After much media barracking, the long awaited Voluntary Assisted Dying Bill 2019 has been tabled in the WA parliament. For months the media have been running confronting and tragic stories of loved ones dying in agony.
The consistent theme has been that all this could have been avoided if physician assisted suicide had been available. It is all part of a well-meaning but orchestrated campaign to pressure our MPs to wave the legislation through.
We have been told in every story that “palliative care could not control their pain”. But never has there been any attempt to explain what this “palliative care” actually consisted of, or who provided it. Given Western Australia has only one quarter of the palliative care specialists it needs, there is every likelihood that these tragic stories resulted from a lack of quality palliative care. My heart goes out to those whose loved ones have suffered needlessly.
I worked in cancer palliative care in the 1980s, and I never saw anyone die in significant physical pain, thanks to the commitment and expertise of a pioneering palliative care physician, Dr Ruth Redpath. In those very rare cases where a person becomes very restless or appears in significant pain as death draws nigh, palliative sedation can be provided. This puts the person in an induced coma as the body goes through the final shut down process. Like all medicine, palliative care has progressed significantly since then.
In announcing the legislation, the Health Minister Roger Cook said it contains over 100 safeguards and is intended to provide a compassionate exit for the small number of people for whom palliative care can’t control their pain. But the legislation provides for something very different.
Closer examination reveals that these safeguards, are simply steps that have to be followed. You need to find 2 doctors, who have undergone the VAD training to sign off on three successive requests. We know that under the short-lived NT legislation, people doctor shopped. So that is not a safeguard. To qualify, a person must be suffering from a terminal illness and be expected to live less than 6 months, or 12 months in the case of a neuro-degenerative disorder. To be eligible, a person must be ‘suffering’ but that need not be in the form of physical pain.
There is no provision to require a psychiatrist to determine that the person is not suffering from depression, which might cloud their ability to make a properly informed decision. The legislation also provides for a doctor to initiate the discussion and suggest to the patient that they consider applying for physician assisted suicide.
In trying to sanitise physician assisted suicide, the legislation states that a person who ends their life by drinking the toxic cocktail of drugs is not committing suicide!
Doctors can refuse to accept a request for VAD. But even if they refuse it on conscientious grounds, they must provide the person with the documentation that the Health Department prescribes, which will presumably show the person how to find a doctor who will.
In jurisdictions where physician assisted suicide is available, it is rare for a person to access VAD for reasons of physical pain: A more common reason is that the person feels they are a burden to their family. The availability of VAD will generate its own subtle pressure to make use of it. Indeed, to not use it, can be seen to unnecessarily burden one’s family.
The role of government is to care for its citizens, not to provide means for doctors to help them commit suicide. The focus needs to be on care, not killing.
This legislation is inherently unsafe.
Link to Ministers media statement: https://www.mediastatements.wa.gov.au/Pages/McGowan/2019/08/Landmark-voluntary-assisted-dying-legislation-to-be-introduced.aspx