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75% of Victorians want a Voluntary Assisted Dying Law.
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Too many Victorians are dying bad deaths, despite the best medical care available. With no law to help them, terminally ill elderly Victorians, in particular, have been taking their own lives, alone and in violent ways.
The reality for some Victorians who are at the end of their lives is that even the best palliative care will not relieve pain and suffering. Those close to them are powerless to help.
The Victorian parliament will hold a conscience vote on voluntary assisted dying in the second half of 2017. This means each and every state member of parliament will vote according to his or her own thinking.
If the law is passed, it will come into effect from 2019.
In Victoria today, it is legal, if you are dying and suffering beyond medical help, to end your suffering by committing suicide, often violently and alone.
It is legal to refuse all medical treatment, food and water, and to die slowly of starvation and dehydration while your disease takes its course.
It is legal for a doctor to slowly drug you into a coma while your family waits for days, or weeks, for you to die. This can happen without your consent.
But it is not legal if you are dying and suffering beyond medical help to end your suffering painlessly and quickly with the help of a doctor.
As a patient, do you have any legal right to insist that a doctor gives you more, or faster, pain relief. That decision is entirely up to the doctor whose personal beliefs you may not share.
This is why we need a law. So that we all have a legal right to be protected from unnecessary suffering at the end of life – so doctors have a legal right to help us - and so there can be more compassionate choices if we’re dying and suffering than starving ourselves to death, being slowly drugged into a coma, or taking our own lives, violently and alone.
Some organisations, like Right to Life and others, assert that Voluntary Assisted Dying laws are not safe. They warn of vulnerable people being coerced to end their lives for other peoples’ gain.
Numerous independent inquiries have found no evidence that this has occurred. These include:
Representatives of peak elderly and disability groups in Belgium, The Netherlands and Oregon also report no abuse of their members under these laws.
Victoria’s proposed law is designed for those at the end stage of a terminal illness whose suffering is beyond meaningful medical help. It is very hard to coerce a vulnerable person into a terminal illness they don’t have. Even harder to coerce two doctors, whose work will be subject to review, to agree with them. That’s why the safeguards work.
As the cross-part inquiry found, Victorian doctors already practice unlawful assisted dying, but they do so ‘without regulation, support, transparency or accountability’.
For those doctors currently faced with the agonising choice of helping a patient to die and breaking the law - or abiding by the law and leaving that patient to die with great suffering - a Voluntary Assisted Dying law provides protection. More than protection, it provides guidance and the opportunity to consult with colleagues and also the family of the person who is dying.
Those who oppose this law refer to Voluntary Assisted Dying as ‘patient killing’ or ‘state sanctioned killing’.
This dishonestly avoids the central fact that the law is to help those already being killed by an incurable disease. Being voluntary, it is entirely up to the patient whether or not they choose to end the suffering caused by that disease.
Neither are doctors being asked to ‘kill’ a patient. In reality, what they’re being asked to do is what they already do - make a careful diagnosis that a patient’s condition is terminal and their suffering intolerable and go through with them their treatment options.
If the patient meets the legal requirements for assistance to die, they write them a prescription for a life-ending medication. After that, it is up to the person whether or not they use it.
Only one person is being asked to make a life and death decision. The person who is dying.
Australia has one of the best palliative care systems in the world. However, it is a fact that they can’t help everyone. In Palliative Care Australia’s own words: “Even with optimal care not all pain and suffering can be relieved”.
By their own estimates, the numbers of people truly beyond their help are about 4%. Their suffering, as recorded in evidence to the parliamentary inquiry, can be savage.
This is no criticism. It simply reflects the reality of modern medicine, which can keep us alive longer but which still has no cure for diseases like cancer and Motor Neurone Disease.
The question is: why should those who palliative care can’t help, be left to suffer when we have the means to help them?
In the words of the ‘father’ of Australian palliative care, professor Ian Maddocks:
“If compassionate and loving care towards patients and families is what palliative care is all about then assisted dying is part of that. It is time the profession dealt with it”
The committee recognised the reality that for some Victorians who are at the end of their lives even the best palliative care will not relieve suffering. But they also recognised that any such law has to work hand-in-hand with increased resources for good palliative care. We strongly support that.
Voluntary Assisted Dying is not intended to replace palliative care. It is adding one more end of life option alongside palliative care for doctors and their patients to explore. In Oregon, nine out of ten patients who choose a doctor’s help to die are also enrolled in hospice care.
According to the AMA’s code of ethics, doctors are obliged to:
“Respect the right of a severely and terminally ill patient to receive treatment for pain and suffering, even when such treatment may shorten a patient’s life”
Some doctors object to Voluntary Assisted Dying on the basis of the Hippocratic Oath which instructs ‘do no harm’. Others see leaving a dying patient to suffer as the opposite of ‘do no harm’.
A Voluntary Assisted Dying law is voluntary for everyone. It respects and protects the rights of those doctors who object. Just as it protects and respects the rights of those doctors with a different ethical view.
The extreme rhetoric being used by Right to Life and other faith-based objectors – such as ‘patient killing’ and ‘murder’ – is designed to inflame emotions. It does not acknowledge, or address, the clear evidence of suffering happening across the Victorian community in the parliamentary committee’s report.
In a recent visit to Victoria, sponsored by MLC Inga Peulich and Right to Life, US doctor William Toffler suggested privately to MPs that, should Voluntary Assisted Dying become legal, that it be carried out by veterinarians who have “training in giving overdoses to living things, living animals.”
The rhetoric being used by Dr Toffler, Right to Life and others – and endorsed by Ms Peulich - seeks to trivialize the genuine suffering and trauma being faced by Victorian families.
That elderly Victorians are killing themselves violently at the rate of more than one a week, because there is no other way they can be legally helped to end their suffering, is a serious public health issue. It requires thoughtful and respectful debate. Opposing Voluntary Assisted Dying simply on religious grounds and with emotive language is not an answer to this suffering.