Tasmania: A 'Last Resort'?

In 2012, at the tenth anniversary of the Dutch euthanasia laws, Eric van Wijlick, policy maker at the Royal Dutch Society of Doctors (KNMG) lamented that, "Euthanasia has become the central point of conversation between a doctor and a patient who is suffering when it should be seen as a "last resort"." The Royal Dutch Society of Doctors supports the law.
 
What van Wijlick identified was the inexorable change that occurs within society, in this case, the medical fraternity, once euthanasia & assisted suicide have legislative approval.
 
When we talk of a 'last resort' we think of circumstances where everything else had been tried. Therapies, surgery, chemotherapy, palliative care etc. all having been explored without relief and euthanasia being available once these avenues had been exhausted. This, I suggest, is also the common perception by the general public.
 
But that's not the way the Tasmanian bill is framed. But even the Tasmanian Premier seems not to understand this. In a recent tweet she said:

 "Adequate palliative care services 1st, then #choice "True. That's what our legislation says too. Last resort only."

Not so, the bill is not a last resort (although that might be a good name for a motel for death tourism), the provisions do not require palliative services to be undertaken nor does the bill require that the person is actually terminally ill.
 
President of the Tasmanian Dignity with Dying group, Margaret Sing in a letter to the local paper claimed that "...both the people making the voluntary assisted dying request and their doctors must be satisfied that there are no other treatment options to improve the people's condition or to relieve their suffering". The bill says that the doctor must 'discuss' any relevant treatment options but the existence or otherwise of treatment options and any decision to take them up or not is not a prerequisite. Sing may have been intending her comment to reflect the reality, but the quote doesn't help clarify that at all.
 
The Examiner Newspaper added to the confusion yesterday:

But Margaret Singh (sic) of Dying with Dignity Tasmania said the laws would apply to the 5 per cent whose suffering could not be relieved through palliative care - about eight or nine people a year.

Notwithstanding that the '5%' figure is not a settled fact; the inference here is that the 'eight or nine people a year' would have tried palliation and found the results wanting. Again, this is not the case.
 
There is nothing in this bill that defers or delays a person's conversation with their doctor about a euthanasia request to a 'last resort' stage. In does say that a 'progressive medical condition' would need to be in the 'advanced stages' but it fails to define the term 'advanced stages' leaving the door open for an interpretation that it may mean anything but the initial stage.
 
Consider the Dutch Law. It has remained unchanged since 2002, giving rise to claims that the Act is, therefore, robust and that the 'slippery slope' doesn't exist. The slippery slope, contrary to what others would have us believe, is more than just a simple observation about the statute. Consider, however, comments from the Inge Freriksen, spokeswoman for the Dutch Health Ministry (from the same article quoting Van Wijlick): "the statute has remained unchanged, but what has changed is the way doctors interpret it." Such interpretations now include newborns with disabilities, Alzheimers and, most recently, euthanasia because of a disability.
 
The same article, in what seems to be put as a positive, mentions that, 'Euthanasia was provided to an Alzheimer's patient for the first time last year, something which "would have been unimaginable in 2002," said Walburg de Jong of the group Right-to-Die NL.
 
When we talk of 'unimaginable' it is sobering to think in terms of what the Dutch themselves clearly saw as being beyond the reach of the law in 2001 when it was debated in their parliament. Like the observation earlier, the Dutch may well have had the 'last resort' in mind. But that's not what we see now at all.
 
I see no reason not to believe that a Tasmanian law would not do likewise. In fact, there's every reason to believe that it would.
 

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