Switzerland has not approved suicide pod.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The International media is gaga over Philip Nitschke's Sarco or suicide pod. I try not to write a lot about Nitshcke because he runs a suicide business where he provides online suicide books and devices and he has a website and chatroom explaining to people the best suicide methods.

When the story was released, I called Sarco a deadly lucrative stunt for Nitschke and I suggested that the article by Clare O'Dea for Swissinfo confirmed my thoughts. O'Dea wrote:

The first Sarco is being displayed at the Museum for Sepulchral Culture in Kassel, Germany from September 2021 to August 2022. The second turned out not to be aesthetically pleasing. For that and various other reasons it’s not the best one to use.

In suggest that the purpose of Sarco is to promote Nitschke's suicide business. This is precisely why Sarco is designed in an aesthetically pleasing manner.

Now Snopes published an article by Nur Ibrahim stating that Switzerland has not approved Nitschke's suicide pod. I don't always agree with Snopes, but Snopes is correct when it states:

Dr. Philip Nitschke, the man behind the Sarco capsule, claims that the pods have passed a “legal review” and will be available for use in Switzerland in 2022. But details of the “legal review” have not been revealed. Experts consulted by Sarco have argued use of the pod falls outside of Swiss law. A number of assisted suicide organizations in Switzerland have also expressed skepticism over using the machine, and the legality surrounding it.

I think that Michael Cook, the editor of Mercatornet, was right when he referred to Sarco as both a gas chamber and a coffin.

Snopes is right when it states that Sarco falls outside of Swiss law.

Nitschke has once again gained international attention and free advertising from the media for his suicide business. As Paul Russell said a few years ago in his article about Nitschke - "It's a business after all."

Paul Russell - South Australia's Assisted Dying Bill is not safe.

Dear Members of the South Australian House of Assembly, 

Voluntary Assisted Dying Bill 

Paul Russell

My name is Paul Russell. About 10 years ago I started a national organisation to oppose euthanasia and assisted suicide after working actively against such legislation for the previous decade in one guise or another.

I gave up this work during the Victorian debate nearly four years ago now when my wife, Anne, was diagnosed with metastatic breast cancer.

These last four years have been an incredible journey as our family moved from living with someone dying from cancer to living with someone living well with cancer. It has been a rollercoaster for all of us and a continuing journey of love and solidarity.

When I left my work, some wondered whether or not this ‘first-hand-experience’ would change our thinking on the subject. It has certainly informed my thinking and, because of it, I find myself even more firmly opposed.

Does this experience make my observations unique? No, not at all. But I ask you to consider that, in combination with close to two decades studying this issue, that it is at the very least, an informed opinion.

I hope you can take the time to read on.

When the Premier of this State can say, in the chamber, that this bill before you is about when, ‘… after all other efforts to cure an illness, relieve the symptoms and make daily life more bearable have been tried and failed…’1 – a claim that is not supported by anything in the bill - I am left to question whether the rhetoric has run ahead of the reality. More concerning, however, is the unsupported claim that this bill is the most conservative bill with the most safeguards.

Most conservative bill ever? 68 safeguards? Really?

The Cambridge Online dictionary defines a safeguard as:

a law, rule, or something that is done to protect someone or something from harm or damage 

The Voluntary Assisted Dying Bill 2020 in its Victorian iteration was claimed to be “the safest and most conservative (legislation) in the world”. This was based upon the claim that the legislation contained ’68 Safeguards’. The final report of the Victorian Ministerial Advisory Panel in 2017 went so far as to list these supposed ‘safeguards’ alongside other legislative instruments from various other jurisdictions to attempt to show how other jurisdictions were putatively ‘less safe’ than this new model.2

Two questions need to be considered when assessing these claims.

Firstly, what constitutes a ‘safeguard’ in such legislation and, secondly, who is it that these ’68 Safeguards’ seek to protect from ‘harm or damage’? 

It might seem somewhat trite to observe that the inclusion of safeguards in such legislation has the primary end in convincing legislators to support the proposal. However, it is worth considering that, without so-called ‘safeguards’ few legislators would support assisted dying legislation. 

Safeguards in euthanasia and assisted suicide legislation have always been thought of as those inclusions that seek to protect vulnerable people; people who, for whatever reason, may be coerced or feel pressured into choosing death; where a decision to choose death via such legislative provisions was not truly voluntary. 

In 2020, McDougall and Pratt published a paper that looked at the Victorian legislation asking the title question: Too much safety” Safeguards and equal access in the context of voluntary assisted dying legislation3. Based on a ‘rights’ framework, the authors argued that some elements of the legislative framework were too restrictive and denied equal access. 

It terms of the so-called ‘safeguards’ they made the following observations:

While the elements of the legislation within the comparison table (referred to above) are all framed as safeguards, they are not all aimed at patient safety specifically. Some, such as the conscientious objection provisions, are explicitly labelled by the Ministerial Advisory Panel as “practitioner protections” … The word “safeguards” is thus used broadly in the Victorian context, to include patient-focused and practitioner-focused elements of the legislation. Diverse provisions of the Victorian legislation – such as the prohibition on health practitioners raising VAD, the requirement for one of the doctors to have expertise in the relevant condition, the strong protection for conscientious objectors, and many others – are all framed as safeguards.4 

So, the ‘sales-pitch’ that the bill before the South Australian Parliament has “68 Safeguards” may be true in the broadest terms as described above, but in terms of protecting vulnerable persons – what we normally think of when ‘safeguards’ are mentioned – there are no more protections here than in any other form of words presented to the parliament over many decades. The same problems remain. 

The vast majority of the “68 Safeguards” either protect the doctors involved or are simply procedural. Procedural matters are always open to challenge and change as has been seen in many jurisdictions post-legislative assent.5 Erring on the generous side, only about seven of those safeguards listed could reasonably be construed as attempts to protect vulnerable people. As noted earlier, they are really no different to any we have seen in South Australia over the last 17 legislative attempts. 

I urge you therefore, to reject the notion that this bill is somehow ‘safer’ than any others. 

As with every form of legislation ever proposed in this space, no amount of so-called safeguards can guarantee total safety. It is simply an impossibility. Even if every step in the process is adhered to, once the poisonous substance is issued to the person concerned there is no way of telling whether it was ingested freely, without coercion or without force or pressure, subtle or otherwise. This creates a dangerous opportunity for abuse and no-one would ever know.

