The never ending argument over voluntary euthanasia

We’ve been discussing and debating this topic endlessly as a country for decades.

There’s been legislation passed, legislation failed and so much uproar from both sides.

No matter where you stand there’s a lot of passion on the subject.

To truly understand the arguments surrounding the debate, you need to step back and under each side’s arguments.

After all, the battle comes down to those fighting for “the right to die with dignity” and those fighting for “the right to life”.

The arguments against voluntary euthanasia

Right to Life is one of the many organisations campaigning against voluntary euthanasia in Australia. The organisation’s website sets out 10 arguments against voluntary euthanasia.

1. Alternative treatments exist. Right to Life argues that there is an alternative to euthanasia and terminally ill people don’t have to suffer. They point to research that shows “virtually all unpleasant symptoms” experienced during terminal illness “can be either relieved or substantially alleviated”. They believe instead of allowing terminally ill people to diem there should more appropriate and effective care and training available so doctors don’t follow “the easy option of euthanasia”.

2. Requests for voluntary euthanasia are rarely free and voluntary. It’s also argued by Right to Life that people with terminal illnesses are vulnerable and suffering from fear about the future.  “It is very difficult for him to be entirely objective about his own situation,” the website argues. “Many elderly people already feel a burden to family, carers and a society which is cost conscious and may be short of resources. They may feel great pressure to request euthanasia ‘freely and voluntarily’. These patients need to hear that they are valued and loved as they are.” 

3.  It undermines medical research. One of Right to Life’s arguments is that the process of developing treatments to fatal diseases will be threatened by voluntary euthanasia. The argue the threat is from the moving the focus “from curing the condition to killing the individual with the condition”. “Rather than being employed to care and console, funds are being diverted to fuel the strategy of ‘search and destroy’,” the website reads. They believe if voluntary euthanasia is legalised there will be advances in ktenology (the science of killing).

4. Hard cases make bad laws. Another argument put forward by Right to Life is that the legalisation of euthanasia is championed by those who have witnessed a loved one die unpleasantly “often without the benefits of optimal palliative care”. They argue this is where the “misleading” demand for the “right to die with dignity” comes from. “What we are considering is not the right to die at all, but rather the right to be killed by a doctor; more specifically we are talking of giving doctors a legal right to kill,” the website writes. “What we are considering is not the right to die at all, but rather the right to be killed by a doctor; more specifically we are talking of giving doctors a legal right to kill.”

5. Autonomy is never absolute.  Right to Life argues that we are not free to do things “which limit or violate the reasonable freedoms of others”. “No person makes the decision to end his or her life in isolation,” the website reads. “There are others who are affected: friends and relatives left behind, and the healthcare staff involved in the decision-making process.” They believe that the effect of personal decisions on other must also be considered.

6. It’ll lead to euthanasia tourism. According to Right to Life, if voluntary euthanasia is legalised in a country then people for other countries will travel there to take advantage of it. They argue that decisions we make in Australia “have implications for other nations. “Any state considering a change in its laws in this regard has a responsibility not just to its own citizens but to the whole international community.

7. It changes public conscience. Right to Life says the law is a “very powerful educator of the public conscience”. “When a practice becomes legal, accepted and widely practised in society, people cease to have strong feelings about it,” the website reads. They point to Nazi Germany, arguing that many involved in the Nazis euthanasia program were doctors “motivated initially buy a compassion for their victims.” “Once doctors start killing, it is possible for them to carry on doing it without feeling any guilt,” Right to Life writes.

8. It violates codes of medical ethics. Another argument put forward by the Right to Life is that voluntary euthanasia is against the codes of medical ethics. They write that “traditional medical ethical codes have never sanctioned euthanasia”. Right to Life also points to the World Medical Association’s Statement of Marbella in 1992 that “assisted suicide, like euthanasia is unethical and must be condemned by the medical profession”. “When a doctor intentionally and deliberately enables an individual to end his life, the doctor acts unethically,” the website reads.

9. It gives too much power to doctors. The organisation believes call for euthanasia have been encouraged by “either by the failure of doctors to provide adequate symptom control, or by their insistence on providing inappropriate and meddlesome interventions which neither lengthen life nor improve its quality”. Right to Life argues that doctors’ decision making can be affected by their degree of tiredness or feelings towards their patients. “Voluntary euthanasia gives the medical practitioner power which can be too easily abused, and a level of responsibility he should not rightly be entitled to have,” Right to Life writes. “Voluntary euthanasia makes the doctor the most dangerous man in the state.”

10. It’ll lead to involuntary euthanasia. The Right to Life website again points to Nazi Germany as an example of how voluntary euthanasia will “lead to involuntary euthanasia”. “What ended in the 1940s in the gas chambers of Auschwitz, Belsen and Treblinka had far for humble beginnings in the 1930s in nursing homes, geriatric institutions and psychiatric hospitals,” the website states. It also points to research from the Remmelink Report stating that more than 1000 of the over 3000 deaths from euthanasia in the Netherlands in 1990 were not voluntary. “History has shown clearly that once voluntary euthanasia is legal, involuntary euthanasia inevitably follows,” Right to Life claims.

