Today's announcement by the Andrews government that they will back the introduction of assisted dying legislation is good public health policy, long sought after by a clear majority of Victorians.
It comes off the back of a 10-month cross-party parliamentary inquiry into end of life choices, which put forward undeniable evidence of suffering in our community because of existing laws.
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Euthanasia around the world
Advocate Andrew Denton speaks about Australia's role in spreading euthanasia laws around the globe.
It found repeated examples, for those with a serious and incurable condition, of inadequate pain relief and of deep suffering beyond even the reach of palliative care. It found doctors breaking the law and relatives risking being put on trial to relieve the torment of their patients and loved ones. And it tabled the testimony of coroner John Olle, who detailed the horrific ways in which desperately ill Victorians are taking their own lives to end their agony.
This included the case of a 90-year-old man with cancer who killed himself in a particularly horrific way.
The coroner estimated the number of elderly Victorians taking their own lives to escape the ravages of incurable diseases at one a week. Faced with such evidence, the inquiry found a clear case for law reform.
Its recommendation was that voluntary assisted dying – with strong safeguards – be introduced as another option at the end of life. The law they proposed, and that the government will now consider, is conservative, offering relief from suffering to those who are in the "last weeks and months" of an incurable illness.
They will have to be at a point, agreed by two doctors, where, medically speaking there is no more hope. At that time they can be written a prescription for a lethal drink that they can choose to take – or not. Overseas experience shows that more than a third of patients choose not to, simply having the means to control the end being powerful palliation in itself.
Based on recent experience in South Australia, where similar legislation failed by just one vote to pass the lower house, politicians will be lobbied by church groups and conservative elements of the medical community. The key arguments they will hear are likely to be:
1. That assisted dying is "state sanctioned killing". This phrase will be hammered again and again and it will dishonestly avoid the central fact that the law is to help those already being killed by an incurable disease. Being voluntary, it is entirely up to the patient whether or not they choose to end the suffering caused by that disease.
2. The slippery slope. That passing a conservative law will inevitably lead to wider ones over time. This argument says yes, we know that real people in our community are dying in agony or suiciding to avoid it, but we refuse to do anything about it for fear that, somewhere in the future, a parliament may decide to help hypothetical other people.
It is also contradicted by North American laws, on which the committee have largely modelled theirs, that have been unchanged since their introduction 20 years ago.
3. More resources for palliative care will solve all suffering at the end of life. While the inquiry, quite rightly, recommends greater resourcing for palliative care, it is clear that this alone won't fix the problem. In Palliative Care Australia 's own words, "even with optimal care we cannot relieve all pain and suffering". Their statistics, collected every year from 106 palliative care units around Australia, prove it. The Victorian inquiry found the same.
This is not a criticism. Australia has one of the best palliative care systems in the world. It simply reflects the reality of modern medicine, which can keep us alive longer but can't always treat what comes with that.
4. That granny will be coerced into ending her life so the family can get the inheritance. This has been tracked closely in jurisdictions overseas. Independent authorities there have found no evidence that it has occurred. The safeguards written into the legislation have been proven to protect the vulnerable. Only those dying of an incurable illness can access this law. It is very hard for a greedy relative to coerce granny into an illness she doesn't have. Even harder to coerce two doctors, whose work will be reviewed, to agree with her.
5. Do no harm. The AMA, who represent less than a third of Australia's doctors, cite this as their guiding principle in opposing these laws. Other doctors see leaving a dying patient to suffer as the opposite of "do no harm". Both are entitled to their ethics. The question is, should one set of ethics be imposed on everyone?
The answer, of course, lies in the proposed law, which is voluntary for doctors and nurses as much as for patients.
In giving evidence of elderly Victorians taking their own lives, coroner Olle said of the families left to pick up the pieces: "They know this person is screaming for help, but no one is going to answer the call, not in this society."
Victoria now has a chance to be the society that does.
Andrew Denton is a television personality and campaigner for assisted dying.Â
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