Labor MP for Eastern Victoria Region
MANY of us have dealt with end of life situations that were difficult and distressing. To experience extreme physical or psychological pain – or to witness the suffering of a loved one – prompts many people to ask: “Why can’t we do more?” “Why can’t we offer better options?”
Euthanasia and assisted suicide have long been proposed as a compassionate way to end suffering.
I believe that, while the impulse to relieve people of suffering is completely understandable, the framework proposed in the Bill currently before Victorian Parliament will cause more harm than good.
I was a member of the Legislative Council Committee that examined this issue. The potential for very complex situations to arise towards the end of life was reinforced by hundreds of written submissions and direct evidence provided to the committee by individuals experiencing terminal illnesses.
For many proponents, the key argument in favour of euthanasia and assisted suicide is the importance of respecting individual choice in the way that a person wishes to end their life.
I believe that euthanasia and assisted suicide are not simply a matter of whether to give effect to an individual’s choice about their own treatment. These practices necessarily involve third parties, usually medical practitioners, in acts that will intentionally result in death. As such, acts of euthanasia and assisted suicide move from the purely private realm into the public realm.
Therefore, we should consider not just the potential benefits for people who seek an end to their suffering but also balance this against the risk that many more people will be put at risk of coercion, pressure and unscrupulous behaviour.
While not all pain can be managed, it can be managed in the vast majority of cases and the proportion of cases in which pain can be managed is constantly increasing. Experts in palliative care, oncology and related fields almost unanimously agree that almost all symptoms arising from physical pain at the end of life can now be managed. Palliative care and oncology experts who gave evidence to the Inquiry stated that, over long careers, the number of people expressing a desire to have their life shortened was very small.
Even where there is an expressed desire to die, it is critically important to understand the nuances of such requests. Where the person making the request is experiencing depression or a mental illness, which is relatively common, there are usually other treatment options worth exploring. Holistic palliative care and other forms of assistance can often provide effective relief, even if not complete, and can often lead to a reversal in the expressed desire.
In practice, euthanasia and assisted suicide are a disproportionate response that cause far more social harm than good.
It concerns me that the number of instances of euthanasia and assisted suicide is growing rapidly in all major jurisdictions where it is legal. This has been occurring for almost two decades in some jurisdictions. The usage of euthanasia and assisted suicide in practice is far out of proportion to the situations that were originally used to justify the practice in these jurisdictions: namely, that small minority of cases where the symptoms of pain are unmanageable.
Moreover, the rapid growth in documented cases of euthanasia and assisted suicide probably materially understates the actual prevalence of the practice. There is a widespread failure of safeguards and procedures across jurisdictions, including doctor shopping; a failure to diagnose and treat depression; a failure to consult appropriate specialists; and low rates of reporting.
While legalisation was supposed to bring what was occurring in the shadows into the light, legalisation in these jurisdictions has simply pushed the boundary of what is legal out further and may have increased the amount of activity that occurs beyond the sight of regulators.
In countries with legalised euthanasia or assisted suicide, many vulnerable people are being placed in difficult situations in which they have to make irreversible, complex choices under a great deal of pressure. Evidence suggests that it is doubtful that safeguards are working as intended for such people.
I support treating people experiencing pain with compassion. But the evidence is clear that safeguards in euthanasia and assisted suicide regimes are difficult to design and enforce and that many people end up making irreversible choices that could have been avoided with access to higher standards of medical and palliative care.
MPs in the Upper House last night voted 22-18 in favour of a second reading of the bill. Debate on amendments will start on November 14 when MPs are next in Parliament, with several MPs seeking a reduction in the life expectancy time limit from 12 to six months.
This one’s for Ray: Bass MP Brian Paynter on why he supports the legislation.
Life and death: MP for Eastern Victoria Harriet Shing on her support for voluntary assisted dying.