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Federal

May 17, 2016

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A report from a Victorian parliamentary committee is expected to recommend legislative changes that would permit assisted dying. The stage for such change has already been set through a series of recent media articles and public events.

Earlier this year, The Age reported the case of 55-year-old Anthony Virgona, who died after declining to undertake the regular dialysis treatment that had been keeping him alive. After 20 years of living with multiple sclerosis, 12 years of residential care, and three years of kidney disease, he’d had enough. Before his death, he told The Age that he believed that patients like him should be able to “make a choice to go peacefully” by taking a pill, rather than by waiting to die from renal failure after the withdrawal of treatment.

Of course, he was not alone in this belief. Earlier this year, The Age ran a lengthy story about octogenarian Peter and Patricia Shaw’s double suicide, undertaken in order to avoid what they considered to be the unbearable humiliations of old age. And late last year, broadcaster Andrew Denton embarked on a campaign in favour of legalised euthanasia in a series of events including a public lecture, podcasts and an episode of Q&A.

Both Denton’s op-eds and the report about the Shaws’ suicides have been widely circulated on social media, where they received a sympathetic response from many who fulminated about right-wing religious politicians refusing to allow patients to choose the time and manner of their deaths. And it’s an issue that is gaining momentum. The legalisation of euthanasia is Greens policy and is widely supported by many who would consider themselves to be broadly left-wing and/or feminist. Yet I would argue that this constituency ought to be very wary of the attitudes and assumptions underlying legalised euthanasia.

I did not give the issue of euthanasia any serious consideration until after my diagnosis of multiple sclerosis. Like so many others, I considered that opposition to euthanasia was a cause for right-wing social conservatives, not for leftie feminists like me. However, as the disease becomes more active, I began to see the ways in which the campaign to legalise euthanasia devalues the lives of people living with a disability and/or chronic disease.

Those who support the legalisation of euthanasia stress that it would be voluntary and that since they would not impose their beliefs about euthanasia upon me, I am not entitled to impose my beliefs upon them. However, this claim is based on an extremely reductive understanding of the context in which such decisions would be made: we are not all equal players in the healthcare market. Euthanasia advocates loudly proclaim their commitment to maintaining their independence, even at the expense of their lives.

But “independence” of the type under discussion is perhaps better described as privilege. For Andrew Denton, the fear that legalised euthanasia would undermine the welfare of people living with a disability is a cynical red herring. It would be “voluntary”, after all; disabled people need not fear that we would be coerced into taking our lives. However, this reads to me like a wilful misunderstanding of our concerns. I wish with all my heart that the late, great, disability activist and euthanasia opponent Stella Young were still here to give him the good hard kick up the arse that he so royally deserves for his patronising exclusion of disabled voices.

I have no trouble envisioning scenarios in which I might prefer death to another round of excruciating physical pain. I support the right of patients to refuse treatment (especially in cases where the treatment is more painful than the disease that it is supposed to treat), as well as their (our) right to be provided with sufficient medication to relieve pain, even when it might shorten their/our lives. But these measures occupy an entirely different moral space to euthanasia. Those of us who live close to the margins know how often the choices provided to us are nothing more than Hobson’s choice.

Studies have found that support for euthanasia is significantly lower among African-Americans than among the general population. Some analysts speculate that this is due to higher levels of religiosity, and this may well play a role. But in a society that is still coming to terms with the idea that “Black Lives Matter”, it is not paranoid for African-Americans to be concerned about the implications of medically assisted suicide. The Victorian parliamentary inquiry has not had the time or the resources to adequately assess the impact of legalised euthanasia upon the most vulnerable members of Australian society.

I would like to have met Anthony Virgona. Although it is important to emphasise that multiple sclerosis has taken a far less serious toll on me that it did on him, some aspects of his online journal are hauntingly familiar. The journal is clumsily written, but it is also lively and engaging. In its early stages, he says he wants it to provide hope to other people coming to terms with a diagnosis of multiple sclerosis. He also chronicles episodes of suicidal depression in the early stages of the disease, during which medical staff did not leave him unsupervised for fear that he might “do something silly”.

Some euthanasia advocates (most obviously Philip Nitschke) believe that patients like Virgona ought to be provided with the means to “do something silly”, even at that early stage of the disease. Others, of course, believe that euthanasia should only be an option when death is already imminent. Virgona himself got through those early suicidal periods to become an advocate and mentor for other patients living with multiple sclerosis. For me, his life ended as and when it should have done — when the only means of prolonging it would have been to force him to continue an intrusive and grueling treatment against his will.

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25 comments

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25 thoughts on “Why I don’t support euthanasia (and you shouldn’t either)

  1. pertina1

    Dr Hussein can decide for herself how to depart this life and I respect her decision. It is a pity she doesn’t extend to me the same respect for my contrary views.

