Victoria

0

Yesterday in a prominent opinion piece in The Age newspaper,1 palliative care specialists argued that palliative care is imperfect and in need of an injection of funds. I agree on both counts.

Nurse Peter Hudson, and doctors Mark Boughey and Jennifer Philip of the Centre for Palliative Care argued that instead of assisted dying as recommended by the recent Victorian Parliament committee report, increased funding of palliative care is ‘the answer.’

Key arguments

Here are the highlights of their opinion piece:
  1. They refer to assisted dying, a neutral expression now in common use amongst both lay commentators and scholars, as a euphemism. Instead they laboriously refer to assisted suicide (suicide is universally seen as a pejorative term with all its baggage about mental illness and substance abuse), and euthanasia (consistently omitting the qualifier ‘voluntary’).
  2. Dying at home should not be the gold standard (despite the great majority preferring it); instead, dying in hospital can be ‘preferred.’
  3. In a profound lack of self-reflection or consistent logic, they say that assisted dying ought to remain outlawed because its outcomes are uncertain. Even assuming the premise of the statement, this would be an identical argument to ban palliative care, whose outcomes are at least equally if not considerably more uncertain.
  4. They falsely imply that users of assisted dying not infrequently experience “very unfavourable” reactions to the drugs. This is simply untrue and I challenge them to provide the empirical evidence that they state is so very important.
  5. Tellingly, they describe a peaceful assisted death as “sanitised,” signalling their intrinsic disapproval of other’s choices.
  6. They say that focus should remain on increased resourcing of palliative care, failing to mention that the Parliamentary committee’s report indeed recommended increases in palliative care funding and improvement of evidence-based practice. Overseas evidence also reveals improvements in palliative care in jurisdictions with assisted dying legislation. There’s no false dichotomy between palliative care and assisted dying as the authors try to insinuate.
  7. They assume that medical interventionism (what they have to offer) is the correct and normative response, ignoring the fact that some people simply don’t want more interventions.
 

The filibuster

In a journal article recently published by two of the opinion piece authors,2 and repeated in principle in the Centre’s submission to and appearance before the Parliamentary inquiry,3,4 they say that:

“Increased resources and effort must be directed toward training, research, community engagement, and ensuring adequate resourcing for palliative care to benefit many before further consideration is given to allocating resources into legalising EAS to respond to the requests of a few.”

Notice two things about their recommendation—the filibuster.

Maximising what cannot be done

Firstly, they say we must not just ban assisted dying, but that it is dangerous even to talk about it: palliative care must be improved even “before further consideration is given.” The specific purpose of this part of the filibuster is to maximise what cannot be done: to position even mere conversation, let alone actual reform, as ‘unsafe.’

Maximising the delay

Secondly, nowhere in their argument do they provide a single quantitative metric (and which they strongly argue is necessary for the legalisation of assisted dying) by which the palliative care reforms they advocate might be judged: not a single dollar amount nor a single performance benchmark amongst their many recommendations.

How much will reforms cost, how long will they take, and what performance measure improvements would need to be achieved for the expenditure to be judged effective? What performance measures would need to be reached before it was then ‘safe’ to even consider assisted dying? The authors are entirely mute on these critical matters, while making precisely these evidential demands of assisted dying.

So, the opinionists’ argument allows them to indefinitely say that “more improvements are needed in palliative care before we even talk about assisted dying,” because further ‘improvements’ are always possible.

But all that was a ruse anyhow

In any case, the authors say in their submission to the Parliamentary inquiry that there are numerous problems (spurious, I argue) with legalising assisted dying; that they doubt they could be overcome; and then finally “it should not be construed that we would support the legalisation of EAS if efforts were made to address [the problems].”4, page 6 (Curiously, they omit the third, critical statement from their more public opinion piece.)

This truly exposes the classic filibuster… an open-ended call with no metrics, which therefore can be deemed never to have been met. How convenient. But, even if they were met, the authors still wouldn’t support reform. This begs the question:

If the authors are as so firmly evidence-based—as they take pains to emphasise—why would they not support a reform if the evidence endorsed it?

There must be something other than evidence that drives their entrenched opposition to assisted dying: something so important that it renders all their previous arguments null and void. What might that be?

Who are these people, anyway?

It’s informative to answer the question of who these three from the Centre for Palliative Care are. The Centre sounds like a neutral government body. It isn’t. Don’t get me wrong. I have no doubt that these three are skilled and compassionate practitioners and that the Centre delivers good services.

In reality the Center is a section of Melbourne’s St Vincent’s Hospital. That’s an organisation that proudly states “as a Catholic healthcare service we bring God’s love to those in need through the healing ministry of Jesus.”

