Sally Crossing, who has terminal, metastatic breast cancer, had a question for the panellists on Monday night’s Q&A panel, made up of specialist doctors and advocates, that went to straight to the heart of the voluntary euthanasia debate.
“I want the supreme comfort of knowing my life can be ended if and when I decide enough is enough,” Crossing said.
“Can anyone put a cogent argument as to why I should be denied this choice?”
In an honest and emotional edition of the ABC debate show, audience members shared their experiences living with terminal or degenerative illnesses, and what voluntary euthanasia meant to them.
Among the panellists was a doctor working in acute and general medicine at the Alfred hospital in Melbourne, Karen Hitchcock, who told Crossing that euthanasia was not about a right to die.
“I guess euthanasia, for me, is more about the right for the state to sanction organised killing,” she said.
“It is about the right to kill. I think that is the problem with euthanasia.”
Her view was passionately shot down by Andrew Denton, who has spent eight months researching euthanasia laws in Oregon, the Netherlands and Belgium, and interviewing doctors, patients, and the dying in Australia, where voluntary euthanasia is not legal.
“Death is a fact at the end of life,” Denton said, quoting Eric van Wijlick from the Royal Dutch Medical Association. “What there is is a right to have a choice about how you might die. That is not you killing, that is this lady making her choice.”
Earlier Denton had told the audience that while in palliative care patients could choose to hasten their death by refusing treatment, including food and water, and starving and dehydrating until they died.
“Which can take weeks and which, I’m told, is psychologically painful for the people who die and for those watching,” Denton said.
“But it is ethically unacceptable for a patient to hasten their death by taking a medicine, such as they prescribe overseas, which will kill them quickly and painlessly. I find that an appalling situation.”
Doing so is also illegal.
Rodney Syme, a urological surgeon and president of Dying with Dignity Victoria, described how he had helped patients to die using the illegal drug Nembutal.
“I have openly gone and stated to the police that I have given a man Nembutal,” Syme said.
“I have described the circumstances in which that happened. At the end of the day, the policeman said to me very kindly: ‘I don’t think there is enough evidence to prosecute.’ ”
Tony Jones, the host of Q&A, asked Syme: “Are you actually trying to provoke the police to prosecute you? So you can have a test case?”
Syme: “Yes, indeed.
“I would argue what I am doing in providing somebody with medication is providing them with very, very good palliation.”
Given doctors already gave terminally ill patients opioids, typically morphine, in their final days to relieve their pain, a move which often also had the effect of hastening their death, Syme said that by providing his patients with Nembutal: “I argue that I can provide a person with medication which provides them with palliation, and relieves the psychological and existential suffering which they have when they are facing a dreadful death.
“I believe that is a palliative act.”
Denton proposed a model for voluntary euthanasia he believes would work in Australia, and which he said only competent adults should be able to access. The patient would have to convince two doctors, independently, that suffering was unbearable and untreatable, and all potential treatment options must have been discussed.
“You have to make an application orally and in writing not once but twice,” Denton said.
“You have to be offered mandatory palliative or hospice care as part of the treatment. If all these are agreed, and the two doctors independent of each other – without the family involved in consultation so there is no possibility of coercion from family members – then you can be granted the right to end your life and you will be granted a prescription for the medicine only you can take.”
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