Time for euthanasia to be regulated
By David Swanton
Posted Friday, 29 August 2014 in ON LINE opinion - Australia's e-journal of social and political debate
Posted Monday, 11 August 2014 in The Canberra Times
In recent weeks, Australia's most outspoken voluntary euthanasia campaigner, Philip Nitschke, has been subjected to harsh criticism from some euthanasia supporters, including the ACT's Mary Porter and the chairman of beyondblue, Jeff Kennett.
Given that this criticism is based around actions concerning a recent case of 'rational suicide', an issue that has been raised before with barely any public criticism, I suspect these commentaries are part of a broader campaign to undermine Dr Nitschke, the director of Exit International.
It's hard not to be perplexed by the hypocrisy of this criticism. As people with public standing and substantial influence, why don't Ms Porter and Mr Kennett work to fix the voluntary euthanasia regulatory system, rather than complaining about Dr Nitschke operating in an unregulated environment? There are options the pair can explore.
Does Dr Nitschke push the legal limits in the current environment? Yes. Are there risks that people who are depressed, not elderly or terminally ill might access information in the unregulated environment? Yes. But these risks are mitigated somewhat as Exit members are required to be either seriously ill, notionally older than 50, and not clinically depressed. However, exceptions are permitted, and I'm one such exception.
Since I was in my thirties, I have been actively supportive of the fundamental human right to choose what is right for one's own body. I'm not terminally ill and my mental state has never been questioned.
If I had committed suicide, should Dr Nitschke be blamed? No, as I have shown no outward signs of depression, Dr Nitschke is not my physician, and people of sound mind should be responsible for their own actions.
Rational suicide is not a new issue in Australia, but the level of public debate on the issue is immature. For three years, Lisette Nigot warned Dr Nitschke that she would take her life at 80 because she will have had enough by 80. A movie (Mademoiselle and the Doctor) documented her case.
Iris Flounders chose to take her life when her terminally ill husband, Don, took his life with Nembutal. Neither Iris or Lisette were terminally ill, nor were they depressed. In both cases, the women emphatically told Dr Nitschke, friends and relatives to mind their own business.
There was barely any adverse commentary in the press on these matters, although there were ructions in the pro-euthanasia community regarding Lisette Nigot's case, particularly around where the line ought to be drawn. Dr Nitschke was then understandably surprised and caught off guard in his response to media criticism when ambushed on the most recent case of rational suicide.
We should note that while many people commit suicide, it is not illegal. It was not possible to dissuade these women from their suicides, and regrettably, this will sometimes be the case.
While legislative reform is the main objective of the state and territory-based Dying with Dignity organisations, it is also a desired objective of Exit International. Much of Dr Nitschke's time, however, is devoted to complementary activities, in particular research and providing information on end-of-life options to the elderly and terminally ill.
In pushing the boundaries of what is legally permissible, Dr Nitschke has not always endeared himself to some in the voluntary euthanasia movement. That's understandable (though it is always hoped that those working for voluntary euthanasia reform can work together).
However, his information and guidance not only fills the regulatory gap left by politicians who refuse to act, it is also immensely comforting to the many thousands of Exit members in Australia and overseas who attend his workshops and read his books on end-of-life options.
Acting on Dr Nitschke's advice, thousands of elderly Australians, and many hundreds of Canberrans, have acquired their illegal drugs (imported or manufactured, and stashed well away from inquiring eyes) or other equipment. That's also why so many support him. People, including many average grandparents, need information on drugs now and cannot wait for politicians to legislate for voluntary euthanasia.
At Dr Nitschke's ACT workshop in mid-July 2014, about 115 Canberrans were thoroughly engaged for three hours. How did Exit try to mitigate risks at this workshop? Everyone signed disclaimer forms. Anyone who claimed to be over 50 but possibly was not, was approached by me, or others, and questioned.
This process is not a grilling but an effort to ascertain the nature of their interest, and whether their attendance could be regarded as suspicious or unusual. We blocked someone whose disclaimer form indicated they suffered a depressive illness a decade earlier, until emphatic assertions, including from their partner, that their condition was no longer present.
