Blog by Neil FrancisPosted on Friday 1st February 2019 at 8:55pm
Colorado has just released its second annual assisted dying report
The USA state of Colorado legalised assisted dying via its End Of Life Options [#145] Act in 2016. Its Department of Public Health & Environment has just published its second annual report of statistics of medications dispensed and deaths.
Unfortunately, the Colorado statistics report only all deaths of those prescribed life-ending medications, not those who died using the medication.
In 2017, 70 people who had been prescribed life-ending medication died, representing 0.19% of all deaths.* With Oregon and Washington states clearly showing around 30% of people prescribed lethal medication die without using it, that represents 49 people and 0.13% of all deaths.
In 2018, 104 people who had been prescribed life-ending medications died, representing 0.28% of all deaths. Adjusted to those who would have used their medication, that represents 73 people and 0.20% of all deaths.
The 2017 data is very similar to California's, which also legalised assisted dying in 2016. In 2017, 0.15% of Californians died using its End Of Life Options Act, with 35% of those who had been prescribed the medication having not used it. (California's 2018 annual report has not been released yet.)
The End Of Life Options Acts of both states stipulate that to qualify, a person must be an adult with decision-making capacity and have a terminal illness with death anticipated within six months. Patients may self-administer lethal medication prescribed by their physician: no other person may administer.
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* Total deaths official statistics for Colorado and California not yet available for 2017/2018: total deaths for 2017 and 2018 were calculated using linear extrapolation of USA Centers for Disease Control total deaths data for 1999-2016.
Blog by Neil FrancisPosted on Saturday 11th August 2018 at 11:33pm
Plenty of misinformation will be advanced to oppose Senator David Leyonhjelm's Restoring Territory Rights Bill.
In 1996 the Northern Territory Rights of the Terminally Ill Act (ROTI) came into effect. Just four people had used the Act when seven months later an Act of the Federal Parliament extinguished the NT law, by cancelling the Territories’ authority to enact it.
This week, the Senate [federal parliament] debates the Restoring Territory Rights (Assisted Suicide Legislation) Bill, sponsored by libertarian Senator David Leyonhjelm. If the Bill passes both houses, the Territories will again have the authority to legislate the matter of assisted dying.
Opponents of lawful assisted dying have been sharpening their knives to ensure that Senator Leyonhjelm’s Bill fails and that Territorians remain second-class citizens. In this post I expose one of the desperate and disgraceful pieces of misinformation opponents use to try and curry fear about law reform.
Opponent signals
There are signals from many quarters that assisted dying opponents are dragging out the tired old argument that indigenous Australians are too fearful of assisted dying to allow reinstatement of the Territories’ legislative authority.
The signals are clear, though so far mostly behind the scenes. Nevertheless, they predict a full onslaught of invalid “fear” claims in the parliamentary debate this week.
Populist beginning of the misinformation
Since the NT ROTI Act there have been ongoing claims that indigenous (Aboriginal and Torres Strait Islander) Australians are wholly and deeply fearful of assisted dying law. A chief flag-waver of this proposition is Jesuit Priest Father Frank Brennan. He’s not only argued this line repeatedly in public, but promoted it to at least one parliamentary inquiry.
Fr Brennan likes to frame this argument to suggest that it’s uniquely substantive and persuasive, while other highly relevant information is merely “suggestion”.
“There was a suggestion these fears were whipped up by the churches and other conservative groups.” — Fr Brank Brennan
The “indigenous fears” opinion has been widely disseminated by other Catholics, including now-disgracedFr John Fleming in a paper on behalf of the Catholic Southern Cross Bioethics Institute, and by Mr Paul Russell, Director of “HOPE”, a ginger group established by the Catholic Australian Family Association.
Classic cherry-picking
I’ve called out Mr Russell and others before for cherry-picking information to suit their arguments. And here we are again. In this blog, Mr Russell correctly reports that indigenous NT parliamentarian Mr Wes Lanhupuy voted in favour of the ROTI Act, but dismisses his vote as the result of “pressure”.
What Mr Russell disgracefully omits from his plug is that Mr Lanhupuy was directly involved in the consultation of indigenous communities, and said this in his parliamentary speech:
“The church has been a major voice. … I heard in the community that some of the churches were telling people that they should not support the bill basically because of their religious beliefs. No information whatsoever was given as a reason for that. No information was given whereby people could determine their own beliefs. That was disappointing.” — NT indigenous parliamentarian Mr Wes Lanhupuy (Hansard)
Disgraceful religious prejudice
But there’s more. At the time the federal parliament was debating its Bill to overturn the ROTI Act in 1997, the Senate Legal and Constitutional Legislation Committee conducted a formal investigation and published a Senate report, Consideration of legislation referred to the Committee: Euthanasia Laws Bill 1996. Its 204 pages make interesting reading.
For example, Mr Creed Lovegrove, a former senior Northern Territory public servant leading the Native Affairs Office, reported to the Senate Committee:
“I express my concern, not at the right of certain ideologists to have their say, but at the misrepresentations some were making to people over whom they have an emotional hold. Where this group happens to be Aboriginal, I believe some of the frightening lies they were told about the subject were a psychological and emotional exploitation of them, as blatant as any that has ever occurred in the Territory.” — p 44
…and reported to him by a group of senior and influential Aboriginals:
“They reckon the government is going to round up all the real sick people and those with V.D. and things like that and finish them off.” — p 45
…and on page 44 of the report, the Northern Territory government noted that at least one Aboriginal community wanted to hear the full story about euthanasia, not just the Church story.