I believe St V’s to be a high-quality healthcare institution, but too bad if the patient just wants evidence-based medical care and not the ‘healing ministry’ of a religious figure they may not subscribe to.

The reason this is important is this: what the three authors say about assisted dying is entirely consistent with the Vatican’s stance. I have no idea if any of the authors are Catholic, but what would be entirely surprising is if they published anything at odds with the views of the Vatican given their Centre is deeply embedded within the largest Catholic health and aged care service provider in the country.

For clarity and fairness, I once again place on the public record that I am agnostic.

The ‘Catholic card’

Before Messers Paul Russell, Alex Schadenberg and others leap onto their campaigning steeds to megaphone that I’m ‘playing the Catholic card’ (just wait for it!), let me be clear that I specifically am doing precisely that. For sure, The Catholic Church is not the only religious body resolutely opposed to anyone having the choice of assisted dying, but it’s the premier one.

And, Messers Russell et al would be absolutely right to point out that the authors didn’t raise a single religious argument, so let me save them the bother.

Religious opposition dressed up in secular garb

And that’s the point. It’s abundantly clear from multiple sources that religious opponents have actively decided that they will absolutely avoid using religious arguments because they know it will lose them the debate.

Media identity Andrew Denton’s Better Off Dead podcast series makes this avoidance abundantly clear from the Australian perspective. His insights, having attended a global anti-euthanasia conference in Adelaide, are important and revealing. 

From the North American perspective, a study just published by Associate Professor Ari Gandsman of the University of Ottawa in Death Studies5 reports uncanny North American similarities. Assisted dying opponents have actively decided to cease using religious arguments. Instead, their objective is to create an atmosphere of FUD: fear, uncertainty and doubt. It is only this now, they agree amongst themselves, that will keep assisted dying off the statute books. As Gandsman explains (and I paraphrase), religious opponents have moved from ‘it’s a sin’ to ‘but think about all the perceived risks!’

Again, I reiterate that the three opinion piece authors are likely to be fine nurses and doctors (I have never met any of them), but I do say that their incoherent and self-contradictory arguments against assisted dying, remaining opposed even ‘if’ the evidence for it stacks up, is neither their finest work, nor varies one iota from the religious anchor that the Vatican provides to their Centre’s services.

The importance of mutual respect

If a person says to me “I believe assisted dying is wrong,” I respect that view and admire their resolution. For themselves. Including if it is underpinned by religious belief. If you believe that assisted dying, or surrogacy, or other contentious issue is wrong, don’t participate in it. 

But don’t expect that your own view of your own God trumps everyone else’s God—or lack thereof. In Australia for example, the majority of citizens are not Catholic. And most of those who are—three out of four—disagree with the Vatican’s opposition to assisted dying. The Vatican’s view then is not particularly relevant to anyone but its most ardent adherents.

Respect in both directions is warranted but is rather lacking from the more religious end. My argument is not against Catholicism itself. There are very fine Catholics on both sides of the debate, doing their best to live a deliberatively ‘good’ life.

Conclusion

We can do without the incoherent and indefensible nonsense advanced in secular garb by the religiously opposed.

Be clear folks: the FUD campaign is on its last legs. I will be further exposing rubbish arguments posed by those with religious connections but couched in non-religious language.

In the meantime you can see the clumsy, failed attempt at a filibuster by these three opinionists for what it is.

 

References

  1. Hudson, P., Boughey, M. & Philip, J., 2016, Victoria's proposed euthanasia laws are flawed, Melbourne: Fairfax Media, Accessed 21 Jun 2016, http://www.theage.com.au/comment/victorias-proposed-euthanasia-laws-are-flawed-20160620-gpn9p2.html
  2. Hudson, P., Hudson, R., Philip, J., Boughey, M., Kelly, B. & Hertogh, C., 2015, Legalizing physician-assisted suicide and/or euthanasia: Pragmatic implications for palliative care, Palliative and Supportive Care, 13(5), 1399-1409.
  3. Hudson, P., 2015, Inquiry into end of life choices: Submission 905 to the Parliament of Victoria, Centre for Palliative Care, St Vincent’s Hospital, Melbourne.
  4. Hudson, P., Boughey, M. and Philip, J., 2016, Witness Appearance Transcript: Inquiry into end-of-life choices - Centre for Palliative Care, Parliament of Victoria, Melbourne, 24 Feb.
  5. Gandsman, A., 2016,“A recipe for elder abuse:” From sin to risk in anti-euthanasia activism. Death Studies, In press.
Share This Post:
0
Mrs Inga Peulich of the Victorian Parliament.

