Death, duty, dignity, discretion

Voluntary euthanasia.

Assisted dying.

Physician-assisted suicide.

Mercy killing. 

Right to die.

Death with dignity.

End-of-life choice.

The terminology often sparks as much controversy as the practice itself, and in recent years, the debate has seldom been far from the spotlight.

In the public domain, right-to-die campaigners Lesley Martin, Sean Davison and, most recently, Wellington lawyer Lecretia Seales (who died of brain cancer last year, just after the High Court ruled against her in her case to let her doctors help her to die) have been outspoken advocates for the cause.

In the political domain, there have been several unsuccessful attempts in the past 20 years to get voluntary euthanasia legislation into and through the House.

These have been made by former and current MPs on both sides of the political divide: Michael Laws (National), Peter Brown (NZ First),  Maryan Street and Iain Lees-Galloway (Labour) and, most recently,  David Seymour (Act).

Equally vocal have been right-to-life defenders, palliative care specialists and religious denominations.

The views of many, however, are likely to lie somewhere in the murky middle ground.

The High Court ruled, in Ms Seales’ case, a decision about doctor-assisted suicide must be made by Parliament, not the courts.

That decision, plus continued pressure by Ms Seales’ husband, Matt Vickers, and a 9000-strong petition, led to a Health Select Committee inquiry into public attitudes towards medically assisted dying for people with terminal illnesses.

The committee has been considering the more than 21,000 submissions and has just begun hearing from 1800 of those who wanted to speak.

Ms Seales’ case has also inspired former prime minister and  Law Commission president Sir Geoffrey Palmer, who had worked with the late lawyer.

This week, in a special lecture in her memory,

he proposed a change to the Crimes Act that would allow doctors, in certain limited situations, to help terminally ill patients to die.

The practice would require seven conditions to be met and the Family Court to verify them.

Sir Geoffrey believes such a law would be ground-breaking. In such a contentious area, it certainly offers a potential for  progress on the issue.

It provides safeguards around consent.

It removes the responsibility for decision-making from health professionals, whose duty, after all, is to preserve life.

It does not compel medical practitioners to act, but provides the option only if there is a medical practitioner prepared to provide the assistance approved by the court.

It gives the dying a choice, and it frees their loved ones from making an appalling — and criminal — decision at their behest.

It appears to be a careful and considered means by which some individuals (one of the criteria is those with "grievous and incurable" medical conditions) have the option of being granted their final wish.

Importantly, the safeguards would protect the general public from the perceived or possible risks and pressure a wholesale change in legislation could bring.

It will not find favour with those who argue the right to life above all else.

However, Sir Geoffrey says he is not arguing the case for a "general right to die", and it is desirable to "proceed with careful, small steps".

He says:

"Death is inevitable. By making this suggested exception to the general principle, we would be respecting life. And such a measure would not be a slippery slope toward some ambiguous twilight zone."

His suggestion is the first which appears to offer a real bridge over a very rocky divide.

It acknowledges the State’s duty of care, the individual’s desire for dignity and choice, and urges discretion in any decisions.

His voice is welcome in the debate.