A word on vulnerability 

Every person, every one of us, can and may be vulnerable at some point in our lives. Whether by some trauma, loss of a loved one, serious illness etc., each of us and each of our family members can find our inner resilience tested and even found wanting in the face of such difficulties. 

My family has been travelling that road for a while now. In truth, it’s a bit more like a rollercoaster than a road: there are highs and lows and each of us sees and responds to things differently. Oft times conversations can be clumsy as our understanding and expectations can vary so much. 

Take an example told to me by a palliative care doctor. The family of an elderly woman were called to her side from interstate. She was dying. Her son took the doctor aside and asked him, ‘Isn’t there anything that can be done to speed this up?’ The doctor saw callous indifference in the comment. I saw it differently. Death and dying don’t fit into our daily schedules. When such things happen our worlds are turned upside down and inside out. The sure foundations of our work, life’s routines etc. can often be shaken if not destroyed. It is entirely possible that the words of that man came from such a place of uncertainty as his plans were disrupted by his mother’s dying. His words may have been innocent of any bad intent; but others may have seen it differently. 

Or my dear mother-in-law, who would often say in her later years: “Please! Just hit me on the head, dear!’ We knew this as a cry of frustration and a need for acknowledgement. Others may have seen it differently. 

We cannot legislate against vulnerability nor poor decision making or inadvertent poorly worded comments or gestures. Nor can we reasonably expect that two doctors could sniff out and eliminate the difficult and sometimes awkward expressions that are in essence the outworking of grief and not necessarily a serious request to die. 

Removing the protection of the law 

The Criminal Code sections on homicide and assisting in suicide protect every South Australian in equal measure. This bill acknowledges explicitly that doctors and others who act in accordance with this bill are exempt from the provisions of The Criminal Law Consolidation Act 1935 13a. Criminal liability in relation to suicide. What was a crime one day becomes legal by the stroke of the Governor’s pen. 

Whatever protection this law provides for all citizens is removed for those who are seeking access to their own death via Voluntary Assisted Dying. 

But more than that; once the poison is dispensed and taken home, the person involved now has no effective protection from the laws on homicide as well. 

How so? Put simply: where death is an expected outcome and a ‘success’, is there any reason to investigate what might actually be a homicide or perhaps assisting in suicide outside the provisions of the bill? 

Placing the substance in a locked tin is hardly a safeguard. No-one is safe from a person with nefarious intent. Be it forcing the person to ingest the poison when they either were not ready or did not want to, or pressuring them to take it themselves, there is no independent person to verify what took place. No police investigation, no trial. 

Remember Anne Marie Smith anyone? Abuse happens behind closed doors and in the dark places. This bill provides opportunity and obfuscates possible motive.

Two doctors

One of the supposed safeguards in this bill is the involvement of the medical profession in the process. People trust their doctors. Including them really does make us think that only those with a sound mind and settled intent will ever be prescribed the poison; that they fulfil the important role of ‘gatekeepers’.

Both the coordinating medical practitioner and the consulting medical practitioner must assess that the person is ‘acting voluntarily and without coercion’ and, their request is ‘enduring’. Surely this safeguard protects vulnerable people?

It may – but it may not.

Strangely, the bill does not mention depression, anxiety or hopelessness. Yet the detection of depression in patients by doctors is known to be a hit-and-miss affair. Likewise even for oncologists:

• UK GPs recognize depression in only 39% of all depressed patients attending their practices.6
• Oncologists recognize 33% of mild-to-moderate cases of depression and only 13% of severe depression cases in their cancer patients.7
• Nurses under-identify severe depression cases in their cancer patients.8
  

And yet all this bill does is suggest the possibility of a mental health professional being involved, whose opinion may even be discarded. 

No-one will ever be able to gainsay the opinion of either of the two doctors. That we ascribe such omniscience in our medical profession is staggering. That we even ask them to decide who lives and who dies is an appalling affront to medicine.

Doctors are human too. They can be affected by pressure, coercion and empathy in their decision making just like the rest of us:

Transference and countertransference feelings are normal and can occur in any doctor-patient relationship. When these feelings heighten around emotionally intense issues, they can exert coercive pressure on clinical decision-making with an obligatory quality that is difficult to resist.9 

Let’s be realistic. Yes, this is a safeguard. But let’s not kid ourselves into thinking it as failure proof. It isn’t!

Which begs the question? How safe is safe enough? Or to put it another way: What level of risk are you willing to accept? When the risk is that some people may die against their expressed wishes or without their ultimate consent and even by nefarious intent, I would argue that no risk is acceptable. 

Inexorable incremental extension 

Some call it the ‘slippery slope’ which is not an accurate characterisation. Incremental extension, whereby the criteria is adjusted and expanded in steps and overtime, is however a reality that cannot be ignored. 

When I think about the various euthanasia type bills that this place has seen over the last few decades, there have been many different starting points; variations usually designed to be a very minimal approach to allowing people to be made dead with the approval of the state.

Phillip Nitschke would rail against these restrictions. He, and others, would often call them ‘hoops to jump through’ or even ‘roadblocks’ to what he called ‘a peaceful end’.

Nitschke is right. He is right to observe that the restrictions in this bill are essentially bogus.

If, as this bill proposes, we accept that people can choose to die and be aided to do so by the state, what right have we to limit that?

What about a 17 year old with a terminal condition? What about someone with a prognosis of more than six months? What about simply for mental health conditions that aren’t terminal? What about people who feel that they have completed their lives and simply want to exit?

Maybe we’re not enshrining a ‘right to die’ in this bill. I say maybe because it seems to me that this slogan adopted by pro-euthanasia groups over many decades, while now discarded, is in fact the truth of it.

Some may wish to observe that ‘a ‘right’ is universal, but this is only limited to a few’.

Precisely. Limited to a few – the place where we start. It becomes thereafter a ‘right’ nevertheless.

And I think of the media stories we have heard of late, heart-rending stories of people who are using their situations in the push behind this bill.

But I ask, do you think that these kind of stories will simply go away if we pass this bill? That hasn’t happened in other jurisdictions that have gone down this road, so I don’t see why it would happen here. Already we have seen such stories emanating from Victoria pushing to amend their legislation (upon which this bill is modelled).

And it is compelling. Why? Because whether we accept that we are creating a ‘right to die’ or not, it is difficult to bat away those cries because of our natural empathy for those who are suffering and because it would seem an injustice to deny to one what we have allowed for another.