We have refused people entry to workshops and Exit membership when their eagerness to procure drugs bordered on the fanatical or their behaviour was otherwise peculiar. And I direct people to an appropriate medical professional if there are doubts about their mental state. Nonetheless, appropriate legislation would give society more certainty about what goes on.
Politicians, parliaments, assemblies and society have so far abrogated their responsibilities for regulating voluntary euthanasia. The onus is therefore on Exit and Dr Nitschke to screen those who may not be suitable for the information provided in his books and workshops.
This is not ideal because such screening cannot be perfect, especially in an unregulated environment. Consequently, given Ms Porter's and Mr Kennett's general support for euthanasia, I propose to outline some activities that they could undertake to further the euthanasia cause, and I would be happy to work with them to ensure this occurs. In this way, their concerns about Dr Nitschke's activities can be addressed.
In addition, it would be a good opportunity for Ms Porter to act on the information she obtained during her three-week European study trip examining euthanasia.
The Commonwealth's Euthanasia Laws Act 1997 prohibits the ACT from legislating for voluntary euthanasia. But, unsurprisingly, there are ways around this. One is an issue I first raised with then chief minister Jon Stanhope, and it was raised again by Queensland University of Technology law professor Ben White at a euthanasia forum organised by Ms Porter earlier in 2014.
It is possible under section 20 of the ACT's Director of Public Prosecutions Act 1990 that the ACT attorney-general could direct the ACT director of public prosecutions (DPP) on the circumstances under which the director should institute or conduct prosecutions for an offence.
For example, the DPP could be directed not to prosecute a physician for assisting with voluntary euthanasia, so long as various conditions are met, including that the patient be assessed for the absence of any depressive illness, or perhaps that the patient is terminally ill etc.
This is not legalising euthanasia. It is only specifying the conditions under which a person assisting with voluntary euthanasia would or would not be prosecuted. Given the minor penalties that have been given to elderly Australians who have assisted a terminally ill spouse or partner to die, this would be an understandable and reasonable direction to the DPP.
The ACT Legislative Assembly would need to be onside with this proposal, and this, I suggest, is one option on which Ms Porter could focus her efforts to achieve regulatory reform.
Mr Kennett is concerned that information on end-of-life options should only be available for the terminally ill, for those for whom the dignity of life has been lost and under special conditions (presumably not for the clinically depressed). This cannot be completely assured, even with legislation. But penalties can be provided to deter regulatory breaches, so voluntary euthanasia legislation is highly desirable.
Society needs to have a clear debate about rational suicide, and given that parliaments struggle with voluntary euthanasia, any such debate is unlikely to be free of invective and visceral reactions for some time.
Unfortunately, many Liberal and Labor politicians nationally, and many Liberal politicians in the ACT Legislative Assembly, do not support voluntary euthanasia. Greens politicians are generally supportive.
Mr Kennett could usefully lobby his Liberal colleagues (even assisting Ms Porter with her proposed discussions) to legislate for voluntary euthanasia and reduce the risk that some people, including those who are depressed, could access information on end-of-life options.
Furthermore, media organisations might want to place greater emphasis on scrutinising the intransigence of politicians who refuse to establish appropriate regulatory systems despite overwhelming public support. The media might also offer a more balanced appraisal of Dr Nitschke's activities, because in a democracy, no public activities should be beyond reasonable scrutiny.
Philip Nitschke won't go away. He has been the strongest activist for euthanasia reform and the provision of information to the elderly and terminally ill for almost 20 years-in Australia, and now overseas. He has ruffled feathers and will continue to do so.
Dr Nitschke cares for people, particularly when they are at their most desperate. People will continue to derive comfort from his advocacy, determination, advice and research into end-of-life options. And despite increased diligence in mitigating the risk of information getting into the wrong hands, it will, no doubt, still occur.
However, if politicians don't like the fact the voluntary euthanasia agenda and Dr Nitschke's activities are moving into areas they don't agree with, they should establish a voluntary euthanasia regulatory framework.