Fake news — avoiding healthcare
There were also widespread claims that indigenous Northern Territorians were avoiding presenting to medical centres for healthcare for fear of being euthanased. However, the Senate report noted (p 52) that the claim was controversial, and that the Northern Territory government had provided statistics to show no significant decrease in presentations for treatment.
In a classic opponent manoeuvre when the data yet again didn’t fit the story, it was then claimed (p 52) that future data could show a decrease in presentations.
Morally bankrupt argument
But that’s a morally bankrupt argument. You don’t deny Jack the right to drive a car because Jill has an ill-informed phobia that Jack’s right is likely to contribute to her own death. Rather, the ethical approach is to provide Jack with his right and to provide Jill with education.
And that’s precisely what the NT government did. In today’s money, it stumped up $500k for education programs, and those programs were beginning to take effect. In testimony to the Committee, Reverend Dr Djiniyini Gondarra (opposed to the legislation) conceded that the education efforts had been somewhat effective in overcoming fears about the ROTI Act (p 52).
Ironic reverse discrimination
Perhaps one of the most ironic aspects of church-led fear of the ROTI Act was the Act’s “reverse discrimination” itself. The Act required, if the doctor and patient did not share the same first language, that a qualified and authorised translator be engaged before the patient might qualify for an assisted death.
Given the rarity of qualified and authorised translators, especially in remote communities, indigenous Northern Territorians would have had significantly less access to use the law than their white, city-based fellow citizens.
Putting it into perspective
Setting aside the dreadfully misinformed fear of assisted dying law and its stoking by churches, the question arises as to the prevalence of indigenous residents in the Territories: both Northern Territory and Australian Capital Territory. I’ve retrieved Australian Bureau of Statistics data from the 2016 census to answer that question (Figure 1).
Figure 1: Australian Territory indigenous populations Source: Australian Bureau of Statistics, 2016 census
Indigenous peoples represent a quarter of the population in the NT (25.5%), and a tiny minority (1.6%) in the ACT. Across the two Territories, that’s 10.3% of the population. Even if all the indigenous citizens opposed assisted dying law reform (which is clearly not the case), their impact on overall attitude would be minor.
By way of comparison, most national polls find around 12% of Australians opposed to assisted dying law reform. And, as I’ve factually demonstrated, almost all of that is faith-based. Such ‘fears’ are not a valid reason to prohibit others from pursuing a choice they deeply feel is moral and justified.
Playing the race card
Indeed, if opponents were intent on justifying the denial of a parliament to legislate for assisted dying on the basis of supposed indigenous attitude — playing the race card — then they must also by corollary campaign for the denial of State parliaments to legislate. That's because there are nearly four times as many indigenous Australians in NSW (216,170) and three times as many in Queensland (186,483) as there are in the Northern Territory (58,246) [2016 census data].
To argue one and not the other is to flip-flop.
Contact your Senators now
Church-whipped fear about assisted dying law amongst indigenous Australians is appalling and to be condemned, as is spreading false claims about a supposed reduction in presentations for medical care.
Senators will be inundated with false claims as they contemplate the Leyonhjelm Bill — including that indigenous Territorians are terrified of assisted dying law. (Lyeonhjelm’s Bill doesn’t legalise assisted dying: it only restores Territory parliament rights to consider the reform.)
It’s critical that Senators also hear from supporters of Territory rights — that Territorians not be treated as second-class citizens compared to State-based citizens.
To that end YOU can do something right now! Use the Go Gentle Australiasubmission page to send a message of support to your State or Territory Senators now. Go Gentle make it so easy, by showing you who your Senators are by merely entering your address.
Disclaimer: I do notclaim, suggest, imply or impute that any individuals named in this article were personally or individually responsible for, or were involved in, any misinformation being provided to indigenous Australians about assisted dying law.
Blog by Neil FrancisPosted on Sunday 22nd July 2018 at 12:14am
DyingForChoice has translated the entire 2016-2017 report into English
Belgium's Federal Commission of Control and Evaluation of Euthanasia this week published its full 2016–2017 biennial report. The report is published only in French and Dutch, which places English-speaking jurisdictions at something of a disadvantage.
DyingForChoice has translated the entire report, as well as a copy of the Belgian Euthanasia Act (2002) as it currently stands with amenedments, so that English-speaking audiences can read and understand it.
A summary of key points, the full report in English, and a full copy of the Euthanasia Act, can be found in this Fact File.
Fact file by Neil FrancisPosted on Sunday 22nd July 2018 at 12:07am
DyingForChoice has translated the Belgian 2016-2017 report into English
The Belgian Federal Commission of Control and Evaluation of Euthanasia has released its full 2016–2017 report. Its reports are published only in Belgium's two national langauges: French and Dutch. So that English-speaking countries can read the report in full, DyingForChoice.com has translated the entire 70 page report into English.
Major takeouts of the 2016–2017 report include:
There is ample evidence that doctors take diligent care by often consulting more widely than the Act requires.
Assisted dying by advance directive remains very uncommon (1.3% of 2016/17 cases): almost all cases are by current request.
There has been a significant increase in the ‘poly-morbidities’ category, in part because of a change in the classification system, but also because more folks fall into this category as the population ages.
