The Victorian State Parliament will debate legislation to approve physician assisted dying at their next sitting. Premier Daniel Andrews has called for a respectful debate knowing that any discussion of assisted dying provokes passionate responses.
Some advocates of assisted dying suggest people of religious persuasion should refrain from making comment. They argue faith is a personal matter and has no bearing on how we frame secular society. What they fail to understand is that people of faith are called to positively influence society. They are called to reveal the heart of God who values every individual. They are called to affirm life.
My motivation for participating in this debate is also shaped by personal loss. I know the heartache of losing a loved one to suicide. I know what it is to wrestle with the why. I know what it is to live with the feeling that I could have done more.
This debate is personal. It challenges our understanding of life. It focuses on the rights of the individual. It asks us to weigh up the factors that might influence our decision making.
I would like to share with you
10 Compelling Reasons For Opposing Assisted Dying.
Reason One: It is not possible to differentiate between ‘assisted dying’ and ‘assisted suicide.’
The World Health Organisation defines suicide as “an act with a final outcome, which the deceased knowing or expecting a fatal outcome had initiated and carried with the purpose of provoking the change that he/she desired.”
When the Coroner is establishing the cause of death, his interest lies in the intent. Were the person’s actions designed to cause their death? Did they want to die? Was there written evidence to suggest that this was the case?
Assisted dying ticks all these boxes and more. The only difference is that the means of death is pre-determined.
Reason Two: Authorising the use of medication to end life undermines suicide prevention strategies to restrict access to means.
One of the proven strategies for reducing the number of suicides is to identify and limit access to means. A suicidal person’s access to means, or methods, can be reduced through (1) physically impeding access; (2) reducing the lethality or toxicity of a given method; or (3) reducing “cognitive access,” that is reducing a particular methods appeal.
Assisted dying gives prominence to a particular method of dying, the ingestion of lethal medication. Media coverage of assisted dying may act as a catalyst, leading vulnerable people to search the internet for effective ways of ending their life. The promotion, publicity, and legislation of assisted dying will encourage more suicides.
Suicide is never a legitimate option. We must do all in our power to give people a reason to live.
Reason Three: Embedding assisted dying in law makes suicide socially acceptable.
Assisted dying sets a benchmark. It normalises suicide as an acceptable response to suffering. It says suicide isn’t always bad. It sends a message that if you’re experiencing chronic depression, debilitating illness or unbearable pain, taking your life is an option.
Natasha Michael, Director of Palliative Medicine, Cabrini Health, reminds us of the value of targeted care and support. She says,
“People with terminal or severe chronic illness can go through periods of wanting to die, but this can be overcome with good care and support.”
Actor Christopher Reeve suffered fractures to the top two vertebrae of his spinal cord in a riding accident at an equestrian event. In intensive care, on a respirator, after the spinal cord had been reattached he mouthed to Dana his wife: “Maybe we should let me go.” Reeve said he needed to know what she was thinking. Life would be different. Reeve said in an interview it was his wife’s support that kept him from choosing death over living on a respirator.
Reason Four: Providing the terminally ill with more choices about life and death is an unacceptable burden that increases anxiety.
Having the option of death becomes an added burden. As Martha Minow says,
“The lens of legally sanctioned assisted dying colours all other choices.”
Communicating to those who receive a negative diagnosis that ‘dying with dignity’ requires gaining consent to end their life, places a burden on the patient to focus on dying rather than healing and care.
Margaret Somerville believes assisted dying will threaten the way we process death. She says,
“Assisted dying will seriously harm our capacity to find meaning in the face of death.”
Assisted dying will weigh on the minds of fragile or vulnerable people, particularly those who are old or live with disabilities or even just perceive themselves as a burden on their families.
Reason Five: By reducing end of life choices to boxes ticked trivialises death and dying and undermines the basis of palliative care.
Palliative care aims to improve the quality of life of patients with terminal illness. For those who work in palliative care, there is a value (dignity) in caring for the weak and vulnerable. Improving the availability of palliative care should be prioritised.
As Archbishop of Vancouver, J. Michael Mill points out, “At the root of the desire for assisted dying is the fact that adequate palliative care is often unavailable, which can lead to thoughts of suicide.”