Mrs Inga Peulich is MLC for the Victorian state region of South-Eastern Metropolitan and is Shadow Minister for Multicultural Affairs and for Scrutiny of Government. She is a member of the Parliament's Legal and Social Issues Committee, which recently recommended assisted dying law reform.

She has previously made clear her personal opposition toward assisted dying law reform. It's no surprise then that she wrote a minority report against her own Committee's final recommendations. What is surprising is the incoherence of her report.

They're biased but I'm not

Mrs Peulich rails against the inquiry being held in the first place, saying that she outright opposed the call. It's curious then that she remained on the Committee once the inquiry was mandated by the Legislative Council.

Even more telling is that Mrs Peulich accuses her fellow Parliamentary Committee members of unmitigated bias—that they simply reached a foregone conclusion. Not only does such hubris demonstrate a breathtaking disregard for the dedication and professionalism of her fellow Parliamentarians, it reveals a comprehensive failure of self-reflection: that other members are biased for the possibility of a supportive stance, but she is not for her preset and entrenched opposition.

The criticism is all the more galling for the fact that Mrs Peulich missed a number of meetings to hear from expert witnesses. Other members were informed and their position changed or at least nuanced by the evidence and advice.

The ramble

Mrs Peulich's minority report then launches into a ramble of conjecture, raising many of the tired old discredited arguments against assisted dying without reference to a single cited fact; incoherently even making points that the Committees' final report (hundreds of pages, fully cited) can't support...and ones that I specifically, comprehensively and evidentially refuted in my submission to and expert witness appearance before the Committee.

At least one appropriate omission

I can say that in response to a question Mrs Peulich asked me about non-voluntary euthanasia in the Netherlands, in what she might have anticipated as a 'gotcha' moment, I used empirical scientific evidence to blast the premise of her question—that legalisation of voluntary euthanasia has increased the rate of Dutch non-voluntary euthanasia—out of the water. The rate has dropped dramatically, not increased. At least she didn't raise that hoary old Dutch chestnut directly in her report.

Selective perfectionism

It would be tedious to address every item of unsupported conjecture and misinformation in Mrs Peulich's report. However, one other claim is worthy of discussion. It's an argument she's made before. She says this in regard to assisted dying law reform:

"...people will die as a result of accident, error or misdiagnosis. Any accidental loss of life – even the loss of one life, means such a regime cannot be justified."

Putting aside for the moment the premise of the statement, Mrs Peulich's selectivity is remarkable.

Published scientific research shows that of hospital admissions (Australia), around 0.4% result in death as a consequence of preventable medical error.1 The study was published some twenty years ago, so let's assume that the error rate has dropped—by virtue of greatly improved record keeping, communication, transparency, procedures and technology since then—by a factor of ten: that is, a preventable medical error death rate of 0.04%.

That still means that at least dozens of Victorians die each year as a result of preventable medical error.

If Mrs Peulich argues that no system can be justified if it results in the erroneous loss of a single life, then she must equally argue for the closure and prohibition of the entire Victorian hospital system. Or admit that she's irrationally biased against the option of assisted dying.

Missing critical Oregon 'information'

Yet the most telling thing is what is missing from Mrs Peulich's minority report.

On April 8th 2010, as keynote speaker and in her capacity as member of the Victorian Parliament, at Australian Catholic University's Interfaith Symposium on Death and Dying, she made this unequivocal statement:

"The Oregon experience, which legislated the taking of medication to bring about euthanasia indicates unfortunately that it does occur, that older patients who are tapping into more expensive care are encouraged often to bring about their own earlier demise."

Such a situation would be a very, very serious matter indeed.

But did Mrs Peulich furnish any evidence to support her allegation? No, none whatsoever.

If she believes this matter to be true, and it would be of critical importance to the inquiry to which she was directly a party and would strongly support her case against reform, why does it not appear in her minority report?

Mrs Peulich, put up or apologise

The claim is bunkum. Having extensively studied dozens of reports about and scientific studies into practices in Oregon and personally interviewed key Oregonian stakeholders (for, against and neutral), I have found not a shred of evidence that supports Mrs Peulich's categorical assertion.

I expressly challenge Mrs Peulich to furnish the necessary, verifiable, authoritative evidence (not mere self-serving gossip and scuttlebutt), and to explain why it does not appear as evidence to her own Committee's investigation.

If she is unable to provide such evidence or satisfactorily explain its absence from her minority report, it is my view that she owes the people of Victoria an apology for the spreading of misinformation on the taxpayer's tab.

A dead bat to this challenge would only serve to highlight that her claims are rubbish and that this kind of approach deserves no place in the important public discourse about assisted dying.

 

----------

1. Wilson, Ross McL, Runciman, William B., Gibberd, Robert W., Harrison, Bernadette T., Newby, Liza & Hamilton, John D.. 1995. The Quality in Australian Healthcare Study. Medical Journal of Australia 163: 458-471. 