And I note with interest the recent recommendations of the Queensland Law Reform Commission on this issue. Amongst other things, they recommend ‘12 months to live’ as their starting point.

We heard much made of the notion that the various bills and Acts in each state should be uniform in their application. Well, Queensland just blew that out of the water totally!

Well, let them do what they will do. Your responsibility is for the welfare of South Australians and not to kowtow in obeisance to another state simply on the basis that they walked down this road first.

I also recall in 2010, a WA MLC who had designed a bill telling pro-euthanasia supporters that he knew not everyone would be happy with how he had framed his bill, but that it was a ‘good start’. 

Turning briefly on Canada. Canada, with a political system very much like our own. Canada legislated for what they call ‘Medical Aid in Dying’ in 2016 in response to an order to do so from the Canadian Supreme Court. In a further court decision on September 11, 2019 the Quebec Superior Court, struck down the requirement that a person be terminally ill to qualify for euthanasia in Canada.

In response, the Canadian government developed and passed bill C7 in March of this year. C7 went beyond the direction of the courts.

As Alex Schadenberg writes:

• Bill C-7 removed the requirement in the law that a person’s natural death be reasonably foreseeable in order to qualify for assisted death. Therefore, people who are not terminally ill could die by euthanasia.
• Bill C-7 created a two track law whereby a person whose natural death is deemed to be reasonably foreseeable has no waiting period, and could die on the same day as their request, while a person whose natural death is not deemed to be reasonably foreseeable would have a 90 day waiting period before being killed by lethal injection.
• Bill C-7 permits a doctor or nurse practitioner to lethally inject a person who is incapable of consenting, if that person was previously approved for assisted death.
• Bill C-7 approved euthanasia for people experiencing mental illness alone. Parliament placed a hold on this category of deaths for 24 months to enable the government to establish protocols for killing these people.

So, I ask rhetorically, why not start at where Canada is now? If that’s where this is heading, why not just bite the bullet and start a little further down that road?

I can’t imagine that anyone in our parliament would accept such a proposition at this time. Which goes to further prove the point that, in reality, all this talk of safeguards is really only there to make legislators feel less uneasy about supporting the idea of state-endorsed suicide. Because that’s what we are talking about here. It’s our starting point and it would be foolish to think that it will finish at this spot. It’s a beachhead for what will follow. It prises open the door and leaves it ajar.

By passing this bill you will have created a monster; a voracious monster that your successors will be compelled to feed. Yes, that would be their decision, but you will have made that possible.
You will have crossed a divide that has stood since ever laws were codified.

Somehow we make heroes of those who seek to push this kind of change. We all need heroes. The true heroes are those like Anne who teach us how to live well in difficult circumstances. Like her, I ask you to take courage and make a decision to choose life.

Please, don’t go there; we can all live without it.

With thanks and appreciation.

Paul Russell
paulstud@chariot.net.au 

1 HOA Hansard 26th May 2021

2 Report can be found here: https://www2.health.vic.gov.au/about/publications/researchandreports/ministerial-advisory-panel-on-voluntary-assisted-dying-final-report Tables can be found at pages 217 - 220

3 McDougall, R., Pratt, B. Too much safety? Safeguards and equal access in the context of voluntary assisted dying legislation. BMC Med Ethics 21, 38 (2020). https://doi.org/10.1186/s12910-020-00483-5 available at: https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-020-00483-5

4 Ibid.

5 See for example: https://alexschadenberg.blogspot.com/2021/05/pressure-to-expand-euthanasia-in.html

6 Thompson C, Kinmonth AL, Stevens L, Peveler RC, Stevens A, Ostler KJ, Pickering RM, Baker NG, Henson A, Preece J, Cooper D, Campbell

7 Passik SD, Dugan W, McDonald MV, Rosenfeld B, Theobald DE, Edgerton S. Oncologists' recognition of depression in their patients with cancer. J Clin Oncol. 1998 Apr;16(4):1594-600. doi: 10.1200/JCO.1998.16.4.1594. PMID: 9552071.

8 McDonald MV, Passik SD, Dugan W, Rosenfeld B, Theobald DE, Edgerton S. Nurses' recognition of depression in their patients with cancer. Oncol Nurs Forum. 1999 Apr;26(3):593-9. PMID: 10214600.

9 Hicks, M.HR. Physician-assisted suicide: a review of the literature concerning practical and clinical implications for UK doctors. BMC Fam Pract 7, 39 (2006). https://doi.org/10.1186/1471-2296-7-39

Euthanasia lobby confirms elder abuse risk – but doesn’t seem to care

This article was published by Mercatornet on September 5, 2017

Paul Russell

By Paul Russell - The director of HOPE Australia

The Netherlands legalised both euthanasia and assisted suicide in 2002. The data shows an overwhelming preference for euthanasia. In 2015, there were 6672 euthanasia deaths and only 150 assisted suicide deaths; the total comprising at least 4.5% of all deaths.

In recent years the discussion about ‘life ending actions’ has turned to assisted suicide for ‘completed life’; where a person over a certain age may declare that they wish to end their lives even though they may have no serious medical issues.

Debate has raged back and forth on this new development for some years. An expert committee recommended that changes to the law not proceed, but there remains support from within government and some of the minor parties.

Reports in 2016 suggested that the government had drafted legislation. Health Minister, Edith Schippers, has said that "because the wish for a self-chosen end of life primarily occurs in the elderly, the new system will be limited to them”. The lower age limit is rather arbitrary with debate ranging from 60 to 70 years of age.

Legislation is expected to be introduced in late 2017. It is expected to take the form of a new law rather than an amendment. This seems to be because the existing provisions require medical opinion and support whereas this new form of assisted suicide may have more in common with the mail or online order system made notorious by the Australian activist Dr Philip Nitschke and his organisation, Exit International.

But this is not the first time that such a move has been put forward. As with all of these debates, there’s a long lead-in time while the discussion of the agenda looks to forge a beachhead of public opinion.

In 1991, Dutch Supreme Court Judge, Huib Drion, argued for “The self-chosen end for old people,” over the age of 75. He suggested a two-stage process where a person would self-administer a substance that would have no immediate effect that could be followed up later by the second stage substance that would react with the first and bring about death by suicide. The idea became known as “the Drion Pill” though no such pill was ever developed.

The publication of his paper in a newspaper, NRC Handelsblad, in 1991, sparked a significant controversy with letters of support for many weeks and Drion receiving a great deal of public attention.

