Martin's surgeon admits deficiencies

By JAMES GARDINER

The surgeon who operated on Lesley Martin's mother believed she had between six and 18 months to live, he told the High Court at Wanganui yesterday.

But the same surgeon conceded deficiencies in the way Joy Patricia Martin was discharged from hospital following cancer surgery and treatment for complications in 1999.

Mrs Martin was dead barely a month after leaving hospital for the final time.

Her daughter, a euthanasia advocate, has denied two counts of attempting to murder her mother.

Day two of the trial, which has attracted international attention, saw evidence given by the three doctors who dealt with Mrs Martin in the last months of her life.

Surgeon Roelof Van Dalen told Crown prosecutor Andrew Cameron that Mrs Martin came close to death after surgery because the wound where part of her bowel was reattached became infected.

Dr Van Dalen said an autopsy after Mrs Martin's death on May 29 showed that wound had healed but what would have eventually killed her was a cancerous tumour on her liver, which Mrs Martin declined surgery for.

Under cross-examination by defence counsel Dr Donald Stevens, QC, Dr Van Dalen said that as well as the cancer, Mrs Martin had suffered from pneumonia, an infected blood clot in her pelvis, fluid around the lung, respiratory complications, a urinary tract infection and septicemia.

She also had nausea, vomiting, dehydration and was struggling to eat.

Yet, when she was discharged from Wanganui Hospital with just a week's supply of anti-nausea medication, it took 11 days for him to notify her GP, Dr Bevan Chilcott. It was Martin who took primary care of her mother.

Dr Stevens described the delay as "inexcusable"; Dr Van Dalen said it would have been "unhelpful".

Dr Stevens: And if a defence expert says it was inexcusable, are you going to disagree with him?

Dr Van Dalen: No.

"How was the doctor to know that Joy Martin was at home and what treatment was required?"

"Well, that's a problem."

"It's a problem all right."

Dr Stevens wanted to know why, given that Mrs Martin's condition was terminal, a palliative care specialist had not been consulted prior to discharge.

Dr Van Dalen said he could not recall whether Wanganui had access to such a specialist at that time.

"I was expecting her to go home and to slowly improve, not to deteriorate."

He said he assumed Martin, an experienced intensive care nurse, would have notified him of any problems.

Dr Stevens asked whether he was aware that one of the "givens" of palliative care was that a health professional should not be responsible for the care of one of their loved ones.

"The evidence in this case will be that Lesley Martin should never have been left to look after her own mother because she was so close to her mother."

In To Die Like a Dog, a book published two years ago, Martin, 40, said she promised her mother she would not let her die in pain and administered a high dose of morphine and tried to smother her with a pillow in the days before her death.

It was only after the book was published that the charges were laid.