 


Share This Post:
0
St Patrick's Cathedral, Melbourne, Australia. Photo: Donaldytong

On Wednesday 19th November 2015, the Catholic Church appeared before the Victorian Parliament's Legal and Social Issues Committee. Monsignor Anthony Ireland, the Episcopal Vicar for Health, Aged and Disability Care, and Father Anthony Kerin, Episcopal Vicar for Life, Marriage and Family gave evidence about end-of-life decision making. They made a factually wrong allegation about Oregon during their testimony.

Anthony Ireland spoke first, making it clear that they were appearing before the Committee with delegated authority from the Catholic Archbishop of Melbourne (Denis Hart) and with the endorsement of the Victorian Catholic Bishops. He emphasised that "the Catholic Archdiocese of Melbourne does not come to this Committee with fanciful or frivolous arguments."

During question time. Committee Chair Edward O'Donohue asked the Vicars if they had any evidence from lawful jurisdictions to back up their claim that legalising assisted dying would result in a significant reduction in medical research. The Vicars flailed about with vague hypotheticals, but no evidence.

Committee Deputy Chair Nina Springle remarked that some of their testimony was inconsistent with direct evidence from lawful jurisdictions and invited them to reflect on the contradictions. To this, Anthony Kerin stated:

"We know, for example, since Oregon legislated, that the standard suicide rate has increased remarkably and alarmingly. It's not yet the largest rate in the US, but it's getting there, when Oregon had a very, very low suicide rate prior to that."

Let's not mince words: the allegation is comprehensively false. In fact it's three false statements all wrapped up into one.

The USA government's CDC mortaility database provides solid empirical data. Here's Oregon's longitudinal suicide rate statistics, including sixteen years before its Death With Dignity Act (DWDA), and sixteen years after.

Oregon suicide rate

Here are the pertinent facts about Oregon's general suicide rate:

  1. The average for the 16 years after the DWDA is lower than, but not statistically different from, the 16 years prior to the Act.
  2. There was a massive drop in the suicide rate two years after the DWDA came into effect, and the rate has risen only from there.
  3. The rise from 2000 onwards is repeated in the majority of USA states and in the national average. The trend increase in Oregon is not statistically different from the national trend increase.

 
By way of comparison, here's Vermont's suicide rate for the same period.

vermontsuiciderate.jpg

Now, Vermont didn't have an assisted dying law until 2013, and no assisted deaths occurred under the law in that year, so the suicide rate cannot have been affected by an assisted dying law. Yet the picture is similar to Oregon's.

Here's the USA national suicide rate for the same period, with the unemployment rate added.

USA suicide and unemployment rates

There are numerous and complex reasons for suicide and for changes in the rate, but a key one in this USA case is unemployment, which after falling in the 1990s rose abruptly from 2000 onwards.

Has Oregon's suicide rate been worsening relative to other USA states, though? The state annual suicide rankings are informative.

Oregon suicide ranking among all USA states (number 1 is worst)

Prior to the DWDA, the trend in Oregon's suicide ranking among all USA states was deteriorating (where ranking number one is the highest suicide rate). Since the Act came into effect, the trend is improving. The difference in trends is statistically significant. In the sixteen years since the Act came into effect, Oregon has appeared in the "top ten" six times, compared with twelve times in the 16 years prior to the Act.

So, let's examine the three elements of the Catholic Church's statement:

1. "Since Oregon legislated, the standard suicide rate has increased remarkably and alarmingly"

This statement is false by omission. It is critically relevant to mention that Oregon's suicide rate dropped massively two years after the DWDA came into effect. Only after 2000 did it begin to rise—like most states and nationally—and in response to a rising unemployment rate.

2. "Oregon had a very, very low suicide rate prior to that [the DWDA]"

This statement is completely false. Oregon's mean rate suicide for 16 years after the act is not significantly different from the mean for 16 years prior to the Act. Indeed, government data back to 1968 shows Oregon's general suicide rate has always been high and never "low", let alone "very, very low".

3. It's not yet the largest rate in the US, but it's getting there"

This statement is completely false. Oregon's suicide ranking amongst USA states was worsening prior to the DWDA, but has been improving since.

It's very disappointing indeed that the Catholic Archdiocese of Melbourne would offer such profoundly false testimony to a legislative committee making inquiries on behalf of the people of Victoria. The offense is all the more grevious because of the unequivocal manner in which the statement was made, and that the witnesses specifically stated they did not bring any fanciful or frivolous arguments to the Committee.

It's time to comprehensively stamp out false information about assisted dying, no matter how fervently it might be believed by its proponents. Watch this space: there's plenty more to come!