Cancer is still the major reason that patients choose assisted dying (64% in 2016/17), though its proportion of contributing illnesses is falling.
The number of assisted dying cases in relation to psychiatric illness went down, not up, compared to previous years.
Since changing the law in 2014 to permit assisted dying choice for minors, there have been just three cases: two in 2016 and one in 2017, all of severe and intractable illness. Extensive consultation occurred in each of the three cases, including assessment of decision-making capacity by at least one specialist child psychiatrist or psychologist.
The typical age profile of euthanasia cases has in recent years increased a decile, as the population ages. Our own analysis of Belgian official death stats (not the Commission’s) shows that the elderly are not an ‘at risk’ group: the age distribution profile of assisted deaths is still younger on average than total deaths.
The Commission notes that cancer diagnoses are increasing, so the counts of assisted deaths are expected to continue to rise in coming years.
The Commission discusses several cases that required extended review, but no cases were referred to the public prosecutor in 2016/17.
The full (unofficial) English report can be downloaded here: PDF 1.4Mb.
A full (unofficial) English translation of the current version of the Belgium Euthanasia Act can be downloaded here: PDF 0.3Mb.
The authoritative original versions of the Belgian 2016-2017 report can be accessed in French and Dutch.
The F filesPosted on Saturday 18th November 2017 at 11:27pm
Jones, Paton and Kheriaty's articles demonstrate poor science and multiple, egregious instances of bias.
In 2015, Dr David Jones and Prof. David Paton published an article titled “How does legalization of physician-assisted suicide affect rates of suicide?” in the Southern Medical Journal. The article purported to establish suicide contagion from Oregon and Washington Death With Dignity Act (DWDA) deaths to “total suicides.” It also purported to establish no decrease in general suicide rates, which Jones & Paton argued should occur by substitution of assisted death for some general suicides. (Notice how these two ‘expected’ results — an anticipated rise and an anticipated fall in suicide rates — are at odds in principle.)
In my thorough and empirically-backed response, I expose the disgraceful playbook of these authors as they shambolically commit no fewer than ten deadly sins against science in the pursuit of their opposition to lawful assisted dying.
In 2015, Dr David Jones & Prof. David Paton published an article in the Southern Medical Journal titled “How does legalization of physician-assisted suicide affect rates of suicide?” This study examines the article, as well as an enthusiastic editorial of it by Dr Aaron Kheriaty in the same journal issue, both of which portray “suicide contagion” from Oregon and Washington’s death with dignity acts (DWDA).
However, while contagion from general suicides is a well-established phenomenon, there are multiple sound reasons to reject contagion theory in relation to assisted deaths, including:
Most healthcare professionals readily acknowledge key differences in the characteristics of assisted deaths: for example, a fully informed, tested and rational decision with shared decision-making.
Those using Oregon and Washington’s DWDAs are, by qualifying for it, already actively dying. Thus, they are choosing between two ways of dying rather than between living and dying.
Most of those using the DWDA discuss it with their families (expected, peaceful death), whereas most general suicides occur in isolation and without discussion (unexpected, often violent death).
Multiple studies show that while families of general suicide experience complicated bereavement, families of assisted dying cope at least as well as, and in some cases better than, the general population or those who considered but did not pursue assisted death.
Even if “suicide contagion from assisted dying” theory were sound, direct evidence from official government sources shows that the number of potential suicides in Oregon in 2014 would have been fewer than 2 in 855 cases: undetectable by general modelling methods.
Jones & Paton’s article title conveys an air of skilled and scientific neutrality. However, close examination of the article, and Kheriaty’s editorialisation of it, reveals least ten serious flaws or ‘scientific sins.’
The authors demonstrated little understanding of the complex issues surrounding suicide, willingness to unjustifiably equate assisted dying with general suicide, contentment with failing to search for, consider or include contrary evidence including from sources they cite to argue their case, unreasonable trust in a model that couldn’t hope to legitimately resolve their premises, satisfaction with executing their model amateurishly, a disposition to overstate confidence of causation in the absence of meaningful statistical correlations, and an inclination for emphasising results in accordance with their theories while de-emphasising or ignoring others.
Any of these flaws was serious enough to invalidate Jones & Paton’s article and Kheriaty’s conclusions of it, yet there is not one deadly flaw: there are at least ten.
Their claim of a supposed 6.3% suicide contagion rate from assisted dying in Oregon and Washington is a conceptual and mathematical farce.
The Southern Medical Journal is a peer-reviewed journal. However, it is difficult to reconcile the rigorous standards and sound reputation that peer review is intended to maintain, with the numerous, egregious flaws in this study and its dissemination.
Rather than inform the ongoing conversation about lawful assisted dying, the Jones & Paton and Kheriaty articles misinform and inflame it.
Given the numerous egregious flaws, both articles ought to be retracted.
Blog by Neil FrancisPosted on Monday 13th November 2017 at 6:28pm
The deeply-flawed Jones & Paton, and Kheriaty articles purporting to show suicide contagion.
In the ongoing political campaign against assisted dying law reform, opponents have spread one piece of egregious misinformation after another. One of the most common is supposed “suicide contagion” from assisted dying laws to general suicide, a theory popularised by Catholic Prof. Margaret Somerville. Despite the nonsense of her claim being comprehensively exposed, she still believes that her opinion “will prove to be correct.” Two journal papers published in 2015 purported to, but didn't, establish suicide contagion in Oregon and Washington states.
