Euthanasia referendum: The Kiwi who will choose to die if the End of Life Choice Bill passes

"It's not good news, Stu."

Those were the words Stuart Armstrong's GP, a long-time friend who had delivered his daughter, spoke through tears in May 2014 as she confirmed the worst - his illness was incurable.

The Cantabrian, a vocal advocate of the End of Life Choice Bill, always knew prostate cancer was something he'd have to keep an eye on - his father had it, as did his grandfather.

But he'd recently been told his disease wasn't high-risk, so the news came as a shock. He'd taken his family out for dinner just five months prior to celebrate a gleason score of 6/10, indicating his cancer was slow-growing.

However a subsequent check-up revealed his prostate-specific antigen levels were still rising, and earlier biopsies hadn't exposed the true extent of what was really going on inside his body.

Tests showed he now had a gleason score of 9/10, indicating his cancer was aggressive and had already spread beyond his prostate to his skeleton.

It was terrible news that confirmed his illness would eventually kill him.

Armstrong becomes tearful when he speaks about this period of his life. It was a time filled with impossible choices - whether to find out how long he had left, how to break it to friends, what the remainder of his life would look like.

"It was one of those nightmarish situations where you think you've got everything under control and then you get the news. It hits you quite hard, but I had some good friends to talk to and as gutted as they were, they were very supportive," he said.

Armstrong says he feels saddest for his wife and children.
Armstrong says he feels saddest for his wife and children. Photo credit: Supplied

"For my wife, of course, it was pretty shocking. My family took it pretty well, albeit with the frustration that I shared of having done everything right and still getting the worst result you can get.

"They do remarkably well and I feel saddest for them, really, more than for me."

While well-supported, there was no getting past the reality that Armstrong's aggressive cancer had left many of his aspirations in tatters.

The bad news had arrived just after he and his wife had bought a 20-acre property off his father in West Melton to house their horses, and his adult children were on the cusp of their own personal milestones.

"When you're 54 and not looking like you'll make 60, and your daughter and son are at the stage where they might get married and have children, you straight away think, 'Bloody hell, I'm missing all the things I'd love to see'," he said.

"With the loss of everything, the plans and goals you had... we had all that all set up and then your life is shattered and your dreams are gone. It hits you fairly hard."

Armstrong found out about his terminal diagnosis just after buying a 20-acre property with his wife.
Armstrong found out about his terminal diagnosis just after buying a 20-acre property with his wife. Photo credit: Supplied

'I'm physically functioning': The effects of the cancer six years on

Armstrong doesn't know how much time he has left, but he's already defied the odds.

Less than 30 percent of men diagnosed with stage four prostate cancer will make it to five years, but Armstrong passed the six-year milestone back in May - and he's aiming to crack the 10-year mark in 2024.

He's been prescribed Goserelin, a hormonal treatment that suppresses testosterone, to keep death at bay. It's given him "moobs and a bit of a tummy", but it's buying him time.

From the outside though, Armstrong's death seems a long way off. The 60-year-old's active and busy lifestyle jars when seen through the lens of a terminal cancer diagnosis.

Last October, more than five years on from the day he was told he had an incurable disease, he won the New Zealand over-45 and over-55 men's singles table tennis title. The night before this interview he'd done 23 press-ups, and he regularly carts bales of hay around the property for his wife's horses.

"It's funny how it works, but until the Goserelin injection fails to suppress the cancer - the lesions remain across my body - and until they overwhelm the medication I'm fine, I'm physically functioning," he explained.

His physical health is made all the more astonishing when you consider he's also running as the ACT candidate in the Selwyn electorate - a position he took up after seeing leader David Seymour's End of Life Choice Bill pass through Parliament.

He also works as a taxi driver for the local disabled community. Armstrong took up that role shortly after his diagnosis, tossing in his high-stress business development role for something without the pressure.

"It's a great job. It pays effectively nothing, but the people are nice, I like helping them, and the day-to-day work is lovely - it's no stress," he said. "That's possibly part of the formula that's seen me make it to six years instead of three or four. I'll keep on doing it."

Armstrong is now running for the Selwyn electorate with the ACT Party.
Armstrong is now running for the Selwyn electorate with the ACT Party. Photo credit: Supplied

The only sign something's not quite right, Armstrong says, is the way it affects his mental state. He says he lives "under a cloud of depression" that is triggered unexpectedly.

