Editorial: Desire to die needn't be a rallying cry

Opinion

Margaret Page says she no longer wants to live.

The 60-year-old, who suffered a cerebral haemorrhage 20 years ago and has been living in a Wellington care home since 2006, is, therefore, starving herself to death.

She has not eaten for 12 days and has drunk only a small amount of water.

Three psychiatric examinations have found her lucid and capable of making her own decisions.

It is hardly surprising, however, that her wish has sparked a debate about moral, ethical and legal issues, especially those confronting the medical profession.

A catalyst for this has been the demand of Mrs Page's separated husband that she be force-fed.

This might well happen if she were a political prisoner involved in a hunger strike.

But she is not in the care of the state. She has taken her own decision, and her care home has chosen to respect that as her right.

This course is underpinned by section 11 of the New Zealand Bill of Rights Act, which decrees that "everyone has the right to refuse to undergo any medical treatment".

It is reasonable to assume that refusing food and water falls into the same camp as refusing other forms of treatment.

Patients' right to reject treatment negates much of the debate about doctors' responsibilities for keeping them alive. The profession's hands are effectively tied.

This is not the sort of emergency situation prompted by, say, a suicide attempt, which would demand their intervention.

Further, there is increasing disincentive for doctors to contemplate force-feeding.

The World Medical Association has revised its once-qualified position on hunger strikes and doctors' response by stating that "force-feeding is inhuman and degrading treatment".

It has said, in effect, that, when applied to someone who wishes to die, the practice amounts to an additional cruelty.

Those in favour of intervention also find the weight of recent judicial decisions against them.

In Britain in 2008, a terminally ill teenager won the right to die after she was taken to court by her local hospital in an attempt to force her to have a heart transplant against her wishes.

In a case with even greater parallels, an Australian quadriplegic last year won a landmark legal right to starve to death.

Western Australia's chief judge ruled that Christian Rossiter had the right to direct his own treatment and that his nursing home would not be criminally liable if it complied with his wishes.

It is important to recognise the distinction between his case and that of Mrs Page and instances of euthanasia and mercy killing. In the latter, someone takes the life of another and may well be liable to a charge of murder or manslaughter.

Mrs Page's case is about passively allowing someone to die, to give up the fight. As such, it is somewhat distasteful to see her circumstance being seized upon for the pursuit of an altogether different agenda, that of the legalisation of voluntary euthanasia or assisted suicide.

Lesley Martin, having been sentenced to 15 months' imprisonment for the attempted murder of her dying mother, is now campaigning for "dignity havens", which would provide "both palliative care plus an option of legalised assistance in dying".

That means the granting of a legal right to administer drugs with the specific aim of ending a person's life.

Frustratingly for Lesley Martin, Parliament is not persuaded to address the issue.

In truth, devising a robust regime, armed with adequate safeguards to control the risks of mercy killings, appears hardly feasible. Issues of intent will always overhang them.

Certainly, the whole concept is far removed from the issues raised by Mrs Page's wish to starve herself to death. It may seem unconscionable to allow anyone to die and, inevitably, her case is stirring emotional turmoil.

But Margaret Page's right to stop eating, like that of an elderly or terminally ill person in his or her own home who might refuse food or medicine, need not be something for public campaigners.