The aim in looking after the terminally ill is usually to keep the patient as comfortable and calm as possible and to allow them as much dignity and pleasure as possible. Sadly, the disease process itself does not always make that possible - as we saw in this tragic case of Chantel Sebire.

Have to wonder though, why there is such an insistence on analgesics [pain-killers] alone outside of palliative care units. Sedatives, muscle-relaxants, TV on to bloody awful soapies, visits by noisy great-grandkids and a whole lot of other things can help alleviate suffering.

One of the best medicines I saw prescribed for a terminally ill patient was “30 ~ 60 ml of the mixture [a damned good brandy] p.r.n. [as required]“. What? In breach of hospital regulations? They might get picked up for drunken driving? They might become alcoholics. Yeah, right.

http://alsblog.wordpress.com/2008/03/04/heroin/

However linking heroin relegalisation to euthanasia relegalisation would unnecessarily complicate both political debates.

Many doctors are sympathetic to euthanasia and will “allow” it to happen. Many cancers are essentially untreatable, one GP said that the best pain killer and palliative is heroin, which is now illegal.

It is worth recognising that there may be a range of reasons for other people to want us to begone - including our incontinence, confusion or sundry other messy issues. The ROTI Act in the NT recognised that these issues could be present and had in place processes to guard against them. While the Act was not in place long enough to be completely sure that the processes were sufficient, there was never any suggestion that the people who did take advantage of the Act did so because they were convinced by relatives or friends.

Andrew [16]:

Many Aboriginal people in the NT were very concerned about the ROTI law. Many Aboriginal people in the NT have strong religious beliefs. At the time there was a strong campaign telling people that the law would give doctors the right to kill them. The law was a worry for them and they found it hard to support. The law was passed though following the support of an MLA who had senior, traditional status representing an almost exclusively traditional Aboriginal electorate.

Surely the key to this issue is that it is about ‘voluntary’ euthanasia. It is therefore a matter of establishing a process that gives us all confidence that it is a voluntary decision. ROTI came close to that. It may even have been very good. It was knocked off not because it didn’t work but because it was considered to be morally wrong by some who held religious convictions, others who were politically gutless and some others who seemed to worry that it was all going too far.

Just to note - aboriginal people in the NT are overrepresented in the incidence of suicide.

http://www.mja.com.au/public/issues/185_06_180906/mea10056_fm.html

I have always thought that the need to have psychiatric services and alcohol targetting programs was the real way to go for those concerned about suicide.

Unfortunately as I pointed out in my post previously there is no split up that I know of that can isolate the effect of the ROTI Act on the stats.

However, given that there were four assisted suicides over the period of the Act’s validity which amounts to approx 1.5 deaths per 100000, and the overall suicide rate seemed to be about 18 and rising, straining at a gnat and swallowing a camel seems to be an apt description.

The present situation is that we will not allow those with terminal illness and in pain to end their lives with dignity, but otoh (according to the report above) other suicides at far greater rates don’t get more than a ‘tut tut’.

(For example, there are plenty of broad programs to stop alcohol abuse, but how many ones targeted at individuals who have shown themselves to be at risk?)

What a good idea - or two!

One of the great joys in life is seeing donated-organ recipients restored to good health.

Ken Parish [20]:

I don’t dismiss out of hand the “slippery slope” and “greedy relatives” scenarios of people like Graham Bell. They’re not common but they’re certainly real situations.

Perhaps a little more common than is supposed.

Hands up any doctors, nurses, pharmacists, other health workers and clergy who have NOT been asked - on the quiet - if there was something to hurry things along.

No, not distressed relatives hoping that the unendurable suffering of their loved one will not drag on for much longer. That’s a normal humane reaction to a terrible situation; their motive in even saying something at all is ALWAYS for the comfort and peace of their loved one; that they have said something is, in itself, a measure of their anguish.

Hands down.

Now, hands up all those who have NOT been asked to hurry things along for the messy, the noisy, the incontinent, the confused, the bed-ridden and the like.

Hmmm. I see.

So back to my point. Do not imagine that the administrative, financial and social incentives to bump off the inconvenient can be ignored in any useful discussion of euthanasia in Australia.

BTW the bbc have an interesting page summarising basic for and against positions.

http://www.bbc.co.uk/religion/ethics/euthanasia/

Like all ethical dilemmas its a difficult one.

