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Euthanasia: "Are you asking me to kill her?"

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It was not meant to happen this way.

Jane Morris was assured her mother Elizabeth would not feel pain, anxiety, thirst or hunger as she entered a state of "terminal sedation".

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At 77 years old, Elizabeth was dying of motor neurone disease and the treating doctors withdrew her fluids and nutritional supplements.

But expectation of a humane death gave way to horror; even the best palliative care was not enough to ease the pain Elizabeth suffered, Mrs Morris said.

"She was one of the minority - it doesn't happen to everyone - but it happened to mum," Mrs Morris said.

"She had pain, breakthrough pain, because her prescribed dose was unable to adequately palliate her pain at all times.

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"She managed to express to us her fear and in one of her conscious moments was able to convey to us that she wanted to be fed through her PEG tube. This was so very traumatic for all of us, many staff included."

Mrs Morris recalls being told that her mother could not be fed, though they were finally allowed to give her some milo-stained water.

She said when she asked for her mother's pain relief to be substantially increased, she was told by a doctor: "Are you asking me to kill her?".

"No, I was not trying to have my mother murdered, I simply wanted her suffering to end, and probably ours."

Mrs Morris greeted with relief the news that in future, terminally-ill patients like her mother could be helped, legally, to die. 

That relief came with her confidence that the laws, set to be introduced to both houses of Victoria's parliament next month, will pass in a conscience vote.

People within a year of dying from a terminal illnesses could access lethal medication within 10 days of asking, under Victoria's proposed euthanasia laws, which have been described as the most conservative in the world.

Disappointing some, dementia will not be grounds for eligibility under the proposed laws. People with mental health disorders or a disability would also be excluded, unless they were also suffering from a terminal disease.

And criminal offences could be introduced to prosecute those who "induce" a person to request to die – though penalties are yet to be decided upon.

The details about Victoria's proposed euthanasia laws are contained in 66 recommendations outlined in the Andrews government's Ministerial Advisory Panel report on voluntary assisted dying.

One government minister told Fairfax Media the proposed model contained "more than enough" safeguards to allow legislation to pass parliament. "The key criteria have been met," the minister said. "I think it will be tight but I think it will pass."

The proposed model was described as the most conservative in the world and "distinctly Victorian" by Professor Brian Owler, chair of the advisory panel and former president of the Australian Medical Association.

"Some will be very critical of our recommendations," Professor Owler said. "For some, they do not go far enough. For others they should not exist at all."

Health Minister Jill Hennessy said she expected it would take around 18 months to implement the laws. Ms Hennessy said she was particularly concerned by evidence from Victorian Coroner John Olle that about one Victorian took their life every week due to the absence of legalised euthanasia.

"It is my very strong view there is widespread community support for reform in this state," Ms Hennessy said.

It is expected that about 150 people a year will access assisted dying legislation in Victoria, though this would likely increase over time.

The panel recommended that all requests to die be independently assessed by two medical practitioners, neither of whom is in a position to benefit from the person's death. One must be a doctor who has been qualified for at least five years.

People must fulfil six criteria to be eligible: that they are expected to die within a year; are aged over 18; have an incurable terminal disease; and they have a medical condition that  causes suffering that "cannot be relieved in a manner that the person deems tolerable".

Anyone who asks to die must go through a three-step request, the advisory panel recommended. There is a verbal request by the patient, followed by a written request, then a final verbal request.

A minimum of 10 days must pass between the first and final request, unless the person is assessed as likely to die within 10 days.

Much unites those on either side of the euthanasia debate. Many agree that palliative care needs to be better funded and available to more Victorians sooner.

But they remain fundamentally divided on what rights should be given to a small number of people for whom even the best medical treatment is not enough to relieve their suffering.

The Victorian branch of the Australian Medical Association still does not want doctors to be involved in procedures that end life. But AMA Victoria president Dr Lorraine Baker said the association respected that the decision to introduce euthanasia laws was "ultimately a matter for society and government".

Associate Professor Mark Boughey, Director of Palliative Medicine at St Vincent's Melbourne, a Catholic hospital, said St Vincent's was concerned that patients given one year to live could make a request for "assisted suicide" when it was difficult to make an accurate estimate of how long people had to live. 

Upper house crossbench MP James Purcell said he would vote for the proposed model and expressed confidence it would gain enough support in the parliament.

Mr Purcell said he had spoken to many people in the community who supported change.

"I've had so many dinner discussions with nurses and doctors that I don't have a problem supporting it at all," he said.

Liberal MP Georgie Crozier said she was keeping an open mind but wanted to consider the details of the proposal before deciding how to vote.

"I need to see the legislation," she said.  

For others, it does not matter what is in the legislation - their opposition to euthanasia is complete.

Former motoring journalist Chris de Fraga, 80, has just undergone surgery after "his right pelvis collapsed because cancer ate the bone away".

From his private ward at Malvern's Cabrini Hospital, he said the medication he was on mostly kept his pain at bay. 

He does not believe anyone should have access to euthanasia.

"I just think it's up to God to determine these things," Mr de Fraga said.

On the steps of Victoria's Parliament House, Jane Morris argued every individual should be given a choice. Although she is not sure what her mother Elizabeth would have done, she said at least they would have had a discussion, while she still had a voice.

"The issue has been finally brought to the dinner table. We have families and friends talking about something that was once considered taboo."

If you are troubled by this report, experiencing a personal crisis or thinking about suicide, you can call Lifeline 131 114 or beyondblue 1300 224 636 or visit lifeline.org.au or beyondblue.org.au

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