Share This Post:
0

On 16th September 2015, the Victorian Director of the Australian Christian Lobby (ACL), Dan Flynn, appeared as a witness to the Victorian Parliament’s end of life choices inquiry being conducted by the Legal and Social Issues Committee. He made a number of mistaken statements, but what was most worrisome was the revelation of the ACL’s real agenda: to wind back patient rights more than a quarter century.

 

Out of touch

In his opening address, Mr Flynn opined that assisted dying was 'not supported' by a 'broad base' of Victorian Christians (not just the ACL). This belief is diametrically at odds with clear and repeated evidence from multiple sources.

In 2012, I reported on a Newspoll study into Australian attitudes towards assisted dying. Not only did a whopping majority of citizens support assisted dying, but so did a great majority of Anglicans, Catholics and other Christians (Francis 2012).

 

Australian attitudes to assisted dying law reform in 2012

Newspoll 2012: Australian attitudes to assisted dying law reform by religion (green=support, red=oppose)

These national results are reflected by a sample of over 60,000 Victorians through the VoteCompass system during the 2014 Victorian election (Stayner 2014). It confirms a substantial majority of Catholics, Protestants, other religious and non-religious Victorians support assisted dying law reform.

 

votecompassvicvereligion2014.jpg

VoteCompass 2014: Victorian attitudes to assisted dying law reform by religion (grey=population average)

Out of date

Mr Flynn then referred to a Tasmanian Parliament’s inquiry into assisted dying which rejected law reform. However, the inquiry to which he refers was held in 1998, when Oregon’s Death With Dignity Act had barely been established, the Northern Territory’s Rights of the Terminally Ill Act had been extinguished within just eight months of coming into operation, and the Dutch, Belgian, Luxembourg, Washington and other legislation and judgements did not yet exist.

So, the Tasmanian Parliament’s rejection came from a position of a then general lack of information. The Oregon law has been in effect since 1997, the Netherlands and Belgium since 2002, Washington since 2008, Luxembourg since 2009, and so on. There is now plenty of evidence that assisted dying law reform doesn’t cause slippery slopes that opponents love to theorise about.

Wrong about ‘United Nations’

Mr Flynn then said that the United Nations had in 2012 expressed concern about a ‘lax attitude’ towards euthanasia in Europe, specifically mentioning the Netherlands and Belgium. This is completely untrue. Because it’s easy to make a simple blooper during a presentation, we’ll put aside the fact that he meant to refer to a completely different organisation: the Council of Europe.

We know this because he read directly from Council of Europe declaration 1859 (Council of Europe Parliamentary Assembly 2012). His ACL submission (Australian Christian Lobby 2015) reports (as he read out) exactly one sentence of the declaration, with his added emphasis, as:

"Euthanasia, in the sense of the intentional killing by act or omission of a dependent human being for his or her alleged benefit, must always be prohibited."

But presented in this manner the statement is quite misleading. As I explain in a forensic analysis of the misinformation campaign about this resolution (Francis 2015), the resolution was utterly clear about its intent: it was not about euthanasia (it explicitly said so), but rather about advance care planning. What the resolution spoke against (in the one sentence conveyed above) is non-voluntary euthanasia, not voluntary euthanasia. Both sides of the assisted dying debate agree that non-voluntary euthanasia (one person deciding for a hastened death on behalf of another) is not acceptable. It is not contentious.

In no way did the Council of Europe's resolution critique voluntary euthanasia or comment on any jurisdiction in which it is legal. And, the United Nations source to which the ACL submission refers was released in 2001, fourteen years ago and at the time of the Netherlands' Euthanasia Act was before the Dutch Parliament. With then limited information about how such laws work in practice, it expressed concern about the upcoming Act.

Wrong about Belgium’s law and practice

Mr Flynn referred vaguely to two cases of euthanasia in Belgium in which persons who requested and received euthanasia were not experiencing intolerable pain, which Mr Flynn asserted was a required safeguard in Belgium’s euthanasia Act. This was another supposed example of transgression of safeguards.  Wrong again.

While the Belgian Euthanasia Act is officially published only in Dutch and French, a robust English translation has been prepared under the supervision of Professor Herman Nys of the Centre for Biomedical Ethics and Law at the Catholic University of Leuven (see Parliament of Belgium 2002). The word ‘pain’ does not appear in the Act… at all. What does the Act have to say about the legislature’s intent on who may qualify? The relevant clause in Section 1 says:

"the patient is in a medically futile condition of constant and unbearable physical or mental suffering that can not be alleviated, resulting from a serious and incurable disorder caused by illness or accident."

