Euthanasia by any other name

Paul Russell
15 November 2012
Reproduced with Permission

Discussion about end-of-life issues simmers away in Australia. Reluctant as most of us naturally are to do so, it is nevertheless worthwhile to discuss with friends and family, and in public forums, ideas about health care, advance directives and our choices in such circumstances.

Likewise, there is nothing wrong with a discussion about euthanasia and assisted suicide. However, the discussion will be fruitless if, following the advice of Sydney academic Lyn Carson, we begin to change its terms. In a recent contribution to the Sydney Morning Herald Carson made a case for euthanasia by defining it as "assisted dying". But holding to recognised terms and definitions is incredibly important to such discussions. If we don't really know what it is we are asking for we are more likely to be dissatisfied with the outcome. As with decisions of a medical character, informed consent is paramount.

Substitute phrases like "assisted dying" and "death with dignity" might be great marketing slogans to soften the hard edges of this debate (used almost exclusively by those who support legal change), but they will not help us or any parliament debating the matter to make sound judgements.

Recycling a favourite argument of Dr Phillip Nitschke, Carson attempts to draw us to the conclusion that the law is an ass: suicide is not illegal - but helping someone to suicide is. Ergo: we should change the law in favour of assisting suicide.

Suicide is not illegal, true; but assisting in a suicide remains in our criminal code precisely because once a third party becomes involved there is a risk of coercion and abuse. One need only reflect on the growing community concern over abuse of elderly people in Western countries, including Australia, to conclude that assisted suicide is a recipe for elder abuse. And, while suicide may not be a crime, none of us has a right-to-die; there is no right to kill ourselves.

Carson is correct in her observation that there is something of a "mismatch" between the results of parliamentary debates over many years and public opinion on the issue. She points out that that there have been a dozen attempts "to make laws allowing people to control their own deaths" (euthanasia) but the only one that succeeded was overturned within a year. It is worth reflecting upon the fact that, in respect to such debates, politicians are well aware of the gravity of the situation and in my experience do not take their roles lightly. So why the disparity?

It is in our parliamentary debating chambers that MPs, tasked with informing themselves of exactly what is happening in places such as the Netherlands, Belgium and Oregon, that a thorough stocktake of all the arguments pro and con is most likely. They are not simply saying yes or no to a phone poll. Indeed, it is when they get past the clever slogans and begin to weigh up the data that the majority see how our most basic responsibility -- that of protecting vulnerable citizens -- is compromised by allowing euthanasia and assisted suicide. That is why they have repeatedly decided to exercise appropriate caution and support the status quo. It is an informed decision.

The effect of legislating for euthanasia and/or assisted suicide is much broader than the limited models that we are being asked to accept. When we legislate for euthanasia and/or assisted suicide, we are really saying that these solutions are acceptable for everyone - not just the terminally ill with less than six months to live (or however else we want to define it). In law we will be creating a quasi-human right to be killed. The limitations we place (safeguards so-called) are essentially there to salve our consciences and to make us feel a little less queasy about supporting state-sanctioned killing.

My grounds for saying this? Firstly, the move to support assisted suicide rather than euthanasia by the pro-euthanasia groups in the past few weeks is really more about divining what our MPs might tolerate; as one MP admitted a few years ago, it's seen as a good start. I would be sceptical of any claim to a moral epiphany here.

Secondly, if at some later time one of these groups builds public momentum towards an expansion of who qualifies for termination, would we then be debating whether or not we wanted to allow euthanasia as well as assisted suicide? No, we will already have made this decision. All we would be discussing at this juncture is the relative merits of expanding who qualifies. If by this time Australians thinking like the Dutch -- who see such legislation as a sort of human right - how could we then discriminate against anyone seeking to die?

As the British House of Lords Committee on Medical Ethics concluded, it is impossible to set secure limits:

"…to create an exception to the general prohibition of intentional killing would inevitably open the way to its further erosion whether by design, by inadvertence, or by the human tendency to test the limits of any regulation."

We must continue to protect all people equally. Risks to vulnerable people cannot be eliminated by weasel-worded legislation premised on a "right to die". By all means, let's discuss end-of-life issues openly and forge the way for better care and real choices, but let's make informed decisions cognisant of our human nature and mindful of the risk to others.