Hundred of supporters of euthanasia from around the world flew into Melbourne for a Global Right To Die conference, held on October 8, 2010.
The theme of the conference, which is held every two years in different parts of the world, was “Dying with Dignity – bridging principles and practice”. It was supported by the World Federation of Right-to-Die Societies, Australian pro-euthanasia groups and the estate of the late Dr Clem Jones OA (the long-time lord mayor of Brisbane).
The opening address was due to have been given by Victorian Labor MP, Maxine Morand, who two years ago introduced Victoria’s controversial Abortion Law Reform Bill (enacted in October 2008). However, as she was unable to do so, her colleague Candy Broad, a Victorian upper house Labor MP, delivered the speech instead.
Ms Broad discussed the medical profession’s divided attitude towards euthanasia. When Victorian upper house Greens MP, Colleen Hartland, unsuccessfully moved to legalise euthanasia in her state in 2008, the Australian Medical Association (AMA) opposed her bill while the Australian Nursing Federation supported it.
Margaret Otlowski, a law professor from the University of Tasmania, claimed that the medical profession is supposedly increasingly resorting to covert forms of euthanasia, either by withdrawal of nutrition and hydration from a patient or by sedation which hastens death. She proposed that, rather than driving this practice underground, government should legalise it so as better to regulate it.
Dr Charles Douglas, senior lecturer in clinical ethics and health law at the University of Newcastle, questioned whether doctors were clear in their own minds what their intent was in prescribing drugs to relieve pain which would probably hasten death.
He quoted a survey of surgeons which revealed that most had practised “slow” euthanasia but were reluctant to do so in one hit with a “lethal bolus”. He conceded that deliberate killing by doctors was “problematic”, and suggested that these surgeons were perhaps not the sort of people who should be dealing with “end-of-life” situations.
Dr Roger Hunt, director of Adelaide’s Western Palliative Care Service, said that terminal sedation is “slow” euthanasia, and that, in his opinion, doctors are merely concerned with distancing the immediate connection between the treatment/sedation and death. This seemed to imply that doctors are concerned more with not being seen to kill rather than the best interests of the patient, and that their claim that their intention was to alleviate suffering, and that hastening death was incidental, is hypocritical.
In those few overseas jurisdictions where euthanasia is legal, often the doctor does not actually administer the lethal dose. In the American state of Oregon a doctor has to prescribe the lethal dose but does not have to administer it and in the majority of cases is not present at the death. In Belgium, according to the American Journal of Critical Care (September 2010), a large majority of nurses surveyed wanted to be involved in the patient’s decision-making process as “otherwise they would experience ‘moral distress’ at having to carry out someone else’s instructions”.
In Switzerland, patients practise “do-it-yourself” euthanasia.
Dr Hunt called the law “an ass” after he described how he administered a “lethal bolus” to retired politician Gordon Bruce, who was suffering from motor neurone disease. Dr Hunt has not been charged with any offence.
Professor Otlowski spoke of the “connivance” of Australia’s legal authorities in doctors’ widespread flouting of the law. She said that the euthanasia lobby’s strategy should be to get whatever is legislatively possible at present. She said, “For Australia, perhaps the most feasible approach, at least for the time being, is to adopt the Oregon approach.” Implicit in her statement was the intention to extend the operation of the law when the time is right.
Neil Francis, president and CEO of Dying With Dignity Victoria (DWDV), visited Oregon in 2008 and produced a DVD, extolling the virtues of the euthanasia laws there. He was accompanied on his trip by Ken Smith, Liberal MP for the Victorian state seat of Bass, who has declared his intention to introduce a private member’s bill to legalise euthanasia if he is re-elected in November.
Neil Francis, in his DVD, looks to Oregon’s euthanasia legislation as a model for Australia to emulate: it allows patients to make their own decisions about end-of-life care, and supposedly has sufficient safeguards.
However, the reality in Oregon is that although the doctor is supposed to make a report on each death, there are no penalties if he doesn’t. Furthermore, as the doctor is usually not present at the death, he has to rely for his report on the evidence of those present. Such a system is wide open to abuse.
One of the conference delegates was Rev. Dr Francis MacNab, a psychologist and currently executive minister of St Michael’s Uniting Church, Melbourne. He admonished churches for not being entirely convinced of the benefits of euthanasia. He called for the legalisation of euthanasia in order to deprive churches, doctors and government of the power to curtail a person’s autonomy in choosing how to die.
The most disturbing information was about the corruption of palliative care by integrating euthanasia as one of the “treatments” or measures available. This is well under way in Belgium where physician-assisted death is an integral part of palliative care.
Terri M. Kelleher is a research officer for the Australian Family Association.