Suicide or Palliative Care ..

it’s my right to choose.

I first heard about Phil Nitschke when he was working at Royal Darwin Hospital and he appeared in the local press waffling on about nuclear warships visiting Darwin and the lack of a disaster management plan in case an accident happened.

The next time I saw him was at the senate hearings (I think) about the Rights of the Terminally Ill legislation that offered Territorians a dignified exit and which was subsequently overturned by the Feds at the direction of a person that Professor Bunyip should have reserved his undiluted spleen for. (If that is a hanging participle preposition and offends the literate amongst you, then I apologise.) He was unusually articulate and extremely passionate at the hearings. Of course most of what he said was trivialised by the press and misunderstood by the politicians. He seems to have become more and more confrontationist as he “continues to promote his proposed suicide pill, has produced a suicide bag, and has constructed a carbon monoxide suicide machine.”

I’ve blogged before about my thoughts on the right to die including my total and absolute disgust at opponents who have orchestrated the public vilification of people like Nitschke and an endless stream of obfuscation and outright lies in an attempt to support their arguments. I was browsing a link to ONLINE Opinion when I happened to notice the latest effort by Mary Joseph in pumping up public opinion to try and stop me from exercising my right to die.

This is the danger of legalising euthanasia or assisted suicide. It puts the onus on each suicidal or terminally ill person to decide to continue to live. These options can be difficult to resist when you’re ill – even more so when others believe the “rational choice” is to end your life.

It would be impossible to frame adequate safeguards against non-voluntary euthanasia if voluntary euthanasia were to be legalised. It would be next to impossible to ensure that all acts of euthanasia were truly voluntary and that any liberalisation of the law was not abused.

Philip Nitschke co-wrote an article in the medical journal The Lancet detailing the experience with euthanasia in the Northern Territory. The article revealed that “pain was not a prominent clinical issue in our study. Fatigue, frailty, depression and other symptoms contributed more to the suffering of patients”. These are the factors that should be addressed if we are to prevent more people abandoning themselves to the despair of suicide.

The drive for euthanasia may well reflect a lack of understanding of the treatment options available to people with a terminal illness. Palliative care accepts that a point has been reached where a cure is no longer possible. It switches emphasis from medical treatment to treating symptoms so that the patient can live or die in the most comfort possible.

No-one who has nursed a terminally ill patient knows that “the treatment options available “ are limited, usually to taking the patient to the edge of unconsciousness using huge doses of morphine. What kind of life is that ? Where is the dignity in just existing ? I don’t want to keep breathing with all the senses of a cabbage.

The article continues the right-to-life mantra that only the God-fearing religious have rights. The right to be bigoted, the right to interfere in other peoples demise, the right to overturn legislation legitimately passed in other jurisdictions. No where in any of their propaganda do they discuss the rights of the terminally ill.

And all this bullshit about better palliative care will reduce the desire for suicide – some pain CANNOT be ameliorated. No matter what care is provided, no matter how good the pain management, no matter what the chances are that there may be remission, when I can no longer wipe my arse I want to die! And nobody else has the right to stop me.

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Ken Parish
Ken Parish
2022 years ago

Wayne

Actually it’s a hanging preposition, I think, but if it’s good enough for Les Murray it’s good enough for you and me.

On your substantive points, I agree. I still think Nitschke is a bit dodgy though. But that woman who claims it would be impossible to frame laws that would adequately protect against involuntary euthanasia is full of excreta. The NT laws were mostly OK, except that they needed to provide for certification by 2 designated government medical officers rather than any two doctors (which could mean Nitschke and some other doctor with equally fast and loose views about euthanasia).

Link
2022 years ago

(Dear) Wayne,

I agree with Ken, Nitschke does seem a bit ‘dodgy’ but he’s probably a very compassionate man. Its a real problem to legislate in favour of assisted legal suicide. Someone is bound to use it to their advantage causing another’s premature demise. My father, as many doctors (did) practised a form of euthansia, where sedative type drugs were gradually increased. He possibly could’ve been taken to task about it, if anyone had been stupid enough to tackle him on it, but given that the man was clearly not a murderer who was going to do challenge him? It was an unspoken yet well understood means of palliative care for the very, very old, and terminally sick and it probably is practised in many ‘Aged-Care Facilities’.

I think Dad would’ve run a million miles in the other direction if he received some form of legal instruction to put a person out of their misery. I don’t think he would’ve been able to do that.

TrueRWDB
TrueRWDB
2022 years ago

A very balanced comment, Link, on a far more complex issue than either Wayne or Ken are prepared to acknowledge. The old “unofficial” system of mercy killing had a lot going for it. Nitschke’s a self-publicist, ego-maniac, and wild-eyed radical.

The difficulty of “advantaged” euthanasia isn’t easy to solve. I always worry when anyone says “it’s OK, it’s in the government’s hands”. (Even if they are doctors!).

Kay
Kay
2022 years ago

I do think this is a very difficult issue. I share the concerns of many people (including Mary) that legalising euthanasia could lead to people feeling pressured to end their lives in order to end their family’s suffering, when they would not choose to for themselves.

On the other hand, I support the right of the terminally ill to end their lives if they so desire. And I thought it was inappropriate of the Federal Government to overturn Territory legislation.

I admit didn’t look closely at the legislation at the time, not being anywhere near NT nor part of the fed gov, and maybe it does do everything necessary to address Mary’s concerns.