"The physical stuff is one thing, but the main way it affects you every day is the sadness. I let myself grieve every few weeks, then I just dust myself off and get on with it," he said.

"The thing is with this that it could be the next test I have [when my medication will be ineffectual], or the one after, or the one three months later where it's going to have overtaken the medication and we need to be looking at other options."

It's then, when his quality of life begins to deteriorate, that he wants to be given the opportunity to die how he wants.

Armstrong says he wants to go out on horseback, surrounded by his wife and family.

'They can remember me as I was'

Based on recent polling, he's confident that choosing how he wants to die is an opportunity he'll get.

"I'm not afraid of death, because I know when my life is finished it'll be according to my set of rules," he said.

"I'll be able to say, 'Hey, I don't feel curling up in a ball in palliative care in some shitty hospital somewhere amping up the morphine until I slowly drift into unconsciousness'."

Armstrong with his mother.
Armstrong with his mother. Photo credit: Supplied

While he doesn't fear death, Armstrong says he's still very much "pissed off" about his prognosis. But the anger is a motivating force, too - it's why he's spent the last two-and-a-half years attending meetings, Select Committee hearings and campaigning hard for the End of Life Choice Bill.

"To a lot of folk, this is just a coffee chat, isn't it?" he said. "But for me, I know that in a few short years it'll be useful and very important to me to not see my family around me witnessing the suffering and suffering with me.

"They can remember me not as some dried-up old bloody skin-and-bones skeleton, but a little bit more as I was - an active, energetic, sporting person. That choice means a hell of a lot to me.

"I want them to see me as I am at my best, and I don't want to put them through the misery of what I've seen others go through. I don't want to see them witness that - it'd be awful."

'I'm happy with that as a legacy'

Euthanasia has its critics, with one of the primary arguments against it that there aren't enough safeguards in the End of Life Choice Bill to adequately protect vulnerable Kiwis.

Renee Joubert, of anti-assisted dying lobby group Euthanasia Free, told Newshub last month that the Bill in its current form "requires no cooling-off period; no independent witnesses to protect against abuse; and no mental competency test when receiving euthanasia".

Fellow lobby group Care Alliance says the proposed legislation is "badly drafted and dangerous", as it's broader in its scope and riskier than similar assisted dying laws overseas. 

But Armstrong says the End of Life Choice Bill actually has too many caveats and protections, and doesn't go far enough in allowing people wanting to relieve their suffering by ending their lives to do so.

"There's no slippery slope; there's no 'Granny has a great estate and the kids want to get rid of her' - none of that. There are so many safeguards in this Bill to protect people that need to be protected," he said.

"Can you please just consider it's not going to affect you personally, in any way, shape or form, unless you choose it to? It has zero impact on the lives of those who don't support it, none... this is not compulsory. That's why it's called 'End of Life Choice'.

"If you're thinking of voting against it, you're denying people choice. Why would you do that? It staggers me."

Even if the 'yes' campaign wins, there's no certainty Armstrong will benefit personally from the End of Life Choice Bill.

Preliminary referendum results will be released by the Electoral Commission on October 30, with official results released a week later on November 6. From then, it'll be another year until a law is passed allowing Kiwis to apply to be euthanised.

There's no saying when Armstrong's prostate cancer will overwhelm his medication - and if that point comes before November 2021, it may well be too late.

Armstrong believes the End of Life Choice Bill has too many caveats, if anything.
Armstrong believes the End of Life Choice Bill has too many caveats, if anything. Photo credit: Supplied

But while Armstrong's crusade to legalise euthanasia is of course a personal one, he's spurred on too by the prospect of his efforts enabling others like him to choose when they go.

"I'm really looking forward to a positive result in the referendum, so that people like me - and those who are the quiet ones who sit back and wonder what's going to happen when they die - that they have the ability to go on their own terms," he said.

"I'm very much happy with that as a legacy. If that's all I achieved in my life - I helped get the referendum through - I'd be proud of myself."

Kiwis will be able to vote in the End of Life Choice referendum on October 17. The referendum will be held alongside the general election and the cannabis legalisation and control referendum.

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