Euthanasia and assisted suicide will, when the NSW Act comes into operation on November 28, be legal in 26 jurisdictions – including all six Australian states.
In Colombia, Italy, Germany, Austria and Canada it became legal following decisions of high courts based on an alleged constitutional or charter right.
In the Netherlands, euthanasia was first declared legal by courts interpreting the defence of “force majeure” (in the common law the “defence of necessity”) to mean that when a doctor is faced with otherwise unrelievable suffering in the patient he or she is, as it were, forced to kill the patient if the patient requests it.
In some US States, such as Oregon, assisted suicide became legal following a popular vote.
In all other jurisdictions, including the Australian states it came about as a decision of the legislature or Parliament.
BETTER OFF DEAD
In every case, legalisation creates an exception to the otherwise universally applied criminal laws prohibiting murder – to which consent is never a valid defence – and assisting a person to suicide.
Legalisation also abandons a public policy commitment to suicide prevention for all – in Australia commonly referred to as a “Towards Zero” policy.
These carve outs from the criminal law and from suicide prevention efforts are based on the idea that some people are right to think they are better off dead. It then becomes a good thing for the State to authorise health practitioners (or in Germany anyone at all) to either supply the person with a lethal substance to commit suicide by ingesting it or directly administer a lethal substance to kill them.
Generally, the public and parliamentary case for legalisation has been based at first on a claim that a small number of terminally ill (or chronically ill) people cannot be adequately helped by palliative care so that direct killing – by suicide or euthanasia – is the only way to provide them with a peaceful death.
This has been combined with an argument that the choice to end one’s life is a valid exercise of autonomy. This argument has most often been advanced by the white, well and wealthy.
For example, James Downar, a pioneer of euthanasia in Ontario, has described the typical case as involving a self-willed captain of industry who demands the right to exit on his own terms because that is how he manages the rest of his affairs.
Reported deaths by assisted suicide in 2022 accounted for 0.43% of all deaths of white Californians – 27 times the rate for blacks and 14 times the rate for Hispanics.
However, there is accumulating evidence that once legalised euthanasia becomes a threat to more vulnerable people.
Since 1998, 125 Oregonians have died from ingesting a prescribed lethal substance after expressing concerns about the financial cost of treatment.
In Canada, euthanasia is now being openly offered as an alternative “solution” for poverty, homelessness and disability, including the notorious offer of euthanasia to a female veteran and Paralympian as an alternative to waiting for a stair chair.
From March 2024 euthanasia will also be offered as a “solution” for people dealing with mental illness as it already is in the Netherlands and Belgium.
Two cases from the Netherlands highlight the tragic abandonment involved in this approach:
A man in his 60s with Asperger’s, described as “an utterly lonely man whose life had been a failure”, was euthanased because he was “horrified at moving into sheltered accommodation”. Although he had been diagnosed with “severe and probably chronic depression with a persistent death wish” another psychiatrist, after seeing him just once, certified that he was free of depression in order to facilitate his euthanasia.
Another man in his 30s, also with Asperger’s, was euthanased based on his distress at “his continuous yearning for meaningful relationships and his repeated frustrations in this area, because of his inability to deal adequately with closeness and social contacts”.
In Belgium, persistent suicidal ideation is now accepted as valid grounds for euthanasia.
In opposition to the notion of being Better Off Dead is the wonderfully named disability group NOT DEAD YET!
These are some of their astute observations on assisted suicide, based on their lived experience of disability:
Although intractable pain has been emphasized as the primary reason for enacting assisted suicide laws, the top five reasons Oregon doctors report for issuing lethal prescriptions are all disability issues: “loss of autonomy”, “less able to engage in activities”, “loss of dignity” “loss of control of bodily functions” and “feelings of being a burden”.
In judging that an assisted suicide request is rational, essentially, doctors are concluding that a person’s physical disabilities and dependence on others for everyday needs are sufficient grounds to treat them completely differently than they would treat a physically able-bodied suicidal person. There’s an established body of research demonstrating that physicians underrate the quality of life of people with disabilities compared with our own assessments. Nevertheless, the physician’s ability to render these judgments accurately remains unquestioned. Steps that could address the person’s concerns, such as home care services to relieve feelings of burdening family, are not explored. In this flawed world view, suicide prevention is irrelevant.
STATE PERMIT TO KILL
In Victoria it is not sufficient for a doctor to agree that you are better off dead before being able to kill you. You also need a formal permit from the Secretary of the Department of Health and Human Services.
Victoria boasts of its 68 so-called safeguards but these are illusory. Mostly they just require ticking a box.
Dr Nick Carr was found to have acted unprofessionally and fined when he failed to get the required two people to actually witness an applicant sign the final request form.