I also don’t think it’s fair, either to doctors or their patients, to leave it in the hands of individual doctors to decide whether to risk themselves by participating in unsanctioned euthanasia. I can see your point, Link, about your Dad running a million miles. But what about the people who’s doctors don’t want to take that risk?

David Tiley
2022 years ago

We are fearing brutal and malignant behaviour here, and saying that refusing euthanasia is better, despite the obvious horrors that can create. You only have to look at Nitschke’s publically described stories.

But the brutality is already possible. Evil children can bully oldies into suicide, or neglect them until they decline into depression and self neglect. The elderly can be sent home from hospital on Fridays, or refused medication which is “too expensive”.

My bet is that every one of us shudders in horror at the idea of some of the nursing homes supporting our relatives right now.

I have to say all these are much worse and more likely than the abuse of a right to euthanasia. The solution is the same to both – the provision of adequate public health support, so people do not die away from the mainstream of human life.

The worst risk is that the government will ration care. These old folks can only last another year, so let’s not try and save them now. But we don’t need euthanasia to do that – the structure of public health administration will conceal and encourage that perfectly well, thank you very much.

Or it will, if we don’t keep watching. In the end its about political agendas. Will we fight for the rights of the aged?

woodsy
woodsy
2022 years ago

It was largely because of the situation that many compassionate doctors like Links father found themselves that Marshall Perron introduced the bill. Most supporters of the Rights of the Terminally Ill sympathised with doctors who, while knowing that assisted suicide was an option for the patient, were fearfull of the legal consequences.

If you look closely at the Act http://www.nt.gov.au/lant/parliament/committees/rotti/rotti95.pdf you’ll see that it was drafted so as to give support to medicos who understood their patients, without forcing anyone who was opposed to the idea. The doctor who treated our son was completely against any discussion of suicide. If David had been a little older (the patient had to be over 18) and he wanted to prosecute his right to die, he would have had to get another doctor.

To hold a reasonable debate about assisted suicide and/or euthenasia I believe it’s important to get over the ‘greedy granchild syndrome’ and dismiss the ‘slippery slope’ arguement that supporting the right to die will lead to the promotion of eugenics programs to rid society of the mentally retarded and encourage routine abortion. Until we can have civilised discourse free from the rubbish poured forth from the right-to-life proponents, I will continue to support the likes of Kevorkian and Nitschke.

TrueRWDB
TrueRWDB
2022 years ago

I suppose it’s easy for the passionate to dismiss the arguments against voluntary euthanasia’s possible descent into a form of “compulsory” euthanasia as not civilised discourse, but I’ve seen too many families descend into vicious in-fighting over wills to believe that everyone close to a dying patient is concerned solely about the patient’s welfare. Until that last comment I thought this thread was pretty civilised in its content.

Ken Parish
Ken Parish
2022 years ago

TRWDB

Here are the key sections of the Rights of the Terminally Ill Act (NT). I think you’ll agree that they cover pretty much everything one would want to see dealt with to ensure that a patient’s euthanasia decision is entirely, voluntary, informed and uncoerced. As I said previously, the only things I would like to have seen added were that the medical practitioners should have been ones designated by government to ensure they could not be Nitschke-types with aggressively pro-euthanasia attitudes, who might sign the required certifications as a political act when the statutory preconditions didn’t in fact exist. That was clearly the case with Nancy Crick, who didn’t have a fatal illness. The central sections are sections 7 and 8:

7. Conditions under which medical practitioner may assist

(1) A medical practitioner may assist a patient to end his or her life only if all of the following conditions are met:

(a) the patient has attained the age of 18 years;
(b) the medical practitioner is satisfied, on reasonable grounds, that

jen
jen
2022 years ago

What is the big deal about dying? It is as big a deal as taking my next breath – or not – life goes on.
This culture has alienated dying from everyday living. Medical science can keep us alive a lot longer – the issue is whether we are alive – alot happier I agree with Tiley – nursing homes -corrals for the old and infirm are shudder material – because many helpless people who are not ‘getting better’ shouldn’t be in one big conglomerate – it is not balanced.
The legal consequences of discreetly allowing a patient to OD are far more terrifying than a piece of thought out and agreed upon legislation that allows us to choose with no legal backlash for those who help us.
And I bet that many people make pacts with loved ones to engineer death.
Medical science is a problem at the moment – regarding how to die – and medical ethics need to concentrate on ‘above all do no harm’ seeing as medicine has redefined what harm can be. – A bout of hospital can prolong an agony existence and see you rotting away for much longer in a cardboard box swathed in fresh bandages or semi-conscious surrounded by the semi-conscious – but is not everybody’s notion of a good life or death.

Cancergiggles
2022 years ago

At some time in the relatively near future, when my time comes and the drugs don’t work, I’m off. Plan it and bugger the laws and cretins who pontificate on a subject of which they have absolutely no knowledge. Got very close once and made the choice to carry on but a platoon of marines won’t stop me when I decide to go.
Best
Cass

Ken Parish
Ken Parish
2022 years ago

Good luck Cass and may you have a pain-free, dignified death at a time of your choosing. It occurs to me that cancer sufferers have at least one “advantage” over some other fatal illnesses, in that they’re usually on morphine and can save just a little bit at a time towards the day when exit in a blaze of o/d glory is indicated. I wonder how many doctors turn a blind eye to patients stocking up in this way. Hopefully lots. I don’t really like the sound of most of Dr Nitschke’s contraptions.