Assisted dying law reform opponents are still relying on a 2015 paper by Catholics David Jones and David Paton, bolstered by a glowing editorial of it written by Catholic psychiatrist Aaron Kheriaty, published in the Southern Medical Journal, as continued ‘proof’ of suicide contagion theory, at least in respect of USA states Oregon and Washington (since data from other lawful jurisdictions contradicts the theory).
Jones & Paton’s article reported the use of econometric modelling to test for ‘suicide contagion’ from Oregon and Washington’s Death With Dignity Act (DWDA) laws. But, in an exposé to be published this week, no fewer than ten ‘deadly sins’ of the study are peeled back to reveal the rot within.
The very deep flaws and biases of the original articles include:
Cherry-picking information from cited sources to argue their case, while omitting information from the same sources that contradicted their case;
Including test and control subjects whose consequence was likely to maximise the likelihood of finding a positive association;
Demonstrating a poor understanding of suicide and its risk and protective factors and failing to control for most confounding effects in their econometric model ‘pudding’;
Overegging the “causative suicide contagion” interpretation when no correlation between assisted dying and general suicide rates was found; and
Failing to use direct, robust and readily-available evidence that showed their study couldn’t possibly have hoped to return scientifically valid “contagion” proof.
The USA’s National Violent Death Reporting System (NVDRS), of which Oregon is a founding member, shows that even if “assisted dying suicide contagion theory” were true, fewer than 2 of 855 Oregon “total suicides” in 2014 could have been attributed to “contagion” from DWDAs.
Further, both Oregon and Washington state rankings for suicide rates have improved, not deteriorated, since their DWDAs came into effect, while the suicide ranking for a relevant control state — Oklahoma — has deteriorated substantially over the same time.
Ultimately, through numerous and deep methodological flaws, the Jones, Paton and Kheriaty articles reveal a bias to promote “assisted dying suicide contagion theory” while ignoring the robust evidence from multiple lawful jurisdictions, including in their own ‘study,’ that contradict it.
The exposé, titled “The ten deadly sins of Jones, Paton and Kheriaty on ‘suicide contagion’,” will be published by DyingForChoice.com later in the week.
Blog by Neil FrancisPosted on Monday 30th October 2017 at 11:20pm
With a handful of exceptions, the Coalition has demonstrated itself to be 'unrepresentative swill' on assisted dying law reform.
It was with tongue in cheek that I recently quoted former Prime Minister Paul Keating to wonder if politicians voting on assisted dying Bills were ‘unrepresentative swill.’ The now-obvious answer to this question has become more than just humorous, with the publication yesterday of the Hansard record of Victoria’s Legislative Assembly vote on the Voluntary Assisted Dying Bill 2017.
How ironic it was that the very day after I quoted Keating’s slight against his then-hostile Senate, Keating himself, a conservative Catholic, would come out against voluntary assisted dying (VAD) reform.
Hansard record makes compelling reading
But, more importantly, the Hansard record of votes on the Victorian Bill in the lower house make for compelling reading.
Figure 1 shows Victorian voter support for VAD (from ANU Australian Election Study 2016 data) by political preference, and MP votes in support of the Victorian Bill (lower house, 2017).
Figure 1: Victorian electorate support and MP vote support for VAD (lower house, 2017) Sources: AES 2016; Hansard
It’s quite obvious that Greens MPs (100% v 91%) , Labor MPs (86% v 84%) and minor/independent MPs (67% v 76%) approximately represented the proportion of voter support. (It’s unsurprising that all Greens MPs vote in favour of VAD Bills: it’s Greens policy; while it’s a ‘conscience’ matter for other parties.)
The yawning Coalition chasm
But the yawning chasm of Coalition MPs not representing their own voters (14% v 73%) is even more stark. That’s a gap of nearly sixty percentage points. Surely that would be enough to raise the eyebrow of any conservative voter?
Aside from a handful of Coalition MPs who voted in support of the VAD Bill, it’s clear that there’s generally no real ‘conscience’ vote across the Coalition benches.
The corridors have been buzzing with stories of threats to Coalition promotions and preselections, and threats to preference deals for the state election next year, though of course there’s nothing public and on the record. Just the serene statement that “our members have a conscience vote.” The discrepancy amongst Australian Coalition ranks has been formally uncovered before in university research.
It’s a national story
However, it’s not like this is confined to Victoria. Here’s the same chart (Figure 2) for all state VAD bills across Australia since 2000 which have had a division on the vote — so we know who voted which way.
Figure 2: Australian electorate support and state MP vote support for VAD (all state Bills since 2000) Sources: AES 2106; Hansards
Again, the largest and most striking gap between voter desire for reform and MPs opposing their voters’ wishes is amongst the Coalition ranks, at a full sixty percentage points short of proper representation.
It’s a similar picture to that published by university researchers in 2008, who found just 17% Coalition voting support in favour of VAD in the federal parliament, too.
As I’ve explained before, the Party leader’s public statements can be ‘persuasive,’ and Mr Matthew Guy, leader of the Victorian Parliamentary Coalition, has made his entrenched opposition to this reform loud and clear.
