GP’s dying defence: I did not murder mum

This is Stephen Edwards’ dying declaration, the defence he did not get to make in court to charges of murdering his aged mother and conspiring to cover up the alleged crime.

Former NSW GP Stephen Edwards. Picture: John Feder

This is Stephen Edwards’ dying declaration, the defence he did not get to make in court to charges of murdering his aged mother and conspiring to cover up the alleged crime.

The case against the NSW GP was abandoned in 2020 after he contracted incurable cancer.

Now, in the shadow of his own death, Edwards is speaking out. He is no longer Dr Edwards because his medical licence has been suspended, much like the life he had before he was committed to stand trial for matricide and named as a suspect in the death of his father, David, 91.

No more serious accusation could be levelled against a doctor who had devoted himself to the care of the elderly and the dying.

“I did not murder mum and I most certainly did not kill my father,” Edwards tells The Weekend Australian, breaking nearly six years of silence. That would be against everything I stand for. It didn’t happen.”

But here is Edwards’ challenge: read his story and decide for yourself whether he is innocent or guilty, a man wronged by investigators who put two and two together and came up with five or whether he is Dr Death, the nickname he wore when he was remanded to the same high-observation cell block of a Tasmanian prison as the mass murderer, Martin Bryant.

It’s a story etched in the grey of the blurred ethical and legal lines doctors confront when treating the elderly or the very sick in that last, often trying stage of life. A dying person can lawfully be given potentially lethal quantities of pain-relieving drugs so long as the intent is to relieve suffering, not kill, under the time-honoured Doctrine of Double Effect. If death is a “side effect” of treatment in these circumstances, so be it.

While recognised in English case law, the principle has never been tested in an Australian court, legal scholars say. Edwards doesn’t deny giving both his parents “generous” doses of painkillers, including morphine. Had it proceeded, the trial would have turned on his motivation.

Did he help 88-year-old Nelda Edwards end her life when she refused to change her mind about following David to the grave? Or was he merely trying to make his mother comfortable in the confronting hours leading up to her death in March 2016, albeit in a manner he came to regret?

She died barely 48 hours after her husband of 68 years, in the Hobart home they loved.

Edwards, 66, says the case was not about euthanasia, adamant that he is neither for nor against voluntary assisted dying, though both his parents were passionate advocates of it. The elements would be more straightforward were that the issue – easier to define in the black and white of law, more readily consigned to the debate that consumed the nation as one state after another flagged or introduced VAD laws while he waited for his day in court.

In lieu of a jury verdict which he is convinced would have gone his way, Edwards has set out to clear his own name. He has told his story in a book due to be published in February to tell what really happened to his parents so people can judge him on what he calls the facts, rather than disputed allegations. Above all, he doesn’t want Dr Death to be his epitaph.

He hasn’t got much time, because the cancer that erupted in his liver has spread remorselessly: the trunk vein draining deoxygenated blood from the lower limbs and pelvis, the inferior vena cava, is engulfed and he’s waiting to find out whether the inoperable tumour can be contained. His weight has crashed by 20kg.

“I have been hard done by,” he says quietly. “I didn’t murder my mother – I tried to help her. I can’t prove it, but I was bloody angry and depressed and sad for five years and I think that might have something to do with the cancer. I was quite healthy until this case.

“I would like to clear my name and I would like the police and the prosecution to be made accountable. I would like some recognition that these charges should never have been brought. I would like an acknowledgment that what happened to me should never have happened – and I don’t think that’s too much to ask.”

Rejecting this, Tasmania’s Director of Public Prosecutions Daryl Coates SC says his office at all times believed Edwards faced a “reasonable prospect” of being convicted before he was discharged due to his illness, on public interest grounds. “The crown case against him was based on expert evidence, circumstantial evidence including post-offence conduct after his mother’s death and admissions Mr Edwards made to police,” the DPP says. “Tasmania Police conducted a thorough and detailed investigation.”

So let’s rewind to where it all began, in the late summer of 2016, when Edwards received a phone call from his brother, Leigh.

Edwards with parents David and Nelda.

