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1 Submission to the Senate Euthanasia Inquiry Bill Muehlenberg Spokesman, Family Council of Victoria August 2014 the Family Coun

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1 Submission to the Senate Euthanasia Inquiry Bill Muehlenberg Spokesman, Family Council of Victoria August 2014 the Family Coun Submission to the Senate Euthanasia Inquiry Bill Muehlenberg Spokesman, Family Council of Victoria August 2014 The Family Council of Victoria strongly disapproves of any move to legalise euthanasia, and strongly rejects the Bill put forward by the Greens. Legalised euthanasia is problematic for a number of reasons. The following document spells out these concerns in detail in a fully-referenced paper. The Case Against Legalised Euthanasia The case against legalised euthanasia needs to be spelled out in detail. This is especially urgent since there seems to be so much moral and intellectual fuzziness concerning this debate. Therefore I here offer ten major reasons why no civilised society should move in this direction. However, first a word about terminology. Terminology and definitions In this important debate, it is imperative that we clearly define our terms before proceeding. This is vital because so much misleading language is being used in this debate, and so many euphemisms are being tossed around. Indeed, emotive imagery and deceptive language are clouding what this issue is really about. As J. Daryl Charles puts it, “Euthanasia today depends on euphemisms. Orwellianisms such as ‘exit preference’, ‘death with dignity’, and a ‘right to die’ are absolutely critical to its cultural legitimation. Empowered by sentiment, euthanasia rhetoric is dependent on images and symbols.”1 For the purposes of this book, euthanasia is simply about one thing. It is not about halting futile treatment. Nor is it about the alleviation of suffering (this is known as palliative care). Euthanasia is an act that directly and intentionally causes a person’s death. As bioethicist Mark Blocher explains, “Euthanasia is an act that involves an intention to produce death. An essential component of euthanasia is the intention behind either an action or a refusal to act to knowingly bring about a person’s death.”2 Norman Geisler and Frank Turek put it this way: “We will use the term ‘euthanasia’ to mean an act that intentionally and directly causes a patient’s death.” Thus there is a “crucial difference between taking a life intentionally and allowing a death naturally. The first is homicide, and the second is a natural death”.3 The important point is this: there is a huge difference between letting nature take its course and actively hastening or inducing a patient’s death. Because this is such a critical issue, and one which is so often confused (often deliberately by the pro-euthanasia camp), it is worth spending a bit of time on this, quoting a number of authorities. Ethicist Daniel Callahan offers this distinction between allowing to die and intentional killing: “A lethal injection will kill both a healthy person and a sick person. A physician’s omitted treatment will have no effect on a healthy person. It will only, in contrast, bring the life of a sick person to an end because of an underlying fatal disease. the doctor who, at the patient’s request, omits or terminates unwanted treatment does not kill at all. Her underlying disease, not his action, is the physical cause of the death.”4 As Andrew Lansdown explains, “euthanasia has little to do with refusing futile or extreme treatment. The man who rejects a heart transplant or declines a third bout of chemotherapy is not committing suicide, but rather is accepting the inevitability of his own death. The doctor who withholds or withdraws undue treatment at the request of a terminally ill patient is not killing his patient but rather is refusing to prolong his patient’s life at any cost. Properly understood, euthanasia involves an intentional act to end a person’s life. Opponents of euthanasia do not advocate the unnecessary and unwelcome prolonging of human life by artificial means. Rather, they oppose active measures to bring human life to a premature end.”5 1 Indeed, it needs to be repeated that the refusal of treatment is not to be confused with euthanasia. Both the cause of death and intent of death are quite different. As ethicist Margaret Somerville explains, “In refusals of treatment that result in death, the person dies from their underlying disease – a natural death. The withdrawal of treatment is the occasion on which death occurs, but not its cause. If the person had no fatal illness, they would not die. In contrast in euthanasia, the cause of death is the lethal injection. Without that, the person would not die at that time from that cause.”6 Monique David puts it this way: “Currently, there is much confusion; many accept euthanasia because they do not want their lives to be maintained artificially nor to become victims of excessive treatment. However, these practices can be legitimately refused by the