Here’s the submission I made to the relevant committee of the Senate of the Australian Parliament regarding Senator Richard Di Natale’s private member’s Exposure draft of the Medical Services (Dying with Dignity) Bill 2014.
I have read the Exposure draft of the ‘Dying with Dignity’ Bill.
I would oppose its passing into law in Australia.
I write as a Christian minister, to reinforce my opposition, and that of many other Christians, to euthanasia and to physician-assisted suicide.
It is important to remember that with euthanasia, we are not talking about refusing burdensome and futile treatment, nor the administration of appropriate drugs for pain management, such as morphine. Both of those steps are legal and ethical.
Euthanasia refers to the deliberate administration of a drug, intending to cause the death of someone who is suffering. The stark reality is that it is a doctor killing a patient! (Or enabling that patient to kill him or herself).
I note carefully the safeguards in the exposure draft. Specifically, I am still concerned that the ‘second medical practitioner’ and the ‘third medical practitioner’ [§12 (d) & (e), respectively] have quite limited roles in the process. In addition, the description of the second medical practitioner as one who “holds qualifications or experience in the treatment of the terminal illness” [my emphasis] is far too vague.
Notwithstanding safeguards, the permission of any physician-assisted suicide will
- fundamentally change the doctor-patient relationship;
- begin to normalise euthanasia as an acceptable option; and
- inevitably lead to demands to widen its availability.
The potential for abuse is horrific. The evidence from places like the Netherlands is of a ‘slippery-slope’, with categories widening beyond the terminally ill, even to those who do not consent, to the mentally ill, to minors, and to disabled infants.
Legalizing euthanasia also introduces the potential for subtle but inappropriate pressures to be brought to bear on vulnerable persons, by relatives or an overburdened and underfunded hospital system.
By contrast, the medical evidence is that advances in palliative care have improved the symptom control of patients at the end of life, and where expertly used, suffering is minimal. I urge legislators to put their efforts into funding the improved provision of palliative care.
What follows is a selection of writing from a variety of angles expressing the concern.
Archbishop of Canterbury, Justin Welby, in The Times on the UK ‘Assisted Dying Bill’:
[…] It would be very naive to think that many of the elderly people who are abused and neglected each year, as well as many severely disabled individuals, would not be put under pressure to end their lives if assisted suicide were permitted by law.
It would be equally naive to believe, as the Assisted Dying Bill suggests, that such pressure could be recognised in every instance by doctors given the task of assessing requests for assisted suicide. Abuse, coercion and intimidation can be slow instruments in the hands of the unscrupulous, creating pressure on vulnerable people who are encouraged to “do the decent thing”. Even where such pressure is not overt, the very presence of a law that permits assisted suicide on the terms proposed by Lord Falconer of Thoroton is bound to lead to sensitive individuals feeling that they ought to stop “being a burden to others”. What sort of society would we be creating if we were to allow this sword of Damocles to hang over the head of every vulnerable, terminally ill person in the country? […]
Dr Theo Boer, Professor of Ethics, Protestant Theological University, Groningen, and member 9 years of a Regional Review Committee assessing euthanasia cases for the Dutch Government, supported their euthanasia law, but now thinks he was wrong:
[…] In 2007 I wrote that ‘there doesn’t need to be a slippery slope when it comes to euthanasia. A good euthanasia law, in combination with the euthanasia review procedure, provides the warrants for a stable and relatively low number of euthanasia.’ Most of my colleagues drew the same conclusion.
But we were wrong – terribly wrong, in fact. In hindsight, the stabilization in the numbers was just a temporary pause. Beginning in 2008, the numbers of these deaths show an increase of 15% annually, year after year. […]
Other developments include a shift in the type of patients who receive these treatments. Whereas in the first years after 2002 hardly any patients with psychiatric illnesses or dementia appear in reports, these numbers are now sharply on the rise. Cases have been reported in which a large part of the suffering of those given euthanasia or assisted suicide consisted in being aged, lonely or bereaved. Some of these patients could have lived for years or decades.
Dr Peter Saul, Senior Specialist in Intensive Care and Head of Clinical Unit in Ethics and Health Law at University of Newcastle, asks “Do people really have the right to a rational suicide?”, pointing out that the ‘right to die’ is not listed in the UN’s Universal Declaration of Human Rights:
[…] Nowadays, the law prohibits suicide in more specific settings, guided by a US case that suggested, among other things, that “protection of the interests of innocent third parties” and “maintaining the integrity of the medical profession” could weigh against self-determination.
Philosophers vigorously disagree, but most continue to see contemporary reasons to question rational suicide, some arguing that the idea is nonsensical, while others argue that intervention to prevent suicide is warranted in any case, as an assessment of rationality is difficult to make.
[…] Rational suicide may exist, but is as sad as that driven by mental illness. It deserves our attention and our compassion, but not our complicity.
Dr Giles Fraser, former Canon Chancellor of St Paul’s Cathedral London, a liberal theologian, writes that he has “no absolute religious objection to assisted dying”:
[…] But I do have a serious anxiety that we hugely underestimate the emotional complexity of giving patients this choice. For what it says to many people who are dying (and because of that, often exhausted and confused) is that it is now within their power to relieve the emotional distress of those who surround them. It presents the dying with the option of giving their loved ones the gift of their simple swift end. And thus it opens up an emotional minefield of second-guessing and lonely choices.
[…] When the moral history of the 21st century comes to be written, I predict we will look back with horror at how the word choice became a sort of cuckoo in the nest, driving out all other values. This week, in an editorial, the BMJ decided that patient choice now trumps the Hippocratic oath. The moral language of the supermarket has become the only moral currency that is accepted. Which is why, for me, assisted dying is the final triumph of market capitalism: we have become consumers in everything, even when it comes to life and death. And as history demonstrates, the losers in this equation are always going to be the most vulnerable.
Legalising euthanasia or assisted suicide privileges individual choice in a way that threatens protection of the rights of the weak and often defenceless. As Christians, we believe God who has a special concern for the vulnerable and so we want our society to protect them. I oppose this draft legislation.
Canon A. R. (Sandy) Grant
St Michael’s Anglican Cathedral, Wollongong
21 August 2014