Two recent articles on euthanasia and assisted suicide in the Australian press serve to highlight the dilemma of the form of any legislation that might be proposed as well as the reality of what crossing the Rubicon of the prohibition on killing or assisting in suicide will mean for a society like ours.
Senator David Leyonhjelm (Assisted Suicide. OnLine Opinion, 8 Sept) poses the classical libertarian view (that: 'permission from government should not be required') while The Age writer, Julia Medew records the view of one of the doctors she interviews as seeking legislative control (Don't-tell doctors supporting secret euthanasia deaths The Age, 7 Sept).
Medew's premise is the classic shibboleth of 'it's happening now, so let's legalise it'.
That these two views on the same subject are contradictory, one to the other, serves to highlight the need for continued prohibition. Both views are utopian in essence - they cannot be attained no matter how much we might wish it were so.
Both are an appeal to autonomy. Leyonhjelm calls it 'individual freedom' and 'the right to die at the time of our choosing'. That last slogan and its many variations in use by the pro-euthanasia and assisted suicide lobby are modified for public consumption and for the sake of creating some legislative appeal in and through the presentation of limited legislative models. For example, access only for people with a terminal illness.
Leyonhjelm's libertarian view seems to be consistent with that of Philip Nitschke; that any adult of sound mind should have access to suicide methods. Nitschke's views (and Leyonhjelm's by default) are considered by their pro-euthanasia and assisted suicide lobbyist counterparts as 'unhelpful' to debate.
And so they are. Limited legislative models are a Trojan horse for a broader application. Whether such limitations are honestly held objectives or simply 'a foot in the door' matters little. Whereas proponents of a limited legislative model focus on an emotive case for a limited cohort, Nitschke's interventions run contrary to that kind of rhetoric. Nitschke and Leyonhjelm point to the ultimate reality, while the limited legislative thrust simply starts us off on the road to get there.
If we're arguing for a 'right-to-die' then the existence of such a 'right' creates philosophical and practical implications for any limited public policy that would discriminate against, for example, non-terminally ill people.
Medew's article offers us three examples of where doctors or relatives may well have crossed the line on assisting in suicide (not euthanasia as the article's title errantly suggests). Whether these people would have qualified under a limited model cannot be determined; but it would be foolhardy to assume that creating a limited model would stop any doctors from continuing to operate outside any extant framework in circumstances where their patients did not qualify.
If it's all about ending suffering and about a 'right-to-die' then Nitschke and Leyonhjelm are right. Roll on the next wave of revelations about doctors acting outside the law for 'compassionate' reasons or look to the inexorable bracket creep of euthanasia in places like Belgium or The Netherlands.
Interestingly, in two of the stories described in The Age article, Medew observes that the concerns of the women in question were not principally about pain at all. The first cited that 'she did not want to reach a point where she could not look after herself'; the second, 'feared being unable to remain in her home.' These are understandable concerns, but not, one would have thought, reason to apply the death sentence. Yet last week in The Netherlands a nursing home came under scrutiny for the euthanasia death of a woman who cited her fear of living in a nursing home as her primary reasoning for asking for someone to kill her. Add that to other examples from the Benelux countries of euthanasia for blindness, anorexia, loneliness and even in the dark throes of clinical depression, and the utopian ideal of a controlled legislative environment or even an absence of any possible maleficence (in a libertarian regimen) are really castles-in-the-air.
That there can be no 'right-to-die' seems to have escaped the thinking of all concerned. Nitschke once suggested that, just as there's a right enshrined in International Human Rights to 'freedom of religion' which implies 'freedom from religion', that the UN Human Rights Declaration of a 'right-to-life' implies a 'right-to-die'. This is simply nonsense. How can there be a 'right' to something that, by our very existence, will come to us all. Regardless of the rhetoric about 'at a time of our choosing', it is still predicated upon a right that does not and cannot exist. It is a house of cards.
This reality was most eloquently described last year by the Irish Lords Justice in the Fleming Case: "â€¦ the protection of the right to life cannot necessarily or logically entail a right, which the State must also respect and vindicate, to terminate that life or have it terminatedâ€¦ that would be the antithesis of the right rather than the logical consequence of it."
Should we ever forget that freedom to do certain things also implies a freedom from having certain things done to us; in other words, not to be endangered in any way or to be unjustly deprived of our own rights to freedom and security of person, then we're staring down the short barrel towards anarchy. The rhetoric of choice and autonomy in regards to deliberate killing or helping people to suicide may seem beguiling enough; but while the classically libertarian ideal of limiting the role of government in our lives is appealing; it also requires that the natural limits of freedom be observed.
I am of course, referring to the clear, bright line drawn in our criminal codes that protects me from killing you and you from being killed by me. It also protects vulnerable people from the risk of being coerced towards suicide or having suicidal thoughts endorsed and supported by others.
Both Leyonhjelm and the euthanasia movement, generally, is dismissive of the risk to vulnerable people; the latter claiming that their 'safeguards' will guard against such abuse; the former saying that, 'this is not about bumping off granny to inherit the house'. The Irish Justices dismissed this idea, confirming that, 'The medical literature documents specific examples of abuse which, even if exceptional, are nonetheless deeply disturbing.' The very fact that the pro-euthanasia lobby talks about 'safeguards' should be a red flag - we wouldn't need 'safeguards' if there were no risks!
The current prohibition protects us all equally, while crossing the death Rubicon advances risks with each progressive step.
That both of these articles should appear in the media on the eve of World Suicide Prevention Day (10th Sept) is more than a little disturbing; but, then again, there's an election on the way in Victoria. Leyonhjelm closes his article, 'If free people own their own lives, they must be free to end them if they wish.' This is a reckless comment. All suicide is regrettable; all suicides should be abhorred and we should seek to ensure that suicide prevention measures recognise that reality.
If we accept that suicide for the elderly or the ill is appropriate, we send a decidedly mixed message about the value of life. Diminishing the resistance to all forms of suicide by accepting, as Leyonhjelm suggests, that some lives are 'no longer worth living' implies that some suicides are good, that some are acceptable. This can never be the case.
The World Health Organisation reporting recently that one suicide occurs every 40 seconds around the world and that, globally, the highest rate of suicide is amongst people aged 70 and over, should provide us with pause for thought. Are we going to discriminate against the aged and infirmed in terms of suicide prevention; are we going to allow the former Nazi slogan of 'life not worthy of life' to skew our objectives of reducing the incidents of suicide?
A simpler way to look at it might be to question the inclusion of helplines at the end of articles such as this for those for whom the content might give rise to suicidal thought. Do we need to now include a rider to the 'phone xxxxxx for assistance' that says something like: 'if you think your suicidal thoughts are rational, phone Exit; if your old or sick, ring xxxx for a doctor who will help you end it all.'
The only truly consistent approach to the question of suicide is to seek to prevent it in all its forms. Anything less is a failure; a failure of imagination, commitment and of vulnerable people who deserve the protection of the law and the support of our society.
Paul Russell is director of HOPE: preventing euthanasia & assisted suicide based in Australia.
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