Melbourne surgeon is the other Dr Death
Melbourne Urologist Rodney Syme believes choosing when and how you die is a basic human right. He believes it so strongly that he feels compelled to help people in immense and irreversible pain to kill themselves.
Debate about assisted suicide has come to the fore in New Zealand since Labour MP Maryan Street drafted a member's bill to legalise it. The bill is yet to be drawn from the ballot but the Voluntary Euthanasia Society holds its annual conference in Wellington this weekend and Syme was invited to speak about his experience of the delicate topic.
His position is not without its opponents, most prominently the Catholic Church. Syme respects his naysayers but says a law change wouldn't make euthanasia compulsory. "I think it's inevitable. The public want it; they don't all want assistance to die but they want to have the option should the end of life go badly for them."
Syme's perspective was born after 20 years in medicine when one of his patients - a young woman with kidney cancer - was left in indescribable pain after the disease spread to her spine. There was nothing he could do and he knew if the situation were reversed he would have killed himself.
Since he helped his first patient to die in 1976, a "tsunami" of people have sought his help.
His patients tend to be from Melbourne's wealthier suburbs, something he says would become more equitable if euthanasia was legalised. "It happens [now] but it's very arbitrary. If you know the right people to talk to you can get help. If you don't, you suffer. People from poorer areas, the less well-educated, they don't know how to do it."
Legalisation would allow open discussion. Often all people need is to be listened to, to be given options, and to feel like they are in control. Of the more than 1000 people who have asked for help in three decades, only up to 300 have actually gone through with it.
"I probably helped, I don't know, I don't keep a count - but it's somewhere between 200 and 300 people at the end of their life to have a death that they wanted."
In 1992, Syme first admitted publicly he had "helped" people to die. "I've been investigated by the police, interrogated on at least nine occasions, but nothing's ever happened as a result of that."
Only once in 30 years has he received a personal threat - a note in his letterbox. He sees that lack of prosecution and persecution as vindication, and as evidence what he does could, in a "strict interpretation of law", be legal. However, it is a crime to aid and abet a suicide and that leaves most doctors too scared to talk about it, he says.
He does not believe just anybody should be able to "help" here.
"This is one of the areas where I do differ from [fellow Australian doctor known as Dr Death] Philip Nitschke. He puts information on a website so anybody can just get that information and take their own action. I do think there's a need for a medical interface where people can come. They can have their situation properly analysed, openly, sympathetically, and be given the best advice."
Prosecutions of lay people show even the legal fraternity supports a law change with "minimal" sentences handed down, he says, pointing to the case of Dunedin man Sean Davison, who was given five months' home detention, rather than the maximum 14 years' imprisonment, for assisting his cancer-riddled mother to die.
"If doctors were able to provide this assistance it wouldn't be necessary for family members to put themselves in jeopardy."
In any euthanasia legislation there are always multiple safeguards: psychological clearance, a stand-down period, multiple medical appointments.
Dr Syme said safeguards were important but no one could be talked into killing themselves. The idea people could be bullied into it was used by opponents to create fear and uncertainty.
"The one thing that is constantly brought up by opponents is that vulnerable people will be harmed by this, well now who are the vulnerable people? I don't know who they're talking about to be quite honest."
Ending a life is a serious decision and Syme firmly believes none of the times he helped was a mistake. That's proven, he says, by the fact no families have complained.
"If you were told you had a lump in your breast and you had no pain, no distress, you think I would help you to die?
"No bloody way.
"But if you came to me with cancer riddling your skeleton and through your lungs and perhaps in your brain ... now you've got severe suffering, now I will listen to you, and if you ask me, I'll probably give you help."
Sunday Star Times