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40 Voluntary Euthanasia in Australia Newsletter 40 February 27 2017 End of Life Choice Newsletter on current debates Impact on Patient Care had administered drugs in doses larger Under the existing legal framework, what Voluntary than necessary to relieve symptoms with is available to patients at the end of life the intention of hastening death. (Douglas et depends on what their doctor may suggest al, MJA, 175/10, p511) or be willing to do. In the absence of Euthanasia in These findings were echoed in a 2007 criteria and safeguards, decision making study that found 43% of doctors who had relating to assisted dying depends on the treated at least one terminally ill patient values of individual doctors and their Australia had been asked at least once to hasten interpretation of a death by administering drugs. The study situation. also found that 35% of these doctors reported administering drugs with the Professor of Public The following description of the intentionof hastening death at least once. Health at the current practice of voluntary University of euthanasia in Australia is from the Despite facing potential criminal convictions, Melbourne, Rob final report of The Parliament of Victoria medical practitioners are openly performing Moodie, expressed this Legal and Social Issues Committee Inquiry unlawful assisted dying. This is occurring in view in his submission: Into End of Life Choices, June 2016. an unregulated environment, sometimes in circumstances that compromise patient care. For many doctors their ability to (pp173-185) provide adequate end of life care and Prosecutions for assisting another to die Dr Edward Brentnall, MBE, OAM, told to relieve intolerable pain and Family and friends have been prosecuted the Committee that he and other doctors suffering can become an entirely act to end patients’ lives: arbitrary situation which depends on for assisting a loved one to die with the medical practitioner’s courage offences ranging from aiding and abetting Many doctors have acted to end T and moral beliefs, on the patient’s suicide to attempted murder. patients’ lives when their suffering is disease, and on where the patient is due to an incurable illness. I have based. There have been 10 prosecutions in certainly done so. Victoria over the last 25 years. Nobody Certain patients may gain access to lethal Professor Hal Swerissen of the Grattan prosecuted for assisted dying has received medications or assistance from health Institute: a custodial sentence. practitioners in ending their lives. Others We currently allow voluntary may have the means to travel to a A constant theme in case law is the euthanasia, but we have it hidden. jurisdiction where assisted dying is remarkable degree of leniency shown to Doctors not prosecuted permitted. These options are far less offenders, even though there is a clear There have been no prosecutions of accessible to disadvantaged groups. violation of the criminal law. This pattern doctors in Australia for assisting a patient of leniency resonates with experiences in This point was also made by Dr Roger to die, despite evidence that they do. Hunt, Medical Head of Palliative Care at other Australian jurisdictions and in There are several reasons: international jurisdictions. the Queen Elizabeth Hospital in Adelaide • criminal law institutions have no way in his submission: The reliance on individual discretion to of identifying end of life medical achieve just outcomes rather than the The law is unfair because it doesn’t cases that ought to be investigated treat people equally. Some people systematic implementation of the law … can be helped to die on their own suggests that the law as it stands does not • police and prosecuting authorities are terms as a result of their knowledge align with the community’s views of reluctant to pursue suspected cases of or connections; some are able to reprehensibility. This analysis is reflected doctors performing assisted dying hasten their death by the refusal of life-sustaining treatment. But others in the judgment of Justice Cummins in • there are serious evidentiary obstacles do not have access to the means for DPP v Rolfe: in proving that a doctor intended to their life to end. Your actions do not warrant hasten the death of a patient in In the absence of regulation, there is the risk denunciation; you should not be administering treatment. of a lack of accountability, transparency, punished; there is no need to deter The obstacles to prosecuting doctors and oversight of medical practices that end you from future offences; and you do for providing assisted dying and the lenient in death. As such, there is a risk of not require reformation. treatment of people charged with assisting a inadequate protection of vulnerable people If such actions are not reprehensible, it is loved one to die indicate serious flaws in the from coercion, no verification that assisted important to determine whether it is end of life legal framework. dying is a measure of last resort and no reasonable and just that people who assist established criteria for assessing the merits The widely acknowledged fact that of a request for assisted dying. a loved one to die should bear the stigma members of the medical profession are and opprobrium of prosecution and This point was made clear by Professor known to be breaching the law but avoid Moodie in his submission: criminal conviction. prosecution shows that those in authority There is almost complete silence Unlawful medical practice do not believe that justice would be served within the profession about the end A 2001 study of the attitudes of surgeons by robust application of the law as it of life practices that do occur, and to assisted death found that 36 per cent stands. this lack of transparency actually can open up the possibility of abuse. Newsletter of the South Australian Voluntary Euthanasia Society saves.asn.au 0421 305 684 SAVES was established in 1983 to campaign for legal, medically assisted save.asn.au choice in end-of-life arrangements. The aim is to relieve suffering by providing choice for people at the end of their life. SAVES works in the community and with Members of Parliament to achieve law reform. An assisted dying law would not result in more people dying, but in fewer people suffering. “Knowing the pathology being faced, the lack of any treatment to reverse its inevitable progress, and aware that effective palliative care is doing its best, I “I think those who have a terminal illness may recognise that a patient’s option for and are in great pain should have the an assisted death is logical, and is sought right to choose to end their lives, and with clarity and respect, free from anger those who help them should be free from or despair. In such circumstances I would prosecution.” value an assurance that I would incur no risk of criminal action in providing Prof Stephen Hawking, Cosmologist and assistance for that release.” Author Em Prof of Palliative Care, Ian Maddocks, AM MD FRACP FAFPHM FAChPM DTM&H Senior Australian of the Year 2013 Resources Specialist Support Groups Andrew Denton’s GoGentleAustralia Christians Supporting Choice for Voluntary Euthanasia website christiansforve.org.au http://gogentleaustralia.org.au Doctors for Voluntary Euthanasia Choice SAVES End of Life Choice Newsletters drs4vechoice.org http://www.saves.asn.au/newsletters.php South Australian Nurses Supporting Choices in Dying The Wheeler Centre podcasts Better Off facebook: SA Nurses Supporting Choices in Dying Dead My Body My Choice http://www.wheelercentre.com/ facebook: facebook.com/pages/MY-BODY-MY-Choice-VE broadcasts/podcasts/better-off-dead Voluntary Euthanasia Youth Advocates The Voluntary Euthanasia Story: the epic facebook: Support SAVE-YA Law Reform journey to make it legal - Adelaide forum, Lawyers for Death with Dignity June 2015 saves.asn.au/lawyers http://www.saves.asn.au/resources.php.
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