The Olympics are soon to commence and our state and local government leaders are in Tokyo, hopeful Brisbane might win the right to host in 2032. Yet the posturing, contortion and linguistic gymnastics have been going a lot longer.
In recent weeks the Parliamentary Health Committee has been holding meetings around the state, tasked with focusing on the draft “Voluntary Assisted Dying” legislation presented it by the Queensland Law Reform Commission in May. Instead of probing the legislation for functionality or any evident weaknesses, the hearings have devolved into a re-run of the 2019 public hearings, with many people relating harrowing experiences of the traumatic deaths of relatives. These no doubt were cathartic, but personal anecdote only takes the process so far.
Surprisingly the most pertinent comments about the VAD legislation were revealed not in the Health Committee hearings but just outside the nearby Budget Estimates.
The Premier, Annastacia Palaszczuk, quoted in the Courier Mail on July 17, said “it is absolutely not physically possible to put in palliative care into every community in Queensland.”
That admission alone was discouraging but what uncomfortably hung in the air was left unsaid – that the solution to this funding shortfall is to provide VAD instead. Never mind its’ delivery is beset by the same logistical problems in remote areas. Never mind that the calculus which governs allocation of resources reasons it to be cheaper to offer euthanasia and assisted suicide than palliative care. No, such a stark decision is better portrayed as offering “choice” to the terminally ill.
Not that we are surprised by such euphemisms being used to powdercoat the truth. For decades now the public have been treated to a regular massaging of the euthanasia and assisted suicide message.
Writing recently in the Psychiatric Times, a group of American psychiatrists, medical ethicists and a palliative care physician rejected the idea there is a fundamental difference between a decision of a terminally ill person to ‘directly hasten one’s own death’ and ‘conventional suicide’, and should be treated as very different things.
The authors said just because some legislatures have redefined the concept of suicide does not mean that “this redefinition is conceptually or ethically justified”. They cite numerous court decisions in support of their position, as well as the recent decision by the American Medical Association to re-affirm its use of the term “physician assisted suicide”(PAS) in all of its publications, at the same time rejecting the use of the euphemistic term “medical aid in dying”(MAID), despite significant pressure by powerful forces to do so.
The authors argued:
“The process typically described as MAID in no sense aids dying; on the contrary, it rapidly converts an ill individual into a dead one.”
“While redefining suicide averts legal liability for physicians providing MAID, it does not change the essentially unethical nature of the act itself.”
Indeed these language changes do nothing to help patients; they serve only to ease the consciences of politicians, bureaucrats and physicians pushing the practice to avoid the “hard” work of keeping people alive and comfortable as long as possible.
The group also argue that the data demonstrates that requests for assisted suicide are not made primarily because a patient is experiencing intractable physical pain, but rather due to more existential concerns such as loss of autonomy, independence and control.
The authors quite rightly assert that these concerns represent a form of psychological distress, which are best managed by physicians qualified to provide supportive and empathetic counselling and/or cognitive behavioural interventions, provided to both patients and their families.
“Some cancer patients may make erroneous assumptions, like, ‘No one can help me’ or ‘No one understands what I am going through.’ Such cognitive distortions may respond favourably to cognitive behavioural interventions and potentially avert or abort a request for PAS.”
“Indeed, it has been found that requests for physician-assisted suicide are unlikely to persist when compassionate supportive care is provided.”
“Through high-quality care, effective communication, compassionate support, and the right resources, physicians can help patients control many aspects of how they live out life’s last chapter.”
The crucial chapters on the VAD legislation will be written in September when State MPs vote.
Queensland still has the opportunity to place itself on the “right side” of history.
If you would like to express some views on the issue to your local member ahead of the vote some food for thought is contained here. We don’t need to go down the same path as those countries who have unfortunately given up on their terminally ill and instead have codified into laws the view that society agrees that some lives are not worth living. We can do so much better than that. We deserve better than euthanasia and assisted suicide.