Inform your own voting
As debate in Victoria’s upper house commences tomorrow, we’ll be watching who’s in favour and who’s against. And we’ll report the voting record to help inform how you cast your own vote at Victoria’s state election in November next year.
In the meantime, here’s the full record of the Victorian Legislative Assembly votes.
Full voting record – Victorian Legislative Assembly 2017 VAD Bill
Ayes
47
Noes
37
Allan, Jacinta
Labor
Angus, Neil
Liberal
Andrews, Daniel
Labor
Battin, Brad
Liberal
Britnell, Roma
Liberal
Blackwood, Gary
Liberal
Bull, Josh
Labor
Blandthorn, Lizzie
Labor
Carroll, Ben
Labor
Bull, Tim
Nationals
Couzens, Chris
Labor
Burgess, Neale
Liberal
D'Ambrosio, Lily
Labor
Carbines, Anthony
Labor
Dimopoulos, Steve
Labor
Clark, Robert
Liberal
Donnellan, Luke
Labor
Crisp, Peter
Nationals
Edbrooke, Paul
Labor
Dixon, Martin
Liberal
Edwards, Maree
Labor
Fyffe, Christine
Liberal
Eren, John
Labor
Gidley, Michael
Liberal
Foley, Foley
Labor
Guy, Matthew
Liberal
Garrett, Jane
Labor
Hodgett, David
Liberal
Graley, Judith
Labor
Kairouz, Marlene
Labor
Green, Danielle
Labor
Katos, Andrew
Liberal
Halfpenny, Bronwyn
Labor
McCurdy, Tim
Nationals
Hennessy, Jill
Labor
McLeish, Cindy
Liberal
Hibbins, Sam
Greens
Merlino, James
Labor
Howard, Geoff
Labor
Northe, Russell
Ind.
Hutchins, Natalie
Labor
O'Brien, Danny
Nationals
Kealy, Emma
Nationals
O'Brien, Michael
Liberal
Kilkenny, Sonya
Labor
Pesutto, John
Liberal
Knight, Sharon
Labor
Richardson, Tim
Labor
Languiller, Telmo
Labor
Riordan, Richard
Liberal
Lim, Hong
Labor
Ryall, Dee
Liberal
McGuire, Frank
Labor
Ryan, Steph
Nationals
Morris, David
Liberal
Smith, Ryan
LIberal
Nardella, Don
Ind.
Smith, Tim
Liberal
Neville, Lisa
Labor
Southwick, David
Liberal
Noonan, Wade
Labor
Suleyman, Natalie
Labor
Pakula, Martin
Labor
Thompson, Murray
Liberal
Pallas, Tim
Labor
Tilley, Bill
Liberal
Paynter, Brian
Liberal
Wakeling, Nick
Liberal
Pearson, Danny
Labor
Walsh, Peter
Nationals
Perera, Jude
Labor
Watt, Graham
Liberal
Sandell, Ellen
Greens
Wells, Kim
Liberal
Scott, Robin
Labor
Sheed, Suzanna
Ind.
Spence, Ros
Labor
Staikos, Nick
Labor
Staley, Louise
Liberal
Thomas, Mary-Anne
Labor
Thomson, Marsha
Labor
Ward, Vicki
Labor
Williams, Gabrielle
Labor
Wynne, Richard
Labor
TOTAL AYES
TOTAL NOES
Labor
38
Labor
6
Greens
2
Greens
0
Liberal
4
Liberal
24
National
1
National
6
Other
2
Other
1
TOTAL
47
TOTAL
37
Abstained
2
Asher, Louise
Liberal
Victoria, Heidi
Liberal
Did not vote
1
Brooks, Colin
(Speaker, Labor)
Note: The vote represents 87 of 88 seats. The seat of Northcote was vacant owing to the untimely death of its representative, Fiona Richardson, from cancer.
Blog by Neil FrancisPosted on Wednesday 18th October 2017 at 9:41pm
The Victorian parliament is debating the Government's Voluntary Assisted Dying Bill
Former Australian Prime Minister Paul Keating once famously branded the Senate “unrepresentative swill” for obstructing his legislative agenda. Today, the question of how representative our political masters are remains moot.
Major community support for VAD
Take voluntary assisted dying (VAD) for example. Poll after poll demonstrates that the overwhelming majority of Australians want this additional choice for people in extremis at the end of life. The impeccable Australian Election Survey (AES) conducted by Australian National University scholars last year confirmed that 77% of Australians want VAD reform, with 13% undecided and just 10% opposed.
Strong support (43%) is ten times greater than strong opposition (4%), and support is high across the political spectrum: amongst minor/independent (69%), Coalition (77%), Labor (80%) and Greens (87%) voters. Public support has been in the majority for more than four decades.
Political support missing in action
But since the Northern Territory Rights of the Terminally Ill Act in 1996, none of the many VAD Bills before various state parliaments has passed. And the Northern Territory’s Act was torn down by the federal parliament just eight months after coming into effect.
A 2008 university study of federal MP voting opportunities found 100% of Greens, 55% of Labor, and a paltry 17% of Coalition MPs voting in favour of VAD.
New analysis
Now, a new analysis of the ten state VAD Bills since 2000 where final divisions were called, offers further insights. It found 100% of Greens MP voting opportunities were in favour, along with 51% of Labor, 29% of minor party and independent, and a similarly paltry 17% of Coalition MPs. Excluding South Australia, whose parliament has debated the greatest number of VAD Bills, the Coalition support rate was just 9%.
