Doctors Opposed to Euthanasia
Letter to Members of the Tasmanian Parliament
Care of Parliament House
HOBART TAS 7000
14th October 2013.
Dear Member of the Tasmanian Parliament,
We are writing to you regarding the Voluntary Assisted Dying Bill 2013 soon to be debated in your parliament.
We note that the AMA has confirmed its opposition to this legislation, and it will be no surprise to you that we also oppose it.
We whole-heartedly affirm the general concept of ‘Ending Life with Dignity’. Many of our members are directly involved in end-of-life care, either as Palliative Care physicians, doctors involved in the care of patients with cancer, or as doctors working in acute medical settings where patients frequently die. Our members are commonly involved in the care of patients where treatment is administered which may potentially inadvertently hasten death and where futile or unwanted treatment is withdrawn or not undertaken. However, we do not agree that euthanasia or assisted suicide should be allowed as a valid or licit means of achieving a dignified death.
Indeed, we observe that at this time in history, when medical practice and, in particular, the practice of palliative medicine, is so advanced, that there is no valid need to consider alternatives that involve killing the patient instead of relieving suffering. We note that Tasmanian Health has recently received substantial Federal Grants to expand the availability of palliative medicine which, we believe, goes a long way to addressing the remaining concern of equal access for all Australians.
The Voluntary Assisted Dying Bill 2013 places the medical practitioner at the centre of actions that intend the death of the person either by direct action (euthanasia) or by providing the means (assisted suicide). We become ‘gatekeepers’ to an early and unnatural death. Much of the medical decision making process pivots on a subjective assessment as to whether or not the patient’s medical condition or degree of distress is ‘eligible’. We find this extremely objectionable.
Additionally, primary medical practitioners are being asked to make assessments of the person’s mental state and also whether or not there is any evidence of coercion of the person by a third party. By and large, GPs are not trained to make such assessments and even psychiatrists accept that making a proper evaluation at one consultation is problematic. We understand that there is an ‘option’ for a referral to a specialist; however, the problem still remains. We have also observed the decline in psychiatric referrals under the Oregon Death With Dignity Act over the last decade when studies have shown that one in four applicants suffers clinical depression, which is treatable. We find nothing in the VAD Bill that would suggest any other outcome over time.
This bill puts the vast majority of doctors (those who would not assist in any way with intent to kill) in difficulties in respect to persons in their care. In Washington State and in Oregon, where assisted suicide is legal, supporters of the legislation keep lists of the doctors who will help a patient to die. We see no reason to expect that this will not be the case in Tasmania. In Washington (and perhaps Oregon) supporter groups actually provide coaching tips to people who want to access the legislation about what to say to their GPs; and, if the GP does not agree, who to go to instead. We see this as causing a fracture in the doctor-patient relationship. A long relationship with a patient, where addressing their medical and pastoral needs is the primary concern, is possibly lost. There is nothing to prevent a person changing GP and requesting their death at a first appointment and beginning the process at that time.
We note in the Tasmanian press a recent claim that, a doctor who “by the administration of a medical service intended to reduce or temporarily relieve a terminally ill patient's suffering, knowingly hastens the death of the patient” would be liable for murder.
“To put it simply, if a medical practitioner knowing that a patient is likely to die because of the existence of terminal disease hastens the death of that person to prevent further suffering, that medical practitioner commits the crime of murder.” (The Examiner 9th Oct).
This is not the case at all. If death is not intended, and under the principles outlined below, a doctor is provided the necessary protection that ensures he or she can provide appropriate care. The following clause is from the South Australian Act and is similar to other states. We understand that, even in the absence of such a statute (as may be the case in Tasmania), a common law protection under the provision of necessity with due care would nonetheless apply. We would have no objection to a similar Act being introduced in Tasmania, and, indeed, would encourage it to forestall any confusion.
Consent to Medical Treatment and Palliative Care Act 1995 (South Australia)
16 Protection for medical practitioners etc.
A medical practitioner responsible for the treatment or care of a patient, or a person participating in the treatment or care of the patient under the medical practitioner's supervision, incurs no civil or criminal liability for an act or omission done or made—
(a) with the consent of the patient or the patient's representative or without consent but in accordance with an authority conferred by this Act or any other Act; and
(b) in good faith and without negligence; and
(c) in accordance with proper professional standards of medical practice; and
(d) in order to preserve or improve the quality of life.
DOE affirms that patients have a right to a dignified death; however, along with the majority of doctors, we deny that euthanasia should be enshrined in law as a valid means to this end. We endorse the AMA’s opinion that Medical practitioners should not be involved in interventions that have as their primary intention the ending of a person’s life
Please feel free to contact Drs Madill or McKenna for more information (see below)
We urge you to reject this bill.