MAID in Canada

A good friend of ours has shared some notes on Canada’s new provisions for Physician Assisted Dying. In that country it’s termed Medical Assistance in Dying, MAID. And, of course, it's now become legal. 

However, hopeful reformers there are afraid that the legislation is too limited. For instance, when people sign the request for MAID, there have to be two witnesses in attendance. But there are so many restrictions around who these witnesses can be, that it is simpler if they are complete strangers.

So our friend has volunteered to be a witness and has in fact done it three times.  The patients can’t have MAID for at least ten days after signing and of course can change their mind at any time, or they can wait for as long as they like. On a whimsical note, she told us, "One woman was very interested in my red boots and asked me where I got them.  And I thought to myself, `Surely she isn’t going to go out to buy boots at this point.`"

Methodist Supernumerary Fund

For nearly ten years, retired ministers in the Supernumerary Fund of the Methodist Church of New Zealand have had no increase in their pension. For some beneficiaries, especially widows, this has been a difficult time.

This seemingly unjust situation has arisen partly because the Government’s Kiwi Saver scheme was required to replace the Church Fund. So this was no longer topped up from ongoing subscriptions as might have been expected.

But there were also more significant changes. First, the Government insisted that the Church’s Supernumerary Fund be put into the hands of a specialist company. It failed to serve the Church well. Then the Government allowed the Church to take back control of its own fund. Through these messy arrangements, substantial capital was lost.

Now a special Committee has been charged by the Conference to find a means of building up the capital again. A logical place for them to look might be the “PAC Endowment” which is open to receive suggestions from anyone in the Church.

Before people start to quibble over the use of PAC funds, the Church could reflect on how this huge fund was created. It came from the long term lease of the Prince Albert College property in Auckland – including but much more than the lovely old terrace shops at the top of Queen St.

Prince Albert College was originally built, on this land which was granted to the Wesleyan Mission in the 1830s for educational work . The school was to provide education for the children of Wesleyan missionaries throughout the Pacific. Instead of having to leave the Mission field to provide schooling for their children in England the missionaries would be able to remain in their chosen work and have their children well educated in the Pacific.

And who paid for this imaginative and costly enterprise? The Missionaries themselves. The Ministers of the time contributed to raise the capital fund that began Prince Albert College. It was to be for their children. They put in the original ten pound shares. 

Given this background, it might be seen to be appropriate to transfer some money from the PAC Endowment to ensure that today’s retired clergy and widowed partners receive a pension of which the Church can be proud. Ministers sowed the seeds of that fund in 1836 out of their own pockets. Let the present retirees enjoy a little of the vast harvest of property inflation 180 years later.

The Ca Pros Report

Just a quick update:

After about nine months of PSA flat-lined between 25 and 30, this week's two-monthly test is 40, a 25% increase. This is along the lines of the very steep increases of 2015 and a bit worrying.

However, I'm taking the long view and figuring that an increase from 25 to 40 in about ten months is really quite small!

But, I guess my oncology specialist will be wanting to see me before long...

"I Believe"

Here's a postscript to my last post on the relevance of Christmas carols:

In the last few months, Chorus members wanted to learn "I Believe". Some of them, I suspect,  chose it because it was more like "ordinary singing" than Barbershop. However, our indefatigable Director prepared a great arrangement in barbershop style and I crafted scores for everyone.

The problem was, there's only one verse and just singing the whole thing twice through didn't seem to make an item, no matter how "lovely" people thought it sounded.

Personally, just about everything in this song represents a whole style of theology that I have long since relinquished, so when the possibility arose that one of us might write a second verse, I had a go. I wrote the following and nobody complained about it so we learned it:

I be-lieve that some-where in the heart of me a vis-ion burns;

I be-lieve that in the eyes of friends a-round I see hope yearns;

I be-lieve that some-where in a hurt-ing world some-one will go

To ease the pain.

I be-lieve, Oh, I be-lieve.

I be-lieve that in us all the fut-ure of the world is sure;

I be-lieve that we are those whose life and all its works en-dure;

Ev-ry time I hear a new born ba-by cry

Or touch a leaf or see the sky,

Then I know why I be-lieve.

But in the end of year Village concert by the Barbershop singers the other night, we were  apparently running out of time so my verse somehow got omitted! 

Oh, the trials of a Progressive in an alien world!

Carol time again

Shirley Murray’s touching hymn based on Away in a Manger has moved me to propose including it in our Barbershop Christmas Carol presentation in a few days. The association of everyone’s memories of that particular melody with some concern for a refugee baby on a sinking raft in the Mediterranean is profound.

Oh, dear, what a fuss.  Our manager has apparently heard from “several” members who object. Some apparently need to practice the tune first. So he has decided we will not sing it. One member who obviously know it well emailed me personally to say that she will NOT sing any other words to that tune.

All a little frustrating when, for three years, I have tried to suggest that we might sing something a little more relevant to the season and, hopefully, a little more theologically sound than the repertoire of the average shopping centre. But to no avail.

