Time to pause and to think some more

by Paul Russell:

If Ross Fitzgerald's thesis on the pages of Fairfax newspapers last week about why euthanasia remains illegal in Australia is correct and if his claims in favour of reversing the situation are also correct, then perhaps, as I think he is suggesting, there may be little that stands in the way of achieving his agenda. But if it were really that simple then, surely, we would have had laws years ago. That we have not, I suggest, points to the fact that there's more to it than Fitzgerald's simplistic argument; his assertions are, at best, only part of the consideration and certainly not the whole picture.

Fitzgerald would have us believe somehow that euthanasia is a right that we should have access to. He like others before, points the finger at groups within our community whom, he asserts, are getting in the way. They are apparently the problem.

It's an old trick. Religious leaders and politicians are easy marks. Politicians rarely rate well in the trust stakes and religious authorities aren't doing that much better at the moment. Easy marks that only serve to deflect scrutiny.

That religious leaders by and large oppose euthanasia is simply a well known fact. Likewise the reality that, apart from what must been seen in a historical context as an aberation in the Northern Territory two decades ago, at every other engagement with the political process, bills continue to fail.

To expect religious leaders to facepalm at Fitzgerald's observations and subdue or dismiss their own objections is plainly not going to happen. The question is whether their objections have merit; whether, in a secular society, what they say has any standing or not.

Politicians, regardless of their personal preferences, are charged with protecting citizens and promoting the common good. They, more than any other group of persons in this country, are charged with scrutinizing legislation under these two related tests. In observing parliamentary debates over many years I have seen many politicians struggle with the tension between wanting to support the idea, for compassionate reasons, and recognising the inherent problems black-letter law has with trying to protect the vulnerable. In reality, parliamentarians by and large, shine in applying their onerous duties in such debates. It isn't easy.

Certainly they will be well aware of the polls. It is often said that the first thing politicians learn to do is to count the numbers. 80% polling support is undoubtedly a significant pressure point. But what do the polls really tell us?

When we think of informed decision making, single question polls simply don't make the mark. They don't inform the public of the framework of any particular bill, nor do they provide any historical background. In essence, all they really tell us is that a majority of Australians do not want fellow citizens to suffer at the end-of-life. It is ironic that, when euthanasia is sold as being voluntary with the implied necessity of fully informed consent, single question polls that cannot pretend to reach that threshold are somehow holy writ.

I invite readers to consider: If euthanasia was removed from the question and from our thinking; in otherwords: if it were not an option, how would we respond? Better care is the answer as it always is: better care treats everyone equally.

This point about equality was amplified well on The Drum program recently by Get Up's senior campaigner, Miriam Lyons: "It's very hard to call a choice truly free and truly dignified unless it is made from a position of equality. So that means you have to have the best aged care, the best palliative care that a civilised country can afford, that the quality of pain relief is not going to depend on your level of income and that's not the case in Australia right now. We need to make sure we do a lot more to make sure that is the case so that people aren't making this choice in a situation where perhaps what they really need is better mental health treatment...".

And so, there's clearly more going on here that deserves thought. Take as a further example the widely held notion that euthanasia is there for those who have tried every therapy or management option without success. This, I suggest, is the scenario that many Australians will have had in mind when answering the poll and when thinking of euthanasia. It is the classic 'last resort' scenario which is reinforced by many of the hard-case examples that find their way into our media.

But it simply is not true. No-one can force anyone to undergo any treatment. Along with the great advances in modern medicine in the last 50 years is the recognition that people can decide for themselves to say a clear 'No'; to refuse treatment; its about choice.

Whether or not the proposed treatments would be effective in dealing with symptoms or whether or not they might offer the possibility of remission, it still remains entirely up to the person concerned to decide. It is similar in a way to whether or not the suffering of a person is considered 'unbearable and untreatable'. It is all rather subjective and, in terms of a euthanasia law, it is likely impossible to frame it any other way.

So, it is then possible for a person with a difficult diagnosis to refuse treatment and to assert therefore, that their condition is 'untreatable'and their suffering 'unbearable' and to request euthanasia in a situation where many if not most people would rightly deem a request for euthanasia in such circumstances as being significantly premature. What might be understood as euthanasia as a 'Last Resort' is perhaps more accurately described now as an 'early intervention'. A published study from April 2015 noted that "almost 40 percent of the patients who received euthanasia did not see a palliative care specialist nor interacted with a palliative care team." That's their choice, but it is a vastly different landscape I contend, from what most people think of.

Fitzgerald summarized his case in support of euthanasia by wondering if, 'the Australian bishops and the Quebec Committee were looking at the same information!' A committee of the Quebec Parliament considered and then recommeded euthanasia legislation. I think it probably more worthy to ask where the Quebec Committee and an earlier Royal Society of Canada Panel were looking.

There are many who question the Quebecer's impartiality, including eminent Australian ethicist, Margaret Somerville who said the report, 'is not balanced and reads rather like a pro-euthanasia manifesto.' Observing that two-thirds of the submissions argued against euthanasia, Somerville concludes that, 'If we are to have a discussion about euthanasia, it must be an unbiased one. It's hard for me to conclude from its report that the National Assembly committee undertook such an unbiased reflection.'

Readers may say, 'That's all well and good but really only boils down to opinion.' That's true. The question then becomes one of whose opinion or what opinions seem to reflect what we know about the human condition. Is it reasonable to assume that all is well in Belgium, Holland etc., that their laws work well, or is it more reasonable to accept, as Quentin Dempster admitted on The Drum, that 'of course, any law can be abused'.

Of the 80% that signal support for euthanasia via the polls I wonder how many, when ticking 'yes' have some reservations, some proviso about making sure that people are protected from abuse?

When such abuse might see the object of the abuse dead, we need to pause and to think some more.

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