The concepts of dying well and a “good death” were once very popular. Everyone aimed to do this, and even expected it. It meant dying with dignity, with one’s loved ones around and at peace with the idea. Sadly this is often no longer a likely expectation.
Something has gone badly wrong. Medical science has extended our lives, and often improved their quality — but the end still comes, we may just take longer to get there. While medical miracles and improved technology can save us from the ravages of all sorts of illness and even death, we have not, as a society, kept up with the non-medical part of death and dying. In fact, there has been a creeping medicalisation of what really belongs in the largely personal worlds of ethics, morals, faith and philosophy.
As a person with metastatic cancer, and one who has worked on behalf of people affected by cancer for the past 11 years, I have watched and listened to the various arguments, trying to understand how we can arrive at an outcome which allows accommodation of all views; i.e. from those totally against assisted death choices to those who wish to face the end of their lives differently, with dignity and control. This accommodation must of course include safeguards against abuse — as achieved in other jurisdictions. It seems to me that we have succumbed to legislation which reflects the views of an influential few, and of those who fear that safeguards cannot be provide to protect the weak.
People who are facing the unrelenting and debilitating destruction of their quality of life should be able to make an informed decision about its continuance or not. They should be able to implement this decision by seeking expert assistance which is not prescribed by law as it presently is in our ethical backwater. Yes, we need a legislative change which reflects the needs and wishes of the many, yet respects the beliefs of those who do not agree. In this aspect the issue is quite similar to that of abortion — and most of the western world has come to accept its legalisation and the right of choice in one’s life.
As a civil society we expect people to make informed decisions all through life. We educate and encourage them to do this. We praise and commend patient autonomy in self management of illness and medical conditions, and indeed of our psychosocial state. But quite illogically, not at the end of life, when we are expected to submit to the preferences, religious beliefs and present legislation which negates all this, just when we need it most.
Did you know, that if you confide in a health professional employed by NSW Health, that you are thinking about taking control over the manner of your dying (ie away from the medical professions’ control), then he or she is legally required to refer you to a mental health team and a psychiatrist? The regulations reflect the view that anyone contemplating ending their own lives, for whatever reason, must be mentally unstable and in need of rescue by medication. How could we have arrived at such a situation, where one size is supposed to fit all? It feels like the nightmare worlds imagined by science fiction writers … How can the value of the individual’s self determination be so callously and inhumanely disregarded?
Because we have often handed the care of the dying to religious organisations, these beliefs may be implemented when we are least able to protest. There should be choice which includes a non-religious pathway open to all dying people who need care. A further consequence of religious management of palliative care is that medical specialists and care teams are expected to concur with the managers. This surely influences the training of palliative care specialists and teams.
The time has come when the personal or religious views of some, who are ideologically against any form of assisted death and who have held sway over the debate so far, should be recognised as just that — their view — and should definitely not be forced on those who do not have these beliefs. It strikes me that this is part of our basic freedoms. Every opinion poll since the 1980s has shown that a good majority of Australians want voluntary euthanasia legislation along the lines of the Netherlands and Oregon.
We know that our options for dying with dignity and control have been gradually reduced by the protective state. Many see this as an invasion of human rights. In Australia it has become impossible to access the “best” and most humane drugs — although we allow them for our four-footed friends. It is now almost illegal to think about ending your life in the manner you wish, let alone ask for assistance or advice from those competent and willing to provide the latter. Suicide is not illegal, but help is — does this really make sense?
Every year more western countries strive to unshackle themselves from the prejudices of previous generations. The list of successes includes the Netherlands, Switzerland, Belgium, Luxembourg, two American states — Oregon and Texas, and Albania. It was briefly legal in the Northem Territory. The Scottish Parliament will soon be considering the Proposed End of Life Choices (Scotland) Bill.
But for now we are supposed to feel more comfortable when the dying person loses autonomy, responsibility and respect, in order to satisfy the prejudices or fears of the few who have taken dignity and control from us. I for one, am dreading my dying days, but being an optimist and fully of sound mind, I remain hopeful that reason will prevail and the law will be changed so I can seek assistance when and if I need it. When that happens, the dread will vanish and I will approach my death with dignity and control.
Sally Crossing AM wrote this piece in advance of a public debate on euthanasia, to be held in Sydney on Feb 3
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This article encapsulates much that underpins the ‘Culture of death’. The Left-liberal case that elevates personal autonomy above all else exposing those incapable of exercising or expressing their autonomy to the caprice of power . How true that abortion reflects the same struggle. The most innocent and helpless have their lives taken from them by the very people charged with their security.
