Out of Misery: Should euthanasia be legalised in Australia?

Saturday, 27 September, 2014

My cat Toto was recently euthanised. Everyone I told offered me similar words of condolence—“at least we were able to put an end to his suffering”. This was of great comfort to my family and I. We appreciated the power to grant a well-loved family member the dignity of dying without pain.

How is it, then, that when it comes to the suffering of our human family members, no such dignity is offered in Australia? It seems absurd that pets have more rights when it comes to dying peacefully than their human counterparts. The debate surrounding euthanasia remains complex and polarising. However, like many issues circulating ethical debate, euthanasia is not seen as a pressing issue for mainstream society. We find budget cuts and Tony’s mispronunciation of “Canadia” far more protest- and media-worthy. I took the death of my cat as an opportunity to educate myself about the issue and examine why euthanasia remains so troublesome to implement.

Voluntary euthanasia is the practice of ending an individual’s life painlessly at their request. The term is often confused with involuntary euthanasia. The important distinction between them is that when someone is involuntarily euthanised, they are killed despite their wish to remain alive, for example as punishment for a crime. Involuntary euthanasia can also refer to an instance where the patient is not equipped to make a decision regarding their life, such as being comatose or having a specific mental disability).

Legalising voluntary euthanasia already has a convincing precendent. In the US, Washington and Oregon have adopted the Death With Dignity Act. Under this policy, the patient must make three separate requests to be euthanised. Two doctors have to confirm the patient’s status as terminal (meaning their disease is incurable and will lead to death in no more than six months) and their psychological competence. .If they are physically able, they must administer the drug themselves. .

Holland and Belgium have legalised euthanasia with a similar model. However, Switzerland—which legalised euthanasia in 1942, the first state to ever do so—has a pivotal point of difference. Under their legislation, the patients need not by euthanised by a medical professional. Their policy condemns selfish motives, meaning that family and friends may assist their family members in suicide but will be interviewed to establish whether their intentions were altruistic. All assisted suicides are videotaped and shown to police.

Closer to home, renowned terminal care physician and euthanasia advocate Dr. Philip Nitschke—or “Dr Death”, as the ever-tactful media called him—successfully lobbied for the passage of the Rights of the Terminally Ill Act in May 1995. For nine months in the Northern Territory—before the law was overturned by the Federal Parliament—Nitschke assisted four terminally ill patients in dying with dignity. Nitschke has since invented several mechanisms and drugs that allow terminally ill patients to end their lives, including an “Exit Bag”, a barbiturate testing kit, and easily-manipulated Nitrogen canisters. Dr. Nitschke proposes that “everyone over the age of 65 should have access to these drugs”. In contrast, Dr Kashyap of Monash Hospital argues that the existing laws regarding end of life care are adequate.”There is provision as a doctor to make decisions in conjunction with our patients to use treatment that may improve comfort yet hasten death,” Dr Kashvan explains. He points to the danger of allowing those not necessarily in a rational mindset to make the decision, or to have another make it for them. He suggests that Issues of carers finding the patient a burden or benefitting financially from the patient’s death would inevitably arise.

Supporters of the legalisation of euthanasia in Australia point to the fact that palliative care simply cannot address all suffering. A recent study in Oregon found that 86 per cent of those who utilised legal euthanasia in 2013 were already enrolled in a hospice program. This throws shade over Australia’s ‘pro life’ groups’ assertion that hospice care has developed to the point where terminally ill patients can live out their days in painless dignity. In response, they tend to fall back on a more troublesome argument—that terminally ill patients cannot be entirely competent in their decision to end their lives. Prominent anti-euthanasia lobby group Right To Life Australia claims “those who regularly manage terminally ill patients recognise that they often suffer from depression or a false sense of worthlessness which may affect their judgment”. It’s condescending to assume that terminally ill patients should relinquish their agency, simply because they are in unbearable suffering. An American model—where psychiatric testing is central to all current legislationis an effective approach to deal with this argument.

Similarly, it is not true that euthanasia is impossible to regulate, as is often argued. Public health studies from Holland reveal that the number of patients euthanised has remained steady for several years. Corruption will always exist in the medical industry, but the legalisation of euthanasia—if anything—will decrease it, as it will stop doctors from needing to bend laws for their terminally ill patients. Countries where voluntary euthanasia is legal have also found that the  law has the potential to improve palliative care, since it decreases the burden of terminally ill patients on the health system and frees up hospital resources for those who wish to remain living.

So what does this mean for Australia? An Australia Institute survey in 2011 showed that 77 per cent of Australians were in favour of voluntary euthanasia. Surely a majority in favour of a law is sufficient motive to legislate? This is a democracy, right?

That is not to say that there aren’t questions that remain unanswered. But, at the very least, let’s bring the debate back into the mainstream and work on developing a system that balances regulation with freedom, autonomy and dignity.