Overall, while state Labor MP votes fell 29% short of Labor voter attitudes, Coalition MP votes fell an astonishing 60% short of Coalition voter attitudes. At the state level, Coalition MPs had the most voting opportunities — nearly half (48%). No wonder passing VAD Bills is challenging.
It begs the question, how is it that our legislative representatives fail to reflect clear public majority views on matters of conscience for so long?
Hidden reasons behind MP opposition
Obviously, lobbying on both sides of the conversation in part informs MPs’ views, but there are several more persuasive factors.
For a start, there’s a “truism” held by many MPs that their vote in favour of a VAD Bill would lose them more votes at a general election than would a vote against the Bill. However, the opposite has been demonstrated in multiplestudies.
Further, I’ve shown before that opposition to VAD is largely religious. A university study has also found that those who are more religious and who are politically engaged tend to hold very conservative views. So while there are religious MPs on both sides of politics, Coalition MPs are naturally more inclined to hold much more conservative views.
But that doesn’t fully explain the massive 60% representation gap on the Coalition side, either.
In good conscience?
A key factor lies in the seemingly reassuring principle of the “conscience vote.” The major parties have announced that their members are accorded a conscience vote (also known as a “free vote”) on the VAD Bill. That simply means that there’s no official published party policy on the matter and party members may vote freely on the basis of their own conscience.
There are two significant issues with this state of affairs.
The first is that the member may refer exclusively to their own conscience. But what if the MP’s conscience is at odds with the electorate’s? For my home state of Victoria, the 2016 AES study found 79% of the community in favour of VAD. There are 88 members of the Victorian parliament lower house, and just 40 members in the upper house. Therefore, it’s possible for as few as just 20 Victorian MPs to vote “no” in order to extinguish the will of 3.2 million Victorians (79% of 4.05 million Victorian voters).
If that weren’t enough, the second issue is that the right to ‘conscience’ is granted only in respect of the Bill itself, not on procedural matters about the Bill. It can make a huge difference.
How the parry works
Here’s what happened in 2008 when Victorian Greens MP Colleen Hartland’s VAD Bill was before the Legislative Council. MPs were afforded a conscience vote, and many of them had said they were supportive of VAD in general, but couldn’t support Hartland’s Bill in its current form. (That’s also a common ruse of MPs who in reality oppose the reform in principle but wish to appear ‘open minded’.)
When the final vote on Hartland’s Bill was lost, then Greens MP Greg Barber immediately moved a motion to refer the Bill to a parliamentary committee so that it could be improved to MPs’ satisfaction. Neither Labor nor Coalition parties afforded their members a conscience vote on this procedural matter, instead directing MPs to vote against such motions. The referral, which may have resulted in Victorians having wider end-of-life choices years ago, was cynically buried.
Most voters remain unaware of the shenanigans played in the corridors of power to achieve such results.
Australia’s special political conservatism
They’re not the only shenanigans, though. Another university study comparing federal MP conscience voting patterns in the UK, New Zealand and Australia found Australia to be different, accounting for why the UK and NZ have legalised marriage equality, while Australia hasn’t.
Firstly, the centre-left in Australia has a larger proportion of Catholic members than in the UK and NZ, accounting for some of the shortfall in Labor representation of progressive views.
Secondly, those amongst Coalition ranks, but with more liberal social consciences, had been lashed by Coalition party whips to vote against progressive reform. So while there was a public display of fairness and neutrality, the reality was quite different.
Borne out in state parliaments
These findings are replicated in Australian state parliament votes too, with Coalition MPs rarely if ever voting in favour of progressive social reform. Coalition MP votes on VAD including and since Hartland’s legislative attempt in 2008 are telling: in Victoria 2008 10:5 against, in Tasmania 2009 6:0 against; in Western Australia 2010 19:1 against; in NSW 2013 10:0 against; in South Australia 2016 14:7 against and in Tasmania 2017 13:1 against.
Rather than reflect 77% Coalition voter support for VAD, Coalition MP voting patterns reflect the highly negative stance of party leaders, whipped through the parliamentary party membership. For example, then WA Premier Mr Colin Barnett made it clear he thought assisted dying was “government-sanctioned killing”. Tasmanian coalition leader Mr Will Hodgman said that “protection for [vulnerable] people cannot be guaranteed.” Then-NSW Premier Mr Barry O’Farrell declared himself “strongly opposed”.
Back to Victoria’s Bill under debate
The situation in Victoria is looking somewhat more positive, with Premier Mr Daniel Andrews and many in his Cabinet publicly supporting reform. A lengthy, detailed, professional and well-resourced process has informed the crafting of the Bill.
However, opposition leader and would-be Premier Mr Matthew Guy has stated his resolute opposition to it and that he intends to vote “no”. That would mean he is quite comfortable for his own personal view to extinguish the contrary views also held in good conscience by 34,626 of the 43,831 voters in his own electorate of Bulleen, and 3.20 million of Victoria’s 4.05 million voters. (Electorate numbers as at 10 October 2017.)
An obvious solution
There’s an obvious solution for MPs whose own consciences disallow them from reflecting the overwhelming majority conscience of the electorate.
They could consider abstaining — simply absenting themselves from the chamber during the division. That would keep their own consciences intact while allowing the electorate’s conscience to be reflected.
