ANALYSIS: Euthanasia Under Review

The Australian state of Victoria is currently conducting an inquiry into end of life issues and the archdiocese of the state’s capital, Melbourne, handed in its submission on the issue earlier this month.

The submission was made by the Episcopal Vicars for Health, Aged and Disability Care and Life, Marriage and Family on behalf of the Archbishop of Melbourne, Denis Hart, with the endorsement of the Bishops of Ballarat, Sale and Sandhurst.

The “Victorian Inquiry into End of Life Choices” was established on May 7 in a decision taken by Victoria’s Legislative Council and must report its findings no later than May 31, 2016.

It will investigate current practices within the medical community and also review existing legislation, as well as considering what legislative changes may be needed.

The Catholic Archdiocese of Melbourne took a strong stand against euthanasia in its submission, which defined euthanasia as being “an act or omission which, of itself or by intention, causes death in order to eliminate suffering.”

According to the government the majority of care in the state is carried out by the private sector. In Victoria the Catholic Church runs 26 hospitals and 89 aged care, hospice and palliative care facilities.

The Catholic Church, the submission explained, believes in holistic care, in which health care does not only focus on the body but also includes emotional and spiritual support.

Care and comfort

This is especially the case in palliative care where the medical focus shifts from care to comfort. In such a context end of life carers must not impose either burdensome treatment or deliberately withdraw treatment to hasten death.

Catholics, the submission continued, also recognize that humans live and die in the context of a community. Thus, best practice care will attempt to surround a patient with a supportive community at the end of life. It also means that the death of a person does not only affect the individual but also family, friends, health care providers and the wider community.

Turning to consider euthanasia the submission noted that there is both active euthanasia, in which a person’s life ends through the taking of a drug or removal of treatment, and physician assisted suicide which involves assisting the death of a person without directly administering any fatal treatment.

“We agree with the World Medical Association that euthanasia is incompatible with the practice of medicine as it involves a deliberate act with the intention to kill,” the submission stated.

Responding to the argument that euthanasia allows “death with dignity” the submission argued that no death is undignified. Moreover, a person’s dignity is not dependent on health, mental state, or pain threshold, but on the condition of being human.

“Euthanasia is not compassionate,” the submission maintained, as it is an “admission of a society’s inability to provide proper care to those at the end of life.”

The dangers of euthanasia have been recognized by legislators in Australia, with only one out of thirty proposals over the last twenty years in Australia being passed, and that one approval was rescinded two years later.

Discrimination

The submission listed a number of reasons for rejecting euthanasia.

+ It legalizes unjust discrimination by establishing a class of people whom it is legally permissible to kill.

+ The doctor-patient relationship is changed with the erosion of the “do no harm” principle.

+ Remote and rural citizens need better care, not euthanasia. Requests for euthanasia are proportionate to the availability of symptom control and in regions where there is a lack of palliative care patients will be influenced by what is available, rather than what they would prefer.

+ Euthanasia attacks the vulnerable. Loneliness, depression, and fear of being a burden are consistently listed higher than pain as reasons for seeking euthanasia.

+ Safeguards do not work. Despite safety provisions and limits in the 2002 law governing euthanasia in Belgium in just over a decade euthanasia is now allowed for children, and patients with autism, anorexia, bi-polar disorder and people who are “tired of life.”

+ Heavy reliance on mental health infrastructure. Mental illness and requests for euthanasia are often linked and with mental health services already overloaded the increased burden from legalized euthanasia will create pressure to relax safeguards.

+ With no other Australian state or territory having legalized euthanasia any change in Victorian law runs the risk of turning the state into a destination for death tourism.

The submission called for an improvement in palliative care for patients. The recommendations included providing services and funding for those people who wish to die at home. As well, funding is needed to provide palliative care for rural areas. Increased support for families and carers of patients is also needed.

A number of other issues were raised in the submission, such as the identification of overly-burdensome treatments and advance care planning to prepare for when people will have lost part or all of their decision-making capacity.

With rapidly aging populations in many countries around the world end of life concerns are certainly set to be a major topic of discussion in coming years.

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