What choice?

In Victoria’s most recent euthanasia statistics, the most common underlying condition of people who have died is lung cancer. 1 in 5 patients who have accessed lethal drugs did so because they were diagnosed with terminal lung cancer.

It’s vital, then, to consider the treatment experience of those diagnosed with lung cancer to determine what other end-of-life ‘options’ are made available to them.

The first study to evaluate the treatment history of patients with lung cancer who opted for euthanasia has uncovered that “20% did not have a radiation oncologist involved when making the decision and 22% did not have a consultation with a medical oncologist”.

The revelations were made in a study conducted by Dr Sara Moore of Ottawa Hospital Research Institute of the University of Ottawa and presented at the World Conference on Lung Cancer.

Dr Monica Malec, a geriatric and palliative care physician at the University of Chicago, said patients were seeking euthanasia “despite the availability of more effective and more tolerable treatment options”, pointing to “loss of autonomy, control, and dignity [as] the primary drivers for seeking medical assistance in dying rather than uncontrolled symptoms”.

But while some patients are asking for euthanasia without considering other treatment options, some are shockingly not even being made aware of other ways to manage their symptoms.  

Dr Moore said:

"Biomarker-driven targeted therapy and immunotherapy offer effective and tolerable new treatments, but a subset of patients undergo medical assistance in dying without accessing -- or, in some cases, without being assessed for -- these treatment options… Given the growing number of efficacious and well-tolerated treatment options in lung cancer, consultation with an oncologist may be reasonable to consider for all patients with lung cancer who request medical assistance in dying."

Dr Moore recommends consultation with an oncologist for all lung cancer patients who request euthanasia. This would ensure all end-of-life choices – rather than just a final and fatal one of euthanasia – are made available to patients.

This isn’t the case being pushed in Australia though. The bill put forward by Alex Greenwich in NSW doesn’t require either of the doctors signing off on a patient’s death to be a specialist in their illness, nor does a patient need to be referred to a specialist before lethal drugs are prescribed.

The doctors approving a patient’s death are required to give information about treatment options available to the patient, but if the doctor is not a specialist, it is difficult to see how they would be able to offer this in any meaningful sense.

And most of the doctors aren’t specialists. Looking at Victoria’s regime, the only one for which statistics are available, more than half of the doctors registered in the euthanasia portal are general practitioners.  Only about 1 in 6 are oncologists.

The illusion of ‘choice’ being pushed by euthanasia advocates is being revealed for the smoke and mirrors that it is, not just in Australia but across the world.