I’m a constituent of Mr Guy’s. Over a period of months I made six robust attempts to meet with him to discuss these matters, especially the covert whip arrangements and the consideration of abstention. I can be persuasive in obtaining appointments, but my best efforts proved wholly unfruitful.
As I said to Mr Guy’s private assistant after the last failed attempt, voters could be forgiven for believing he’s more interested in meeting allegedly shady characters in fancy Brighton restaurants, than meeting with his own constituents.
Victorians are watching the parliamentary VAD debate. We’re taking notes that will inform our votes at the state election late next year.
Indications are at present there’s a good chance that Victorian MPs won’t be “unrepresentative swill”.
Blog by Neil FrancisPosted on Tuesday 10th October 2017 at 7:58am
The Parliament of Victoria is currently debating an assisted dying Bill.
As the Parliament of Victoria prepares to debate an assisted dying Bill, South Australian Catholic anti-assisted-dying lobbyist Mr Paul Russell is at it again. This time he's sent a missive to Victorian politicians shouting about, amongst other things, a crisis of assisted dying numbers in Washington state. He’s conveniently cherry-picked his arguments again.
Mr Russell wrote that in Washington state:
“deaths from lethal drugs prescribed under the Act have nearly quadrupled (376%) from 51 in 2010 to 192 in 2016.”
His latest claim extends his misinformation crown title.
Don’t get me wrong. He cites the correct raw data figures for Washington. But he packages them up handily with FUD (Fear, Uncertainty and Doubt) wrapping, all tied up with the most sinister bow he can muster.
I’ve criticised the use of uncontextualized raw data before, and I do so again.
The relevant facts
Washington state legalised assisted dying by ballot in 2008. The following year the law was put into practice, and 2010 was the first full year of its operation.
Here’s the rate of assisted deaths as a proportion of all deaths in Washington state for all the years on record. As you can see, the rate hasn’t even reached one half of one percent of all deaths in 2016.
2009
2010
2011
2012
2013
2014
2015
2016
0.07%
0.11%
0.14%
0.17%
0.23%
0.24%
0.30%
0.35%
Never ones to miss out on an opportunity to spread FUD, if it were just one case last year and two this year, assisted dying opponents would be shouting from the rooftops: “Crisis!! 100% increase!!”. But in reality, only a small minority use the law, yet thousands of patients and their families are given comfort by the option being avaialble even if they don't use it. That message was made loud and clear by Oregon Senator Ginny Burdick. Washington's Death With Dignity Act is modelled on Oregon's, and Oregon's Act has been in effect for twenty years.
A Catholic trifecta
Of course in his missive, Mr Russell, like his fellow Catholic whom I’ve also called out for misinformation, Prof. Margaret Somerville, avoids referring to Swiss data. And their fellow Catholic Mr Daniel Mulino, who furnished a minority report to the Victorian Parliament’s recommendations on end of life choices, a report I’ve also called out for stunning misinformation, fudges his numbers about Switzerland, referring to data from 1998 without further context.
Why do these lobbyists avoid or selectively refer to the Swiss situation? Because the actual data is an inconvenient truth to their FUD story-telling.
An inconvenient truth
Switzerland’s assisted dying law came into effect seventy-four years ago, in 1942. If just one person had used the law in 1942, using Mr Mulino’s favourite annual increase figure of 17.5%, that would equate to 110,338 people pursuing an assisted death in Switzerland in 2014.
I say 2014 because that’s the most recent year for which official Swiss Government assisted dying figures are available. And what was the actual figure in 2014? There were 742 cases of assisted dying amongst Swiss residents, and Dignitas reports that it assisted 198 foreign nationals. That’s a total of 940 assisted deaths.
Let’s add another 60 foreign-national assisted death cases from the much smaller Swiss society that provides accompaniment for foreigners. That makes around 1,000 cases in 2014, including all those who came from all over the world. And it’s less than one hundredth of the minimum rate the doomsayers predict by cherry-picking one statistic that suits their argument.
Swiss law has the fewest safeguards
The Swiss assisted dying law has none of the safeguards of the Washington law. By Mr Russell and Co’s reckoning, you’d think that the Swiss (and those who visit) would be dropping off like flies.
By way of further comparison, the doomsayer number of assisted deaths for 2014 (a minimum of 110,338 cases) is substantially greater than the total number of deaths in Switzerland that year: 63,938. It’s an obvious impossibility.
In 2014, the Swiss rate of assisted deaths including all the foreign nationals who came to use its law, was 1.5% of all deaths; and 1.2% for resident-only cases.
And the rate of assisted deaths in Luxembourg in 2014 (legalised in 2009), whose laws are much more liberal than Washington’s though stricter than Switzerland’s, was 0.17% of all deaths. It’s odd how the doomsayers don’t report Luxembourg data, either.
And what are these cases?
These are cases of people in extremis with no realistic prospect of relief or improvement, choosing a peaceful assisted death as a better option than being forced to prolong their torture, according to their own deeply-held beliefs, values and examined consciences.
Mr Russell believes they should be required to endure their torture. There is a point to it, he says: because it joins them “in some mysterious way to the sufferings of Christ”... whether others believe in Christ, or at least Mr Russell’s version of him, or not.
You won't find this degree of candour on his anti-assisted dying website, but you can find it at NewsWeekly, which is run by the National Civic Council (NCC), itself established by Australia's most famous and conservative lay Catholic, B. A. Santamaria. Mr Russell has been President of the NCC South Australian chapter.
