The euthanasia debate

John Kleinsman writes in the SST:

But so, I would argue, is every other personal view. Whether or not people are personally in favour of, or opposed to euthanasia, is ultimately beside the point. To ask this question, as a recent Sunday Star-Times’ poll did, is to ask the wrong question. The crucial question is whether euthanasia can be safely implemented in the current context. Maryan Street, MP, glibly asserts that it can, while ignoring overseas evidence that says otherwise. I and many other New Zealanders of no religious persuasion believe differently. Our argument centres on safety and protection of those who are vulnerable.

If the debate is about how do we make euthanasia safe, rather than does a person have a right to end their own life, then that is a step forward.

We should firstly recognise that we already have unregulated passive euthanasia in New Zealand, where people are allowed to die, even though they could be kept alive. I think there is far greater risk in the status quo, than in legislating the circumstances under which someone’s wishes to die can be implemented with assistance.

The Northern Territory law mandated:

• A patient had to be over 18 and be mentally and physically competent
• The request had to be supported by three doctors, including a specialist who confirmed that the patient was terminally ill and a psychiatrist who certified that the patient was not suffering from treatable depression
• A nine day cooling off period

That seems like good safeguards to me. In the Netherlands the safeguards are:

• the patient’s suffering is unbearable with no prospect of improvement
• the patient’s request for euthanasia must be voluntary and persist over time
• the patient must be fully aware of his/her condition, prospects and options
• there must be consultation with at least one other independent doctor who needs to confirm the conditions mentioned above
• the death must be carried out in a medically appropriate fashion by the doctor or patient, in which case the doctor must be present
• the patient is at least 12 years old (patients between 12 and 16 years of age require the consent of their parents)
• A regional review committee assesses whether a case of termination of life on request or assisted suicide complies with the due care criteria

I think 12 is far too young, and would take the restrictions from the Northern Territory as being stronger.

The reality is that that it is not that difficult to come up with restrictions and safeguards to restrict it to cases where the patient is in immense pain and suffering, and will die anyway. Having a euthanasia law will in fact allow many patients to live longer as as present some kill themselves while they are still able. A euthanasia law would mean they would not have to do so, if they knew later on they could ask for euthanasia. Those who have Huntington’s Disease especially would benefit.

That the dangers of euthanasia are real is readily acknowledged by those wanting to legalise it. It explains why a lot of emphasis is placed on building in so-called safeguards. It has also been admitted by Maryan Street, in a public debate, that no amount of safeguards can stop the law being abused. So the argument about dangers cannot be dismissed as the rantings of “meddling god-botherers”.

Any law can be abused. We have a law against murder, but that doesn’t stop it. We have euthanasia happening at the moment, despite no law. The fact a law can be ignored is not a reason to not rationally consider the benefits of such a law.

I recently met Sean Davison, who was convicted of assisting in the suicide of his mother. He strikes me as a genuine, warm person, who had the courage to follow his beliefs. It is apparent he did not make his decision lightly, and that he thought long and hard about his action. But there will no longer be any need for the same degree of soul-searching if euthanasia was to become legal.

What John Kleinsman glosses over is Sean Davison faced a criminal trial and could have neded up in jail for many years, as the result of his love and compassion. I do not believe making euthanasia legal will mean there is no soul-searching. But it will transfer the decision from Sean to his mother – she is the person who should have got to decide, rather than have her son tormented by agreeing to her wishes.

In addition, in a society that is increasingly characterised by the isolation of the elderly, growing pressure on health care resources, and growing numbers of elderly people requiring expensive care, legalising euthanasia will contribute to those who are at the end of life, and those who are disabled, increasingly feeling they are a burden. They will feel as if they have to justify their existence to the rest of us.

I do not accept that argument, and regardless I would propose that it be available only to those in considerable pain and suffering – not just those who are old.

It is what one commentator has called “the distant and off-handed dismissal of the quality of life of certain people”. No law can offer safeguards against this. The right to die will quickly become the duty to die.

It hasn’t where it has been legal. This is just scare-mongering.

We should not underestimate, even for a moment, the subtle ways, conscious and unconscious, families have of putting pressure on their own to relieve their burden of care – both emotional and financial. Those working with the dying know this only too well. The very act of making euthanasia legal will remove the most effective barrier we currently have against such abuses.

Simple – you do not allow it, unless they are in pain and suffering. Merely dying of old age will not qualify.