The World Federation of Right to Die Societies (WFRTDS) also picked up on the idea as did its Dutch counterpart the Dutch Right to Die society (NVVE) and the former Dutch health minister Els Borst who was instrumental in the introduction of the 2002 euthanasia law.

In 2003, the WFRTDS adopted a name change to their policy support for Drion’s idea, calling it, instead, “The Last Will Pill” and noting that the resonance of the use of Drion’s name limited the association of the idea to the elderly. WFRTDS sees its application more broadly than that.

Both Drion and the WFRTDS are clear in the distinction between the practice of euthanasia in Holland and this new proposal.

The rhetoric is eerily similar to Nitschke and Exit: current euthanasia and assisted suicide laws are medical models that only partially give voice to autonomy. As NVVE chief executive officer Rob Jonquière, pointed out: 

“People want the right to choose to end their life independent of doctors or illness.”

This independence from any medical model has implications. As observed already, there are similarities in the proposals to the modus operandi of Exit and Philip Nitschke.

Another Dutch right-to-die club, The Co-operative Last Will, are also pushing this barrow. They seem willing to sail close to the edges of the law in advocacy and information in a similar way to Exit. They are promoting “a new drug” but refuse to identify it.

“The stuff is legally available and deadly in pure form. It has already been used by people who wanted to commit self-exploitation. There have also been several murders committed by the means.”

This is dangerous talk. As we have seen with the Nitschke methods, people who are not otherwise ill and people who suffered depressive illnesses have been caught up in the hype with devastating personal and family consequences. The reference to murders is chilling: clearly people have been tricked into consuming the drug.

Again, like Nitschke (who once said: “There will be some casualties…”), The Co-operative Last Will organisation is frank about the possible collateral damage:

“The Cooperative Last Will and its members (3,500 people) point out the existence and functioning of the new drug. The club realizes that it involves the risks. An extreme consequence could be that children give the means to their old and wealthy parents because they want to claim their inheritance.

"That kind of criticism is to be expected. But the sale of rope is also not forbidden, and so people rob themselves of life, "says a spokeswoman.” (Emphasis added)

A glib retort and hardly apposite. Robbing oneself of life is suicide – elder abuse to death is murder. But who would ever know.

But collateral damage it will be. Far from stopping Dutch “right-to-die” types in their tracks, such an acknowledgement seems more about deflecting criticism than it is about protecting Dutch citizens from abuse.

One wonders if the Zeitgeist had not been infected this past 20 years and more with the Dutch strain of the euthanasia virus if there might have been more pause for thought. Given that Drion’s infamous idea predates Dutch euthanasia by a full decade; perhaps not!

Paul Russell is director of HOPE: preventing euthanasia & assisted suicide, which is based in Australia.

Australian Assisted Suicide Plan: Only the Beginning.

This article was published by HOPE Australia on July 26, 2017

By Paul Russell

The Director of HOPE Australia.

Don’t look to the starting point; look at the finish line.

The ubiquitous figure of Philip Nitschke and his death peddling organisation, Exit, are never far from the news.

Though eschewed by many on the pro-euthanasia movement, Nitschke does do straight-talking well when he exposes the ultimate end of the supposedly limited (Victorian Premier said: conservative) regimens such as that to come before Victoria.

In recent days two of his members have said in the press that the Andrews Victorian model simply doesn’t go far enough, but is a ‘good first step’.

In 2010 in the Western Australian debate, mover of the bill, The Hon Robin Chapple, told the local pro-euthanasia lobby that he knew his restricted bill wouldn’t please everyone but that it was a ‘good start’.

In New Zealand in 2013, mover of the bill, Maryan Street, responding to a question about the possibility of euthanasia for terminally ill children said:

"Application for children with terminal illness was a bridge too far in my view at this time. That might be something that may happen in the future, but not now."

In the Canadian debate, euthanasia for children, people with dementia and mental illness were excluded from the bill even though the mandate from the Supreme Court in the Carter case suggested inclusion. The government needed to get the bill through and decided to ‘investigate’ these possibilities later.

The Victorian Ministerial Advisory Panel also wrestled with where to set the initial ‘pitch’.

So what’s this all about?

It is a sales pitch, without question. It is all about securing 50% plus one of the votes in the deliberative chambers of parliament.

Once the door is open, as Director of the European Bioethics Institute based in Brussels, Carine Brochier, observed, ‘it will go wider and wider.’

Assisted Suicide – Is It All About The Money?

The following article was published by Hope Australia on July 20, 2017.

Paul Russell

By Paul Russell - the Director of Hope Australia

CEO of St Vincent’s Hospital network, Toby Hall must have been wondering at all the fuss over a simple observation in a recent article in The Australian about his network stating its blanket refusal to cooperate with assisted suicide should Victoria pass the Andrews’ Government mooted legislation.

I have written previously about the Greens’ Party spokesperson, Colleen Hartland calling for the government to review St Vincent’s funding as a response. A veiled threat if ever there was one. Surely the mantras of tolerance and diversity are broad enough to include a health service that has a conscientious objection? Maybe not.

But the most scathing criticism of Hall’s comments came from journalist Andrew Denton; also on the pages of The Australian. Denton was responding to the following statement in the original article:

“St Vincent’s Health Australia chief executive Toby Hall said the Andrews government’s proposed “conservative” euthanasia model was flawed and vulnerable patients would be put at risk by the proposed legislative changes, which he described as a “cheap economic way out”. 

“He accused the government of taking the cheaper option to “give someone a drug and kill them” rather than providing sufficient palliative care for the majority of Victoria’s terminally ill.”

But rather than providing any concrete evidence to support his criticism of Hall’s comments, Denton simply asserts that, “It is both incorrect and highly insensitive to the reality of how Victorians are dying” and then moves on. That is, except for this curious claim:

But by palliative care’s own admission all the resources in the world aren’t going to help them deal with all pain and suffering. It is not medically possible. And until we find a cure for cancer, MND and other diseases, this is unlikely to change.

The first statement seems to be a paraphrase that is, at the very least, debatable – depending on what one might take to be the precise meaning of each of its phrases. The second is redundant – if there were no difficult diseases there would clearly be little if any difficulty in managing symptoms.

But there’s a bigger picture here that Hall was alluding to, made abundantly clear by the call this week by Palliative Care Victoria for an additional $65M in funding in the state to help meet the need and to fill the service delivery and educational gaps. This follows closely upon the New South Wales Government recently committing $100M towards regional and rural palliative care services in that state.

