Discussions about euthanasia

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The Victorian Bishops have recently put out a trenchant response to the latest report of Victoria’s Voluntary Assistance in Dying Review Board (which monitors the workings of Victoria’s Voluntary Assisted Dying Act 2017). In it, they note the lack of information on, and access to, palliative care as an alternative.

Nurse holding patient's hand (Getty Images)

Much of the bishop’s statement echoes criticism from elsewhere. The Canadian Society of Palliative Care Physicians has noted that in Canada, where euthanasia (‘Medical Assistance in Dying’) has been legal since 2016, there is ongoing confusion between it and palliative care. There is evidence to suggest that many Canadians would not have chosen to take this option if high-quality palliative care had been available to them.

While the legislation was proposed as something of a measure of last resort, the numbers already tell a different story. In its first year of operation, 348 people were assessed for eligibility to access voluntary assisted dying. 272 eligible applicants applied for a permit. 231 permits were issued and 124 people died from taking the prescribed medications.

As the bishops point out, the US state of Oregon, with a population somewhat over 4 million, took 17 years to reach these kinds of numbers.

Unfortunately, many of us with a disability look at these figures (and at the proposed legalisation of euthanasia in New Zealand, which will be voted on later this year) with a weary mix of familiarity and horror.

The aged care and disability Royal Commissions both running at the moment point to a society in which older people and those with disabilities are already deemed surplus to requirements. As I pointed out in my previous article, the response to COVID-19 (and especially the way it has been allowed to tear through aged care homes and disability support settings) has done very little to dispel this impression.

 

'It does not help that society has already largely internalised the narrative that a disabled life and — to a lesser extent, an elderly one — is not one worth living.'

 

It does not help that society has already largely internalised the narrative that a disabled life and — to a lesser extent, an elderly one — is not one worth living. Disability activist Samantha Connor has powerfully spoken of the occasion when she put up a sign in jest asking to raise money to send her to a Swiss suicide clinic. To her horror, she found people queuing up to donate with enthusiastic support, noting that if they were in a wheelchair, they would also want to die. No one asked about her feelings or whether she was in need of any assistance. The overwhelming message was that this was absolutely appropriate. Significantly, the context was her attendance at a protest against the film Me Before You (which tells the story of a banker whose quadriplegia inspires them to euthanise themselves). Unsurprisingly, given her experience, Connor is of the view that assisted dying legislation can never be made safe.

This fear appears to give weight to the bishops’ concerns over one of the report’s key recommendations: the proposed weakening of the current law which prohibits a doctor raising the possibility of euthanasia in advance. Many older people and/or people with disabilities are already reliant on the support of others — the suggestion that they may be a burden on others and hence better off dead (which is already a staple of mainstream discourse and which formed the subtext of Samantha Connor’s interactions with her would-be donors) is damaging enough without them hearing it from their medical practitioner.

Aside from the high take up and the fear for those whose lives is already undervalued, there is a long history of boundaries being blurred in practice in order to expand the scope of euthanasia laws. As long ago as 1998, Canadian disability advocate and biochemist Dr Gregor Wolbring noted the gradual widening of euthanasia categories from ‘terminal illness’ to ‘incurable illness’ (and thence physical disability) and from ‘physical’ to ‘emotional’ suffering.

Even more alarmingly, the empirical data from around the world suggests that the requirement for patient autonomy has also been relaxed. Wolbring already noted the rise in euthanasia of those with limited capacity (and the removal of obstacles to it) and a study by Irene Tuffrey-Wijne and others has confirmed the lack of safeguards in the Netherlands in such cases. Disturbingly, as the bishops note, there is nothing in the latest Victorian report on the mental health of those requesting euthanasia. There is also, one might add, nothing said about disability — cognitive or otherwise.  

It is long past time for an honest discussion of how and when our society values human life. With any luck, the bishops’ letter will serve as a catalyst for this discussion.

 

 

Justin GlynFr Justin Glyn SJ has a licentiate in canon law from St Paul University in Ottawa. Before entering the Society he practised law in South Africa and New Zealand and has a PhD in administrative and international law.

Main image: Nurse holding patient's hand (Getty Images)

Topic tags: Justin Glyn, COVID-19, disability, ableism, euthanasia

 

 

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Existing comments

What it is that strengthens people who care for a loved one who lives with a disability? The key word in that sentence is "loved" and it may sound a bit simplistic but it is anything but. It can be a common view in society that caring for a disabled person is burdensome. The caring can involve long hours, hard physical work and a lot of patience. However, love is up to the task and what's more important: love is received. That is the sort of reasoning that should be used to improve our delivery of high quality palliative care.
Pam | 10 September 2020


Thanks, Justin. The notions that some lives are not worth living and that I am entitled to do what I like and to hell with the consequences have many supporters. Just ask battered women, sexually abused minors, those abused due to their vulnerability through old age or disability, refugees and indigenous Australians. If you are on the outer, you don't count.
Kim Chen | 10 September 2020


Well said Justin. So called "Voluntary Euthanasia" and the philosophy behind it put us on a very slippery slope to the sort of world Hitler and the Nazis would rejoice in.
Edward Fido | 11 September 2020


Of 272 "eligible candidates" for state sponsored execution only 124 were finally killed by doctors preparing and handing them the poisoned cup, a practice abandoned two and a half millennia ago when the ancient Greeks, guided by the physician, Hippocrates, dispelled barbarity in favour of ordered civilisation and, amongst other civilising ordinances, abandoned euthanasia. I wonder why more than half the "eligible candidates" bailed out. I wonder how many of the 124 who took the poisoned cup were of sound mind. I also wonder how many doctor-killers were recruited as public executioners and what fees they charge. I wonder if, as a government backed service, it is free or at least covered by Medicare. Surely in any civilised society like Australia it should be.
john frawley | 12 September 2020


Would that the bishops were as vocal in their concern for the negligence in aged care provisions that have led to the unsolicited deaths of hundreds of elderly patients in the last 6 to 8 months. Or for the hundreds of women that die every year at the hands of their partners.
Ginger Meggs | 13 September 2020


We all have disabilities. We have them to remind us of the power of God. In the Gospel of John, Jesus calls himself “the light of the world” and demonstrates the truth of his claim by bringing light physically and spiritually to a man born blind. His disciples asked him, ‘Rabbi, who sinned, this man or his parents, that he was born blind?’ Jesus answered, ‘Neither this man nor his parents sinned; he was born blind so that God’s works might be revealed.' Think of that each time you recognise your own disability, and those of others. It is sin that brings forth death, not any form of disability. Thus Euthanasia, the fruit of sin, is Sin. Because it is death.
AO | 14 September 2020


Two of my very close relatives died over the last two years. Both had been long term breast cancer sufferers and they succumbed to metastatic conditions, one from lung and oesophageal cancer and the other from ovarian and pancreatic cancer. Both were cared for in capital city palliative care facilities, one public and the other private, the first for ten days and the second for a grim twenty eight days before they passed away. Both had considerable suffering and discomfort and were pleading with family and doctors to help them die. Towards the end they suffered from terror, panic, indignities and embarrassment arising from scary nightmares, confusion, inability to eat and drink and extreme embarrassment from a range of indignities including faecal vomiting and the sounds and smell of bodily functions. Don’t let palliative care specialists convince you they have the answers. They do not. Sophisticated pain relief is only part of the equation. Sorry, Father Justin, I used to sympathise with your views on this subject, but now I do not. My recent experiences have turned me into a proselytising convert to the cause of voluntary assisted dying. Thank God I am on the same side as the majority of Australians.
VAD Convert | 16 September 2020


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