Let Us Die With Dignity


"I have cancer, it cannot be treated and I am terrified of the pain and suffering to come." I have heard this many times from not only people with a terminal illness, but also from doctors who have told me of the dilemma they face when patients experience intractable suffering.

Right now, a patient in such a terrible situation can by law refuse any and all forms of medical treatment, including life saving treatment. This means they can starve themselves to death and it would be unlawful for anyone to intervene. That’s a pretty lousy option.

Supporters of legalising the right to die want what doctors (and vets) already have: access to the means to die a peaceful, pain free death at a time of their choice.

Being denied that assistance compels some to end their suffering using whatever method they can access, and they have to do it alone. Hanging is the most common, also the use of firearms.

Understandably, people with a terminal illness want to be able to die in the company of loved ones without placing them at risk of being charged with a criminal offence.

Decriminalising an assisted death would improve the doctor-patient relationship by allowing, for the first time, an honest, frank discussion between the two. The law currently prohibits this. Any doctor who discusses patient’s options to take their own life currently places themselves at risk of being charged with assisting suicide. A doctor can only try to talk a patient out of suicide; they cannot advise or help them to do the job efficiently, peacefully and with dignity.

Far from placing medical personnel in a more difficult situation, legislation recognising the right of a person with terminal illness to die is voluntary for everyone, not just the patient. Doctors, nurses, chemists all have the option of not being involved with a request for assistance to die.

Voluntary euthanasia legislation does not require anybody to do anything. If you don’t agree with it, conduct your life as if the legislation did not exist. Only personnel who are willing participants need to be involved.

Legislation would enable doctors to follow their duty of care to relieve the suffering of the most unfortunate minority of people for who even the best of medical care fails. The Australian Medical Association and Palliative Care Australia both acknowledge that this minority exists.

It is often argued that legalisation of voluntary euthanasia is unnecessary. It is stated that, in the presence of pain, additional pain-alleviating morphine may lead to death and such an outcome is acceptable.

In this situation, high doses of morphine are used to alleviate pain and the side effects — breathing is suppressed and death occurs as an unintended side effect of the treatment — the so-called “double effect”.

A key issue here is that the legality of such treatment relies entirely on what is in the practitioner’s mind. Provided the intention was to relieve pain and not to cause death, such management is not illegal, but the intention can never be ascertained without doubt.

Doctors may be vulnerable in such situations to a witness complaining the doctor acted hastily or intended to hasten death. Such a complaint could have grave legal consequences for the doctor. A second, not infrequent issue is that pain may not be a prominent symptom, making death by morphine legally unjustifiable.

As long as voluntary euthanasia remains illegal, optimal care is inevitably being denied to some patients. These people have unbearable pain, and may suffer a tortuous existence as a result of their poor physical condition.

Medical assistance to die is legal now in several European countries (such as the Netherlands, Belgium, Luxembourg and Switzerland) and some states of the United States (Oregon, Montana and Washington), and has given medical practitioners in those jurisdictions the option of complete, compassionate medical care for their patients.

In the proposed legislation currently before the NSW Parliament, important safeguards are included to ensure a second medical opinion regarding a patient’s diagnosis and prognosis. There is also a mandatory "cooling off" period once a patient has stated their wish to have an assisted death. A psychiatric assessment is also necessary to ensure a patient is competent to make an informed decision.

Opponents of right to die laws ignore the fact that none of these safeguards apply when a patient exercises the right to refuse life saving medical treatment.

The Rights of the Terminally Ill Bill before NSW Parliament aims to empower the patient to make their own choices, to have the right to a dignified death. Surely, on our deathbed, each of us should have that ultimate choice.

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