The reality is that, in spite of Australia’s Palliative Care Services being ranked second in the world behind Britain, there are still service gaps and funding shortfalls. In that context and for some, the supposed ‘choice’ of assisted suicide is, in reality, no choice at all.

This is also true when you consider that in a landmark study by the Grattan Institute a few years ago confirmed that something like 70% of Australians expressed a deep desire to die at home when only 14% of people were actually able to exercise that choice.

So if you live in rural or remote parts of Australia not only will you likely not be able to die at home, but the services you receive could be well below Australian standards or you may need to choose between dying in a regional hospital that may not be able to meet your needs or being transferred to a big city hospital with all of the attendant dislocation. Perhaps assisted suicide becomes a more pressing option when other legitimate choices are limited. Hardly fair is it?

In spite of the need for increased funding for palliative care and end of life care being recognised in the Victorian Auditor General in 2015, the End of Life Choices Inquiry in 2016 and by the Productivity Commission this year, there was no additional funding for such services in the recent Victorian State Budget.

Yet, according to Palliative Care Victoria:

"Currently 55% of Victorian palliative care services report that they are unable to meet the current demand for palliative care. At least 26% of Victorians who die are missing out on the benefits of palliative care, according to the international measures of population need for palliative care."

They further note that there has been no nett increase in palliative care funding from the government since 2014.

Does this sound like a government that has a handle on its agenda? Surely, if they were serious about ‘choice’ as a value in promoting assisted suicide they would have increased funding in the last budget a few months ago; even if only to make the point that they take end of life care seriously.

No doubt they will point to the mooted lead in period until their assisted suicide regime becomes active. But Palliative Care Victoria’s plaintive cry for support won’t fix the gaps overnight. As Liz Carr told Victorian Parliamentarians a few months ago – fix the first 48 recommendations of the Parliamentary Inquiry Report before you tackle number 49 (the suicide recommendation).

Without such funding the CEO of St Vincent’s assertion of assisted suicide may be seen by bean counters as a ‘cheap way out’ has a ring of authenticity.

In Canada, less than a year after the Quebec and Ottawa government's legalised forms of euthanasia and assisted suicide, a research paper entitled: Cost analysis of medical assistance in dying in Canada appeared in the Canadian Medical Journal (CMAJ). It found that "Medical assistance in dying could reduce annual health care spending across Canada by between $34.7 million and $138.8 million." The bean counters must have been in seventh heaven.

The authors summarized: "Our analyses suggest that the savings will almost certainly exceed the costs associated with offering medical assistance in dying to patients across the country, and that the inclusion of medical assistance in dying in the services covered by universal health care will not increase health care spending, but rather will release funds to be reinvested elsewhere." Adding lamely: "We are not suggesting medical assistance in dying as a measure to cut costs." Really?

Daniel Fleming took up the 'economic argument' on the pages of the ABC's Religion and Ethics website, citing the Canadian study:

"Soon after the legislation was introduced in Canada, the above mentioned study was undertaken which had the object of demonstrating the savings to Canadian tax-payers as a result of the legislation. At this point in time, such savings might be considered an ancillary purpose to the explicit purpose of providing PAS-E (Euthanasia and Physician Assisted Suicide). However, they reveal important facts: end-of-life care is expensive, and it is not impossible to imagine a government or healthcare organisation which needs to face this fact during a hard budget agreeing to focus more attention on the cheaper options of PAS-E than on other forms of end-of-life care, an approach which has already been suggested by one of the world's leading economists."

Even the famous Dutch euthanasia enthusiast, Dr. Boudewijn Chabot recently lamented the effect of financial considerations in relation to euthanasia for psychiatric reasons in his own country:

"Ever since budget cuts turned chronic psychiatry into a diagnosis-prescription business, good treatment has become scarce."

Fleming warned in conclusion:

"These are uncomfortable considerations, and they take the debate outside of its typical contours which consider the suffering of an individual and sometimes their family, and whether or not it is right for that person to end their own life with medical assistance. That debate still needs to be had. However we land there, it is crucial to remember that the debate takes place in an ideological context, and if or when the legislation is enacted it will be done in a way that takes it beyond the intent of those proposing it, and into the realm of the value set of capitalism. Any legislation or major social interventions has social consequences beyond its original purpose."

There’s always the money question just as there will always be people who are at risk under any form of legislation. There are winners and losers in all of these debates.

Even Premier Andrews, now the prime mover in the assisted suicide agenda, once noted the money question, as Fairfax media reporter, Farah Tomazin noted last December:

Andrews' resistance was not based on faith, he explained, but from his stint as health minister under the Brumby government. It was during that time the Labor MP saw firsthand the incessant demand for hospital beds in an overstretched system and became increasingly concerned that "these laws might see a rationing of precious health dollars".

Andrews may have changed his mind to support assisted suicide, but his observations about the health system and the temptation to cut and/or limit budgets remains.

What Boudewijn Chabot teaches us about euthanasia.

This article was published by HOPE Australia on June 26, 2017

Paul Russell

By Paul Russell, the director of HOPE Australia

Dr. Boudewijn Chabot is a retired Dutch psychiatrist and psychotherapist. In 1993 he was charged with having assisted in the suicide of a healthy 50-year-old Dutch woman, Hilly Bosscher, in 1991. Bosscher had lost two sons in the previous five years; six months apart. One had committed suicide; the other had died of cancer. Both were in their early twenties. Her grief did not abate; she wanted to die and to 'to lie in between the graves of her two sons'.

The Independent reported at the time that:

"Dr Chabot, now 53, originally trained as a GP before specialising in psychiatry. It was not until he had spent more than 12 years in psychiatric practice that he decided to see patients who had contacted the Dutch Society for Voluntary Euthanasia (NVVE), desperately wanting to die. He has said that he got in touch with the NVVE in order to 'offer my services in difficult cases'. It had been reported that the organisation was unable to find psychiatrists who did not utterly oppose the patient's wish to die."

At that time acts of euthanasia and assisted suicide were not legal but allowed under certain circumstances via court precedents stretching back to 1973 and the Postma case. The "Termination of Life on Request and Assisted Suicide (Review Procedures) Act" would not become law until 2002.

Chabot was tried and acquitted in a lower court. The prosecution appealed to the Supreme Court where a guilty verdict was returned but no punishment was applied. Up until this time euthanasia and assisted suicide cases were not considered lawful without the presence of 'unacceptable suffering' that was defined as physical. The standard defence of necessity or 'force majeure' did not apply to Chabot.