Legislation will provide sureties for society and reduce the risk of inappropriate access to information. If politicians won't act, they should stand aside for those who will.
Discrimination must not be tolerated
By David Swanton
Posted Thursday, 7 February 2013 in ON LINE opinion - Australia's e-journal of social and political debate
The equality of all humans should be one of the most fundamental principles embedded in the moral frameworks and legal systems of civilised societies. It rightly forms the basis of Article 1 of The Universal Declaration of Human Rights.
Unfortunately, such a fundamental principle has not been properly established in many countries. Equality is denied when discrimination occurs. Discrimination is relatively commonplace, and particularly firmly entrenched in many religious organisations. Widespread discrimination can lead to intolerance and conflict, because, unsurprisingly, those who arediscriminated against object to being treated as second-class citizens.
Australia's recently drafted Human Rights and Anti-Discrimination Bill 2012 is commendable in its objectives but does little to reduce discrimination. It claims aspiringly 'to eliminate discrimination, sexual harassment and racial vilification, consistently [sic] with Australia's obligations under the human rights instruments and the ILO instruments'. However, this proposed legislation offers special measures, including exemptions to religious organisations so they can continue to discriminate on such attributes as religion, sexual orientation, gender identity, pregnancy etc. It would seem that most governments lack the courage to stop religious organisations from discriminating. Some religions discriminate against people if they are not of the requisite religion (and subjective religions are related to race/culture), or preferred sex, sexual orientation, and marital status. Australia's proposed legislation does not remove this inequity.
A distinction should firstly be made between invidious discrimination, which should be eliminated, and appropriate differentiation, of individuals or groups. Invidious discrimination occurs when a person or organisation treats others unfavourably because of their particular attributes, whether that be a person's sex, sexual orientation, marital status, race etc. In contrast, appropriate differentiation would allow, for example, without claims of discrimination, segregated sporting events to occur for men and women, and an age limit to be applied to learning drivers, because a reasonable and objective explanation can be developed in these cases.
Within this framework, it is apparent there is no reasonable and objective explanation why a mathematics teacher at any school could not be an unmarried, pregnant, multi-coloured lesbian of no religion (or of another religion). The ability to teach mathematics is independent of the aforementioned attributes. To be denied a job because of a person's particular attributes is a denial of equality that ought not be tolerated in a civilised society.
The discriminatory and bigoted values of some of the mainstream churches are no more ethically 'right' than the racist values that were relatively commonplace in the middle of the twentieth century. How can racial discrimination be ethically wrong but sexual discrimination be permitted? How can there be a moral basis for an Islamic black man who discriminates against women complaining that he is being discriminated against? How can a religious male politician who denies lesbians the right to marriage or to be a leader in his church claim that he treats people equally? There is no justification for any of these situations because there is no moral distinction between these types of invidious discrimination. Intolerance of, and discrimination against, people with particular attributes is bigotry.
Many religions try to justify their religious discrimination as a right, the freedom to practise one's religion. But such a right impacts adversely on others. So what happens when there is a conflict between religious freedoms and the rights of an individual, such as an individual's right to be treated equally and not to be subjected to invidious discrimination?
Many religions preach some variant of the ethical golden rule, or doing unto others as they do unto you. Members of one religion would not like members of other religions to exercise their religious freedom if that involved the imposition of the other religion on them, or allowing the other religion to kill them (if that were a 'view' of the other religion). Even if it were something more trivial, such as having another religion's eating rituals being imposed on them, this would be a cause of stern objection.
That people do not want their individual rights to be violated by another religion (or any other person, organisation or government for that matter) is the key. It is then straightforward to conclude that a freedom of religion should only extend so far as to where it does not impinge on the rights of other individuals. People can believe in and practice what they wish, no matter how profound, or silly and deluded, that might be, but not if it denies other people's equality or human rights, causes discrimination, or otherwise adversely affects other individuals. A regime of religious discrimination juxtaposed on a principle of doing unto others as they do unto you is hypocrisy.