Career of caring

He was living in Phegans Bay, a picturesque hamlet outside Woy Woy on the NSW central coast, with a partner he refers to as Jamie. (Like many names in the book, it has been changed for legal reasons.)

Edwards practised palliative medicine for the elderly and was in round-the-clock demand to attend nursing homes or to make house calls. “I had never wanted to be stuck behind a desk,” he recalls. “With a boot-load of equipment, I liked to solve problems as I drove from home to home.”

Leigh was calling with bad news. Glendon, 67, the second of the four brothers, had died in Thailand while working there as a contract teacher. What Edwards didn’t know then was what their bereaved parents had decided to do: they stopped eating and drinking, resolved to die.

A week or so later, Leigh, 63, was back in touch. Dad had lost so much weight that the outline of his teeth could be seen through his wasted cheeks. Edwards now learned of the suicide pact. Alarmed, he cancelled his rounds and jumped on a plane.

The first thing he noticed when he examined his father was his breathing: alternating between rapid and shallow, and stopping altogether for a heart-pounding duration of up to 30 seconds. Edwards recognised it as Cheyne-Stokes breathing, a telltale of impending death.

He reached out to his father’s GP and briefed the doctor on David’s condition as well as his expertise in palliative care. They agreed Edwards should look after David at home; the Hobart GP arranged scripts for morphine and the sedative midazolam, which Edwards administered. His father died next morning, March 2, after falling into a deep sleep.

Nelda was still refusing to eat or drink anything except a sip of brandy-and-dry someone had foisted on her. The house in dress-circle Sandy Bay, overlooking the waterfront, was busy. Eldest brother Robert, 69, had arrived with his wife and children.

They tried to impress on Nelda how much she had to live for: the grandkids, her options to move in with one of the families or take up assisted living. She could shop, travel, enjoy cruises. Yes, she was reliant on a walking frame. “But, mum, you’re doing so well,” Edwards told her. “You’ve improved so much since your last fall.” She wouldn’t relent. On the day of her death, March 4, Edwards saw her soon after he awoke, early. She was sitting up in a bedjacket, looking tired, a cup of cold tea untouched by her side.

“Please, Stephen, give me something to help me sleep,” she pleaded. “I just want to rest properly. Mum, you know I can’t do that,” he replied. “Yes, you can,” she said. “You gave something to your father that let him sleep. Please, Stephen, just a few hours.”

a family snapshot from Edwards’ youth.

Parents’ death wish

Nelda and David had made no secret of their determination to die on their own terms.

They had sourced information from Philip Nitshke’s pro-euthanasia organisation Exit International and joked about taking the maverick medico’s “magic pills”. Edwards promised them he would be there when the time came. But it would be to make them comfortable, not to help them die.

On and on it went. Nelda said she had fasted for the same time David did so why wasn’t she dying? Edwards gently explained her health was “robust” compared with her husband’s. At one point, she reminded their sons that she was a former nurse and knew how to cut her wrists; she just didn’t want her body to be found in a cold and bloody bath.

Reluctantly, Edwards agreed to help her – to sleep, he emphasises. Her longstanding insomnia had been compounded by the onset of dementia. An intensely modest woman, who once confided to Edwards that his father had never seen her out of a nightie, she would have hated the thought of strangers in the bedroom.

“I didn’t fancy another argument … I succumbed,” he says.

At 8.30am he gave her a “decent” 2.5mg dose of clonazepam from the left-over supply that had been prescribed for David. No effect. After another two doses, administered 30 minutes apart, she fell into a light sleep for about an hour. “Despairing, I gave her another dose along with 10mg of morphine, praying for a synergistic effect. It worked. She slept,” Edwards says.

He and Robert held vigil at the bedside while Nelda tossed and turned, the rest of the family hovering in the kitchen. As the day wore on, she become increasingly still. What’s going on? Robert asked. Edwards said she would come around when the drugs wore off. But by 4pm, her breathing had become ragged. Robert put his hand over her mouth to check she was still moving air, a gesture that would bitingly rebound on him.