As Wesley Smith reported, this was a 'show trial' and there was never any intention to punish Chabot but, rather allow the case to set a new legal precedent.

Following the Supreme Court decision in November 1993 the Royal Dutch Medical Association (KNMG) amended its 1984 guidelines to include the possibility that there may be cases where 'it is merciful, such as if a patient has serious psychiatric problems and has no prospect of improvement'.

From The Independent:

"Chabot was put in contact with his patient through the NVVE in the summer of 1991. Two months of intensive consultations followed, during which he tried to find a way into her 'closed world of suicide'. She had planned to take her own life since the death of her second son earlier that year and had bought a plot of four graves, two for her sons, one for herself and another for her estranged husband. A suicide attempt the night of her second son's death failed."

Chabot also consulted with other psychiatric professionals; though none reportedly examined the woman. According to Chabot, he suggested that she try anti-depressants, but she refused both the medication and an entrance into a therapeutic community.

The Chabot case opened the door to euthanasia and assisted suicide for psychiatric reasons. This is a classic case of 'bracket creep' or incremental extension. The recent interim report of the Victorian Ministerial Advisory Panel notes well that in their consultations there are those who have argued for a different 'starting point' that is much broader in application that parameters suggested by the earlier Parliamentary Committee report.

One way or another, such extension is inevitable.

But Chabot offers us another consideration both in the 1993 case and his recent lament about the application of the Dutch law published in NRC Handelsblad on June 16, 2017.

Chabot is severe in his criticisms of the developments in the application of the Dutch law in recent years. He's not at all concerned about the skyrocketing numbers of deaths ("In the last ten years, the number of euthanasia reports has increased from two thousand to six thousand per year.") but rather the changes that have seen the 'due care criteria' morph in ways that suggest that euthanasia and assisted suicide 'on demand' is now the prevailing paradigm.

"To understand what has gone wrong, the reader must know the three most important “due care criteria” of the law. There must be: 1) a voluntary and deliberate request; 2. unbearable suffering without prospect of improvement; 3. No reasonable alternative to euthanasia. 

"The second and third requirements are closely linked because if another solution, such as specialist palliative care, is indicated, the suffering is not without prospect of improvement. If the patient refuses that option, the physician will not be convinced of the “unbearable” nature of the suffering and will not provide euthanasia. 

"At least as important is what is not in the law. There is no requirement that the disease has to be physical, and the doctor need not have a treatment relationship with the patient."

Chabot's concerns are well founded. They relate to the subjective nature of 'unbearable suffering' and the reality that the term 'no reasonable alternative' has also become entirely subjective. He does not note the irony that this was precisely the situation with Hilly Bosscher more than 30 years ago: there were alternative treatments available that she refused and her suffering was clearly unbearable to her.

The Victorian Parliamentary Committee suggested a framework for assisted suicide and euthanasia with certain qualifying criteria. They included:

– is at the end of their life (final weeks or months of life)– is suffering from a serious and incurable condition that is causing enduring and unbearable suffering that cannot be relieved in a manner the person deems tolerable (so similar to the Dutch Due Care criteria #2 & #3)

The Interim Report of the Victorian Ministerial Advisory Panel suggested the possibility that 'final weeks or months of life' could be determined formally as a prognosis of either 6 or 12 months to live. At no time has there been any suggestion that a person who 'qualifies' need to have first exhausted any reasonable treatment options. That stands to reason in as much as no-one can be forced to accept any treatment offered. But I wonder if the public sees it that way.

Chabot laments:

"Once upon a time, moving to a nursing home or receiving treatment with some medication was still considered a “reasonable alternative” for euthanasia. At least it had to be tried. Many doctors now accept that a patient can refuse a reasonable alternative and that this does not create a barrier for euthanasia. That brake has now also disappeared."

That description would seem to be the starting point in the proposed Victorian regime. Any thought in the mind of the public that a death by assisted suicide or euthanasia would be a 'last resort' option only, cannot be sustained.

The same applies to the role of the psychiatrist. Chabot is concerned that in a majority of the notified cases of euthanasia for psychiatric reasons were 'executed' by the Dutch End-of-Life Clinic:

"What happens to doctors for whom a deadly injection becomes a monthly routine? They are surely well-intended, but do they also realize how they are fanning a smoldering fire that can become a blaze because they fuel the death wish of vulnerable people who are still trying to live with their disabilities? 

"The End of Life Clinic is now actively recruiting psychiatrists. It justifies this by pointing to the long waiting list. Their task: relieving the unbearable and unrelievable suffering from psychiatric patients through euthanasia. Every time the Clinic is in the news, a wave of depressed patients whose treatments are allegedly exhausted but many of whom have never been properly treated report to the Clinic. Ever since budget cuts turned chronic psychiatry into a diagnosis-prescription business, good treatment has become scarce. 

"The newly recruited psychiatrists won’t need to enter into a treatment relation with the patient. The evaluation committee has accepted that in the case of severe physical illnesses. Now it has also applied this to incurable brain diseases—without discussing it with members of the psychiatric profession by the way."

Will the same be said of the Victorian regime? Will the role of psychiatry be reduced to a 'diagnosis-prescription' type business where the therapeutic role of the profession is ignored or, at least, only given lip service?

That was precisely what occurred during the time that euthanasia was legal in the Northern Territory in the mid-1990s. The Lancet report on the four deaths that occurred under the short-lived regime showed scant regard for the law and the role of the psychiatrist was seen as just another hoop to jump through or tick on a list of checkboxes.

The Victoria Branch of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) noted similar concerns in their submission to the Victorian Ministerial Advisory Panel:

"The VIC Branch also notes that, due to the often rapidly changing manifestations of mental illness, proper assessments are best undertaken by clinicians with the benefit of extended interactions over a significant period of time with the individual in question. As such, the views of psychiatrists and/or other mental health professionals with established therapeutic relationships with individuals seeking voluntary assisted dying (sic) should be sought wherever possible."

Yet the thrust in terms of the law proposed for Victoria seems likely to only require a psychiatric evaluation for the sake of concerns about capacity and not necessarily about suicidal ideation or the presence of psychiatric illness (though that may be implied). Moreover, as the RANZCP report also notes, there remains a significant risk that the treating doctor and the second confirming doctor may miss signs of psychiatric concern:

"In situations where a patient has a terminal condition causing enduring and unbearable suffering, there is a risk that symptoms of mental ill health may be mistaken by a doctor not trained in psychiatry for an 'understandable' reaction to their condition. Furthermore, traumatic brain injury, addiction issues, dementia and delirium may all confound assessments of capacity and non-psychiatrically trained doctors 'are not well placed to recognise the presence of these conditions in the medically ill population'."

