Chris Fotinopoulos believes dignified dying requires fewer restrictions on individual autonomy in end of life care.
Australia’s persistent anti-euthanasia stance is unfair, cruel and insensitive. It provides limited means to adults of sound mind to die on their own terms.
The current law on euthanasia restricts control and choice for certain terminally ill patients. It does so by denying them access to death-enabling drugs, information on how to administer them and appropriate medical support – including a physician’s assistance when needed.
The law compels certain individuals to die in ways they abhor and cannot easily escape. Meanwhile, others die peacefully and in control – often in their homes surrounded by loved ones and with appropriate medical assistance, albeit clandestine.
I’m always intrigued by the announcement of a prominent Australian’s death. The deceased invariably dies peacefully at home, with loved ones by their side. Why it is that the powerful and well connected often depart gently? Why are the less privileged compelled to endure irremediable suffering over a prolonged period?
I’m reminded of a story a young man told me last year. He spoke movingly about how he lost his mother under tragic circumstances that could have been avoided if not for the state’s stance on voluntary euthanasia.
His mother was suffering from a serious long-term mental illness. Her desperate plea to her doctors to help end a life that she described as “a living hell” were consistently dismissed as irrational. She was ultimately forced to die a violent death at her own hand.
According to her son, the life she foresaw was a life that she did not want. There was very little the medical profession could do to help her end it. His mother’s only option was suicide, which she took one lonely night at home after manically swallowing a cocktail of prescribed pills washed down with alcohol.
Her neighbour discovered her decaying corpse with a plastic bag over its head days after she died what must have been a horrible death.
This had a profound psychological impact on her son. He experienced depression, anxiety and complicated grief. The horror of his mother dying painfully and alone in such a setting is something that will stay with him to his grave.
A humane, just and civilised society should never insist on laws that allow such tragic deaths to continue. It should certainly not allow those rendered powerless through serious illness to suffer horrible deaths of this kind.
Society should do far more to empower the vulnerable through the provision of appropriate medical assistance, guidance and legal support. It should help them govern their life in a way that minimises suffering and delivers dignity in death.
Horrible deaths are not only restricted to the home. They also take place in hospitals and inpatient hospices. Years ago I spoke with a senior oncologist at The Royal Melbourne Hospital. He spoke candidly about the problem in accessing life-ending medication for his patients.
He spoke of a seriously unwell middle-aged female patient who he regarded as a friend. She had no immediate family or close friends to help her finish her life well. She did not have a network of people who could help enact a plan that allowed her to die peacefully and with dignity in the comfort of her home. The only person who could help was her oncologist but he was legally unable to do what he understood would give her dignity in her death.
In this case both patient and doctor were locked under state control. They were denied choices available to those who have the good fortune, legal nous and medical support to implement their plans away from the state’s reach.
The contradictory and confused nature of our anti-euthanasia laws become apparent when viewed in light of the state’s stance on suicide. Suicide is not illegal. Australians are at liberty to take their own lives through a variety of different means assuming they have the physical capacity to do so. Despite the grief suicide can cause to bereaved loved ones it is nearly impossible – and arguably unethical – to prohibit.
If someone has the ability to end their life they are free to do so. However those who are unable to end their life by their own hand are forced by the law to endure prolonged, unnecessary and irremediable suffering.
Anti-euthanasia advocates often argue palliative care is far more humane and caring than killing. They suggest more funding be directed to palliation rather than amending laws that allow the terminally to seek direct death. But those who take this line fail to acknowledge that some patients find death while under palliative sedation repugnant and unacceptable.
Denying a terminally ill person the option of choosing direct death over unwanted palliation is an infringement on their autonomy.
We need to appreciate that palliative care and physician-assisted death are not mutually exclusive. Indeed, terminally ill individuals who have high quality palliative care may be more open to the idea of assisted dying than those who do not.
Research conducted at Brunel University in London found terminal-cancer patients in British hospices were more likely to consider doctor-assisted dying than those in hospitals. This contradicts the commonly-held view that assisted dying would decrease if options like palliation and hospice care were readily available.
Voluntary euthanasia laws would not diminish the value of human life. They would enhance the prospect of a peaceful death by shifting control away from the state and other institutions. If individuals were granted control over this decision they would be empowered to achieve what they believe to be a good death.
If we are committed to delivering a good and peaceful death to all, then the law must extend personal autonomy, greater control and genuine informed choice to all Australians.