntary Euthanasia Society of New Zealand (VESNZ).
"Our experience is that it is difficult to obtain a conviction for these offences where it is obvious that the accused did not stand to gain."
A recent VESNZ survey showed that 71% of New Zealanders support medically-assisted death.
The survey of more than 2000 New Zealanders aged 15 years and over, conducted in November by market research company Colmar Brunton, revealed that 71% wanted the legal right to choose a medically-assisted death if they, personally, had an illness or condition from which they had no hope of returning to an acceptable quality of life.
The question asked was: "In some countries, though not all, if you have an illness that results in your being unable to have an acceptable quality of life, you are legally allowed to get help from a doctor to help you to die.
If you had an illness or condition which resulted in your having a quality of life that was totally unacceptable to you, would you like to have the legal right to choose a medically-assisted death?"The Times of London reported in an article on March 31 that 80% of British people believed assisted suicide was an acceptable option for patients suffering terminal illnesses.
