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Euthanasia: Legalised Patient Killing Pushed Again and Again

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The push to legalise euthanasia is never ending, and Victoria is one of a number of Australian states hard at it. Just the other day the Ministerial Advisory Panel on Voluntary Assisted Dying released its final report on the issue. The 257-page document can be found here: www2.health.vic.gov.au/about/health-strategies/voluntary-assisted-dying-bill

Of course this is not a bill, but the material from which a government bill can be drafted. A quick look at the final report is a real cause for concern. There are 66 recommendations found there, and the entire report is supportive of legalised euthanasia.

So we await what the Andrews’ government will actually do with all this. But we already know that the Andrews’ government has given its full backing to the report, saying it accepts all 66 recommendations, and a bill will be introduced sometime this year.

Both the media and Andrews have talked about all the supposed safeguards that will be in place. Andrews said, “This will be the safest scheme in the world, with the most rigorous checks and balances.” Um, where have we heard all this before?

Every time a new euthanasia bill is introduced we are told there will be no slippery slope, there will be no abuse of the provisions, and everything will be just fine. But as I have carefully documented in my recent book, whenever we legalise euthanasia we find the supposed safeguards have not done any good, and a real slippery slope indeed occurs.

As I state in The Challenge of Euthanasia:

For all the talk about “safeguards”, there certainly can be no really effective safeguards in legalised euthanasia. Countries which have legalised euthanasia speak much about stringent conditions and strict safeguards, but the reality is quite different than the rhetoric. These folks have always insisted that this would just be available for hard cases of terminal illness and incurable suffering of the elderly and dying. It would be well regulated and it would not spread to other sections of the populace they insisted. All this has been shown to be utterly false.

And I offer plenty of horror stories from Holland, Belgium, Canada and other places which have already gone down the path of legalised euthanasia. It is frightening stuff indeed. Yet those pushing for this will never inform you of these slippery slopes in action, and of all the breakdowns of the safeguards.

Already there have been three great responses to this report from those who know the dangers of seeking to legalise patient killing. Let me quote from all three. Paul Russell of Hope said that the report is “a sugar-coated bitter pill”. He explains:

Dr Owler told The Guardian that, the panel’s final report outlined 66 recommendations and safeguards, and that the model was “the most conservative model for voluntary assisted dying in the world”.

I guess it just wouldn’t have been the same to claim that the model was, perhaps, the “second best” or, maybe “in the top ten”. But to call legislation that allows a doctor to kill a patient or to help them to suicide “conservative” really is a bit much. Will it mean that fewer people will die than in, say, Belgium or Canada?

Various reports have numbered 66 and 68 safeguards and I guess that might simply come down to a definition of what actually constitutes a safeguard. One suggestion is that, in terms of assisted suicide, the dispensed medication would need to be kept in a locked tin. But whether that’s safe or not would likely depend on who held the key.

But it does raise the question: how many safeguards are needed to make such a law safe? We’re not talking safer; which the “conservative” comment tends to allude to, but safe. No possible problems; no adverse outcomes; no one made dead who did not really want to be or who was not as ill as expected; no one suffering suicidal depression at any point in the process, no bracket creep etc. In other words, totally safe.
There are always winners and there are always losers in any legislation. But this is not like any other type of law. The finality and tragedy of “unsafe” law cannot be dismissed. The law must be totally safe. The reality is that there’s no safe way to kill people or to help them to their suicide. It simply can’t be done.

He continues:

Throughout the Panel’s report, as in most of the pro-assisted suicide banter, what stands out the most for me is the total absence of any understanding of the human person and what it is like to be given a bad diagnosis or prognosis. It’s a rollercoaster. Life is turned upside down, shaken hard and returned with a thud to the compounding reality that life for the person and their family will never be the same again. Conversations change. There are no right answers to the difficult questions about treatment options and whether or not to fight to the last or to simply let nature take its course.

As British comedian and disability activist Liz Carr told the Victorian Parliament earlier this year, she simply doesn’t want this option because, “I’m afraid I might use it.” Life tells us not to make important decisions under pressure or stress; but when is that a reality for someone who is facing their death?

Even under the tick of all of the qualifications and all of the processes, there will still be people who choose to suicide at a darker moment that, absent the option, might be a little brighter the next day. There is no safe way to do this and no way of protecting vulnerable people – and that could mean any one of us.