This raises serious questions about the mechanism that supposedly 'protects' people who are vulnerable. If neither of the two assessing doctors suspect a psychiatric issue, nothing more is done.

Will the final recommendation due to be made to Premier Daniel Andrews at the end of July include a requirement that a psychiatric evaluation takes place in a therapeutic context? This would imply a relationship over time that seeks a remedy to the presenting psychiatric issues. But time may well be short. Or will this all fall back on self-determination, as it did in the Chabot case, and an acceptance that, even though the patient may have therapeutic options available - both psychiatric and medical - that refusal of any or all treatment is a fast track to suicide?

"In psychiatry, an essential limitation disappeared when the existence of a treatment relationship was no longer required." Chabot.

The outcome is grave and irreversible. The Andrews government has been talking into an echo chamber, yet most Victorians will likely be unaware of the proposal and even less aware of how any proposed law might operate. The idea that assisted suicide and euthanasia are a 'last-resort-only' option; that people would need to at least try 'reasonable' options, has never really been the case yet is likely to be the general public view.

With thanks to Professor Trudo Lemmens for the English translation of the recent Chabot article.

Elder abuse is a clear and present danger in the euthanasia debate.

This article was published by Mercatornet on June 15, 2017.

Paul Russell

By Paul Russell - the director of HOPE Australia

June 15 is World Elder Abuse Awareness Day. Timed to coincide with this international day, the Australian Law Reform Commission has released its final report into a long-running inquiry on Elder Abuse and the Law.

Running to 432 pages, the report takes a comprehensive look at the legal landscape across Australia and argues for a comprehensive nation-wide approach to tackling Elder Abuse. While looking mainly at the law, it also looks at abuse in Aged Care settings and argues for an overhaul of staffing, staff training, recruitment and mandatory reporting type structures to protect people.

The report also looks at training for lawyers and medical professionals.

What is elder abuse?

The World Health Organisation describes Elder Abuse as: ‘a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person’

It is recognized to 'take various forms, such as physical abuse, psychological or emotional abuse, financial abuse, sexual abuse, and neglect. The World Health Organization has estimated that the prevalence rate of elder abuse in high-or middle-income countries ranges from 2% to 14% of people usually defined as 'over the age of 60 or 65 years'.

The WHO also noted that research in other predominantly high-income countries has found ‘wide variation in rates of abuse in the preceding 12 months among adults aged over 60 years, ranging from 0.8% in Spain and 2.6% in the United Kingdom to upwards of 18% in Israel, 23.8% in Austria and 32% in Belgium’.

Whether there is a connection between the extremely high rate of Elder Abuse in Belgium and the existence of their euthanasia regime can only be guessed at, though intuitively one could easily develop a 'best guess' argument based on culture alone.

The report notes that 'vulnerability' to such abuse is not necessarily related to the age of the person. However, the effects of aging, broadly understood, can make our elders vulnerable to such abuse. There is also a connection to disability as noted in the report:

"While older people should not be considered vulnerable merely because of their age, some factors commonly associated with age can make certain older people more vulnerable to abuse. Disability, for example, is more common among older people. More than 80% of people aged 85 years or over have some disability. While fewer than one in 20 Australians under 55 years have ‘severe or profound core activity limitations’, almost one-third of people aged 75 years or over have such limitations." The authors go on to add: "Vulnerability does not only stem from intrinsic factors such as health, but also from social or structural factors, like isolation and community attitudes such as ageism. All of these factors contribute to elder abuse."

We have discussed ageism before in terms of the dominant meme that elderly people are 'burdens'. Similar observations can be made in respect to 'ableism' and disability.

By way of explanation - a simple anecdote:

Dr. Kevin Fitzpatrick OBE and I shared a podium in Ireland a few years ago. Kevin became a paraplegic after an incident 40 years previous. He asked the audience to imagine that he and I separately visit our doctor; both of us displaying suicidal tendencies. Kevin observed that, in my case, I would be offered all sorts of support and interventions under suicide prevention strategies. In his case (as had been his experience) he said that the doctor would say that they understood why he wanted to kill himself because he had such a difficult life.

As Liz Carr recently observed, treating each of us differently based on disability is scary in terms of assisted suicide and euthanasia and is one of the reasons why many people living with disability do not want such laws. They already experience discrimination in medical care and recognise the potential that such discrimination will also be present in discussions on this subject.

Orwellian Bill due to be introduced in New South Wales Australia in August preceded by 'group think'

This article was published on the HOPE Australia website on June 12, 2017.

Paul Russell

By Paul Russell, the director of HOPE Australia.

A draft bill is currently being circulated for comment and consultation in New South Wales. A consultation is being conducted by the 'NSW Parliamentary Working Group on Assisted Dying'. Although this sounds rather official, essentially the members of this group are simply a common interest group of MPs within the parliament.

Not only is this 'working group' not an official organ of the parliament, the consultation itself holds no official status either. You've probably guessed; the members who will oversee the consultation are also the members of the working group!

Like the Ministerial Advisory Panel in Victoria, submissions will be kept in confidence and not published and there will be no consultations with the public; only community information sessions.

So, good people of New South Wales! Do you think, after all of this takes place, that you'll feel like you've been consulted; that those charged with the grave task of chin rubbing, head scratching and deliberating over clauses in the bill will have taken an objective and hard-headed look at the draft? Will the bill be the most comprehensive and safe ever?

If you think that - then I've a bridge you might want to buy!

No, this is just another long-winded attempt to buy the public confidence on an issue that they (the public) are decidedly uncomfortable about.

And what of this 'draft' bill? No point wasting ink on analysing clauses at the moment; that can wait until the bill is tabled in parliament. Apart from the novel lower age limitation of 25 years, it looks most like almost any other bill we've seen over the last decade and more. This despite the parliamentary group claiming to have 'consulted extensively since 2015 with key stakeholder organisations and parliamentarians in NSW on the Bill'. But, maybe they did consult and maybe there are simply just very few ways of couching doctor killing and assisting in suicide in legal terms.

