By Yasmin Noone
Like it or not, the debate about voluntary euthanasia has more to do with palliative care workers more than any other sector professional because, in the event that the law is changed, they will be the ones most involved in hastening a person’s death, a ‘pro-choice’ advocate said.
Australia’s peak body for aid-in-dying law reform, YourLastRight.com, is using National Palliative Care Week (22- 28 May) to reignite conversation about euthanasia, while emphasising the link between palliative care and assisted dying.
The organisation, which is the national alliance for all state and territory ‘Dying with Dignity’ societies, believes that access to quality palliative care should go hand-in-hand with the availability of legal physician-assisted dying for terminally ill Australians.
And while Palliative Care Australia’s (PCA) official stance on the matter is that it neither supports nor opposes physician-assisted dying and voluntary euthanasia, the Dying with Dignity alliance says palliative care workers would play a major role in legally hastening a person’s death.
“There is a view amoung a cohort of palliative care workers that voluntary euthanasia has nothing to do with palliative care,” said YourLastRight.com chairman and CEO, Neil Francis.
“They are entitled to that view, although it is not one that I share.”
But, Mr Francis stressed, should voluntary euthanasia be legalised, participating in the termination of someone’s life “…would not be a [compulsory] part of a health care worker’s job description”.
“One of the important ethical factors in providing choice for patients who want to request voluntary euthanasia, is that there is also a choice for the health [or aged] care worker who declines to participate.
“Providing choice is important for palliative and other health care workers. If their world views are such that voluntary euthanasia is a travesty to them, then they should have the right to not participate.”
Mr Francis said that (pending a change in Australian law) the responsibility of hastening a person’s death would “not be entirely, but largely” borne by palliative care staff.
But, he said, the task would not come down to just one person. Instead, the process of ending someone’s life would mimic the system in Belgium (where voluntary euthanasia is now legal) and be carried out by a multidisciplinary team of medical and care professionals.
“One of the key things with voluntary euthanasia is that, if legalised, there would be a specialist group of doctors who would be specifically trained in these issues, so that any [other] doctor [or member of staff] could call upon them to discuss the issues involved.
“Belgium is also unique in that palliative care professionals didn’t oppose euthanasia law reform but instead engaged and helped to develop the law.”
Renewed call to change law
This week, YourLastRight.com renewed calls for legislative change to allow access to assisted dying for rational adults experiencing intolerable and unrelievable suffering from a terminal or advanced incurable illness.
Mr Francis said that to help those patients, “…politicians must change the law to allow rational adult patients to have choice and control over the end of their lives.”
If euthanasia was legalised, those who opposed the law would also have to choice to “simply ignore and reject it,” he said. “The law would not create compulsion on any individual but instead it would simply create choice on how to act.”
According to Mr Francis, the quality of palliative care in jurisdictions that have legalised aid-in-dying such as the Netherlands, Belgium and the USA states of Oregon and Washington, remains high and integrates well with aid-in-dying.
“[When a perso- in the countries above-chooses to hasten their death], family members usually gather around them and play their favorite music, reminisce over photo albums, exchange expressions of love and then the patient takes the medication.”
A concern expressed by opponents of voluntary euthanasia is that legalisation would lead to non-voluntary euthanasia (hastening death without a current explicit request from the patient).
However, Mr Francis said, published research shows non-voluntary euthanasia is practiced in Australia (where there are no euthanasia laws) at five times the rate of the Netherlands (where there is).
“In the Netherlands and Belgium, the rate of non-voluntary euthanasia has decreased (not increased) since their euthanasia laws came into effect in 2002.
“…Obviously there are a range of world views around the community. The law [in Australia] currently respects the view of a small minority and currently denies the world view of the majority of Australians.
“The most important thing to do now is to have the discussion about voluntary euthanasia. Dying and death are not issues that are popular. You can’t just stand around the barbie, throw on a snag and talk about euthanasia and death.
“I warmly congratulate PCA for their campaign in National Palliative Care Week, [which aims] to engage the community in the topic and creating conversation.”
Mr Francis said he is available to discuss the topic of voluntary euthanasia with anyone who would like to do so. For more details, visit YourLastRight.com