ON a slight tangent, but still on the topic of mortality, it is a good reminder to complete an Advanced Health Directive (downloadable online) and also to think about sharing your useful bits when you are gone

The federal Parliament is now on a seven week break, and doesn’t sit again until May 13th, the day the Rudd government brings down its first Budget. In the case of the Senate, this will be just the eleventh sitting day for the year. However, there is…

I don’t have any fundamental moral objection to euthanasia for non-depressed adults who freely and voluntarily conclude on rational and credible grounds (as assessed by approved doctors) that their life has become hopeless and intolerable beyond reasonable prospect of improvement. Note the numerous qualifications. Unlike Niall, however, I don’t dismiss out of hand the “slippery slope” and “greedy relatives” scenarios of people like Graham Bell. They’re not common but they’re certainly real situations. Allowing for legal euthanasia beyond actual terminal illness allows greater scope for those sorts of fears to find fertile ground in public imagination. Thus my pragmatic position, and incidentally my reason for labelling Nitschke a “fanatic”, requires drawing the line (somewhat arbitrarily I accept) at and not beyond the point of terminal illness.

I agree that people with deep moral opposition to the concept of voluntary euthanasia are very unlikely to support a law that seeks to legalise it (although I wouldn’t call all of these people fanatics). However, the point I was trying to make is that these are not the only people who are opposed to - or unconvinced about - euthanasia laws. Telling people who may be unconvinced that they are basically heartless or cruel, or that they are just cowardly people scared of offending religious fanatics, is not likely to make them more supportive.

BTW, I wasn’t in the Senate when the Andrews Bill was debated, although I did follow the debate closely, and have followed the issue relatively closely (although far from forensicly) since then.

No doubt one can mount a respectable argument for allowing euthanasia in such circumstances…

For the record, Ken, do you yourself support legislation that enables assisted suicide in these circumstances? I would have thought that the basic logic is the same.

I also wonder what exactly a passionate euthanasia advocate has to do (or not do) in order to avoid being perceived as ‘fanatical’. In Nitscke’s case, did he do anything in particular that worried you, or do you just have a vague sense that he’s excessively enthusiastic about bumping people off?

Your reminder of the need for moderation (if only to avoid antagonising those whose support or at least non-opposition is necessary) is perhaps salutary. However it’s also insufficient. I don’t remember whether you were in Parliament when the NT legislation was voted down by the initiative headed by Kevin Andrews and his group. However, if you were then you would presumably remember that the NT law included quite extensive safeguards to ensure that only terminally ill people, and only those who freely and voluntarily consented while not in a state of clinical depression, undue influence or other state of mind which might affect their decision, could access state-approved euthanasia.

That said, I thought (and still think) that the law could have been improved. It relied on certification by (from memory) two doctors including a psychiatrist, but left it open as to who they could be. Thus it remained possible that somewhat fanatical if sincere doctors like Phil Nitschke might issue a certificate in a situation that didn’t strictly fit the statutory requirements but did fit his own moral criteria (e.g. a person whose life had become painful and intolerable but who was not in fact suffering a terminal illness, like Nancy Crick). No doubt one can mount a respectable argument for allowing euthanasia in such circumstances, but there’s much less chance of achieving a broad consensus on it. It opens up the situationm for fears about greedy relatives of the sort that Graham Bell has expressed on this thread.

Nevertheless, having endured the full gamut of the debate on euthanasia as a practising and academic lawyer with a deep interest in the question from several perspectives, the view I ended up forming is that the religious fanatics will never agree to a euthanasia law, and will never even mute their opposition, irrespective of how many safeguards are built into such a law. Their opposition is not susceptible to any form of compromise or rational persuasion. Hence my own view is that we need to find a way whereby the pro-euthanasia majority will be both sufficiently intellectually persuaded and sufficiently passionately committed to the principle to be prepared to override the religiously based objectors. Situations like that of Chantal Sebire provide opportunities that should be grasped. Thus I don’t shy away from emtoive expressions like “religiously cruel minority”, because they accurately express the situation and speak to the large majority whose emotional and rational support will be needed if a reform is ever to be taken forward.

1. I appreciate this is an issue that some people feel strongly about, but I suggest it would be beneficial to drop the religion bashing line of rhetoric. I find it offensive to suggest that the only people opposed to such laws are a “religiously cruel minority”. I also don’t think the only reason laws have not been passed is because it “isn’t a vote-changing issue except for the religiously-motivated minority opponents.” I think one of the reasons why Parliaments have stayed away from this issue is that it is exceedingly difficult to legislate for (which I think is the point Graham is making), even though most people recognise the current situation is well short of ideal. Sugggesting that everyone who might be uneasy about such a law is just some sort of narrow-minded religious bigot who thinks people should suffer is not a good way to win their support.

2. I’m not trying to derail the thread by turning it into one on Philip Nitschke, but I think it has to be said that as a leading advocate for such laws, he does not give me great confidence that whatever legal boundaries are put in place will be strictly followed.