However, no action has been taken against the Secretary of Health for issuing a permit based on that unverified application despite the VAD Review Board clerk picking up the error.
A recent Freedom of Information request obtaining Review Board minutes has revealed that the Board is more focused on threatening and persecuting any aged care or health facilities that resist euthanasia and assisted suicide or doctors that criticise its implementation than in preventing abuses.
After receiving a report of a person having a seizure after ingesting the lethal poison prescribed under a State issued permit, the members of the Board with clinical experience simply claimed that the seizure was unlikely to be related to the ingestion of the substance – showing no awareness that this was a reported complication in Oregon.
In response to reports of some deaths from assisted suicide being unduly prolonged the Board recommended more recourse to euthanasia instead.
The promise of a peaceful death by assisted suicide or euthanasia is a false promise – the complication rate reported in Oregon averages 7.5% each year.
In the Netherlands, complications occurred in 3% of cases of euthanasia, including spasm or muscular twitching, cyanosis (blue colouring of the skin), nausea or vomiting, tachycardia (rapid heartbeat), excessive production of mucus, hiccups, perspiration, and extreme gasping. In one case the patient’s eyes remained open, and in another case, the patient sat up.
In 10% of cases the person took longer than expected to die (median 3 hours) with one person taking up to 7 days.
In Victoria and other Australian states there is no requirement for reporting complications.
COERCION
Assisted suicide and euthanasia laws usually require that a request be voluntary and free of coercion. To be truly voluntary a request would need to be not just free of overt coercion but also free from undue influence, subtle pressures and familial or societal expectations.
A regime in which assisted suicide is made legal and in which the decision to ask for assisted suicide is positively affirmed as a wise choice in itself creates a framework in which a person with low self-esteem or who is more susceptible to the influence of others may well express a request for assisted suicide that the person would otherwise never have considered.
Elder abuse, including from adult children with “inheritance impatience” is a growing problem in Australia. This makes legalising assisting suicide unsafe for the elderly.
Some supporters of assisted suicide don’t care if some people are bullied into killing themselves under an assisted suicide law. AS Dr Henry Marsh, a British neurosurgeon and proponent of legalising assisted suicide and euthanasia, put it "Even if a few grannies get bullied into [suicide], isn’t that the price worth paying for all the people who could die with dignity?".
DEATH BY ADVANCED DIRECTIVE
Courts in the Netherlands have now authorised the direct killing by administration of a lethal substance of a person who is declaring they want to live and physically resisting the administration of the substance if a doctor considers them to no longer be fully competent and the conditions of a previously made advanced directive for euthanasia to be present.
Signing a document stating that “If I ever have to go to a nursing home and I am no longer competent to decide, then I authorise in advance a doctor to kill me” is sufficient to justify what would otherwise be murder.
ERRORS
Go Gentle founder, Andrew Denton, was forced to admit to the Project when pressed that “There is no guarantee ever that doctors are going to be 100% right”.
Whether it is a wrong diagnosis, faulty prognosis, failure to offer effective treatment or missing depression or coercion, there are people wrongly killed by euthanasia in each of the 26 fatally flawed experiments in legalised euthanasia or assisted suicide.
SUICIDE PREVENTION LIES
It was claimed during the parliamentary debate in Victoria that legalisation would prevent 50 suicides each year. Not only has there been no such decline, but there were 62 more suicides in Victoria in 2022 than in 2017, when this claim was made. The suicide rate among those aged over 65 years increased in Victoria between 2019 and 2022 by 42 per cent—five times the increase in New South Wales.
The international evidence shows decisively that legalising assisted suicide and euthanasia does not prevent suicide and probably increases non-authorised suicide as well as the overall suicide rate.
We need to reaffirm suicide prevention for all and not abandon those we think would be better off dead by affirming suicide or euthanasia as a valid choice.
FIGHTING BACK
Be informed – See Australian Care Alliance website – especially under FACTS. http://australiancarealliance.org.au/
Some hope – in Canada a recent attempt to prevent euthanasia for mental illness coming into force on March 2024 as scheduled was defeated by just 17 votes – 167 to 150.
In Australia we need to analyse the evidence and keep criticising the dangers of the euthanasia program.
In 1941, Hans and Sophie Scholl read the powerful denunciation of the Nazi’s Action T4 euthanasia of the disabled program by Bishop von Galen. In her trial for treason for the distribution of the White Rose leaflets urging opposition to Hitler and Nazism, Sophie said “Somebody, after all, had to make a start”. Professor Kurt Huber, who also was executed as a participant in the White Rose group, said the leaflets aimed “To call out the truth as clearly and audibly as possible into the German night”.
We need to be those who “make a start” and “call out the truth”, and refuse to co-operate with in any way or to accept as permanent the euthanasia and assisted suicide regimes.