To avoid claims of having hypocritical bigoted views, one would think that religious organisations would reject their current discriminatory views and advocate legislative change that condemned and prohibited all invidious discrimination. Unfortunately, enlightened change is not the way of the bigot.
To explore further the nature of religious discrimination, consider the following scenario. What if a new religion were to be established tomorrow, and an inspired person drafts a religious text that reflects the views of the newly conceived and perfect God. The newly drafted religious text includes the following verses attributable to the new God.
- A black person should learn in quietness and full submission. I do not permit a black person to teach or to have authority over a non-black person; the black person must be silent.
- Any black person who is arrogant enough to reject the verdict of the priest who represents your God must die.
- A black person who works on God's holy day will be put to death.
- If a person has sex with a black person, both of them have done what is detestable. They must be put to death; their blood will be on their own hands.
The above verses are racist and abhorrent. They deny black people equality. Such a religious text must be treated with the contempt that any racially discriminatory text deserves. The proponents of the new religion would say that their God moves in mysterious ways or that the text is not meant to be taken literally. Neither explanation conceals the underlying racism and discrimination.
The astute observer would realise that these verses have been extracted from the Christian Bible and reworked to substitute the phrase 'black person' in biblical verses that condemn women, non-believers, a person who works contrary to God's laws, and homosexuals. It is clear that the terms 'woman', or 'gay, lesbian, bisexual, transgender, intersexperson', 'Caucasian male', or 'pregnant person' could have been similarly substituted.
If the newly drafted religious text is abhorrent, discriminatory and unacceptable in modern society, then so too is the Christian religion. Other discriminatory religions and organisations should be condemned with equal vigour.
It follows that public funding or support of any discriminatory religious organisations should be handled in the same manner as that for a body that might discriminate on the basis of race: governments should condemn them and never support or finance them, directly or indirectly.
It is absurd in modern society that governments give massive tax exemptions, and exemptions from discrimination legislation, to religious organisations. Many religions teach that only people of their religion are worthy of reward in a speculated afterlife. They discriminate in churches and hospitals, educational institutions and nursing homes. In recent times a horrendous record of child sexual abuse in religious institutions has become public. Furthermore, many churches indoctrinate children to worship a god or gods that, according to their scriptures, are guilty of indiscriminately killing humans-the most warped of moral messages. Religions peddling discrimination and perverse moral messages deserve condemnation.
It would seem that the Universal Declaration of Human Rights is no more than an aspirational piece of paper. People must work hard to secure the most fundamental of rights, because, while governments continue to allow people, organisations and religions to invidiously discriminate, there can be no equality.
Part 1. Arguments for euthanasia
1.1 Rights of individuals in a democracy
1. John Stuart Mill, one of the architects of democratic doctrine, advanced the principle that ‘the only purpose for which power can be rightly exercised over any member of a civilised community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant’. Accordingly, democratic societies can make laws to prohibit murder and robbery, but should not make laws to prohibit sex before marriage, religion, or voluntary euthanasia. This is because patients who desire euthanasia for themselves are not physically harming other people.
2. Mill’s philosophy can be reduced to the statement that, ‘in any legal issue between an individual and the state, the burden of proof for showing that an individual’s behaviour is undesirable, always rests upon the state, not upon the individual’. The onus is thus on those opposed to euthanasia to substantiate why voluntary euthanasia is fundamentally flawed.
3. The concept of individualism is fundamental to democratic political theory. In a democratic society, individualism posits that latitude be given to individuals to behave as they wish, and to develop and satisfy their interests. Mill stated that ‘Over himself, over his own body and mind, the individual is sovereign’. To deny a person the right to live his or her life as he or she wishes implies that each individual does not know what is right for himself or herself.
4. Mill rightly acknowledged that that principle was only meant to apply to people in the ‘maturity of their faculties’. That is, only those who are mentally competent, which excludes patients with dementia or those with clinical depression (while these conditions persisted), would be able to make a well informed decision about voluntary euthanasia.