Rachel Carling-Jenkins has also written about this report. She said:

The question of whether there should be a law in Victoria that allows people to commit suicide with medical support or to die by euthanasia was never really dealt with by the committee in any detail. Certainly, the report itemised the case for and against, but it never discussed the pros and cons nor did it grapple with the inherent risks nor the moral and ethical concerns. (Think: if we need to talk about ‘safeguards’, then there’s something inherently ‘unsafe’ about the practice)

If this were an environmental impact statement for a large urban development no government would proceed based on such a flimsy and inconclusive presentation. Yet when talking about a literal ‘life and death’ issue, Premier Andrews and his Health Minister seem driven more by ideology than common sense. This is reckless, dangerous and ill-conceived.

My colleague, Daniel Mulino MLC tabled a dissenting report last year that looked at all of the literature and all of the practice of euthanasia and assisted suicide in the few jurisdictions where it is legal. His work raised significant doubts about the ability of any law to protect vulnerable people or to contain the target cohort. Even a cursory glance at Mulino’s work would cast serious doubt about the glib assertions of the likes of Andrew Denton.

Victorians are being sold a dud. The use of euphemisms such as ‘assisted dying’ to describe medical aid to suicide feeds on our sense of compassion but it leads us down a blind alley. It encourages us to accept that, because it sounds compassionate, it somehow follows that the intention is benign. We’re told that there are people driven to suicide by their medical conditions, but all the government is offering as an alternative is, well, suicide. How is that compassionate? Surely we can do better than that!

And above all of this we have behaviour by the likes of Denton and his cohort that reminds me more of the wild-west snake oil salesman than it does of anything else. Theirs is a simple proposition: create fear in people’s minds that some of us will die in significant pain and then offer them a deceptively simple solution – assisted suicide.

Finally, Richard Egan put it this way:

In Oregon the primary reasons for requesting assisted suicide include loss of autonomy, loss of control of bodily functions such as incontinence and a loss of ability to participate in enjoyable activities. In Oregon last year nearly half (48.87%) of those who died after taking a lethal dose prescribed under the law were reported as being concerned that they had become or would become a “Burden on family, friends/caregivers”. Such concerns as being a burden on the family or fear of incontinence are likely to be accepted as types of “unbearable suffering” under the proposed bill.

If the bill follows the Oregon model it is likely to allow lethal doses of drugs to be stored in the home so they can be taken at any time the person chooses. It should be noted that in 2016 in just over one in five cases (20.6%) was any healthcare provider known to be present at the time of ingestion. In all the other cases there is no independent evidence that the person took the lethal medication voluntarily. It may have been administered to them by a family member or other person under coercion – subtle or violent – or secretly in food or drink. We simply don’t know.

This fact alone makes claims by Denton and by Victorian MPs who visited Oregon that everything there is peachy simply baseless. There is not sufficient evidence to make such a judgement.

Any bill for assisted suicide and/or direct killing is a recipe for elder abuse by heirs impatient for an inheritance. It reinforces despair of life as an appropriate response for those members of the community dealing with the challenges of disability, ageing or illness.
Governments should be focusing on ensuring access to gold standard palliative care for all members of the community including those with motor neurone disease at the end of life, and suicide prevention for all regardless of age, disability or illness.

Yes that is always the way we should proceed here. Offering real help to the sufferer, instead of killing the sufferer, is the way civilised societies deal with such situations. Melbourne ethicist and professor Nicholas Tonti-Filippini passed away in 2014 at the age of 58, after living for nearly four decades with chronic auto-immune disease.

I had the great honour to know the man and work with him on occasion. His words deserve a wide hearing:

I am dealing with my own terminal illness (combination of renal failure, advanced ischaemic heart disease and Rheumatoid auto-immune disease) and am dependent on haemodialysis and palliative care. I have undergone 15 angioplasty procedures and the placement of eight stents to attempt to recover some blood flow after the failure of coronary bypass surgery. The last such procedure was unsuccessful as the blocked artery could not be accessed.

The Rheumatoid disease causes chronic pleuropericarditis. I mention these matters only to establish that I am no stranger to suffering and disability, and am well aware of the limitations of palliative care. It is particularly difficult to control chronic pain because the effectiveness of most forms of pain relief is of limited duration, given the development of therapeutic tolerance. I have reached the limits of what palliative care can offer.

I cannot speak for all people who suffer from illness and disability, but think I can speak more credibly about suffering, illness and disability than those people who advocate for euthanasia presenting an ideological view of suffering and disability. Facing illness and disability takes courage and we do not need those euthanasia advocates to tell us that we are so lacking dignity and have such a poor quality of life that our lives are not worth living.



 

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