The Legal and Social Issues Committee of the Victorian Parliament handed down its long-awaited Report into End-of-Life Choices today.
It makes some valuable comments and recommendations in respect to improvement in palliative care. It acknowledges that access to palliative care is patchy, is overburdened and needs improvement. In a country rated recently as second in an international table for end-of-life care, availability is still more closely related to postcode than to need.
The committee heard from many individuals whose family members had passed away in circumstances that were clearly far from best practice. The committee seems to take it as read that these cases are compelling proof that Victoria needs a regimen of “assisted dying” – euthanasia or assisted suicide.
Few, I contend, are that clear.
While family members often (but not always) called for legislative change, the submissions and stories may well have been evidence of poor care, lack of care options or, indeed, refusal of good care options; we simply do not know. Accepting that poor deaths requires Victoria to help people to commit suicide is a travesty, an abandonment of people in great need.
Certainly, the admission that palliative care is still not able to meet needs is welcome. Sadly, however, the committee believes that for those who cannot access palliative care, death is an alternative. The committee was supposed to improve choice; suicide in such circumstances is no choice at all.
Of course, when the committee talks about “assisted dying” it really means euthanasia, assisted suicide, or both. Reluctance to call a spade a spade is telling.
The government has six months to respond, so a legislative framework may not follow the committee’s recommendations. There are a number of areas which need close scrutiny.
* How any doctor can accurately predict that the person is in the “final weeks or months of life” is not stated. Nor is it easy to predict.
* The person does not need to be actually dying from a condition. In April this year a Quebec man who had been partially paralysed for a number of years but who was not dying, starved himself to the point where he was actually dying from starvation so that he could fulfil the criteria for assisted suicide. He was living with a disability. Disability may become a reason for suicide.
No more potent example of disability discrimination exists currently than the new Hollywood movie, Me Before You in which a quadriplegic young man commits suicide in a Swiss clinic. Disability advocates across the globe have been outraged by the depiction of disability as being “worse than death”. They are calling it “disability snuff porn” and asking people to boycott the film. The Victorian Parliament has strengthened those concerns.
* The committee seems to be claiming a mandate for assisted dying when no mandate exists. Approximately 78 percent of substantive submissions were either against euthanasia and assisted suicide or were neutral and preferred to focus on end of life care more generally. Overall, submissions ran about 56 percent in favour with the remainder either being opposed (about 35 percent) or neutral (about 7.3 percent). The clear mandate is for better care.
The two dissenting reports give a far more robust analysis of available evidence than the entire Majority Report.
The Hon Inga Peulich MLC summarizes the concerns about human destruction via assisted suicide well:
“Any accidental loss of life – even the loss of one life, means such a regime cannot be justified, just as the loss of life, due to capital punishment, deliberate or due to a possible miscarriage of justice, cannot be justified and was the reason for its abolition.”
Daniel Mulino MLC’s analysis forms not only a sound academic and rigorous approach but also, by implication, is damning of the narrow, outcome focus of the Majority Report. He states:
“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 low rates of reporting.
“While legalisation was supposed to bring what was occurring in the shadows into the light, legalisation 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.”
Even tempered and thorough, Mulino concludes:
“The Majority Report asserts that the evidence is ‘clear’ that safeguards work in jurisdictions with legalised euthanasia and assisted suicide. A balanced reading of the evidence would lead one to conclude that such an unequivocal statement is not true.”
The Majority, though, has presented the Parliament and the people of Victoria with a sugar-coated poison pill. We hope that the government will see through this charade and act to protect vulnerable people while prioritising palliative care.