Should voluntary euthanasia be legalised in Australia?

The ethically challenging debate of whether to decriminalise voluntary euthanasia and assisted suicide has been at the forefront of Australian political discussion for decades. We will take an evaluative approach to examining the current euthanasia and assisted suicide policy in Australia, its effectiveness, and whether it should be overturned. I will consider key theories and perspectives on this extensively debated topic while attempting to determine whether voluntary euthanasia and assisted suicide should be legalised in Australia.

While we might determine, that euthanasia and assisted suicide should be legalised in Australia, the real question is – how should it be regulated?

The issue of euthanasia has been frequently discussed in both state and federal parliaments in the past, indicating consistently strong societal views on the issue. It is unlikely that any resolution on this issue will be met with approval by both sides of the debate (Bartels & Otlowski, 2010). That being said, the scale of social concern on this issue demonstrates that the current policy requires attention. If it can be determined that a significant amount of Australian citizens would like to have the option of voluntary euthanasia available to them if necessary (Magnusson, 1996), we must attempt to discover which key players are restricting the decriminalisation and why.

Let us first look at the current policy regarding euthanasia and assisted suicide in Australia. Due to constitutional provisions, legislative change on this issue is required at a State and Territory level. On the 25th May 1995, the Northern Territory Legislative Assembly passed the Rights of the Terminally Ill Act 1995 (NT) by a 15 to 10 majority. The Rights of the Terminally Ill Act 1995 (NT) was repealed after a short nine months, when the Euthanasia Laws Bill 1997 (Cth) was put in place in order to remove power from the Australian territories to legalise euthanasia, therefore overruling the Rights of the Terminally Ill Act 1995 (NT) (Kissane, Street, & Nitschke, 1998).

Many consistent attempts have been made in State, Territory and Commonwealth Parliaments to introduce bills which permit euthanasia and assisted suicide, with the exception of the short lived The Rights of the Terminally Ill Act 1995 (NT), all of the attempts have been unsuccessful (White & Willmott, 2012). There appears to be an increasing amount of public interest in this discussion, and it can be understood that there is a majority of public support in favor of reform (Magnusson, 1996). In Australia, we are witnessing increasing reforms being put forward in overseas jurisdictions, with considerably little attempt by our parliaments to introduce reform on such a substantial issue (Douglas, Willmott, & White, 2013).

Legal voluntary euthanasia is only available to patients who are suffering unbearable pain, whose illness is incurable, and who have authorised the procedure under complete mental capacity. It is exceptionally unlikely that any euthanasia legalising legislation will cover any patient who is not deemed to be terminally ill (Bartels & Otlowski, 2010).

This is where the grey areas of this debate become increasingly visible, and it becomes harder to regulate exactly who has the right to end their own life via these means, if anyone at all.

It is essential in this debate to discuss the viewpoints of the medical practitioners and how the act of euthanasia is considered by those most likely to be administering it. More than ten years ago, Baume and O’Malley’s 1995 study shows that 58% of the doctors surveyed thought that reform was necessary in order to permit active voluntary euthanasia (Baume, O’Malley, & Bauman, 1995). The politically powerful Australian Medical Association’s conservative response has played a significant role in obscuring any reform, which has also created a convenient shield for reluctant politicians who are unwilling to tackle the controversial issue (Magnusson, 1996).

Another major issue involved in legalising euthanasia in Australia is the concept of regulating a self-regarding conduct by individuals. While state interference is generally supported by conservative thinkers in Australia, the politically right-wing are more likely to support interventionist policies which attempt to preserve tradition and customs. While liberal thinkers are more inclined to be skeptical of state interference, especially policies which threaten individual freedom and autonomy, the politically left-wing voters are generally supportive of interventionist policies which promote individual rights, such as the right for equal marriage, and the right to choose how to end one’s own life.

We have already seen the Death with Dignity Act pass in Oregon in 1994, which allows patients to end their lives through self-administration of lethal medications. Statistics show that from 1998 – 2015, the number of prescriptions for the lethal medications given in Oregon consistently grew, as did the amount of prescriptions which were never filled (“Oregon Death with Dignity Act: 2015 Data Summary”). These statistics show us that just over one third of patients who retrieved the prescription did not go through with ending their life (Stingl, 2010).

This shows us how important it is for us as humans to have the options and freedom available in order to consider them autonomously.

It is certainly crucial to consider the realities of social conduct which can be a result of legislations put in place. Assuming that euthanasia and assisted suicide be legalised, the legislation would only be applicable to those who are deemed terminally ill (Bartels & Otlowski, 2010). That being said, it is worth considering those who would wish to commit suicide because of psychological reasons which do not deem them terminally ill.