It’s abundantly clear: mental suffering from an illness or accident qualifies as much as physical suffering, and the suffering does not need to be ‘pain’ as Mr Flynn mistakenly asserted to the Parliamentary Committee.

Mr Flynn also stated that there are mobile end-of-life units in Belgium. There aren’t. (But there are in the Netherlands, and they must follow precisely all the same requirements as anyone else. They operate to provide choice to patients whose regular or reachable doctors disagree with assisted dying and therefore decline to evaluate whether the patient may qualify under the Act.)

Confused about Advance Care Directives

In further testimony, Mr Flynn opined that the degree to which a doctor should be allowed to override a patient’s Advance Care Directive (ACD) is in part influenced by whether the doctor can speak with the patient.

But if the patient can currently speak and participate in decision-making, the advance care directive doesn’t apply: it is mute and of no effect. An ACD only applies when the patient cannot currently participate in their own decision making. That’s (only) what it’s for.

Winding rights back more than a quarter century

But the most worrying aspect Mr Flynn’s testimony was the revelation of ACL’s opposition to the right to refuse unwanted medical treatment.

The Medical Treatment Act 1998 (Vic) has enshrined for now more than twenty five years a patient’s right to refuse any unwanted medical treatments. In 2003 the Supreme Court of Victoria determined that artificial nutrition and hydration (i.e. via tubes) is medical treatment and can therefore be refused under the Act.

But Mr Flynn repeatedly argued that withholding or withdrawing artificial nutrition and hydration, if the patient’s body could ‘absorb’ them, could amount to physician-assisted suicide, and that doctors must be allowed to override refusals. On the matter of patient autonomy, he said that some autonomy rests "with the patients, but a lot of the autonomy in fact is with the doctor”.

When asked if a Jehovah's Witness who refuses a life-saving and simple blood transfusion ought to be allowed to do so, he conceded that they should be entitled to, but that such a case was a “bit of an outlier”. He didn’t explain on what moral grounds one person could refuse a simple procedure to save their life, but another person mustn’t be allowed to even if the likelihood of saving life was doubtful.              

So, the ACL’s real agenda is revealed: it recommends winding back the legislative clock more than a quarter century so as to force patients to endure some medical interventions that they don’t want and firmly refuse, if the doctor wishes to proceed.

No wonder the Committee repeatedly questioned Mr Flynn to ensure they had heard and understood his testimony correctly. In conclusion, Committee Chair Edward O’Donohue observed that Mr Flynn’s evidence was “quite surprising” and “quite contrary” to wide evidence already given.

And it’s no wonder that Theo Mackaay, General Secretary of the Victorian Council of Churches—a group of 30 member churches representing mainstream Christianity—criticised the ACL as “fundamentally conservative” and expressed “deep concern that media portrayal of statements from an established and narrow focused lobby group is presented as being representative of the entire Christian community” (Uniting Church in Australia 2011).

-----

References

Australian Christian Lobby 2015, Submission to the Legal and Social Issues Committee on the Inquiry inito End of Life Choices, Parliament of Victoria, Melbourne, pp. 1-17.

Council of Europe Parliamentary Assembly 2012, Resolution 1859 (2012): Protecting human rights and dignity by taking into account previously expressed wishes of patients, Europe, 25 Jan, pp. 2.

Francis, N 2012, Australian public desire for legalisation of assisted dying in restricted circumstances, YourLastRight.com, Melbourne, pp. 11.

Francis, N 2015, Conservatives fudge Council of Europe declaration 1859, DyingForChoice.com, viewed 2 Jun 2015, <http://www.dyingforchoice.com/f-files/conservatives-fudge-council-europe-declaration-1859>.

Parliament of Belgium 2002, 'The Belgian Act on Euthanasia of May 28th 2002 (unofficial English translation)', Ethical Perspectives, vol. 9, no. 2-3, pp. 182-188.

Stayner, G 2014, Victorian election 2014: Electorate overwhelmingly back voluntary euthanasia, Vote Compass reveals, ABC News, viewed 4 Dec 2014, <http://www.abc.net.au/news/2014-11-23/victorians-back-voluntary-euthanasia-vote-compass/5910668>.

Uniting Church in Australia 2011, Australian Christian Lobby does not represent all Australian Christians, nor all Christian viewpoints, 8 Dec, Media Room, viewed 11 Dec 2011, <http://blogs.victas.uca.org.au/mediaroom/?p=971>.


Share This Post:
0
The Victorian Premier doesn't support assisted dying law reform - at this stage.

Victorian Premier Daniel Andrews reports that he doesn’t support voluntary euthanasia “at this stage” (The Age, 21 Jun 2015), and that his objections are not based on his Catholic faith. I think it is fair to take him at his word given his historical record in facilitating conversation and reform around values-based issues such as abortion. But his current thinking on assisted dying is indefensible as I explain.