    1. Barry Reynolds

      Pertina1 I agree 100%, my body, my life and my choice

  2. Desmond Graham

    Agree with Shakira’s sentiments – the actual euthanasia few years ago that was publicised to take place and did eventuate was for a cancer patient. The forensic physician noted that, at the time of committing the suicide [euthanasia], the person did not have cancer as it had been cured and the doctor of death advising did not know she didn’t have cancer. In actual fact her abdominal discomfort was due to constipation.

    1. Woopwoop

      Well then the fault was with the “doctor of death” for not being thorough with his diagnosis.

  3. jackie dickinson

    I am sorry you have MS, however every case is different.My cousin in the Netherlands took the Euthanasia option after months of suffering with pancreatic cancer which no treatment was able to relieve or cure.
    At the age of 76 and after speaking to the required psychiatrists and specialist oncologists he died with dignity , painfree surrounded by his family.
    He was spared the agony of excruciating pain, unable to eat ,drink, or communicate if he had been left for “nature to take its course”.
    Even doctors here will increase the pain relief which sometimes sends patients over the edge as in my Fathers case.We were made aware of this but his pain was unbearable so the family agreed it was best for him.
    Euthanasia should be an option if correct procedures are followed as in my cousins case.
    I have an Advance Health Directive to say I do not want to be rescusitated, medicated, or have any procedures which will keep me alive artificially when there is no hope of recovery.
    I just want to be pain free, and I would like to decide if possible if I want to stay around in agony, with family reluctant to visit because I am deteriorating, or put a peaceful end to it with some dignity.

    1. tonysee

      You seem to imply that ‘nature taking it’s course’ is necessarily painful, Jackie. I don’t think that’s true in the great majority of cases.

      Also, as the author spelled out, we are allowed under current laws to take medication even if it risks death. But to take medication in order to die is to ‘occupy an entirely different moral space’.

  4. Camm

    Whilst your views are indeed heartfelt, your views remove agency from those afflicted to make their own choices. And as long as strong safeguards exist, I believe we should be able to mitigate any potential issues of coercion.

  5. jackie dickinson

    This is an unfortunate case, but a 2nd opinion should be compulsory to avoid mistakes.

  6. tonysee

    Thank you Shakira. Any attempt to show that this issue doesn’t come down to a simplistic ‘left vs right’, ‘enlightened vs troglodyte’, ‘compassionate vs heartless’, etc., binary is welcome. It’s complicated. We really need to listen to all views.

  7. MW108

    This piece is a classic ‘2 Jews, 3 opinions’ level review -almost-of the fabled but unfounded slippery slope argument that if you regulate assisted dying for one specific set of circumstances pretty soon the govt or some other bogeyman will come for you just because you are a feminist, or academic or something else. i guess Crikey has to accept diverse views on this topic, but FFS at least get a fact-driven dissent from the body of evidence.

  8. LesMallett

    You not choosing to exercise a right is not the same as denying me the right to have the choice. I have lived with a potentially terminal illness for 22 years. If it ever progresses I will kill myself. I am not going to put myself or anyone one through me losing control of my bodily functions.
    So with all due respect take your philosophical BS and get out of the way. I have the right to choose what happens to my body, not you.

    1. David Hand

      No one is stopping you taking your own life Les. Shakira’s point, which I agree with, is the coercion that is likely to occur around the line that must be drawn between murder and euthanasia. It’s all very well to use a pin up, like you do, of someone losing control of their bodily functions but when parliament draws the line as it must when making policy, I doubt it will be that easy. Added to that is the fact that most deaths are also de facto financial transactions and vulnerable people are likely to be coerced by the financial beneficiaries of their death and this will become a real problem.
      I fully expect elderly vulnerable people to front up at a euthanasia centre should any appear in Australia, claiming to have “chosen freely to determine what happens to their bodies”. They’ll even sign the forms.

      1. Dylan Nicholson

        The Netherlands has had legal assisted suicide for 14 years.
        Nobody’s seriously considered revoking that as far as I’m aware, simply because situations such as you raise that could potentially become an issue can be dealt with by carefully formed policy.

  9. Graham Henderson

    The issue is the inviolable right of the individual to personal autonomy and self determination.
    The presence of terminal illness or unrelieved pain are irrelevant. Yes there should be safeguards, and no, they won’t be perfect, but the existing laws deny the right of every living person the chance to control their ultimate destiny.

  10. Dog's Breakfast

    “For Andrew Denton, the fear that legalised euthanasia would undermine the welfare of people living with a disability is a cynical red herring”.

    The number of red herrings used against euthanasia would surely feed the world for the next century. David Hand offers his own versions.

    It is just as likely, probably a stronger argument, to suggest that people given the right to die will hold on for those extra few months/years, and perhaps inspire us all. Not having that right, people have to make decisions in the most difficult of circumstances and as often have to hurry the procedure before they might otherwise wish to ensure it gets done.

    The usual linear thinking leads to poor analysis. The slippery slope is surely the worst argument against anything, and is usually proffered when all other arguments have been exhausted. See also ‘if it ain’t broke, don’t fix it….”, arguments of those who have run out of arguments.

