Last night I attended a Q&A program on euthanasia hosted by Tony Jones on the ABC, Australia’s government-funded national network. I have an interest in medical ethics and was curious to attend a live panel for the first time in my life. At its conclusion I asked a friend who was sitting behind me, a specialist palliative care physician, to sum up the evening. His answer hit the bull’s-eye: it was “The Andrew Denton Show”.
Mr Denton was the star panellist and was described by Q&A as “one of Australian television’s genuine creative forces”. After an eight-month study tour at home and abroad he is commencing a campaign for “voluntary assisted dying”. He spoke more often (11 times) and longer ( about 10.5 minutes) than anyone else and was allowed to interrupt and rebut other panellists. He speaks well and has a knack for funny lines, but I found some of his interventions evasive and patronising.
Once our attendance was confirmed we were asked to submit questions. Mine was: “How do you think the practice of assisted dying in Belgium and The Netherlands impacted on the decision of the British Parliament to reject by 330 to 118 a proposed law on assisted dying for the UK?”
My question was not selected. That made me ask other participants, during the long wait to get into the studio, if they knew how questions were selected. None knew.
Inside the studio, those whose questions were selected were asked to identify themselves so that the cameramen would know where to find them. This made me think about how the order of questions was decided — another unknown.
I had imagined that questions from the audience would be addressed to a panellist. But instead they were addressed to the panel and Mr Jones directed individual panellists to answer them. The Q&A organisers were in complete control.
The first question came from a lady whose mother has disabilities resulting from multiple sclerosis; the mother was present in a wheelchair. Her question was what she could do when her mother asked to die. This set the agenda for the night: how to give persons the right to decide when they will die if the Australian laws do not allow it.
Tony Jones confirmed the expert status of Mr Denton and asked him to elaborate on his findings. In his two minute answer, he conflated what happens in the US state of Oregon (assisted suicide only) with the situation in Belgium and The Netherlands (euthanasia with a few cases of assisted suicide). This allowed Mr Denton to extol the theoretical voluntariness and safeguards of both systems. He failed to mention widespread concern in Belgium and The Netherlands about the illegal application of the law and the extension of euthanasia to many other cases by additional legislation.
At the end of the program, I approached Mr Denton and asked whether he had heard of the mobile euthanasia units that began to operate in early 2012 in flagrant contravention of Dutch law without apparent government response. These vans can be dispatched to euthanase patients in their homes after they or their relatives have submitted an application by telephone or email. The German Hospice Foundation has described this as “inhumane”.
Mr Denton had heard of the Levenseindekliniek (End of Life Clinic), although he failed to mention it in his many interventions.
I also asked him about the international headlines the Belgian Parliament made by approving a law extending euthanasia to children. To my question why he did not comment on these matters in his long answers, he threw his hands in the air and mentioned lack of time.
A gentleman asked about problems with euthanasia in The Netherlands and quoted Dr Theo Boer (a professor of Health Care Ethics at Kampen University, and for nine years member of one of the regional committees reviewing the practice of euthanasia in The Netherlands), statistics from the 2014 Netherlands Euthanasia Report, the Journal of Bioethics, and some internet sites.
Mr Denton responded that De Boer had always been against euthanasia and that his concerns amounted only to saying that 3 percent of all deaths in The Netherlands were the result of euthanasia — apparently that is not much.
A quadriplegic lady expressed her concerns about the potential abuse of euthanasia for people with disabilities. Tony Jones asked for a response from Karen Hitchcock, a doctor who opposes euthanasia. She was interrupted by Andrew Denton who objected to her use of the word “killing”. Then Mr Denton informed us that he had visited peak bodies in both countries advocating for the disabled and that they had said that nothing of the kind was happening.
After warm praise of Australian palliative care led by Mr Denton, two relevant items were quickly brushed aside. Panellist Dr Ralph McConaghy, a palliative care specialist who has been present at more than 5,000 deaths, explained that not one of these patients had asked for assisted dying. My physician friend also commented that persons in palliative care who asked for euthanasia — only about 5 percent — forgot their requests when they were listened to and provided appropriate care.
The rationale for last night’s program was the importance of discussing euthanasia, with which I’d think most people would agree. Yes, by all means let us discuss euthanasia. But let’s do it in an open and honest way. Give us time to discuss the evidence. Don’t manipulate the discussion by skilfully steering it towards a pre-arranged conclusion. Give us a real Q&A, not “The Andrew Denton Show”.
Professor George L Mendz is at the Sydney School of Medicine, University of Notre Dame Australia.