Now a slightly provocative step on my part has outraged our musical fundamentalists. One defended her position by saying, “We’ve got to allow for differences of opinion”. Pardon me, what about some allowance for my difference of opinion? Wouldn’t the Chorus be just a little disadvantaged if I said —

**I will NOT sing anything that doesn’t meet my personal standards of respectability.

**I will NOT help to set out the rehearsal room and bring in the keyboard every week if we are going to sing about the passionate affairs of young lovers.

**I will NOT print music sheets that enable the Chorus to promote mythical, out-dated views of the birth of Jesus.

**I will NOT spend hours on the computer preparing a power point with words for the Christmas audience to sing if I happen to think that the words are mostly untruthful and generally misleading.

But I understand that Barbershop is a community. It recognises that differences of opinion exist among its members as much as the differences in their singing style and range. But it knows that the best result is achieved when our personal views about the music and words are subsumed into a whole that gives pleasure to the singers as well as the listeners.

Not a bad message for Christmas, actually. A pity that our Chorus can’t quite demonstrate that message instead of just singing another verse of “Hark, the herald angels sing”. 

Now, hang on a bit: those are revised words: what Charles Wesley actually wrote was “Hark, how all the welkin rings”. That’s what the musical fundamentalists should be singing in 2016...

Is there another way?

 It seems likely that Parliament is not in a hurry to initiate a comprehensive law for Assisted Suicide. But nor can they easily bring in legislation to prevent the many “managed” deaths that take place already. The status quo is likely to continue in some form or other.

So, instead of putting all our energy into legislating for a comprehensive regime about end of life in general, why don’t we direct attention at the legal issue which inhibits more doctors from exercising the kind of compassion that many do already?

I don’t know much about the legal complexities but it seems to me that adjusting the section of the Crimes Act that makes it illegal to assist a person to suicide would be simpler than trying to achieve agreement for a comprehensive protocol to cover every possible kind of assisted death.

Could we not let the medical profession continue to use its own judgments while knowing that the law no longer makes them vulnerable to a criminal charge. 

Submissions - and the Debate

Big day yesterday. 

We left home close to 1pm and arrived at the Hearing Venue at 3pm, an hour early, to get the feel of the proceedings. However, very wet weather had obviously disrupted the hearings and I was called nearly an hour early.

The two women Committee Members in our room were gracious and really helpful to some of the less confident submitters. We stayed for an hour or two; and it was fascinating to hear the different points of very personal views. Consistent with the overall submissions, the opinions ran about 2:1 against any law change.

But in a break I had a short chat with a young lady on the other side. I suggested that agreement would never be reached on the issue itself and she realised that she’d never thought about that. She probably wasn't going to change everyone. So she then saw she had to consider whether we should change to law to allow for natural differences exactly because there is no agreement. That's what Choice is about.

The most moving moment was when our room finished and about four of us went into another room just to watch. (The Committee was taking hearings in three separate rooms—250 five-minute submitters between 9am and 6pm!). One lady broke down before she could begin her talk and another one from our room went and sat beside her and held her hand. What neither realised at that moment was that the supporter was on the other side of the issue...

Apparently that spirit did not always prevail. One or two people felt that their reception among the audience was a bit hostile. One person at least happened to be in a situation where her voice was the only one on her side and she felt distinctly discouraged. Some of this could have been prevented if everyone had been given more notice of the hearings (mine was only four days!) so that supporters could have attended.

But on the whole, this experience of democracy in action was satisfying. I pay tribute to the MPs who sat throughout this long day and still had to disperse around the country to their homes afterwards. Probably they learned nothing they didn’t know already, but they paid respectful and sympathetic attention to everyone who had asked to make a personal impression.

It was a little anticlimactic to join a few dozen people at the Community of St Luke in Remuera in the evening. They offered a debate between Hon David Seymour, the promoter of the bill that is sitting in Parliament’s Ballot Box and Matthew Jansen, the Secretary of the Care Alliance. Between them was not much agreement, as might have been expected, but also, a wide range of conflicting statistics from the same countries.

And there was an astonishing claim that “If you can give me the name of one doctor who has hastened the death of a patient (“murdered” was the word used) I will go to the nearest Police Station and have him (sic) charged”. I could have given him names of two or three compassionate and practical medicos and someone else said she could name four. But considering 11.2% of NZ doctors admitted in a survey last year that they had taken just such steps, the ridiculous offer was just grandstanding and illustrated only the lengths to which one can when one’s case seems threatened.

Again, the evening produced nothing new. We’ve heard both sides of it all before. Parliament just needs to make a decision. Our best hope is for David Seymour’s bill to pop up out of the Ballot Box. I suspect that the Committee will produce a huge report but no firm strategy for Parliament.

What I said to the Enquiry

My Five Minutes Spoken Submission
to the Health Committee   4 pm 14 Oct 2016

Introduction

I am Dave Mullan, of Red Beach, retired Methodist Presbyter, 81.
I have advanced prostate cancer.