The author argues that those approaching the end of their lives cannot end their lives with dignity because they are prevented from having a doctor kill them. It is then suggested that this dooms them to needless suffering.
Two considerations highlight the fallacy cleverly disguised. To request a doctor to kill you is to request the same doctor to agree that your life is useless. The only person exercising real autonomy in such a contract is the doctor. So at the heart of the euthanasia case is the proposition that doctors be granted the right to decide whose life is valuable and whose life is useless. Ask the general community do they want the medical profession accorded such a power? And what of those who are voiceless? The brain injured, the dementure sufferers, the intellectually disabled, newborns? A right to die would quickly becomea duty to die. For if death is a benefit for those who request it, why would it not be a benefit for those incapable of framing such a request?
These considerations are well recognised by the culture of death enthusiasts and their minions but seldom voiced. Occasionally, in more candid moments, Nietchke has spoken about suicide pills for the depressed teenager, available at the supermarket. More recently we have seen a man murdered by two women, who had his will altered beforehand. Read the scathing comments of his daughter about these purveyors of death.
They would have the helpless murdered just a surely as the unborn and proclaim this as progress. The Left and all they represent are corrupt and vehicles for the worst of despotism.
The real problem here is a religious fundamentalist of all persuasions who believe they have the right to impose their views on others. This is combined with the gutlessness of politicians in general who respond to the concerted pressure from the godbotherers because the community at large, which has a reasonably strong view on this matter, is not represented in the debate.
Individuals should be free to make up their own minds when it is time to go. It is not the role of the state or busybodies to intervene in this process. Whilst it is the responsibility of the medical profession to assist people in need of medical advice, it is not appropriate to to force medical practitioners to prolong life unnecessarily, especially if this is contrary to the expresswishes of the person concerned.
This should not just apply to the aged and medically infirm, it should apply to any individual who desires to end his or her life with dignity. In Melbourne alone, more than 100 people a year commit suicide by jumping off a the West Gate Bridge or throwing themselves under trains on the metropolitan rail network. Road safety experts indicate that there is a similar number of apparent suicides involving single driver vehicle accidents each year.
As a mature society we should be able to ensure that people who wish to end to their lives, be able to do so with dignity after an appropriate medical and psychiatric assessment. I would be more comfortable with the mandatory reporting process, if at the end of the process, the psychiatrist and doctors could conclude that the patient has a rational desire to end his or her life, and could assist them accordingly.
Unfortunately, under a current legal systems, the professionals involved have a mandatory responsibility to deter the patient from a from undertaking or considering such steps. Those whose beliefs preclude such assistance can easily count themselves out of the relationship. Those who wish to assist should be allowed to do so.
I am a doctor who has worked in medical practice for over 34years.I fully support Sallys views.Unfortunately some of my colleagues in palliative medicine believe they can relieve all the sufferring of dying people and do not want terminally ill people to have the right to end their own lives when the patient choses.It is time all of us had the right to decide how much sufferring we are willing to endure at the end of our lives.It should not be up to doctors,priests or politicians to tell us how much sufferring we have to endure.It is one of the most shameful lies of modern medicine to tell dying patients that modern palliative medicine can relieve all their sufferring.Other countries, including the netherlands and US states,have passed legislation to legalise physician assisted suicide with strong safeguards and the evidence of many years of these laws has shown no signicant misuse of these laws.Public opinion studies have shown over 70%of Australians support the right of dying patients to be able to recieve medical assistence to end their own lives after they have been offerred all that palliative care can offer.When will Australian politicians listen to the majority of Australians and not be bullied by religious fanatics or others, no matter how well meaning,who oppose dying patients rights to decide for themselves how much sufferring they have to endure at the end of their lives.Remember we all have to die one day .Do you want the right to decide for yourself how much sufferring you are willing to endure at the end of your life?
I saw my mother die over a lengthy period, in hospital and a nursing home .She had dementia. In the end there was no one there that I had known and a woman who valued her privacy and dignity was wearing nappies for double incontinence, raving. swearing and throwing objects about. and begging my brother to take her into the carpark and run her over.
I,m not suggesting that at that point in her life euthanasia was appropriate because she certainly was incapable of making an informed decision..
However, for myself, if I have any inkling that my end is likely to be similar I will definitely be taking steps to have the right tools in place long before I reach that stage.
An excellent summing up of the current situation and why it is so ridiculous. I had no choice in the matter of being born – at least I should be able to make a rational decision as to when I might die. I understand that a majority of older persons in Australia who kill themselves “choose” to do so by hanging. A ghastly prospect. But then, one cannot readily access barbiturates, some would not own cars, and even if they did so, would not be confident of attaching a hose to the exhaust pipe etc.