Shenanigans in the SA euthanasia debate

by Paul Russell:

The debate on the Voluntary Euthanasia Bill 2016 is set to draw towards the Second Reading vote this coming Thursday the 20th of October in the House of Assembly.

One media outlet called the vote today, suggesting that the bill will fail at this next hurdle.

While we would welcome that outcome, at this moment I think the vote is far too close to call.

The bill presented by Steph Key earlier this year was and remains one of the most dangerous and broadest bills we have ever seen with no qualification other than 'unbearable and hopeless' suffering. In otherwords, its a Belgium type of bill.

Many MPs have been heard to express significant concern over this bill in its current form and I would expect that, had this been the beginning and end of it, the bill deserved to fail next week as it most surely would have done.

But that's not the end. Steph Key has been talking about making amendments to her bill in a very clear attempt to try to get enough MPs to allow the bill's progress.

The final schedule of amendments was released yesterday - 13 pages of changes that are essentially a re-write of the bill in all of its substantive provisions. How any busy member of parliament will be able to process these changes at this, the eleventh hour, is beyond reckoning. That these amendments may never actually become incorporated into the bill given the argy-bargy in the debate on such inclusions is not accounted for.

Clearly, if there had been a sense that the bill was likely to pass in its original form or with minor adjustments, these new amendments would not have been tabled and we would now be heading towards becoming 'the Belgium of the south'. (Note appropriate cynicism!)

But if anyone needed any proof of the difficulty (nay, impossibility) of creating a regime that satisfies the pro-euthanasia constituency whilst also trying to placate concerns about safety etc., then the new amendment schedule should be an eye opener!

While a number of the amendments are exclusively cosmetic and simply for effect the new regime not only prioritises assisted suicide as the primary way to be made dead with euthanasia as a sort of 'back stop' for those people who cannot assist themselves, it also now includes the possibility of a doctor delegating the euthanasia deed to a nurse!

When the Australian Nursing and Midwifery Federation came out publicly in support of this bill a few weeks ago, I joked on local radio that I wondered if nurses would be so keen if it were they and not the doctors doing the killing! I cannot say whether this inclusion is at the behest of nurses or whether they were, in fact, consulted, but the 'Florence Nightingales' of medicine may now become the 'angels of death'!

The amendments also include a regime for the management of the lethal drugs that may be dispensed to a person or a person nominated by them. This section clearly foresees that many of the assisted suicides will take place in the home; the provisions going so far as to say that the person may have someone 'assist' them:

"A person self-administering voluntary euthanasia (sic) may be assisted by such persons as he or she thinks fit."

This is wide open to abuse. A third party could force the person to ingest the lethal substance or trick them into taking it when they may have actually changed their mind or simply said: not yet.

No one will ever know what happens behind closed doors and there will be no way of uncovering the possibility of coercion or even murder.

I would have thought that Key's amendments would have attempted to make the bill less objectionable - not more so.

Even where it does attempt to answer criticisms, the changes are ineffective and trite. For example, the bill says that someone cannot qualify for death merely because they have a disability. 'Merely' suggests that a person with a disability would also need a terminal illness which is intolerable to them. This suggests that there's a clear deliniation between terminal illness and disability. This is simply not the case.

Many people living with disability experience co-morbidities and conditions relating to their disability that, were it not for medical supports of one kind or another, would be terminal. In reality, this is simply a sop to try to squash the disability voice. In a strange way, of course, it thereby recognises its potency.

There's also a rather strange inclusion in the amendments list that I haven't seen before that is worth thinking about. In the directions to doctors about how they are to conduct the interview to assess qualification, they are told that they must provide,

'information explaining that, just because a person makes a request for voluntary euthanasia, the person need not actually end their life.'

This is bizarre! One can easily imagine a person being more than a little unsure of whether or not to proceed towards euthanasia then to be told by the doctor, 'that's alright, you can still apply you know and you can decide later if you want to go ahead with it.' This makes the whole idea of a settled desire for euthanasia (as is expressed in the Low Countries) and a fully informed consent and request a total joke. This is especially so because, as the bill expresses in another place, the person can always say 'no' at anytime.

It's almost like a tout for business.

And, of course, not satisfied that our healers should become killers, doctors are told to lie on the death certificate and list the underlying illness as the cause of death and not the application of a lethal substance.

Once professional integrity and the hippocratic tradition goes out the window, I guess anything is fair game.

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