In Both Sides Now, author and ethicist Leslie Cannold presents two sides of an argument. Then it’s over to you: what do you think is true, and what do you think Cannold really believes?
Today: have Victoria’s much-vaunted voluntary assisted dying (VAD) laws made a significant impact on alleviating suffering of the terminally ill?
No: Despite assurances it wouldn’t happen, the numbers of suicides in the state have risen since the law came in. Yes: After specialised training and safeguards, reports show that many terminally ill Victorians have been able to end their suffering without resorting to suicide.
The statistics are shocking. In 2017 Victoria recorded 694 cases of suicide. In 2020, that number had jumped to 842. That’s a 21.2% increase — what’s going on?
The answer is simple. Almost two years ago, the first Victorian wanting medical help to suicide took delivery from the Statewide Pharmacy Service of enough pentobarbital to put down a horse, swallowed the dose and died. Ever since then, more than 224 Victorians have become victims of state-sanctioned killing.
While advocates of euthanasia claimed during the debate about the contentious new laws that assisted dying would lower Victoria’s suicide rate, we now know this is untrue.
It’s not the pro-death brigade’s first lie. While Aussies may trust themselves to manage their own deaths, they are rightly worried about others. Especially the vulnerable. What about the greedy grandchildren desperate to inherit Nana’s estate? What about the enormous rates of depression in elderly populations who could easily be made to feel, by an overwhelmed spouse or a society that despises dependence and disfigurement, that it’s time for them to go? As US legislator Nancy Elliot reminds us, “euthanasia is a prescription for all types of abuse of people at the most vulnerable times of their lives”.
Australians also know that encouraging doctors to cross the line set down by Hippocrates — who famously said, “I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect” — is a slippery slope. Today, the state says it’s OK to put down the terminally ill. Tomorrow, they could be coming for you.
Which is why holding elites to account on their promises matters. If the new law is actually driving up the state’s suicide rate, rather than deflating it, what else would a thorough investigation of Victoria’s assisted dying regime reveal about what the law really does and doesn’t do?
Last month, Safer Care Victoria and the Victorian Agency for Health Information released the fourth report of the operations of Australia’s first VAD law, the Voluntary Assisted Dying Act. Currently, such reports are issued every six months.
While Victoria’s VAD law passed in 2017, it took a full 18 months to establish the processes and provide training to healthcare providers that would ensure that when terminal and suffering patients started to use it to legally end their lives in mid-2019, the care they obtained would be safe, compassionate and compliant with what is regularly referred to as the strictest VAD law in the world.
How many terminally ill Victorians used the law in the second half of 2020 rather than — as the Victorian coroner John Olle put it during the 2015 cross-parliamentary inquiry into end-of-life choices — stepping in front of a speeding train or tying a hessian bag of sand around the waist and walking off a pier? The answer: 144 (or 175 if you include those whose medication was administered by a doctor).
What does this number have to do with the suicide rate? Literally nothing because voluntary assisted death isn’t suicide.
But even if you insist that it is, only a second grader adds that figure to the raw suicide numbers for 2020 and calls it a statistical jump. Yet that’s what the “no” side has done.
If you do the numbers properly, comparing suicide case rates (not raw numbers) from the full year before the law was in effect, which was 2018 (11.4%) with suicide rates in 2020, the first full year the law was operational (10.8%), you can see that the predictions of VAD have come to pass. In 2020, suicide rates are down against those seen in 2018. By 0.6%.
Sadly, this is how the anti-choice do business. Whether they are fighting the liberalisation of abortion laws or control over one’s own dying, their MO is the same: say whatever you must to get your way. As US anti-assisted dying politician Nancy Elliot puts it:
We have to be flexible … When you have lots of arguments, if one argument gets blown out of the water, you still have more. And each argument will reach somebody else.
The emotive use of the phrase “put down” is just one misleading strand of spaghetti in a frothing pot full of them: each one designed to turn back long-overdue reforms with high levels of popular support by using what Andrew Denton calls FUD: fear, uncertainty and doubt.
The facts about Victoria’s VAD law are these. That voluntary assisted dying has nothing to do with pet euthanasia or — while we’re here — the eugenics-inspired genocide of the Nazis. Those were choices made for one individual by another, for compassionate reasons or with evil intent.
In contrast, VAD is a choice made by the dying person herself both in theory and — here in Victoria with its 68 safeguards — in practice.
Indeed, if there are any concerns about the law’s delivery on its promise, it’s that it is too restrictive and cumbersome to provide relief to many suffering Victorians.
Fully 239 Victorians had their case withdrawn or died before they could complete the legal process, and another 87 sought assistance from the law but were denied permits. And, as Denton has been documenting in the second series of Better Off Dead, the stresses all the procedures put on a dying person in excruciating pain seem less like protection and more like cruel and unusual punishment.
What side are you on? And where do you think Cannold sits? Send your thoughts to firstname.lastname@example.org with Both Sides Now in the subject line.