'To grant a few the right to euthanasia means that the rights of many vulnerable others are compromised'
Considering the euthanasia bill before Victoria state legislators in Australia, Marion Harris, a consultant medical oncologist at a major public hospital in Melbourne, shared her views with The Sydney Morning Herald.
Most patients with incurable cancer battle to the end. They exhaust all evidence-based active treatment options and clinical trials before being told that supportive care measures are now best.
A request to die is uncommon, and is often driven by poorly controlled pain or nausea, as well as fear, loss of function and hopelessness. Usually when pain and other symptoms are under control, good nursing care is on hand, and psychological support has been provided, patients no longer want their death to be hastened.
For family members watching a loved one die, the experience can be agonising. However, with appropriate involvement of palliative care, the preparation and education of family members about the normal processes of dying (such as irregular breathing and fluctuating consciousness), and with the administration of pain relief, there is minimal physical suffering.
When a patient seeks assisted dying, it is often when they are first told they have a limited life expectancy and before they are truly unwell. They are so distressed by such difficult news that they anticipate what is to come and can be consumed with fear and an urge to regain control.
Dr Harris goes on to discuss some of the problems of the bill before Victoria state legislators, before asserting that:
The critical issue is that assisted dying has implications that extend far beyond any one individual and his or her right or choice. These extend to that person's family, community and to society as a whole. To grant a few the right to euthanasia means that the rights of many vulnerable others are compromised.
If assisted dying is legalised and becomes normalised in our society, over time people with incurable cancer and other terminal illnesses will be conditioned and pushed towards it.
Faced with another option, they now have to choose to burden their family with their care. Stories of bad deaths, hopelessness, of being a cost to society, and of having a completed life will combine to suggest that they should choose an assisted death.
Concerning the broader issue of suicide, she says 'it is a mixed message to campaign to prevent suicide in some, while providing the means to others.' Noting the failure to provide 'thousands of Victorians' with 'access to adequate palliative care services', she argues that 'provision of well-resourced palliative care services statewide is the best way to reduce suffering at the end of life - not a lethal substance.'
Regardless of any change in the law, I won't intentionally help my patients to end their lives, nor do I personally know of any doctor who will. It is not the solution to the complex problems people face at the end of life, and it creates more problems and injustices than it solves.
Read 'I won't intentionally help my patients to end their lives' by Marion Harris in full at The Sydney Morning Herald.