It’s not the numbers, it’s the circumstances
To be clear, in no jurisdiction has its legislature enacted access to assisted dying on the basis of a numeric ceiling. They’ve enacted access on the basis of intolerable and unrelievable suffering. And to this day, those are the folks who may be granted access to an assisted death.
Conclusion
Again, Mr Russell (and colleagues) do themselves no favours by conspicuously cherry-picking the data they want to use, and wrapping it up in threatening garb to create FUD amongst politicians.
Blog by Neil FrancisPosted on Thursday 27th July 2017 at 11:52pm
Research results must be judged in relation to the study's methodology.
In his latest blog, titled “Who are you going to trust?”, anti-assisted dying lobbyist Mr Paul Russell says:
“Polling noted today in the Australian shows a significant level of distrust in our political classes to get the issue of euthanasia and assisted dying right.”
He then goes on to quote some select statistics from said poll. In his blog, he mentions nothing about the sponsorship or conduct of the poll. After some searching, I found no other reference to said poll on his ‘HOPE’ website.
This is rather curious, because The Australian article he quotes, points out that the ‘poll’ was commissioned by him (his website is called ‘HOPE’).
Thus, Mr Russell tries to add credibility to his ‘poll results’ in his blog by citing only that it has been reported in a national newspaper. This ‘quote-someone-else-so-it-must-be-authoritative’ rhetorical strategy has been used before by opponents of assisted dying (see Box at end).
But as Mr Russell has himself promoted — happily republishing the opinion of the CEO of Christian Medical Fellowship (UK) — “opinion polls add up to very little.” That’s quite true… when they’re poorly designed and run, including the big no-no, ‘push-polling’, in which the researcher attempts to get the answer they want by crafting questions more likely to get it.
I searched hard for any reference to the methodology of said ‘poll’, but was unable to identify any despite a diligent search. Therefore, we don’t know what approach Mr Russell took: robust or otherwise.
Let’s assume for the sake of argument (and the absence of public evidence) that a poll of some kind was actually conducted. If it were a truly legitimate poll, you’d think that Mr Russell would be shouting about the study from his own rooftop (the ‘HOPE’ website). But so far, he hasn’t.
Mr Russell, while quoting statistics, has said absolutely nothing about the methodology — that I can find via a quite diligent search.
Results can only be interpreted in light of how the research was actually conducted, so quoting a 'study' while failing to publish its methodology in full is an absolute no-no. It only invites derision.
Rebecca Urban, for The Australian, quotes a number of ‘statistics’ from the ‘poll’ seemingly without question. But she’s hardly to blame: she’s skilled at journalism, not primary research.
So, for the benefit of Paul Russell, Rebecca Urban and all journalists reporting claimed statistics, here’s your minimum standard of conduct if the public are not to guffaw at the claims. All reported results must be in relation to properly disclosed methodology:
Who commissioned the research? (✔ Ms Urban reports who)
Who conducted — actually carried out — the research (e.g. a reputable research company)?
What precise population were respondents drawn from, how were they recruited, and screened in or out? What were the counts and percentage participation (approached/participated)?
What were the dates of the fieldwork?
What procedures were used to establish and maintain the authenticity of who was sampled (e.g. if an online poll, could people from anywhere technically participate in this Victorian poll)?
How was the questionnaire administered (e.g. paper self-complete, online, CATI)?
What was the script of stimuli administered to respondents? In other words, what prompts were given and what questions were asked: exact order and wording?
What results were obtained for each question (i.e. full rather than selective crosstabs)?
Until Mr Russell publishes in full how his ‘poll’ was conducted, the only honourable course of action for him to pursue is to withdraw the claimed results.
Until then, we can only see them as untrustworthy and a bit of a joke.
Rhetorical tactic — “Not” quoting yourself
This rhetorical tactic is also used by Mr Russell’s fellow Catholic, Prof. Margaret Somerville. For example, in her 2015 book Bird on an Ethics Wire, in relation to the supposed (but fanciful) fear of being euthanized in the Netherlands if adequate pain management is accepted, Somerville says in Chapter 4:
“It has been alleged that Dutch physicians have interpreted patients’ consent to pain management as consent to euthanasia.38”
If you’re like most people, you’d assume, given the effort of a citation (38), that an independent source had made the statement based on some evidence. Indeed, if you look at reference 38 you’ll see that the author is Lauren Vogel, and the source article is in the Canadian Medical Association Journal. All sounds like solid, legit stuff, doesn’t it?
However, Ms Vogel is a journalist, not a Dutch medic or a researcher, and what she reports in relation to Somerville’s claim is merely a quote of what someone said. And who is that someone? Why, it’s Margaret Somerville — what a coincidence!
Somerville could have just said “I’ve argued this before…”, but instead gives a seemingly robust reference to a source that has the appearance of independence and scholarship. Yet obviously she knows that the source is merely herself saying so.
Let’s be clear: something is not true just because someone alleges it. Even if they allege it twice or more. And happen cite themselves via someone else in the process.
Figure 1: Australian Territory indigenous populations
Figure 1: Victorian electorate support and MP vote support for VAD (lower house, 2017)
Figure 2: Australian electorate support and state MP vote support for VAD (all state Bills since 2000)