But just for once I'd like to see a bill that used the proper terminology. Not here. 'Assisted Dying' is the latest 'group think' catch phrase. And even though the bill describes both euthanasia and assisted suicide, apparently 'assisted dying' is not the same as euthanasia and assisted suicide simply doesn't rate a mention. From their 'Overview' statement:

"Patients may self-administer, or be assisted by their medical practitioners or a nominated person to administer, a lethal substance (as prescribed by regulations) to end their lives, after having gone through the required process outlined in the Bill." 

And then this gem: "The Voluntary Assisted Dying Bill 2017 (NSW) is a Bill that provides for physician-assisted dying, not voluntary euthanasia." 

"Physician-assisted dying involves a medical practitioner making a substance available to an eligible patient (after having gone through a process) which the patient then uses to end their lives at a time and place of their choosing. [ed. assisted suicide: assistance to self-administer] The patient is in control at all stages of the process. Whereas voluntary euthanasia involves, in all cases, a medical practitioner carrying out a patient’s request to end their life up until the point of death." [ed. euthanasia: administration by a third party as in 'assisted by their medical practitioners or a nominated person to administer'].

This really is despicable. It's one thing to develop talking points for a bill. At a stretch one might want to concede that there may be some legitimacy to a consultation that is not consultative and where the inputs (submissions) will not be able to be perused against the outputs (the final bill). But hiding the essence of the program in saccharine sweet euphemisms and then denying any relationship at all to the actual outcome is contemptuous of the New South Wales Parliament and the good people of that state.

Perhaps I shouldn't be too harsh given that Victoria is holding to precisely the same line with the endorsement of the Premier and Health Minister and Tasmania and South Australia saw similar levels of subterfuge in recent bills. It is as if there's some kind of new orthodoxy that demands slavish adherence; where the truth itself is a heresy.

Last time the New South Wales Parliament devoted time to assisted suicide and euthanasia the bill failed at second reading in the Upper House by a vote of 23 to 13 in 2013. There have been a number of changes in the Legislative Council since then, creating some uncertainty about the possible outcome of this bill, should it be debated.

Euthanasia: Truth is the first casualty

This article was written by Paul Russell and published on the HOPE website on May 18. 

Paul Russell

By Paul Russell

Euphemisms have consequences.

The Victorian Ministerial Advisory Panel charged by Premier Daniel Andrews with the task of developing a safe way to kill people and to help them to suicide, released its interim report yesterday.

Set up in December last year the 'expert panel' has conducted state-wide hearings and accepted submissions on precisely how to make a safe law.

The Panel's introductory discussion paper made it perfectly clear that their job was not to consider the ethical/moral concerns: "The purpose of this consultation is to ensure that parliament may debate the merits of voluntary assisted dying through well-informed and workable legislation."

How that outcome could be considered as 'values-neutral' is beyond comprehension. Any proposition that has supposedly been vetted and designed through what I am sure will be described as a 'lengthy and thorough process' would seem to have the 'tick of approval'. The 'merit' is loaded into the outcome as Health Minister, Jill Hennessy confirmed today:

“We have the very best medical and legal experts working on this to make sure that when the time comes, everyone in the Victorian parliament has the information, and assurances they need to make an informed decision about this important issue.”

In the 64 pages and in 29,143 words, the interim report uses the word euthanasia only once - and that in a quotation from a submission. Assisted Suicide is mentioned three times - again, only from quotations and suicide (separately); well, that's where matters become more interesting again.

"Some denominational submissions suggested it should not be called ‘voluntary assisted dying’ because it would obscure the role of medical practitioners in aiding suicide."

Why the mention of 'denominational'? In all of the quotes from various submissions and testimony, no mention is made about the name of the individual or organisation (given only a number), what is it about this reference that requires an identifier? It is difficult to come to any other conclusion than to observe that by the use of 'denominational' the report seeks to dismiss the concerns as being a 'religious objection' only.

The very next sentence amplifies the subterfuge:

"An alternative view was expressed that the language of suicide should not be conflated with voluntary assisted dying because of the person’s proximity to death due to illness."

Who expressed that view? Suicide is suicide; no amount of qualification changes that. But here's where the euphemism becomes really useful: Read the quote again and substitute 'suicide' for 'voluntary assisted dying' and the reasons for its use become clear. This is double-speak.

If any more proof was needed, the next occasion that the 'S' word appears is in the context of a discussion about record keeping and monitoring:

"It was noted that if information about those whose request was denied was linked to other data such as suicides, it would provide a greater understanding of how the framework was operating."

So, if a person gets access to the law, then it's 'voluntary assisted dying'; if they fail to qualify for some reason and end their life by other means it can be called suicide. The premise here, of course, is that 'assisted dying' will reduce the incidence of other forms of suicide. This has proven not to be the case in Oregon and any expectation that it might be the case in Victoria is supposition at best.

There's more! In a discussion about legal liability it is noted that, 'acting outside the proposed legislation, such as aiding and abetting suicide, would still be a criminal offence.'

Indeed. The death might be by precisely the same method under precisely the same conditions - even with full consent - yet if one condition identified in the law is not met, then it is assisted suicide! You couldn't make this stuff up!

But the final mention of 'suicide' is really where obfuscation and euphemisms are so blatantly evident:

"Life insurance 

"The impact of the listed cause of death on insurance eligibility was also highlighted in forums and submissions. It was noted that there should be no loss of insurance benefits as a result of exclusion clauses for suicide. This was one of the reasons many considered that voluntary assisted dying should not be listed on a death certificate. Others were of the view that it was clearly the underlying terminal illness or disease that was the cause of death so there should be no issues with insurance."

Like many other bills we've seen in Australia, this proposition would legislate further obfuscation and would make liars out of doctors by forcing them to falsify the cause of death. Insurance industry bodies have railed against this kind of inclusion previously and for good reason. They raised the same concerns in The Australian today. It opens up the possibility of someone signing up for a life insurance policy only months before their suicide for the benefit of their estate with a minimum of paid premiums. Think of the possibilities of 'inheritance impatience', otherwise known as Elder Abuse.

Further obfuscation came via Victorian Greens MLC, Colleen Hartland in the same article:

“It is the issue around ­insurance, and the reality is that the cancer or the neurological disease is what killed them, they have just allowed to die a bit ­earlier,” she said.

What kind of policy outcome are Victorians likely to gain from all of this if their elected representatives and appointed officials can't get past the fabricated expressions of the death dealing lobby?

Buddha is often quoted as having said that, "Three things cannot be long hidden: the sun, the moon and the truth." He never visited Victoria.

The final report is said to be due at the end of July.