We know from repeated Newspoll Australia studies that amongst the millions of Victorians who want the State to respect their wish to make their own choices at the end of life, three out of four Australian Catholics are in favour of legalised assisted dying—at odds with the ‘traditional’ Catholic stance. Mr Andrews, like a majority of Catholic Australians, may simply not agree with the Vatican line on assisted dying choice, as they don't on a range of matters.

Mr Andrews says that his current objections instead revolve around ‘safeguard’ and ‘balance’ issues in a context of finite healthcare resources.

Let’s examine that stance in the light of the Legislative Council committee inquiry recently launched into end-of-life decision making.

The Medical Treatment Act 1988 confers the right to Victorian patients to refuse any medical treatment. The right applies even if the treatment is life-saving, for example a simple blood transfusion. The Act contains no ‘safeguards’, as the Premier refers to them:

  • The patient is not required to give any reason;
  • The doctor is not required to inform the patient of their condition or likely consequences of any treatment or its refusal;
  • The doctor is not required to consider or assess the patient’s mental capacity to decide including depression;
  • The doctor is not required to recommend a palliative consult (if relevant);
  • The doctor is not required to consult any colleagues for a further opinion about the patient’s illness or mental capacity;
  • There is no obligation on the patient to consider their decision again after a short time;
  • While there is a standard form 'Refusal of Medical Treatment' document that can be signed to provide documentary evidence of the refusal, it is not mandatory;
  • There is no mandated path of reporting or review.

 
Indeed, a doctor who goes on to administer medical interventions to the patient who has refused them is guilty of the offence of ‘medical trespass’ and can be prosecuted.

Further, it is quite legal for a patient to decide to die by voluntary refusal of food and fluids, an option suggested as appropriate by Dr Bill Sylvester in an IQ2 debate at Melbourne Town Hall in November 2012, to a hostile reaction from the audience. Some doctors provide respite care to patients choosing this path. however, like refusal of medical treatment, there are no legislated safeguards.

On the basis of these two kinds of end-of-life decision making that have been lawful for at least a quarter century in Victoria, and which have no legislated safeguards, what evidence do we have of the so-called ‘slippery slope’ of resource-strapped healthcare providers or greedy relatives persuading the sick to choose a path to die earlier rather than later?

Both Victoria Police and the former Minister for Health, the Hon. David Davis, have advised that there are no known prosecutions under the provisions of the Medical Treatment Act 1988 for such inappropriate persuasion.

So, in Victoria we have the experience of two forms of decision-making whose direct and foreseeable consequence is death, with no mandated safeguards and within 'finite healthcare resources' (which Mr Andrews refers to as his reason), not resulting in prosecutions for persuasion to 'choose' death.

If Mr Andrews’ argument is that terminally ill Victorians ought to be denied the right to choose assisted dying because of supposed slippery slopes of persuasion, that argument would exactly and equally apply to the refusal of life-saving medical treatment and to the refusal of food and fluids.

Surely his Government is not suggesting that the existing rights be rescinded: that patients be forced to receive any and all life-saving and life-prolonging treatment in order to avoid a 'persuasion' bogeyman who doesn’t exist?

The Premier's stance is even less defensible in the light of proposed assisted dying legislation which includes a suite of checks and balances that are absent from existing rights.

Some dying individuals, reflecting upon their circumstances and deeply-held values and beliefs, determine that alighting from the train of terminal illness one or two stops before the terminus is a vastly better option than being forced to endure the train ride until the very end. We compound their indignities by saying it’s OK to decide to starve yourself to death (and we might even provide support along the way), but not OK to decide to die peacefully surrounded by loved ones at a predetermined time.

It is commendable that the Legislative Council has resolved to investigate the issue of end-of-life decisions, and whose final report will better inform the Premier and all Parliamentarians. Submissions to the Committee are open until Monday 31st August.


Share This Post:
Victoria's VAD Bill has passed both Houses and is now an Act.

Update 7th December 2017

At 4:10pm on Wednesday 22nd November, the Voluntary Assisted Dying Bill passed both Houses of the Victorian Parliament. The Victorian Governor has signed the Bill into an Act, so it is now law in Victoria, though not yet in effect. The Act will come into effect in June 2019, given Victorian residents facing intolerable suffering from an incurable illness, and who meet a number of hurdles, to lawfully request and obtain a peaceful death assisted by their doctor.


Update 20th October 2017

Victorians are a step closer to having the choice of assisted dying in the face of a terminal illness. After a marathon all-nighter sitting, the Legislative Assembly (lower house) this morning passed the Voluntary Assisted Dying Bill 2017. The Bill will now be sent to the Legislative Council (upper house).