Just over a century ago, my great-grandfather, TW Attwood, was in a deputation to the new Parliament House. He would have argued a strong case—not like mine, which probably doesn’t break any new ground. But the family say he also had great passion. I hope something of that passion in a parliamentary office long ago will be apparent in this submission.—

Tetany Spasms

After an emergency surgery, I woke in the middle of the night with the most appalling pain seizing me. Every muscle between my knees and shoulders seemed to be trying to tug on the massive abdominal incision and tear it apart. It was like every muscle was cramping at once. I couldn’t move for the moments of the attack, couldn’t even breathe, or speak or cry out. I immediately realised this was not normal post-operative pain. Something in me was creating it. Only with a conscious effort of will was I able to unravel the muscles, like easing a possum skin off the nailed board on which it’s been stretched. It took time and the pain continued throughout.

Although I reported this problem to the surgical Rounds team at 8am — and in fact had an episode right in front of them while they stood round the bed — not one of them offered any comment. Subsequent conversations with the pain specialist failed to deal with ongoing attacks for nearly 48 hours.

One night a nurse really listened to me and I was prescribed a drug that stopped the attacks. But there was still no diagnosis. Months later, a very knowledgeable nurse friend suggested that I might have experienced tetany spasms. I surfed the net—as you do—and found a surgeon who had experienced the same very rare symptoms after his own operation and was appalled at the level of pain.

Prospect

If that kind of pain, even in short spasms, is what I might expect when this rather ordinary disease overtakes me some time, I don’t want it. If something like that is what broadcaster Andrew Denton described of his father’s agonising death, I don’t want it. From my own experience with the excruciating agony of those terrifying spasms, I don’t have any confidence that pain of that level will necessarily be palliated or even recognised. Nor do I believe for a moment that pain is a necessary part of the very ordinary business of dying in the modern age.

Reflection

Looking over my submission, I don’t wish to change much. But I hope you will review carefully the sections on—

·       the Slippery Slope and Change and their risks and effects;

·       the suggestion that much traditional religious thinking is not helpful in this debate in the context of a secular society;

·       my claim that medicine, Government, and some Christians are trying to have a bet each way;

·       my view that full agreement on the issue should not be expected

·       but providing for choice is a demonstrably fair and reasonable expectation for some terminal patients.

In every waiting room in the Health system I’ve seen posters encouraging me to become involved in my health decisions—until my last days when my wishes will suddenly expire like a twelve months’ old Prezzy Card. Please now take that further step and allow me a little simple responsibility in my dying. Please extend my personal choice to that life-defining moment.

“Looking Great”

All through my journey with prostate cancer people—becoming aware of my rising PSA said, “But, Dave, you’re looking great.”  They didn’t realise that it was hormone medication that was filling out my face so of course I looked good. Recalling the gaunt, emaciated faces of many terminal cancer patients, what I ask of you now is that after my death, anyone seeing me might say, “Gee, Dave, you’re looking great” — because you gave me the choice of dying with dignity.

And, oh yes, my great-grandfather’s petition to Parliament? The following year, exactly a century ago, Parliament granted their request which led to sweeping changes in the fruitgrowing industry. Tongue in cheek, I suggest that is a great precedent for your Committee today. You, also, could create significant change for our country by encouraging Parliament to permit me and other terminal patients to have some say in our end of life.

Dave Mullan

28/101 Red Beach Rd, Red Beach,  0932      +64 9 426 7562

Anyone remember Ecclesion?

Another fascinating talk we heard last week was from Dr Greta Vosper, minister of West Hills Uniting church in Toronto. Her extreme progessive position has led her denomination to resolve that she must leave her congregation.

But what interested me was one aspect of Greta's description of her congregation's Sunday mornings. They consider issues that are real for the congregation. They  draw freely on other inspiration than merely the Bible. And when business decisions come along they make them on the spot. There is no church meeting nor council so no group of individuals in assigned responsibility to make decsions on behalf of the whole community.

It interested me immediaely. Here was a working model of the Ecclesion Church that I proposed 25 years ago for small congregations.  I reckoned the contemporary church should devote its only gathering time in the week to elements of worship, education, fellowship and doing necessary business.  I'd still be very comfortable in that kind of gathering.

Medical Professionals will Cope with Assisted Dying

Many New Zealand medical professionals are surprisingly supportive of Assisted Dying in appropriate circumstances. Last week Bev and I attended a presentation by Dr Philippa Malpas on the responses of 1000 Doctors and Registered Nurses to a fairly searching questionnaire.

Some of highlights of the results were:

Around a third of doctors and half the nurses “strongly” or “mostly” agreed that AD should be legalised in NZ—assuming proper protocols were in place

A small proportion of the doctors and nurses had already been directly involved in providing or administering a lethal dose of medication to help someone have a hastened death. 

Most wanted a range of measures to ensure their safe participation in legal AD.

There are enough medical professionals prepared to become involved should the law be changed and AD be permitted on a voluntary basis.

It was interesting that TVNZ gave air time to the Care Alliance to attack the research but refused to permit the researchers to correct the misrepresentation. Nevertheless Dr Malpas observed that the law will be changed, sooner or later.