5. Individuals can make important decisions about their bodies when they are young, for example, they can decide to participate in dangerous sporting activities. Women can choose to have an abortion. Perversely, it seems that somewhere between the ages of twenty (when some women might have an abortion) and seventy (the age of some terminally ill patients) women lose legal control of their bodies.
6. Members of the clergy, who seem to be the most vocal opponents of voluntary euthanasia, have imposed their values on other individuals through their opposition to a right to die, but I suspect that they would not entertain a reciprocal arrangement that impinged on their individual freedoms. In the spirit of Voltaire, the clergy and other euthanasia opponents most certainly can remonstrate with people requesting euthanasia to change their minds, but they ought not to be able to compel them by insisting on a legislative fiat in a democracy. Voluntary euthanasia is morally just precisely because it is voluntary.
7. Voluntary euthanasia supporters on the other hand do not insist that all people must have voluntary euthanasia, but rather that everybody be permitted to have the choice. For an issue as personal as one’s own life and death, the choice of how you might die is one of the most personal decisions an individual should make. To be denied the right to make this decision is a blight on modern Australian democracy.
1.2 Whose life is it anyway?
8. Sue Rodriguez was a Canadian who died in 1994 from Lou Gehrig’s disease, but not before taking her case to the Canadian Supreme Court in an attempt to gain permission for her own legal euthanasia. In explaining her situation, she questioned that if she cannot give consent to her own death, then whose body is it? ‘Whose life is it anyway?’ After passage of the Euthanasia Laws Act in Australia, a majority of Australians would have asked the same question.
9. Bob Dent, the first of four people to die under the Northern Territory’s Rights of the Terminally Ill Act, was adamant that the beliefs of others should not be forced on individuals. He said ‘What right has anyone, because of their own religious faith to which I do not subscribe, to demand that I must behave according to their rules’.
10. Sue and Bob reflected what most people think: that a well-informed, mentally competent patient is best placed to make a decision about their own body. How could anybody, or any government, deny that simple fact?
1.3 Popular opinion in Australia
11. The fact that many people favour a particular policy does not make it ethically ‘right’. However, when it comes to public policy, and a choice of what people want for themselves (rather than others in the population), popular support for a policy is a strong argument in its favour.
12. Public polls have shown that about 82.5% of Australians (according to a 2012 Newspoll) support the option of active voluntary euthanasia. This is an increase from 80% in 2010, and from 75% before the Euthanasia Laws Act was enacted. The question asked in these polls was ‘If a hopelessly ill patient, experiencing unrelievable suffering, with absolutely no chance of recovering, asks for a lethal dose, should a doctor be allowed to give a lethal dose or not’.
13. Voluntary euthanasia is therefore opposed by less than one in five Australians. Enactment of the Bill would be the best way to give effect to Australians’ overwhelming preference for a voluntary euthanasia regulatory framework.
1.4 The current Australian situation
14. While legislative reform is the main objective of the state and territory based Dying with Dignity organisations, it is also a desired objective of Dr Nitschke’s organisation, Exit International. Much of Dr Nitschke’s time, however, is devoted to complementary activities, in particular undertaking research and providing information on end-of-life options to the elderly and seriously ill.
15. His information and guidance not only fills the regulatory gap left by politicians who refuse to regulate voluntary euthanasia, but is also immensely comforting to the many thousands of Exit members in Australia and overseas who attend his workshops and read his books on end-of-life options. Acting on Dr Nitschke’s advice, thousands of elderly Australians, and many hundreds of Canberrans, have acquired their illegal drugs (stashed well away from inquiring eyes) or other equipment. That’s also why so many support him. People, including many average grandparents, need information on drugs now and cannot wait for politicians to legislate for voluntary euthanasia.
16. Other Australian doctors have admitted to assisting with voluntary euthanasia. Voluntary euthanasia campaigner and Victorian urologist Dr Rodney Syme admitted in early 2014 to giving a dying man (with oesophageal cancer) the drug Nembutal two weeks before the patient killed himself with it. Yet no legal action has been taken against Dr Syme and nor should it be. He acted in the best interests of his patient.