The vote was won convincingly at 47:37, despite heroic efforts of opponents to create FUD (fear, uncertainty and doubt) through extensive misinformation, and filibustering the Bill's progress by putting up amendements to numerous clauses.

The Legislative Council is expected to debate the Bill next month.


Update 21st September 2017

In great news for Victorians, yesterday (20th September 2017), the Government tabled its Voluntary Assisted Dying Bill into the lower house of the legislature. The Bill is comprehensive, offering Victorians a further end-of-life choice, with numerous safeguards, and the stiffest pentalties worldwide for breaking the rules.

  • Read the Bill's explanatory memorandum (PDF, 273Kb).
  • Read the whole Bill (PDF, 945Kb).
     

Parliamentary debate on the Bill is likely to commence mid October, so now is the time to contact your own members of the Victorian parliament and let them know you support the Bill. If you don't know which electorate you live in or who your members are, or don't have their contact details, then:

  • Visit the Victorian Electoral Commission website and enter your home address, at the top of the page, to find out. It will show you your upper and lower house electorates. Make a note of the lower house electorate (District, in purple).
  • Then go to the Victorian Parliament website and enter your lower house electorate name in the Electorate field (the last one) and click Search, to find your lower house member. Note down your Member's contact details.
  • Then, also click the [Electorate] button on the Member's page (on the right) and then click the Region link on the target page. This also gives you the names and details of your five upper house parliamentarians.
  • Take down their contact details and let them all know you're asking them to support the Bill.

The Standing Committee on Legal and Social Issues (Legislation and References) of the Parliament of Victoria, Australia, has recommended that the Government introduce leglislation to allow assisted dying in restricted circumstances.

Update 9th June 2016

In excellent news for Victorians, the LSIC has recommended that the Government legislate to allow assisted dying in restricted circumstances.

 

"Recommendation 49: The Government should introduce legislation to allow adults with decision making capacity, suffering from a serious and incurable condition who are at the end of life to be provided assistance to die in certain circumstances."

The recommendations include:

  • Eligibility: A mentally competent adult experiencing intolerable and unrelievable suffering, with weeks or months to live. Must be ordinarily resident in Victoria and an Australian citizen or permanent resident.
  • A process by which requests may be made (and rescinded).
  • Checks and tests to ensure that relevant critieria have been met.
  • Establishment of an authority to receive reports of assisted dying and present reports to Parliament.
  • That conscientious objection (to not participate) is protected.
  • That in the case that a patient cannot self-administer lethal medication, a doctor may do so at the patient's request.

 
You can read the full report here.

 

Important!

The recommendation has yet to translate into a Bill and a majority vote of both Houses of the Victorian Parliament. Some parliamentarians are intractably opposed to this reform and it's important that policitians hear from you to know that you want them to support the reform.

Sign the petition to go to all Victorian parliamentarians now, and spread the word!

 


 

 

Submissions were invited from interested individuals and organisations into end-of-life decision-making in Victoria, including:

  • current practices including palliative care;
  • whether current legislation satisfactorily encompasses contemporary community standards, aspirations and views;
  • a review of legislation and practices in other jurisdictions, both within Australia and overseas; and
  • what types of legislative change may be required.

Submissions to the inquiry, which have not been requested to remain confidential, are published on the Parliamentary website here.

Despite the Terms of Reference for the inquiry  (below) do not mention assisted dying, almost all submissions to the inquiry have been made either to support or oppose the legalisation of voluntary euthanasia or physician-assisted dying. Clearly, the community is strongly engaged with the issue.

More information is available on the Victorian Parliament Inquiry's website.

 

Submissions have now closed.

 

Terms of Reference   

 

STANDING COMMITTEE ON LEGAL AND
SOCIAL ISSUES
(Legislation and References)

 

Terms of Reference

58th Parliament

 

Inquiry into End of Life Choices

 

On 7 May 2015 the Legislative Council agreed to the following motion:

That pursuant to Sessional Order 6 this House requires the Legal and Social Issues Committee to inquire into, consider and report, no later than 31 May 2016, on the need for laws in Victoria to allow citizens to make informed decisions regarding their own end of life choices and, in particular, the Committee should —

  1. assess the practices currently being utilised within the medical community to assist a person to exercise their preferences for the way they want to manage their end of life, including the role of palliative care;
  2. review the current framework of legislation, proposed legislation and other relevant reports and materials in other Australian states and territories and overseas jurisdictions; and
  3. consider what type of legislative change may be required, including an examination of any federal laws that may impact such legislation.

 

Share This Page:

Pages

Subscribe to RSS - Victoria