DOE testimony to the Senate on 'Dying with Dignity' Draft Bill Oct 2014

Testimony to the Legal and Constitutional Affairs Committee of the Australian Senate 15 Oct 2014 by Dr. Timothy Kleinig


Testimony to the Legal and Constitutional Affairs Committee of the Australian Senate 15 Oct 2014 by Dr. Timothy Kleinig

Dr Kleinig: Yes. Thank you very much for giving me the opportunity to present today, and sorry that I cannot be there in person. I am speaking on behalf of Doctors Opposed to Euthanasia. We are an affiliation of medical professionals opposed to legalising euthanasia in any form, including assisted suicide. We are a non-hierarchical organisation, so I appear before you as a representative rather than a leader. However, I have been a main drafter of a number of previous submissions—particularly to the South Australian parliament, which, as you know, has been an epicentre of attempts to legislate euthanasia. I am a neurologist specialising in stroke, and I see many patients who might potentially opt for euthanasia under this bill. It is our firm belief that there are only two logically consistent positions to take on euthanasia—either the current ban or allowing euthanasia to any adult of right mind who desires it; or, in the case of their mental incapacity, allowing the decision to be made by their proxy decision-maker. It seems that this is the clear trajectory of euthanasia practice in the Netherlands and Belgium and the clear thought trajectory of people like Philip Nitschke, who, like many of the people who have submitted to this committee, began by arguing for the exceptional cases but has subsequently found it impossible logically to limit euthanasia to the exceptions.

Indeed, this drift is apparent in many of the submissions to this committee on record in the Hansard. For instance, Nine Concerned Citizens, in their presentation, state that 'the bill should be broadened to any mentally competent adult with any distress or suffering they find intolerable, whether or not a treatment exists'. Senator Di Natale asked them, 'What about a 60-year-old or a 40-year-old?' and they replied, 'Why not? There is no logical objection to limit it to a particular age.' And many of the other supporters of the bill have expressed similar views.

Furthermore, this broadening of the legislation is the avowed stance of many of Senator Di Natale's closest supporters. Peter Short, who gave an interview to The Australian magazine this week—and I think he spoke this morning—is on the record as saying that he sees this bill as 'merely the first step, the keystone, in the Berlin Wall of anti-euthanasia legislation that will, once passed, allow extension to patients with Alzheimer's disease, other dementias and other non-terminal conditions'. That is why our group does not feel soothed by the supposed strict safeguards in place and we do not think that we are scaremongering.

To many in the pro-euthanasia movement this bill is the first step but the critical victory, and we in turn see this as a line that must not be crossed. Philip Nitschke gets criticised by the supporters of this bill for his tactics and so-called antics and pranks but he does not get criticised for his logic. I personally admire him, although Idisagree with him. He is a straight-talker. He uses the word 'kill' rather than the words 'dying with dignity' and he follows the logic of his position to its conclusion. I think he represents where euthanasia in our country will be in 50 years time if this bill is passed.

We mention a number of additional concerns in our submission. First, on the whole, doctors do not want this power. So to frame it as a medical service must be the only time the government has ever tried to impose additional Medicare item numbers on us without our consent. Second, once actively assisting death is seen in society as an ethically acceptable response to suffering, suicide prevention messages will be clouded. Third, community support for euthanasia is probably far softer than it seems. In countries where it has gone to referendum, support has plummeted well below the pre-referendum polling levels. I have personally noticed this phenomenon in many of my patients, who have a superficial understanding of what euthanasia is and is not and have not contemplated the implications fully.

Fourth, 'terminally ill' is undefined in the bill. I understand there has been some discussion around this. I personally find it impossible to see how this can be done satisfactorily. For instance, type 1 diabetes is, without medical treatment, a terminal illness; and perhaps patients, under this legislation, may find their treatment overly burdensome and choose euthanasia. Many other submissions, from both the pro and contra sides, have highlighted the difficulties in setting a time limit such as six, 12, 24 months or 10 years.

Lastly, no bill will have watertight safeguards because the decision for euthanasia will always depend on people's wishes, which may change over time; doctors diagnoses and prognoses, which are fallible; and, in this bill's case, the interpretation of the patient's mental state as competent or incompetent. And let me say as a neurologist that this last point is often far greyer than is recognised. While I would like it to be otherwise, doctors are not infallible; and, in this case, mistakes are deadly. Once the patient is dead, of course, we will have no way of knowing whether our diagnosis and prognosis is right or wrong. To illustrate this last concern, I had a patient I diagnosed with progressive supranuclear palsy, which is a terminal illness that robs people of mobility and the ability to swallow safely, leading to death over several years. For the first year or two, he consistently stated how he would opt for euthanasia if it were available. Subsequently he changed his mind and was glad that the option was not available. He died of natural causes last year. I have no doubt that he would have been a casualty of euthanasia laws like these if they were enacted at that time. My feeling is that one death like this is a death too many.

Before we tear down the fence we must consider why it was built. Our society's absolute prohibition of intentional killing in all forms is founded on the premise that no-one should have the power to decide who should live and who should die. Doctors, on the whole, do not want this power and it should not be given to us.

You can read the formal submission HERE.