By Chris Hayes MP for NSW. Article first appeared in the Labor Herald
With the Tasmanian state conference debating whether Labor should create a legal framework to allow euthanasia last weekend, Fowler MP Chris Hayes outlines why euthanasia preys on the vulnerable and why the debate needs to shift to palliative care and investing in the very best end-of-life care for the sick and their carers.
For me, euthanasia preys on the marginalised and disenfranchised. Just as I oppose the death penalty, I oppose a measure that would say to patients that the best we can offer you is an end-of-life solution.
Euthanasia is the deliberate taking of a person's life by lethal injection or other means at their request, for a merciful intention. Euthanasia is not 'turning off a machine', it is not discontinuing or refraining from procedures solely about prolonging life, and it is not the provision of pain relief.
In the 20 years since assisted suicide and euthanasia was briefly legal in the Northern Territory, there have been about 20 Bills brought to parliaments across Australia, and all of them have been rejected.
The reasons have always been the same. There is no way to protect people from abuse of laws that allow doctors to take the lives of patients. There is no way to stop subtle coercion on vulnerable people who get the message that they are a 'burden' and should do the right thing by society. Clearly, there are other ways, including our ever-improving palliative care, to show compassion to our fellow Australians who are suffering.
The Scots have rejected euthanasia
The most recent rejection of assisted suicide was in the Scottish Parliament. Their committee of enquiry raised the perennial concerns about:
Coercion: there is no way to guarantee the absence of coercion in the context of assisted suicide.
Compassion: there are other ways of showing compassion with those suffering, short of helping them to commit suicide.
Suicide prevention: there appears to be a contradiction between a policy objective of preventing suicide on the one hand and on the other, legislation which would provide for some suicides to be assisted.
Two decades back, our own Senate enquiry into the Euthanasia Laws Bill 1996 concluded that euthanasia laws are unsafe and unjust. The committee was concerned with the social pressure that would be brought to bear on people who are sick, isolated and lacking in self-confidence. "The potential for 'guilt feelings' for being a burden may become such that they perceive a subtle duty on them to exercise the euthanasia option," it said.
All euthanasia laws start off with concern for people who are in terrible pain with a terminal disease, but that is only the start. A review in The New Yorker in June shows how broad the criteria have become for euthanasia in Belgium, extending to those who are depressed, distressed or just tired of life. "Although most of the Belgian patients had cancer, people have also been euthanised because they had autism, anorexia, borderline personality disorder, chronic-fatigue syndrome, partial paralysis, blindness coupled with deafness, and manic depression," it said.
Dr Wim Distelmans, the Chair of the Federal Control and Evaluation Commission, which reviews all euthanasia deaths to ensure that doctors have complied with the law, said, "we at the Commission are confronted more and more with patients who are tired of dealing with a sum of small ailments, they are what we call 'tired of life'."
Although their suffering derives from social concerns, as well as from medical ones, Distelmans said that he considers their pain to be incurable. "If you ask for euthanasia because you are alone, and you are alone because you don't have family to take care of you, we cannot create family," he said.
So much for safeguards, so much for social solidarity, and so much for euthanasia only being for terminally ill patients in pain.
The Australian situation with euthanasia
In Australia, psychiatrist Professor David Kissane reviewed the patients who died under Dr Phillip Nitschke in the NT. Of the so-called 'safeguard' of compulsory psychiatric assessment in the NT legislation, Kissane told the 2008 Senate Inquiry:
"Four of the 'seven deaths in Darwin' revealed prominent features of depression, highlighting its strong role in decision-making by those seeking euthanasia. Alarmingly, these patients went untreated by a system preoccupied with meeting the requirements of the Act's schedules rather than delivering competent medical care to depressed patients."
Euthanasia is a failure of medical and social support for the lonely, distressed and depressed. Euthanasia can never be made safe from abuse, and the categories of people who can be put to death medically just keep increasing overseas.
Vulnerable people, people who feel they are a burden, are at great risk from euthanasia. As Dr Karen Hitchcock wrote in the March Quarterly Essay that "almost every day an elderly patient will tell me - with shame - that they are a burden or a nuisance, that they're taking up a hospital bed someone else needs."
In Australia, we are at the forefront of palliative care. We are a caring society and do not want people to think that they are 'burdens' and should do the right thing by the community.
We do not need euthanasia, we need more structured investment in palliative care, delivering the best end of life care possible, as well as, appropriate support for their carers.
Chris Hayes is the Chief Opposition Whip and the Federal Member for Fowler in south-west Sydney.