patient or their family through the ethical perspective of the right to die within the limits of natural death. Euthanasia and assisted suicide advocates claim something else: the right to terminate life at the moment and in the way that the individual chooses - or that someone chooses for them. Therefore, we should not use these terms to refer to the right to die (because this right is intrinsic), but rather to the right to be killed. This desire, expressed as a personal right, demands the intervention of a third party and a legal system that authorizes it. In other words, euthanasia and assisted suicide imply that doctors become agents of death and that society legally recognizes a criminal act to be lawful; or even more pernicious, a medical act.”7 And as ethicist Leon Kass reminds us, the ambiguity of the term “right to die” blurs the “difference in content and intention between the already well-established common-law right to refuse surgery or other unwanted medical treatments and hospitalization, and the newly alleged ‘right to die.’ The former permits the refusal of therapy, even a respirator, even if it means accepting an increased risk of death. The latter permits the refusal of therapy, such as renal dialysis or the feeding tube, so that death will occur. The former would seem to be more about choosing how to live while dying, the latter mainly about a choice for death.”8 Finally, George Pitcher also makes some important distinctions: “Doctors regularly discontinue futile treatment. But they don’t do it in order to end a patient’s life. They are simply recognizing that death cannot be prevented by treatment. We need to understand that end-of-life decisions, which are made every day by doctors, aren’t the same as life-ending decisions.”9 One further issue in terminology needs to be addressed. This has to do with pain relief and the hastening of death. It should be pointed out here that some forms of pain relief may have the unintended consequence of hastening death. When a suffering patient receives an injection of morphine to relieve pain, this may contribute to the speeding up of death. But when analgesics are administered, normally the intention is to relieve pain, not hasten death. In ethics this is known as the principle of double effect. The intent was to do good (relieve pain) while an unintended side effect may occur (the hastening of death). Intention, again, is an important part of this whole debate. John and Paul Feinberg explain the principle: “We are obligated both to preserve life and to relieve pain. Sometimes it may be impossible to do both. If it is impossible to preserve the life of the terminally ill, we are not immoral if we do not. Of course, there is still the obligation to relieve pain and suffering. If we do what we can to relieve pain and in the process hasten death, there is still no moral blame, since we could not preserve life.”10 Margaret Somerville points out the differences between euthanasia and pain-relief treatment: “In both cases there is an effort to relieve suffering. The difference is that the primary aim of euthanasia is to do so by inflicting death, whereas the primary aim of pain-relief treatment is simply to relieve pain – not to shorten life or cause death (although either might be a secondary effect).”11 Euthanasia, then, is about one thing only: the killing of another person. The intent is to kill someone. It does not matter whether this is done with a gun or a lethal injection - the effect is the same. With this definitional framework in place, here then are ten objections to legalised euthanasia, or physician-assisted suicide (PAS). One. The doctor-patient relationship is weakened When the medical profession becomes involved in killing, the delicate trust relationship between patient and doctor is undermined. People trust their lives to doctors and health care workers in the knowledge that they are dedicated to the 2 preservation of life, to healing, to caring. This after all is the basis of the Hippocratic tradition. The Hippocratic Oath includes the commitment not to kill a patient, even if the patient requests such a course. Once doctors become involved in the killing game, once they become “legalised terminators” as Morris West calls them, patients will be in a state of fear and suspicion, not knowing where the doctor is coming from.12 Some may rightly fear whether “every injection, pill or new IV bag is designed to cure or to kill - to end the pain or the patient.”13 But it is not just the patient who is at risk. Doctors too risk becoming desensitised, seeing the taking of life as just another routine procedure. This was exactly the case in pre-Nazi and Nazi Germany. The medical establishment played a large role in the killing of hundreds of thousands of Germans and non-Germans.14 It took less than 20 years for German medicine to make the practice of the widespread euthanasia of “undesirables” acceptable.15 As Leo Alexander has said, the horrible Nazi crimes “started from small beginnings.
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