The Submission by the Victorian Coroner's Office to recent Inquiry into end-of-life issues is a counsel of despair. Coroner Olle and his office focussed upon suicide statistics over a five year period noting 240 deaths of persons who had 'irreversibly diminished physical health'. Olle gave verbal evidence which, in reality, is little more than opinion:
"â�¦ the people we are talking about in this small cohort have made an absolute clear decision. They are determined. The only assistance that could be offered is to meet their wishes, not to prolong their life."
How Olle knows this to be true is not stated. He is really saying that, the only option for these people who have resolved that suicide is their only solution is to provide them with assisted suicide. How is this about providing choice?
A bill tabled in the Irish Parliament (The Dail) by John Halligan MP in late 2015 made the problematic relationship between euthanasia and assisted suicide and suicide, generally, obvious. The bill talks about people with a terminally illness qualifying for being made dead if they have a 'clear and settled intention to end his or her own life.' What would we normally do if we knew someone who had a 'clear and settled intention to end his or her own life?'
These 240 odd people who killed themselves deserved better. Olle and Dr Rodney Syme would say that access to assisted suicide would be better; Syme recently going so far as trying to suggest that assisted suicide isn't actually suicide at all.
But there is a difference between a lovelorn young person contemplating suicide and someone who contemplates a similar action because of diminishing health. That difference is circumstance. Both see no other alternative. Both deserve our support and care. To treat them differently because of their circumstances is both irrational and inhuman. We should no more direct the ill person to suicide that we would encourage the young person to the same end.
What makes the Coroner's summary and its endorsement by both the Victorian Committee and Rodney Syme all the more problematic is the reality that a significant number of the 240 recorded deaths would not qualify for the assisted suicide regimen suggested by the committee. While the statistics record that a small number were close to death, many were not and a number had injuries rather than degenerative or terminal conditions. This leaves us to ask the question: what about them? Are they simply statistical cannon fodder?
The Coroner's Office cannot really know that there were no other possible interventions. Nor can we say that all or any suicide prevention interventions would always be successful. There are far too many variables here - including the possibility of refusal of treatment - for anyone to make a prediction. But we can be certain that, if Olle's observations were somehow adopted into the law, the methods might be different but the outcomes precisely the same.
Yet the committee's report accepts the Coroners advice without any criticism or scrutiny. This despite the ancillary report to the committee containing two significant qualifications about the collection and interpretation of the data, summarising that:
"The CPU (Coroner's Protection Unit) therefore has noted the possibility that ultimately, the deaths reported here will come to be understood as representing a range of different suicide phenomena, and that grouping them together in this study was not ultimately a useful exercise."
Syme's endorsement in the Fairfax Press of the committee report and also the Coroner's intervention is also deeply problematic. He also moves to endorse the use of a prohibited substance to effect suicide for those who clearly would never qualify under the Victorian proposal. It can be read as a defence of his own actions in supporting people with the provision of that same lethal substance, but it is also an indication that, because there will always be those who seek to be made dead who won't qualify under any limited regime, that his extra-legal activities may continue as will advocacy for the expansion of the law. He says:
"Clearly these people have ended their own lives, but have done so in order to end intolerable and unrelievable suffering, after careful consideration, after discussion with their medical adviser and their family. They are of sound mind and not depressed. These features are the antithesis of violent and usually secretive deaths by people who are often temporarily disturbed."
How does he know that? These are assertions without foundation.