17. Australian doctors have been assisting patients with voluntary euthanasia for many years (a survey indicated more than a third of doctors have done so), albeit in an illegal environment. All of this activity is unrefuted, and no serious efforts are being made to stop any of this activity.
18. These matters suggest the following perplexing question. If governments are not intending to prosecute doctors who humanely assist with voluntary euthanasia when it is illegal, why do governments object to its legalisation?
19. Furthermore, many politicians have objected in the media to Dr Nitschke and other physicians operating in an unregulated environment. Instead, it would be preferable if politicians did their jobs and legalised voluntary euthanasia, rather than complaining about what’s happening in an unregulated environment. The enactment of the Bill is a necessary first step.
20. In the words of Marshall Perron, the former Northern Territory Chief Minister, who helped introduce the Northern Territory’s Act, ‘It is surely preferable to have voluntary euthanasia tolerated in particular circumstances with stringent safeguards and a degree of transparency, than to continue to prohibit it officially while allowing it to be carried out in secret without any controls’.
1.5 The issue of rational suicide
21. The Bill refers to people who have a terminal illness. However, there have been a number of recent situations where elderly Australians, who have not been terminally ill, have committed suicide with the aid of Nembutal. I categorise such deaths as ‘rational suicide’ because these decisions have been made, it seems, by mentally competent people who are neither depressed nor terminally ill. Rational suicide is not a new issue in Australia, but the level of public debate on the issue is immature.
22. For three years, Lisette Nigot warned Dr Nitschke that she would take her life at 80 because she will have had enough by 80. A movie (Mademoiselle and the Doctor) documented her case. Iris Flounders chose to take her life when her terminally ill husband, Don, took his life with Nembutal. Neither Iris or Lisette were terminally ill, nor were they depressed. In both cases, the women emphatically told Dr Nitschke, friends and relatives to mind their own business.
23. There was barely any adverse commentary in the press on these matters, although there were ructions in the pro-euthanasia community regarding Lisette Nigot's case, particularly around where the line ought to be drawn. It is worth reiterating that while many people commit suicide, it is legal (perversely, voluntarily gaining assistance with suicide is illegal). It was not possible to dissuade these women from their suicides, and regrettably, this will sometimes be the case.
24. Rational suicides such as those above would seem to be consistent with Mill’s philosophy on the rights of an individual and will continue to occur even if the Bill is enacted. I personally know many people who are not terminally ill, but who might consider taking Nembutal if a number of smaller untreatable illnesses were to adversely affect their dignity or quality of life. The Bill will not address their concerns, which are no less valid because they are not terminally ill. If the Bill is not amended to take these situations into account, then rational suicides will continue to occur in an unregulated environment.
25. In any civilised society, people do not want the option of euthanasia to be made available to those with impaired mental faculties, including the depressed. Good voluntary euthanasia legislation must set the limits so that only people with serious illnesses or poor quality of life can access drugs such as Nembutal, and that people who are depressed or anxious, or otherwise not of sound mind, cannot access voluntary euthanasia. The Bill draws the line at the patient being terminally ill. That is a wonderful start, but it leaves many Australians in the position where they will still be aiming to obtain drugs illegally, just in case, if they ever need them. In regulatory terms, more needs to be done.
1.6 Tolerance in Australia’s multicultural society
26. In recent times there has been debate on the diverse and multicultural society in which Australians live. Tolerance of the values of others is an important element of multiculturalism, however it is defined. To avoid a ‘tyranny of the majority’ situation, the values of different cultural, indigenous, ethnic and other minority groups must be respected.
27. It is surely hypocritical to claim that one is tolerant of others but simultaneously insist that their values about how they live their individual lives, such as a desire for the option of voluntary euthanasia, are wrong and cannot be practised. If some people object to voluntary euthanasia, they need not ever request euthanasia.