It is not unreasonable to suggest assisted dying may encourage neglect of the aged or the running down of services for elderly people. It may also reduce efforts to provide or to improve diagnosis, treatment and care.
Reason Six: People’s motivation for wanting to hasten their death is often varied and needs a compassionate response.
Assisted dying has been legal in the state of Oregon in America for many years. Participants have been asked to state their reasons for choosing assisted dying.
• 92% indicated a loss of autonomy (control)
• 89% a lack of enjoyment of life
• only 25% indicated intractable pain or the fear of intractable pain
Other studies have highlighted further reasons:
– Less able to engage in activities
– Loss of dignity
– Feelings of being a burden
Surely death isn’t the only way to resolve these issues.
Reason Seven: It is outside the knowledge and expertise of medical professionals to know how long a person has to live.
No-one can put a timeline on death. Many people have defied the odds and outlived the sentence they have received. Phoebe Snetsinger was the first person to see more than 8000 different bird species. When she was diagnosed with melanoma in 1981 and given less than a year to live, she knew how she wanted to spend it: seeking out birds. She lived 18 more years and died in a bus crash. She called her autobiography Birding on Borrowed Time.
There is also the possibility of a wrong diagnosis. As one writer put it, “Diagnosis is not a perfect skill, art, nor science and mistakes can occur in a prediction about the outcome of any medical or health condition.”
Reason Eight: Despite assurances there are adequate safeguards in place, there will be people who die against their will.
No safeguards will ever guarantee that deaths under the proposed laws will be completely voluntary. Voluntary assisted dying inevitably progresses to involuntary assisted dying.
Even more disturbing, the right to die with dignity eventually becomes a ‘duty to die.’ The freedom to choose assisted dying may lead to a feeling of obligation if the person believes they are a burden on loved ones or the cost of end of life care is excessive.
Charles Camosy warns of the unintended consequences of legalising assisted dying. He says,
“Human beings are prone to push boundaries and hijack accepted practices for self- serving or even destructive purposes.”
Reason Nine: Assisted dying respects the individual’s right to determine how and when they die but it is by nature discriminatory.
Why should a supposed benefit only be available to those who request it? Bernadette Tobin recognises that amendments to the law are easily justified. She says,
“As soon as assisted dying is in place, there will be pressure to relax the obstacles to the widespread availability of this benefit.”
Reason Ten: Coercion is part of everyone’s lived experience and yet it is to become an offence.
Discussing end of life issues requires a bond of trust between those involved. Allowing assisted suicide would erode the trust between patient and doctor. A doctor’s primary duty is to preserve life. Casting them in the role of assessor, determining a person’s readiness to die and prescribing the means to achieve it seems alien. Are they free to suggest that terminating life may not be the best way forward or is that considered coercion?
Family members also find themselves in an invidious position. Will they be permitted, by law, to advocate for the continuation of life rather than accepting their loved one’s desire to die?
Then there are the family members who might benefit from the immediate death of the sufferer. Leon Klass highlights the underlying pressures that may force someone to consider assisted dying. He says,
“…. illness invariably means dependence and dependence means relying for advice on physician and family. This is especially true of those who are seriously or terminally ill where there is frequently also depression or diminished mental capacity that clouds one’s judgment or weakens one’s resolve. With patients thus reduced – helpless in action and ambivalent about life – someone who might benefit from their death need not proceed by overt coercion.”
In his book Man’s Search For Meaning, Viktor Frankl talks about life in a German concentration camp where he was incarcerated during World War Two. He says,
“The thought of suicide was entertained by nearly everyone, if only for a brief time. It was born of the hopelessness of the situation, the constant danger of death looming over us daily and hourly, and the closeness of the deaths by many of the others.”
Some prisoners took responsibility for their death. They ‘run into the wire,’ a phrase used in camp to describe the most popular method of suicide – touching the electrically charged barbed-wire fence. The penalty for stopping someone running into the wire was death.
Assisted dying allows people who feel their situation is hopeless to ‘run into the wire.’ Are we going to be the guilty bystander?