The arguments for voluntary euthanasia

Director of Ethical Rights Dr David Swanton has penned a list of nine arguments in support of voluntary euthanasia.

1. Rights of individuals. Swanton writes that the onus is on those against voluntary euthanasia to prove that it is fundamentally flawed. “To deny a person the right to live his or her life as he or she wishes implies that each individual does not know what is right for himself or herself,” he writes. ‘The choice of how you might die is one of the most personal decisions an individual should make. To be denied the right to make this decision is a blight on modern Australian democracy.”

2. Whose life is it anyway?. On his post on the Ethical Rights website, Swanton points to the case of Sue Rodiguez in Canada in 1994. “She questioned that if she cannot give consent to her own death, then whose body is it? ‘Whose life is it anyway?’,” he writes. He also uses Bob Dent, the first person to die under the Northern Territory’s Right of the Terminal Ill Act, as an example. “He said ‘What right has anyone, because of their own religious faith to which I do not subscribe, to demand that I must behave according to their rules’,” he wrote. “How could anybody, or any government, deny that simple fact?”

3. Popular opinion. He points to a 2012 Newspoll that shows 82.5% of Australians support having the choice of voluntary euthanasia. “The fact that many people favour a particular policy does not make it ethically ‘right’,” he writes. “However, when it comes to public policy, and a choice of what people want for themselves (rather than others in the population), popular support for a policy is a strong argument in its favour.”

4. Australia’s current situation. There have been several doctors who have assisted suicides of patients, argues Swanton. “Australian doctors have been assisting patients with voluntary euthanasia for many years (a survey indicated more than a third of doctors have done so), albeit in an illegal environment,” he writes. “All of this activity is unrefuted, and no serious efforts are being made to stop any of this activity.” He questions why the government can choose not to prosecute these doctors but can’t decide to legislate in favour of voluntary euthanasia.

5.  The issue of rational suicide.  Swanton points to a number of recent suicides by elderly Australians using the drug Nembutal. He believes while voluntary euthanasia for the terminally ill is a good start, it should be extended to  people who have untreatable illnesses that “adversely affect their dignity or quality of life”. “The Bill will not address their concerns, which are no less valid because they are not terminally ill,” he writes. “If the Bill is not amended to take these situations into account, then rational suicides will continue to occur in an unregulated environment.”

6. Tolerance in our multicultural society. He also argues that the values of different cultures, religions and beliefs should be respected. “It is surely hypocritical to claim that one is tolerant of others but simultaneously insist that their values about how they live their individual lives, such as a desire for the option of voluntary euthanasia, are wrong and cannot be practised,” he writes. “If some people object to voluntary euthanasia, they need not ever request euthanasia.”

7. Freedom of religious expression. The doctor writes that it could argued legislation against voluntary euthanasia could be in contravention of freedom of religious expression, because there are some religions which support it.   He writes it’s regrettable that some of the Christian churches don’t support voluntary euthanasia. “The right for individuals to live their lives as they wish, without being constrained by the religious values of others, must be upheld,” Swanton writes.

8. Economic arguments.  Swanton argues that the health budget savings of allowing voluntary euthanasia could be as much as $100 million. “One must question, as a serious matter of public policy, why public money should be spent on keeping patients alive who do not want to live, in preference to patients who do,” he writes. “It could otherwise be available for additional infant care, cancer therapy or emergency services, where it could save lives and improve the quality of life for others who want it.”

9. The human factor. To deny terminally ill patients the right to voluntary euthanasia is to condemn them to a miserable existence, according Swanton. He argues that not providing the option of voluntary euthanasia is “inhumane and callous “. “It is difficult to deny patients the option of voluntary euthanasia when the patient considers voluntary euthanasia is in their own best interest,” he writes. “When the quality of life is more important than the quantity of life, voluntary euthanasia is a good option.”

So where is the debate at now?

The conversation has flared up again after South Australian MPs debated the issue for a 14th time last month.

While a bill was put forward earlier this year by a Labor and a Liberal MP, some MPs were unwilling to support it because it would have allowed people without a terminal illness access to euthanasia.

Extra safeguards were added last month and MPs will be a granted conscience vote, the ABC has reported.

Debate was meant to start on the bill on October 19, but was delayed because five MPs didn’t support it.

Overseas voluntary euthanasia is legal in some forms in Belgium, Luxembourg, Switzerland, Canada and the Netherlands. While assisted suicide is legal in several US states including Oregon, California, Vermont and Washington.

So, now that you have both sides of the debate – where do you stand?