    It amounts to this, if I want to determine the timing of my own death by state-assisted suicide for rational reasons, my opponents say I can’t, and yet I make no claims on their end of life decision making. That’s it in a nutshell.

    As it is, the impending departures of the baby boomers makes this a policy certainty some time in the next 20 years.

  11. Lee Tinson

    Fact is, it’s always possible and relatively easy (and also not illegal) to commit suicide whenever you want. The major difficulty is making the decision.

    I have difficulty with this author’s use of the word “euthanasia”, which is defined as essentially an act of murder. A person kills a (presumably) loved one because that loved one finds it impossible to do it for themselves.

    I think it is used here (and so OFTEN in this article) as a deliberately pejorative term for what should be referred to as “assisted dying” which is a somewhat different thing.

    What I really wanted to say is that I have always been an enthusiastic supporter of Philip Nitschke, which this author clearly is not, and also of his work while he was allowed to do it. Most opponents of assisted dying are doing it not from a philosophical point of view but from a religious one. So really it’s just supserstition. Also, I think she actually (possibly willfully) misunderstood Denton.

  12. Ben.

    Much like with the gay marriage debate, if these are the best arguments against it then it is surely inevitable.

    1. Dylan Nicholson

      Agreed though for some whatever reason while gay marriage is fairly quickly becoming the norm among developed countries, the same hasn’t been as true with euthanasia (much like drug decriminalisation). This despite the fact that the outcomes from the countries that have adopted such legislation already appear to be generally positive.
      But I’m going out on a limb to predict that within 50 years in developed countries, euthanasia will become one of the most common forms of death, as technology enables us to remain physically alive for longer and longer, but our ability to provide meaningful existence for those that live to 100+ becomes hampered by both biological and economic constraints. Within a 100 years it may well be the only common form of death.

  13. The Old Bill

    So it’s OK to refuse treatment and avail yourself of enough pain killing drugs to make you comatose, but it’s not OK to take enough to cause a pain free death? I don’t quite understand how the former is alright on your moral compass, but the latter isn’t.
    I too have had to face my own mortality. I too know that that we are not equal players in the healthcare market. I cannot afford the 200K needed for the latest treatment for my condition, but if I am ever in the position of needing it before it is on the PBS, I am damn sure I want access to caring professionals who can help me make my own decision on how and when to die.

  14. Jaybuoy

    When the opponents of assisted departure venture in to the area of killing a relly for financial gain they reveal a lot about themselves and add little to the ongoing debate..

  15. Dubious Virtue

    Denying someone the time to choose their own death if they so decide, strikes me as being the ultimate in state ownership: “We own your body, you have no rights over it, and no matter the pain, the suffering, the cost to you or your family or society, we will keep you alive”.
    It is a repugnant and arrogant view that has so little respect for others. It’s the flip side to the type of people who enjoyed experimenting on prisoners of war.

  16. M Lovejoy

    Hussein’s omission of the word “voluntary” in relation to right-to-die issues is significant. I respect her wishes not to choose VE when her own death approaches – I also acknowledge her right to change her mind, as her MS progresses. However, in a secular, democratic society like Australia where public support for VE is high (eg, 82% support in SA), why does she think it’s fine for her to deny me, and others of the majority view, my own choice?

  17. Nicholas

    The conspicuous gap in this argument is the experience of the many jurisdictions in the world that allow assisted suicide. Hussein talks as though we can only speculate about what would happen, but in truth there are many places in the world that have allowed assisted suicide for many years, and the safeguards have worked well and the slippery slope didn’t materialize. I think it’s dishonest to refuse to engage with the extensive evidence that permitting assisted suicide as an option that is available to people under carefully regulated circumstances is wholly compatible with respecting the worth of people with disabilities.

  18. Alan Clay

    Alan
    Shakira Hussein freely offers her MS is not hugely debilitating, nor does Skakira appear to have nursed a terminally ill loved one who begs you to end their life (as they do not have the physical capacity do so and whilst in your embrace repeatedly pleads, “I just want to die! Please, please”. Whilst others stand by and say, “Do not be silly”. So easy to be confident about what others need or want when you do not sit in their seat or stand in their shoes. It is not about forced termination {although it is true I could make a list 🙁 } it is about a considered conscientious choice to move on with dignity and be free from pain and shame. Surely a reasonable accommodation in a civilised society. Please forgive my impromptu attempt at levity, but this is a deeply personal issue for me, I live with my own brain cancer with its accompanying debilitations and try not to take others opinions too seriously. Apologies in advance Shakira, your essay leaves me with the opinion you should write within your area of academic expertise! Moreover, not derogate the freedom of others to have a choice.

    1. Shakira Hussein

      I should have noted that my MS is remitting-relapsing and some relapses has been both extremely debilitating and extremely painful. That gives me a foretaste of what life will be like if and when it should become progressive, as Anthony Vigara’s was. I do not derogate others freedom to kill themselves – I just do not believe that it is the function of the state or the medical system to help them to do so.

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