On Newshub Nation: Simon Shepherd interviews euthanasia advocate Dave Mullan

Simon Shepherd: On the other side of the debate is Dave Mullan, a former Methodist preacher who has been living with prostate cancer for 18 years. Medication to stop the spread is no longer working. So he wants the right to choose when his life ends.

Dave Mullan: It is advanced, spinal-compressive, something-or-other-resistant prostate cancer. It’s resistant to most of the things that they can get to stop it. So it’s got to a sort of end stage now. I have been on the gold standard of Pharmac, Abiraterone, at $50,000 a year, and grateful for that. But it didn’t reduce the cancer at all, or my PSA, which is a rough-and-ready measure of the cancer. And after 18 months on that stuff, when my PSA started doubling every month and got from 50 to 270 in two months, we all had to agree there’s no point in any more of that. So I’m now off the medication.

When you came off the medication, did your doctors say to you, ‘You have this much time to live’?

No, they didn’t. We had a long talk, and we all agreed that that medication was not going to do any more for me, and it was the top-of-the-line, so we agreed this was the end and that I would be referred back to my GP to make me comfortable. Well, I’ve had that said to me before, actually, five years ago when we lived up north. But that was not an opportunity for me to say, ‘How long do you think I’ve got?’ Because you cannot tell with prostate cancer. You just can’t tell. It can move very quickly in some people and very slowly in others. And as you may know, lots of men die with it without even knowing they had it. So it’s a strange and sneaky disease. But of late – the last three months, since we went off Abiraterone – I’ve been feeling pretty ropy. And at present, not eating properly, I can see myself entering a critical stage pretty quickly.

In terms of making you comfortable, what does that look like right now?

‘Have some pills for this, have some pills for that. You may be a bit constipated.’ Constipated? I’m totally blocked up. And dealing with all of that simple stuff has really been much more trying than I expected.

Is it those things which influence your views about euthanasia?

No, not really. No, I’m just going through ordinary pain and dealing with it in an ordinary manner. It’s just really unpleasant. My concern about end-of-life choice is that I might get to a point where I have got a significant pain from the cancer and it is un-treatable. Now, to offset palliative care against choice is not realistic, because palliative care is not able to deal with all pain.

How will you know when you’re ready to make that choice?

I suppose when I am screaming with pain and it is not being dealt with. All the palliative care in the world, even by the specialists, bless their hearts, of hospice, if I’m one of those people who has a pain that cannot be treated, I want to hold up my hand and say, ‘This is it. I’m out of here.’

If you get to the stage where the pain is unbearable and you want to make that choice, what does that look like?

First we’re going to have a big family hooley. We’re going to get everybody together and tell the family stories and the family jokes. Our family used to sing quite a lot; we might even sing some of the family songs. And do all of that sort of stuff and say our goodbyes. I think that is a very important part of leaving this life – disengaging with the people that have been close to you. And if you’re in a coma in a hospital bed somewhere, that’s not possible. So I’d want that first. And then I would like to have the medication available for me to take when I’m ready to take it. And the bill says it’s got to be taken in 14 days or it goes back to the pharmacy. Oh no, please, no, I want it to be available for me to take when I want it.

Currently, the bill says that you have to have a diagnosis of about six month to live. What do you think of that?

I think that’s much better than two weeks, which was proposed at some time. That seems reasonable. But I don’t think I’d be able to find an expert who would be able to say confidently of me I’ll be dead in six months from now or from this time next year. So it may be very hard for me to make a case when the time comes. But I want the opportunity to at least try and make my case.

You’ve been living with cancer for 18 years, and the prognosis has changed over that time. Is there a chance you could make a choice too early?

I think with advanced spinal-compressive, something-or-other-resistant prostate cancer, the answer would be no. It will progress.

So what would you like to say to the politicians who are currently debating this law?

I think what I’d like to say to them is, ‘Look, we know all the facts. We know what it’s all about. Just make a decision. And if you’ve got some doubts about it, try and focus on just the small number of people who are going to be affected by the bill.’ The bulk of the population are not going to be touched by this bill. People who are against it can still not do it. Nobody’s going to be required to do it. They should concentrate just on the people who are going to be affected by it. It might be only 10 people in the first month or the first year. It’s not a whole crowd of people. And nobody else’s rights are interfered with. Just do it.

Transcript provided by Able. www.able.co.nz

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