28. Moreover, if the values of some groups are unethical, particularly if they are discriminatory or hypocritical, they should be challenged. Religious people, such as Christians and Muslims, worship a god that, according to their scriptures, has murdered people. They choose to belong to religions that discriminate against women and homosexuals (despite claiming forms of equality). With such perverse and discriminatory values, they cannot take the moral high ground and demand that other people must conform to their values and eschew the option of voluntary euthanasia.
29. Tolerance for other people means people have the right to believe and act on their beliefs, so long as these beliefs do not adversely affect the rights of others.
1.7 Freedom of religious expression
30. Another argument relates to s.116 of the Australian Constitution. Section 116 states that the Commonwealth shall not make laws ‘for prohibiting the free exercise of any religion’. The clergy and most other euthanasia opponents rely on Christian ethical values. Clearly, those who support euthanasia rely upon different ethical values, such as might be compatible with a ‘religion’ based on the primacy of the quality of life, rather than, for example, a Christian ‘existence for its own sake’. It could be argued that legislation that prohibits people from practising euthanasia could be in contravention of s.116.
31. Jainism can be considered as a religion that supports euthanasia, and if so, practice of this religion is prohibited by an unconstitutional law. Active voluntary euthanasia (so long as there are precautions to prevent abuse) is also supported by some other churches.
32. Despite the more liberal views of Christians, the clergy have been particularly outspoken against voluntary euthanasia. It is regrettable that their views do not reflect church membership and have been manifested in legislation that impacts on people who do not share their religion. The right for individuals to live their lives as they wish, without being constrained by the religious values of others, must be upheld.
1.8 Economic arguments
33. There are limited resources available for health care in the Australian economy. Governments are frequently engaging in cost-cutting exercises, which are their prerogative, and this places further pressure on the health budget.
34. If people who want voluntary euthanasia are unable to obtain it, then Australian taxpayers’ money is being spent to keep them alive when that outcome is not wanted or appreciated. It could otherwise be available for additional infant care, cancer therapy or emergency services, where it could save lives and improve the quality of life for others who want it. Such health budget savings, possibly of the order of $100 million per year, could also be spent on additional palliative care.
35. One must question, as a serious matter of public policy, why public money should be spent on keeping patients alive who do not want to live, in preference to patients who do.
1.9 The human factor
36. Throughout this paper I have been referring to the ‘patient’ or the ‘terminally ill patient’. These are rather impersonal terms, disguising the fact that patients are people—they are people with feelings, and they are loved by friends and relatives. These people must be treated in a humane and compassionate way. Australians are now living longer, and our ailments are often well treated with drugs. But for some people these drugs do not provide a good quality of life, and they may suffer from continuous pain, discomfort or loss of dignity. Some people would like to choose the option of euthanasia.
37. To deny terminally ill patients the right to euthanasia is to condemn them to a miserable existence, contrary to their wishes. It is hard to establish any difference in moral character between someone who denies a legitimate request for voluntary euthanasia, and who subsequently watches that person die a slow and painful death, and someone who watches a cancer-ridden pet writhe in agony without putting it down. Most people—82.5% of Australians—would argue that if you are terminally ill, are of sound mind and not clinically depressed, and choose euthanasia, then it is morally right. Many others argue that this right should be extended to include some who are not terminally ill, but perhaps seriously ill, or with many ailments, but who make a well-informed, rational decision about their end of life options. After all, it is their life. Nobody would want anyone else interfering with their life.
38. For acts such as voluntary euthanasia that impact directly on an individual, the moral and humane thing to do is what is right for the individual, and only each individual knows what this is. Voluntary euthanasia is moral and humane because it is what the individual wants. And that accords with common sense. It is difficult to deny patients the option of voluntary euthanasia when the patient considers voluntary euthanasia is in their own best interest.
39. In summary, not providing the option of voluntary euthanasia is inhumane and callous. In a humane society the prevention of suffering and the dignity of the individual should be uppermost in the minds of those caring for patients. When the quality of life is more important than the quantity of life, voluntary euthanasia is a good option.