Last week The Hon Cate Faerhmann MLC's Rights of the Terminally Ill Bill was introduced into the NSW upper house. This opinion article in the appeared in response:
The proper goal of medicine is to promote the health and wellbeing of the patient. The Greens' Legislative Council member Cate Faehrmann's proposed Bill for the Rights of the Terminally Ill is not in keeping with this goal. The very fact that it has to include so many ''safeguarding'' provisions reveals how this proposal would undermine the role and responsibility of health professionals, and destroy the trust that should exist between professionals and patients.
First, the bill would allow a doctor to choose to assist or for any reason choose not to assist a patient to end their lives. How could doctors be entitled to not assist a patient if this was a normal and therapeutically sound medical request?
Secondly, the bill is limited to patients whose incurable terminal illness causes them unacceptable suffering or distress. Doctors are to inform such patients of the palliative treatments that would relieve their suffering and distress. If the patient declines palliative treatments, the doctor is then free to assist the patient to end their life. What has happened to the doctor's professional responsibility to put the health and life of the patient first? Do we really expect doctors to go along with whatever a patient requests, even when it flies in the face of suitable and available medical treatment?
Thirdly, the doctor has to be sure the patient has considered the implications for their partners and families of the decision to end their life. What has happened to the doctor's own responsibility to consider the impact on other people of the health treatments he or she provides, and moreover, to act on the results of that consideration?
Fourthly, the bill requires various other people to provide support for the doctor's actions: a psychiatrist, possibly a social worker, and then another doctor to confirm that the relevant professionals are acting in accord with the terms of this bill. What has happened to trust in our doctors if their conduct needs to be double-checked by all these other professionals? Moreover, it would seem that the ''secondary medical practitioner'' - who is not the patient's doctor - is the person really in charge, since this person would have final say over the other professionals. What happens if the secondary practitioner disagrees with his or her colleagues - or even with the patient's view of their situation? Are these ''secondary practitioners'' just rubber stamps, or are they expected to exercise their own professional responsibilities?
Finally, of course, in the proposed bill, ''assisting a person to end their life'' includes not merely prescribing a drug, but actually administering that drug. It is one thing to ask someone to give me the means to end my life, it is quite another thing to ask someone to kill me. Do we really want doctors to become people who take life in the guise of ''assisting'' people to end their own lives? There is no ''right of the terminally ill'' that could license ''a duty to kill'' on the part of someone else. The corruption of the English language is collateral damage in this bill.
The truth is we wouldn't need all these ''safeguards'' if this bill was really in the interests of terminally ill patients. What we need is what people always need as life draws to an end: good palliation of distressing symptoms (even if this happens to shorten life), a chance to address the great existential questions about one's life and relationships that death typically raises, and, above all, companionship. So often what may sound like a request for assistance to end life is really a question: will you abandon me? No to euthanasia means no, we will not abandon the dying, and no, we will not legislate to undermine the trust we place in our health professionals.
Gerald Gleeson teaches bioethics at the Catholic Institute of Sydney.
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