A desperate plea is answered

Victoria’s move to help the terminally ill die is a welcome relief for the suffering.

ANDREW DENTON

News that the Andrews government will back the introduction of as­sisted dying legislation is good public health policy, long sought after by a clear majority of Victorians.

It comes off the back of a 10-month cross-party parliament­ary inquiry into end-of-life choices, which put forward undeniable evi­dence of suffering in our com­munity because of existing laws.

It found repeated examples, for those with a serious and incurable condition, of inadequate pain relief and of deep suffering beyond even the reach of palliative care.

It found doctors breaking the law and relatives risking being put on trial to relieve the torment of their patients and loved ones. And it tabled the testimony of Coroner John Olio, who detailed the horrific ways in which desperately ill Vic­torians are taking their own lives to end their agony.

This included the case of a 90-year-old man with cancer who killed himself in a particularly horrific way.

The coroner estimated the number of elderly Victorians taking their own lives to escape the rav­ages of incurable diseases at one a week. Faced with such evidence, the inquiry found a clear case for law reform.

Its recommendation was that voluntary assisted dying, with strong safeguards, be introduced as another option at the end of life. The law they proposed, and that the government will now consider, is conservative, offering relief from suffering to those who are in the “last weeks and months” of an in­curable illness.

They will have to be at a point, agreed by two doctors, where med­ically speaking there is no more hope. At that time they can be writ­ten a prescription for a lethal drink that they can choose to take — or not. Overseas experience shows that more than a third of patients choose not to; simply having the means to control the end being powerful palliation in itself.

Based on recent experience in South Australia, where similar le­gislation failed by just one vote to pass the lower house, politicians will be lobbied by church groups and conservative elements of the medical community. The key argu­ments they will hear are likely to be:

1. That assisted dying is “state-sanctioned killing”. This phrase will be hammered again and again, and it will dishonestly avoid the central fact that the law is to help those already being killed by an in­curable disease. Being voluntary, it is entirely up to the patient whether they choose to end the suf­fering caused by that disease.

2. The slippery slope. That pass­ing a conservative law will inevi­tably lead to wider ones over time. This argument says yes, we know that real people in our community are dying in agony or suiciding to avoid it, but we refuse to do any­thing about it for fear that, some­where in the future, a parliament may decide to help hypothetical other people.

It is also contradicted by North American laws, on which the com­mittee have largely modelled theirs, that have been unchanged since their introduction 20 years ago.

3. That more resources for palli­ative care will solve all suffering at the end of life. While the inquiry, quite rightly, recommends greater resourcing for palliative care, it is clear that this alone won’t fix the problem. In Palliative Care Australia’s own words, “even with optimal care we cannot relieve all pain and suffering”. Their statistics, collected every year from 106 palliative care units around Aus­tralia, prove it. The Victorian in­quiry found the same.

This is not a criticism. Australia has one of the best palliative care systems in the world. It simply re­flects the reality of modern medi­cine, which can keep us alive longer but can’t always treat what comes with that.

4. That granny will be coerced into ending her life so the family can get the inheritance. This has been tracked closely in jurisdic­tions overseas. Independent au­thorities there have found no evidence that it has occurred. The safeguards written into the legisla­tion have been proven to protect the vulnerable. Only those dying of an incurable illness can access this law. It is very hard for a greedy relative to coerce granny into an illness she doesn’t have. Even harder to coerce two doctors, whose work will be reviewed, to agree with her.

5. Do no harm. The AMA, which represents less than a third of Aus­tralia’s doctors, cites this as its guiding principle in opposing these laws. Other doctors see leaving a dying patient to suffer as the oppo­site of “do no harm”. Both are en­titled to their ethics. The question is, should one set of ethics be im­posed on everyone?

The answer, of course, lies in the proposed law, which is voluntary for doctors and nurses as much as for patients.

In giving evidence of elderly Vic­torians taking their own lives, Cor­oner Olle said of the families left to pick up the pieces: “They know this person is screaming for help, but no one is going to answer the call, not in this society.”

Victoria now has a chance to be the society that does.

Andrew Denton is a television personality and campaigner for legalising assisted dying.

From: http://www.smh.com.au/comment/euthanasia-move-is-conservative-but-correc...