3. From memory - I’m sure Ken will correct me if I’m wrong - some of those who expressed strong concern about the NT laws when they were passed were Aboriginal people. That’s not a reason in itself not to have such a law, but it it’s not a factor which should be ignored either.

4. I don’t mean to sound pedantic, but while it wouldn’t have happened without the support of John Howard, I think it is more accurate to say that it was the federal Parliament, rather than the Howard government, which overturned the NT law. It was a conscience vote on a Private Members Bill, and people from Labor, Liberal (including Cabinet Ministers), National and Democrats voted both for and against the Bill.

5. Speaking of Private Members Bills, there is currently a short Senate inquiry into a Bill of Bob Brown’s, similar to one put up earlier by Lyn Allison, which seeks to overturn the federal law which overturned the NT law - that is, it would make the NT law operational again. Bob Brown’s Bill is not likely to be brought on for a vote for a while - I doubt Kevin Rudd would be keen to have the major Parliamentary debate that would be required for such a vote to occur - but people who want to contribute to public and political debate on the issue should put in a submission to the Senate inquiry. This link has details.

“We all have our individual dignity and ought to be allowed to maintain it throughout life, right up until the very end”.

Yea verily!

My opinion comes from many years working in health …. and I think I’ve seen just about the full range of responses to infirmity and age - from giving a slanderously false and misleading history so as to get the stupid old bitch out of that lovely house right through to displaying genuine love and concern..

Many of the aged and the infirmed would be better off in institutional care than in the old homes; that’s not the issue. Annoyance and sloughing off responsibility are common enough and, though not nice, are unlikely to cause grave harm - so they should not cause fear about what would happen if widespread euthanasia were introduced. Introduced, that is, without a hard dispassionate look at the hefty social and financial incentives to get rid of inconvenient and/or expensive oldies and infirmed.

Australia is a lovely country but it does have some very nasty aspects - and the attitudes and the actions [not the flowery words] of some families and most governments towards the aged and the infirmed do have to be recognized, no matter how uncomfortable and confronting that recognition may be.

Trying to introduce voluntary euthanasia in Australia without considering the social and financial aspects would be a disaster - no matter how near perfect the law may be.

I advocate individual rights and freedoms on the subject of right-to-die. We all have our individual dignity and ought to be allowed to maintain it throughout life, right up until the very end. When my essence leaves this vail, it will be with ultimate dignity, without pain and at a time of my choosing. I wish the very same for everyone who desires it.

Mind you, given the naked hatred and contempt I’ve seen expressed by many for the Boomer generation, to which I belong now that they’ve changed the definition of it and thrown the original one (DOB 1946-1950, I believe) down the oubliette, I fully expect some disaffected Gen X sausage to give the orders to bump us off en masse as soon as a chance presents itself, but your comments seem to rest on an assumption that the homicidal impulse is built in to human nature at large. Is that really what you think?

Not critical at all of the efforts of Marshall Perrin nor of the N.T.laws - as laws went, they were very good.

What should alarm us is the Australian propensity to go for manifestly unjust bureaucratic solutions to problems that can be readily solved by involving the object of attention in the decision-making process. I really do mean the object of attention - they quickly cease to be a person with feelings, preferences and rights [despite all the ballyhoo about "protecting clients rights"] when subjected to that sort of process.

For example: Just look at all the pressure, by families, to tip grannies out of their very valuable bits of real estate and into nursing homes, any nursing homes, anywhere. That many of these same grannies were perfectly capable of living out their lives in their old homes if they had a bit of home assistance [ daily short visits by relatives would be nice too]. Assessment teams are not to blame - they are always short staffed and overwhelmed by unfair workloads. Errors of judgement do occur - and greedy families move hell-and-high-water to make sure such errors do occur. e.g.:There are plenty of regulations to prevent greedy relatives from looting granny’s bank account once she goes into a nursing home and her old home is sold off; none at all to prevent a “lucky” purchaser [such as a grandson's partner] of granny’s old home making a squillion.

In the social environment we have here in Australia, not even the finest laws in the universe will prevent the intentional killing of those who have no unshakable and reasoned desire to have their lives ended. Add financial incentives for either families or governments to get rid of them - and they’re as dead as a dodos.

A person with a powerful need to consider euthanasia would be much safer in another country with far less perfect laws but with strong social compulsions against euthanasia-for-profit.

Everyone here restricts discussion on euthanasia to the legal, medical, religious and moral aspects …. yet nobody wants to talk about the social and financial aspects. Okay, What’s the market value of the corpses and how fast can production be increased?