Voluntary Assisted Suicide legislation in NSW: politics vs human rights

During the current term of the NSW state government, the Greens plan to introduce the Rights of the Terminally Ill Bill, which, if passed, would legalise voluntary assisted suicide (VAS) in NSW.

This legislation is only for sound-minded people with an intolerable terminal illness, who request to be allowed to die, rather than suffer indignity and pain before inevitable death. This legislation allows them to take a prescribed lethal sedative, ideally at home with the support of family, and hence to die peacefully.

To commit VAS one must actively seek it out, request it both orally and in writing and fulfill a list of safeguards with assessment by at least two independent medical practitioners. For those opposed to VAS for whatever reason, or those who are just disinterested, undecided or fearful, then this law will have no relevance and won’t change their life or death in any way. For them, it will be no different from the current situation.

People diagnosed with a terminal illness, especially unpredictable cancer, frequently fear how they will die, and having control of the time and manner of their death, if the worst happens, brings tremendous peace of mind. Even the best palliative care cannot ease all suffering in a small percentage of the terminally ill, which means that it is an inescapable fact that some unfortunate Australians have suffered terribly and will continue tosuffer unnecessarily, until the law is changed.

Here are some examples of Australians whose suffering should have been relieved:

• Before Angelique Flowers, 31, died of bowel cancer, she was terrified of possible bowel obstruction causing faecal vomiting, or bowel perforation with excruciating pain. Her dying days were spent desperately and secretively searching the internet for an alternative way out, resulting in isolation from her family just when she needed them most. She felt cheated of a good death as well as a good life.
• An elderly NSW Central coast lady with wasting disease was bedridden and entirely dependent on her lifelong partner for everything. Despite excellent care she was in continuous pain, fully aware and begged to die. Together the couple accumulated sedatives, whereupon he suffocated her with a pillow, made a final visit to his children overseas, then returned and confessed to the police, who had no option but to charge him with murder.
• A middle-aged man, paralysed with neuromuscular dystrophy, was fully aware whilst on life support, communicating only through facial movements. At the mention of his home, family and pets, his eyes welled up with tears. Despite repeatedly indicating that he wanted to die, it took eleven weeks, spent staring at the ceiling, before he died of pneumonia.
• Klaus, in his 60s, had a huge inoperable pelvic cancer affecting his bowel, bladder and spine and breaking through his skin. He was lucid, terrified and, despite specialist palliative care, pain could not be alleviated. Even when he was unable to speak, his pain was evident by his sweating, grimacing, fast pulse and rapid breathing. The 3 month dying process culminated in an agonizing death, witnessed by his distraught family.

These examples fit into a small group of fully aware patients whose deaths involve severe suffering. The frequency of such awful deaths in our community can be estimated from statistics compiled in Oregon, USA, where Voluntary Assisted Suicide has been legal since 1997, and whose law has very similar content and safeguards to that proposed by the Greens. In Oregon in 2011, VAS accounted for 1 in every 420 of their total deaths. Using this incidence and considering the larger population, NSW could expect around 120 VAS deaths annually.

On twelve occasions euthanasia legislation has been introduced to various state and territory parliaments in Australia but only once successfully, in the NT in 1995. This was largely due to NT Chief Minister Marshall Perron’s political skill and strategy, to properly inform colleagues and the media, and preempt scaremongering opponents. Even then, persons unknown told aboriginal elders that the new legislation would permit doctors to round up and kill sick aboriginals.

To this day, the euthanasia debate is mired in misinformation, aiming to create fear and uncertainty. Arguments such as the ‘slippery slope’ and ‘honey pot’ theories are often raised, despite the lack of any scientific evidence. It is claimed that legal VAS would make the weak and vulnerable feel pressured to end their lives, despite the fact that suicide is already legal and that informing, listening to and respecting the elderly serves to empower not weaken. It is a shameful fact that when the desperate elderly do resort to suicide, the commonest method chosen is hanging. In Oregon, after legalizing VAS, the incidence of violent suicide dropped by a highly statistically significant extent, having a 98% certainty that it did not occur by chance.

In NSW, 87% of citizens are in favour of VAS whilst 3% don’t know, leaving 10% opposed. This opposition includes a disproportionately influential conservative minority, led by the Catholic Church. According to former Federal Senator Peter Baume, any politician who condones VAS risks ostracising the 8% of society who attend church regularly and heed church policy. Ironically a two-thirds majority of NSW citizens who consider themselves Christians favour VAS, adding an element of farce not unlike the issue of contraception and Catholicism. No amount of science or suffering will change the Church’s faith-based viewpoint.

The attitude of the Australian Medical Association (AMA) is harder to understand. Despite the Royal Colleges of GPs, Physicians, Surgeons, Psychiatrists and Palliative Care Australia all taking neutral positions on Voluntary Euthanasia, the AMA remains opposed, against the wishes of a majority of AMA members. Current AMA policy has a blind spot for patients whom palliative care fails, offering them neither the choice to control their death nor effective management of their suffering. When medicine has nothing more to offer patients, the issue becomes more ethical than medical, and the AMA should not condemn patients’ choices.

The essence of a free, liberal society is respect and tolerance of alternative viewpoints, provided these are ethical and reasonable. The church has every right to advise its followers but no right to impose its values on 87% of NSW. The Greens’ proposed legislation will respect the rights of VAS supporters whilst not affecting the lives or deaths of VAS opponents in any proven way.

Take any random group of 93 NSW citizens. The chances of a majority, that is 47, out of this group falling into the 10% of NSW citizens who oppose VAS, is less than 1 in a million. So when the 93 members of the NSW Legislative Assembly vote on VAS legalization, if they truly represent their electorates, there can only be one outcome. An overwhelming majority of the people of NSW now need state politicians with the courage of their conviction. This is a human rights issue. Do you want control of your own life and death?

Finally, Senator Ginny Burdick, who has been an Oregon Senator for almost the exact period of time that Oregon has had legal VAS, gives a succinct appraisal of how Oregon’s Death With Dignity Law has fared:

“The law has worked beautifully. The scare stories were just that: scare stories based on nothing. None of the terrible things that opponents predicted has ever come to pass.”