The debate stretched across the week, on and on. By midnight on Thursday last week, amidst rancour and emotion, a vote still hadn’t been finalised. Finally, after a marathon 26-hour sitting, the assisted-dying bill, which allows terminally ill patients to access drugs that can be used to end their lives, passed through the lower house of the Victorian Parliament: 47-37. That was supposed to be the easy part; the bill now faces tight numbers in the upper house.
During the debates over the bill in the lower house, both proponents and opponents sought the buttressing of expert opinion, which is understandable given the sensitivity and complexity of the issue.
Widely cited among opponents was the work of Professor David Kissane, head of the Department of Psychiatry at the School of Clinical Sciences at Monash Health. Kissane wrote a letter to Victorian MPs expressing concerns about safeguards around the clarity of the decision-making capacity of people with severe illnesses, particularly if they develop clinical depression. He concludes: “[P]ermitting doctors to kill will irrevocably change the practice of medicine in Australia, weaken palliative care, and increase the risk for the elderly, frail, disabled and seriously ill.”
What the letter does not mention, as revealed in Crikey last Wednesday, is that Kissane is Subpriory of the Immaculate Conception of the Order of Malta. The Order of Malta is a deeply Catholic organisation dedicated to, among other things, providing palliative care around the world.
“My concerns are clinically directed at quality of care, and unrelated to any hospitaller work for Eastern Palliative Care, which is run in part by the Order of Malta,” Kissane told Crikey. “As a consultation-liaison psychiatry and palliative care researcher at Monash, I express academic opinions with every entitlement to use my academic affiliation.”
To what extent should Kissane’s religious affiliation, and its possible influence on his views, have been disclosed? By the same token, Kissane’s letter to Victorian MPs was on a Monash University letterhead, opening the possibility that it could be interpreted as the view of Monash (the institution does not not have a public stance on the issue).
Steve Ellen, director of the Psychosocial Oncology Program and the Department of Cancer Experiences Research at Peter Mac, told Crikey it was important that academics said where they worked, so their credibility could be tested.
“But it’s very important people are clear about who they are representing,” he said. “I was on The Drum this week, talking about the bill and before I launched into my argument, I made it very clear that Peter Mac does not have a policy on assisted dying or euthanasia, and there are a plurality of views within the organisation.”
Professor of psychiatry at Monash David Copolov said it would be almost impossible to enforce any requirement for academics to disclose any religious underpinnings of their arguments.
“People have such a complex amalgam of motivations — it’s impossible to know for sure,” he said. “What has to be addressed is the overt arguments, not the implicit reasons behind those arguments.”
In parliament, Labor MP Nick Staikos — who is in favour of the bill — talked about how his own religious faith (he was raised Greek Orthodox Christian) influenced his thinking and expressed concerns that the religious basis of many opponents arguments was “reluctantly admitted”. He told Crikey: “As I said in my contribution, this is such a personal issue and everyone approaches it in their own personal way. For some, that is from a perspective of faith. I do not criticise anyone for this and I feel that people should feel free to express their views. If the basis for someone’s opposition to voluntary assisted dying is faith, they should feel free to say so. I also believe it is incumbent on anyone wishing to contribute to this debate that they do not seek to muddy the waters with misinformation.”