Leigh was shocked that Nelda’s dentures were hanging loose in her mouth, a sight their proud mother would have hated. Edwards realised something had happened – a heart attack, possibly stroke. The gaps in her breathing increased as the stop-start rhythm of Cheyne-Stokes respiratory failure took hold. Her rapid heartbeat, likely due to anaemia secondary to a pre-existing myelodysplasia or pre-leukaemia condition, faltered. Their mother was slipping away.

The brothers “of course” discussed taking her to hospital but agreed this was not what she would have wanted, he says. Nelda was groaning in pain. At that point, Edwards now recognises, another doctor should have been called to take over or, at the least, sanction what he was doing. Instead, “knowing death was approaching”, he gave her a single subcutaneous injection of morphine and midazolam, another sedative, again from the stock obtained for David.

He insists this was “terminal treatment”, what he would give any person near death. Nelda died at 8.30pm. “I straightened her body with rolled towels, supported her chin, dentures intact,” he says, describing the scene.

With family members sobbing around him, he rang an on-call GP. Given his mother’s age, health problems and refusal to eat or drink for more than a week, it was “an expected” outcome, Edwards related. Could a home visit be arranged to finalise the death certificate, as had happened with their father? The doctor demurred. No, the police had to be called.

Police investigation

When they arrived later that Friday night, Edwards took them through Glendon’s death and how this had triggered his parents. In his mother’s case, he suspected dehydration and subsequent renal failure as the immediate cause of death.

He failed, however, to mention his use of medication, concerned the police might get the wrong idea. “I felt sure I would be able to justify my actions face to face with anyone with medical knowledge of the dying process,” he says. “This was the humane way doctors treated the dying: do nothing to hasten the process but relieve suffering when able.”

On Monday, after he flew home to Jamie, his brother Leigh called to say the police had been back to search the Sandy Bay property. Well, he had nothing to hide. He had disposed of the left-over morphine properly, emptying ampoules and syrup down the sink and putting the broken glass in the rubbish, which the police had evidently gone through. There would probably be an inquest, but that shouldn’t be a problem. His parents’ treatment hadn’t been any different from what he had done for hundreds of dying patients at home or in aged care in NSW.

The report from Nelda’s post-mortem examination concluded the cause of death was mixed-drug toxicity, with significant contributing factors from her pre-existing medical conditions. These included atherosclerotic and hypertensive cardiovascular disease, senile cardiac amyloidosis, chronic haematoma, a history of falls and vascular dementia. The pathologist noted the level of morphine recorded in the eye fluid was 0.1mg/L, at the lower range of toxicity. The concentration of morphine in the blood came in higher, at 0.3mg/L. The case was complex and presented a number of possibilities with regard to the specific cause of death, the pathologist said, but the accumulated dose of medication could not be directly related to what killed Nelda.

“This was not the damning report that the prosecution wanted,” Edwards says. “There were too many wishy-washy areas to argue, many highlighted by the coroner himself. Lots of areas of doubt were clearly not useful to a robust case against me.”

Two months went by. He was planning to travel to France so he touched base with the office of the Tasmanian coroner on April 27, 2016. The “conciliatory” feedback was that the two-week trip was fine, but he should also check in with the police in Hobart.

Within 48 hours, four officers – a pair of Tasmanian detectives, flanked by NSW uniformed police – appeared at his door in Phegans Bay. Just a few questions to set the story straight, they told him, “all smiles”. Would he mind accompanying them to the local station?

Edwards was questioned for five hours as the detectives put to him their concern about seemingly hoarded prescription drugs and the pro-euthanasia literature found in his parents’ home. He was asked point blank whether he had helped his mother commit suicide.

“I scoffed at these ideas … they seemed happy to let me go,” he remembers.

Next morning, April 29, the police turned up again at the nursing home he was attending. This time, they were all business. He was driven to Sydney and told he would be extradited to Hobart, where he would be charged with Nelda’s murder and conspiracy to pervert the course of justice.

Robert was also charged with conspiracy to pervert the course of justice. The ordeal that would overtake Stephen Edwards’ life and drive a wedge through the family at the cost of his health, his relationship, medical career, reputation and just about everything else he valued had started.

Read part two in The Australian on Monday.