Sitting on the fence is not a preferred option of mine. Set aside the cliché about the potential for splinters in a sensitive area of the body, it means that you don’t really have a view. In fairness, we can’t know about everything so there are times when one will not have an opinion. But this is not so much sitting on the fence as accepting that you can’t have an opinion on something you don’t know anything about.
The Euthanasia legislation passed in the Victorian lower house last week has, not surprisingly ignited passion on both sides and split those normally on the same side of politics. Former Prime Minister Paul Keating came out strongly against the legislation whilst his former numbers man Graham Richardson was supportive. Richardson has had major health issues and told Sky News viewers how he considers that he is a burden to his family and one day will want to control the time and nature of his death. Keating pointed out that the legislation changed the nature of society as it gave licence to end life.
The Federal AMA President took a strong opposing stance whilst other sections of the medical profession have been in favour. The law allows for adults over 18 who have a progressive advanced terminal illness with under 12 months to live and who are of sound mind and have suffering deemed intolerable can apply. The individual must make three clear requests. They must be assessed by two doctors. Those approved will be granted a permit to self-administer a lethal injection. A doctor will only be able to administer the injection if the patient physically cannot and otherwise need not be in attendance. Approvals will be granted by the Victorian Health Department and overseen by an independent panel.
Opponents claim that this is a slippery slope. Real world experience in other jurisdictions suggest that this is not the case.
Personally, I have sympathy with both sides.
Yet there are immediately problems with the legislation. There is no reliable way of predicting who may die in the next 12 months. Some people given weeks to live tell the story 25 years later. Others given the all clear can die suddenly. The concept of “intolerable” suffering is a good one but also lacks any objective measure. People have differing levels of tolerance to discomfort and differing response to palliative treatment.
It is claimed that if people had access to adequate palliative care that they would not seek to end their lives. In many instances that will be the case. The problem though is often, not access to palliative care but that palliation is not always as effective as its proponent’s claim. And it is not a shortage of money. It is that not everyone responds to pain relief and nausea medications. And then in the case of Graham Richardson there is the issue of future incapacity and not being able to feed, bathe, toilet or clothe himself.
Once again it is claimed, rightly, that life is valuable and those who see themselves as a “burden” should not feel that way. In reality, they do and it is their love for family and friends which drives their desire not to be.
My late mother never wanted to die in hospital attached to tubes. She died peacefully in her sleep at age 89 with her cat curled up next to her. She suffered little although her level of function deteriorated sharply in her last few weeks.
Those who have witnessed suffering of loved ones are often strong supporters of assisted suicide and euthanasia. It has been observed often that we put loved pets down rather than watch them suffer but that humans are allowed to suffer. The counter argument is that of better palliative care.
It is also a critical point that ending your own life is different to someone else doing it, even if that is your wish. And we also know that around 3000 Australians commit suicide each year and this figure has not been affected by billions being pumped into mental health services.
Ultimately, we will all die one day. This is not avoidable. The circumstances can be influenced to a certain degree at present. This new legislation allows for a certain group of individuals to determine the time and circumstances of their death. This is what is challenging to many.
So, can I get off the fence? I am in agreement that those who are suffering and have little prospect of recovery and who are not responding to palliative care should have the right to end their suffering. If that shortens their stay on this mortal coil by a few months I struggle to see how that is anyone’s business other than the individual. However, I do not know whether this legislation is the right approach, notwithstanding that on the surface it seems to have numerous safeguards. And whether those with significant assets may be “influenced” by those waiting for inheritance.
Decisions will all be subjective. This is unavoidable. Might “mistakes” be made? Absolutely. Is this something that society can accept? Polls suggest overwhelming public support for this type of legislation. The more that the individual rather than the state has control over their own destiny, the better.
Paul Keating observed that this legislation will change society. As to whether that is for the better or worse I remain on the fence, for now.
Medical Doctor, author, speaker, media presenter and health industry consultant, Dr Joe Kosterich wants you to be healthy and get the most out of life.
Joe writes for numerous medical and mainstream publications, is clinical editor at Medical Forum Magazine, and is also a regular on radio and television.
Joe is Medical Advisor to Medicinal Cannabis Company Little Green Pharma, Chairman of Australian Tobacco Harm Reduction Association and sits on the board of Arthritis and Osteoporosis WA. He is often called to give opinions in medico legal cases.