Dr. Philip Nitschke has commonly stated that he believes even those who wish to be euthanised who are not considered terminally ill should still have the right of euthanasia being available to them (Corderoy, 12 November 2014). As the leading figure in Australia’s fight for euthanasia reform, Nitschke’s views have caused considerable controversy. As one of the most prominent and high-profile voluntary euthanasia advocates and founder of Exit International, Dr Philip Nitschke became the first doctor in the world to administer a legal, lethal voluntary injection under the Rights of the Terminally Ill Act 1995 (NT) (McDougall & Gorman, 2008). Before the act was overturned by the Australian Parliament, Nitschke legally administered the injection to four of his terminally ill patients (Kissane et al., 1998).

If we are to understand that Dr Philip Nitschke and the majority of Australian citizens are pro-reform, then it is crucial for us to determine what key players are determined to hinder any voluntary euthanasia and assisted suicide legislation being passed. As a community, our unwillingness to talk about dying is a major obstacle in our struggle for reform (“The Parliament of Victoria Legislative Council Legal and Social Issues Committee Inquiry into end of life choices”). Regulations on personal issues where religious viewpoints come into play can generate multiple ethical and moral problems within the legislation process. Generally speaking, right-winged voters are more likely to be in favour of issues which follow tradition and are considered in line with religious ideals.

The issue of euthanasia is one which does not align with most religious ideals and this is the cause of the most common argument against reform. In Australia, originally a strong Catholic country, the concept of controlling life and death is seen by Christians (similarly with the abortion debate) as a process which should be reserved for God, not humans or doctors. The Catholic Church make this condemnation of euthanasia clear by regarding suicide and attempted suicide as grounds for excommunication from the church (McDougall & Gorman, 2008).

Around 60 per cent of Australia’s palliative health care services are provided by the Catholic Church – the only area of medical care where a religious group has dominance in provision of care (Syme, 17 August 2014). It can be seen that Catholic medical practitioners are significantly less likely to take steps to hasten death (Baume et al., 1995), and are commonly concerned that any law reform is a slippery slope towards increasing the range of circumstances by amending legislation. While we understand that the majority of Australian citizens would agree with reform to the euthanasia and assisted suicide legislation, the small group of powerful religious and/or conservative elite seem to hold the balance of power on this issue, thus constricting any reform.

It has certainly been demonstrated that euthanasia and assisted suicide should be legalised in Australia. In June 2016, a Victorian cross-party state committee delivered a report which recommends that the State Government legalise assisted dying for people suffering from serious and incurable conditions (“The Parliament of Victoria Legislative Council Legal and Social Issues Committee Inquiry into end of life choices”). Deciding how to regulate euthanasia is a philosophically challenging and daunting task especially when considering all the grey areas in the discussion. The most challenging philosophical aspect which is restricting any legislation reform, it appears, is society’s view on the sanctity of human life.

References

Bartels, L., & Otlowski, M. (2010). A right to die? Euthanasia and the law in Australia. Journal of Law and Medicine, 17(4), 532-555.

Baume, P., O’Malley, E., & Bauman, A. (1995). Professed Religious Affiliation and the Practice of Euthanasia. Journal of Medical Ethics, 21(1), 49-54.

Corderoy, A. (12 November 2014). Dr Philip Nitschke says depressed people can make informed decisions to end their lives. The Sydney Morning Herald. Retrieved from http://www.smh.com.au/national/dr-philip-nitschke-says-depressed-people-can-make-informed-decisions-to-end-their-lives-20141112-11l4c1.html

Douglas, R., Willmott, L., & White, B. (2013). The right to choose an assisted death: Time for legislation? Australia21 & QUT Health Law Research Centre, Canberra.

Kissane, D. W., Street, A., & Nitschke, P. (1998). Seven deaths in Darwin: case studies under the Rights of the Terminally III Act, Northern Territory, Australia. The Lancet, 352(9134), 1097-1102.

Magnusson, R. (1996). The future of the euthanasia debate in Australia. Melbourne University Law Review, 20(4), 1108-1142.

McDougall, J. F., & Gorman, M. (2008). Euthanasia: A Reference Handbook. California: ABC-CLIO.

Oregon Death with Dignity Act: 2015 Data Summary.   Retrieved from http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year18.pdf

The Parliament of Victoria Legislative Council Legal and Social Issues Committee Inquiry into end of life choices. Retrieved from http://www.parliament.vic.gov.au/images/stories/committees/SCLSI/EOL_Report/LSIC_58-05_Booklet_Text_WEB.pdf

Stingl, M. (2010). The Price of Compassion: Assisted Suicide and Euthanasia. Ontario: Broadview Press.

Syme, R. (17 August 2014). At life’s end, we should respect people’s choices. The Sydney Morning Herald. Retrieved from http://www.smh.com.au/comment/at-lifes-end-we-should-respect-peoples-choices-20140814-104cob.html

White, B., & Willmott, L. (2012). How should Australia regulate voluntary euthanasia and assisted suicide? Journal of law and medicine, 20(2), 410-438.

Feature image credit: https://noplaceforsheep.com/2016/07/22/pray-for-the-bigots/
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