Paul Kelly: The case against euthanasia

Senior journalist and Editor-at Large for Australia's National Newspaper The Australian kicks back hard against what some of his journalistic colleagues have been positioning as the 'rising-tide' in favour of euthanasia.

Writing in The Weekend Australian Kelly's article: Legalise euthanasia and compassionate society dies too is a serious and thorough look at euthanasia in practice in the places where it has been made legal and leads Kelly to the conclusion, as his title suggests, that society is irrevocably damaged by the introduction of the practice of doctors killing people.

He opens with an emotive plea:

"If you love your parents, respect your children, care for your society and think compassionately about your world then it is time to open your heartens when a jurisdiction legalises killing or, as it is called, euthanasia."

That there is something of a renewed public interest in euthanasia in Australia at the moment cannot be denied. Partly because this month marks the 20th anniversary of the first euthanasia death under the short-lived Northern Territory law (the first of its kind anywhere in the world) and partly because some journalists have been beating up on the idea, creating something like a self-sustaining whirlwind in all forms of media.

Over these last 20 years, the arguments against euthanasia have not changed. What has changed is the effectiveness of palliative medicine in eliminating pain and suffering. Kelly correctly cautions, however, that 'this is a critical trend but cannot conceal the fact painful deaths still exist and become the main argument for legal change. But euthanasia should not be seen as a substitute for palliative care - that would be a medical and moral blunder."

Kelly's second point is to cite the developments in who gets euthanasia and the rise in the numbers in Belgium and Holland to conclude that, 'where euthanasia is legalised the record is clear - its availability generates rapid and ever expanding use and wider legal boundaries. Its rate and practice quickly exceeds the small number of cases based ont he original criteria of unacceptable pain.'

He makes his point by posing a series of questions which actually chronicle the progress of euthanasia in Belgium and Holland:

"If you sanction killing for end-of-life pain relief, how can you deny this right to people in pain who aren't dying? If you give this right to adults, how can you deny this right to children? If you give this right to people in physical pain, how can you deny this right to people with mental illness? If you give this right to people with mental illness, how can you deny this right to people who are exhausted with life?"

'Culture and values will change to justify the death process' says Kelly as he introduces to readers of The Australian to the story of Tom Mortier and the death of his mother. Kelly uses quotes from Belgian euthanasia supremo, Wim Distelmans to note some of his more outrageous comments that, frankly, raise no notable objection in his homeland.

Kelly quotes Mortier when responding to Distelmans' claim that giving a lethal injection is an act of 'unconditional love':

"I loved my Mother for more than 30 years and I wanted her to live; Dr Distelmans loved her so much - 'unconditionally' - that after a few brief consultations over six months he gave her a lethal injection."

Andrew Denton once commented to me about Tom Mortier's situation saying that, sad as it is, it was after all his mother's decision - it was her choice. No person who has read Tom's story could dismiss what happened so easily - unless they had an agenda. But Denton's words actually uncover one of the most significant changes that euthanasia laws create that, ultimately, become the driver for cultural drift and euthanasia expansion. Kelly writes:

"The trend and logic is unassailable; once legislated the principle of euthanasia is settled and the practice of euthanasia is widened, if not by law then by administrative laxity and de facto regulatory sanction. Of course, many euthanasia cases are never declared.

"A 2012 report by the European Institute of Bioethics said: "Initially legalised under very strict conditions, euthanasia has greadually become a very normal and even ordinary act to which patients are deemed to have a right.(emphasis added)

"Many advocates in Australia use the rights language. Once this takes hold, then holding back the tide is nearly impossible."

Denton and others are in denial of this reality; most likely because they realise the potency and the infallibility of the argument.

The 'rights' argument is also present in the questions posed by Kelly (and cited earlier in this article). It is the denial of human nature: "Experience in other jurisdictions leads to the unambiguous conclusion: the threshold event is the original legalising of euthanasia. After this there is only one debate - it is over when and how to expand the sanctioned killings."

Kelly is higly critical of the Victorian Parliamentary Report on end-of-life choices and cites the dissenting report by The Hon Daniel Melino MLC (Victoria) which, contrary to the style fo the main report, is written in a scholarly manner and is exceptionally well-referenced.

He calls the main reports assertions that a law could be written with 'robust eligibility criteria' and their denial of the 'slippery slope', heroic optimism:

"It is echoed on nation after nation, year after year. It testifies to the deepest humanist conviction that mankind and wise governments can introduce euthanasia regimes with the necessary legal safeguards and the necessary regulatory protections to manage the promotion of death to ensure only net gains for the social order.

"It is surely extraordinary that people sceptical of the ability of governments to get trains running on time fool themselves into thinking they can confidently manage a regime that sanctions the termination of human life."

Kelly goes on to quote the new head of the Australian Medical Association (AMA), Dr Michael Gannon and Liz Callaghan from Palliative Care Australia, both of the opinion that euthanasia does not have a legitimate place in medicine and palliative medicine. Kelly also notes the push from within the AMA for that body to adopt what is known as a 'neutral' position on euthanasia, a tactic that has been tried in a number of jurisdictions and is liekly to fail once more in Australia.

The pro-euthanasia movement know that once the peak medical body 'goes neutral' it can no longer express an opinion either way. Would we want the AMA to adopt a neutral position on medicare or on government health policy? Not likely. They are the peak body whose members, charged with our care, know the reality far better than anyone else. We need them to express an opinion on all sorts of health-related matters, euthanasia being one.

Kelly closes by returning to a personal appeal to his reader:

"If we proceed then life will change, there will be a "slippery slope", your relationship with your doctor will be different, the vulnerable will have a reason to feel uneasy, the push to make euthanasia a right will be inevitable, the frail will feel obliged to volunteer and our values as a community will shift more quickly than you appreciate."

See also:

'Losers and Losers' in Victorian Committee recommendations
Offering suicide to prevent suicide - assertions without foundation
The Andrews' Bill 20 years on - problems remain the same