An Australian way of death: voluntary assisted dying

(Photo courtesy of Wikipedia: Fritz Klein, the camp doctor, standing in a mass grave at Bergen-Belsen [northern Germany] after the camp’s liberation by the British 11th Armoured Division, April 1945)

By Spencer D Gear PhD

This article first appeared in On Line Opinion, 19 March 2020.

John is 65 and has been suffering from cancer for many years. The pain is too much. When he asks his doctor to put him to sleep permanently (kill him!), should the doctor agree? Jean has such severe dementia, lies in bed for much of the day and is in a vegetative state in an aged care facility. She doesn’t recognise me when I visit her.

In the twenty-first century, there is considerable public support for euthanasia to be legalised across Australia. There is a minority group of medical practitioners, Doctors for Voluntary Euthanasia Choice, that is supportive of euthanasia in certain circumstances.

The dangers of the majority view

According to The Guardian Australia Edition “a nationwide poll of 1,032 people conducted by Essential Research has found that 73% of Australians support voluntary assisted dying” (VAD).

If a majority of people agree with a position, does that make it right? An Appeal to Popularity is a logical fallacy that is difficult to notice because it sounds like common sense if the majority of people agree with it. The falsehood is that it doesn’t deal with the content of why VAD is right or wrong for a society or individual.

What is voluntary assisted dying?

Let’s get it clear what euthanasia (VAD) is. We are sometimes confused by the current debate because it seems some are talking about disconnecting life support systems. Others think we deny the patients’ rights to say, “This is enough. I want no extraordinary means to be used to keep me alive when all hope of physical life seems to be gone”.

We don’t need euthanasia for this. It is the common law right of all Australians to decide which treatments they want to have for themselves. We have legislation for an enduring power of attorney and an advanced health directive to cover these medical situations.

(image courtesy docotal)

Euthanasia is “the intentional killing of a person, for compassionate motives, whether the killing is by a direct action, such as a lethal injection, or by failing to perform an action necessary to maintain life. For euthanasia to occur there must be an intention to kill”.

Now, euthanasia promoters don’t use the word “kill”, but it is the only accurate word to describe the reality of what happens. Besides, it is the word that our current law uses. Retired anaesthetist and palliative care physician at Concord Hospital, Sydney, Dr Brian Pollard, stated, “Euthanasia is a form of homicide – even if legalised, it would be legalised homicide. Intention is central to the concept”.

Sad and distressing cases are put forth so that it is made to appear there is a vast amount of suffering for which nothing less than death is good enough. Yet, I am told that those who practise palliative care with the terminally ill encounter few requests for euthanasia by patients. Too often, the distressed relatives who often feel impotent, sense a lack of support, and may be encountering a financial burden, are the ones calling for euthanasia.

I do not reject euthanasia because of the results it is likely to cause.

When Luke Gormally, director of London’s Linacre Bio-Ethics Centre, was in Australia he warned that legalising euthanasia could lead to “killing the disabled and dependent for economic reasons”. He also warned that euthanasia would endorse youth suicide because of the “wholly negative message” it would send to youth.

What will stop Switzerland, Belgium, The Netherlands, Canada, certain USA states and Australia from getting to this example once the slippery slope has begun? The Atlantic (3 Sept 2014) reported this story:

In July 1939, Richard and Lina Kretschmar, two farm workers from eastern Germany, wrote to Adolf Hitler to ask for permission to kill their son.

Gerhard Kretschmar had been born five months earlier with one arm, one leg, and vision loss. The Kretschmars were loyal Nazis, and “The Monster,” as they referred to Gerhard, was considered both burdensome and incompatible with the pursuit of genetic perfection. Gerhard was killed a few days later at a hospital near his home, likely by lethal injection.

The Netherlands has become a dangerous country

We know that when we support VAD, it can go beyond the person’s choice. Holland is the most recent example for which we have clear evidence. That country has permitted VAD for some time, and has legalised it.

The Uniting Church in Australia’s consultation paper, “Voluntary Assisted Dying Queensland Synod 2019” stated: ‘In Belgium and the Netherlands, the criteria for voluntary assisted dying includes that someone be experiencing “unbearable suffering”‘. This paper detailed a very sad case of a person suffering from severe dementia.

Is that all that happens in the Netherlands with VAD?

The Netherlands’ medical doctor, Dr. Karel Gunning, on his 1992 visit to Australia said: “Holland has indeed become a very dangerous country, as patients may have their lives ended without their request and without knowledge of the authorities. The doctor thus has become a powerful man, able to decide on life or death”.

The New Scientist magazine (20 June 1992) confirmed this alarming situation in an article titled, The Dutch way of death.” It stated that:

… doctors and nurses in the Netherlands can practise euthanasia if they stick to certain guidelines. Yet many patients receive lethal injections without giving their consent.

In some hospitals, doctors routinely approach patients who are terminally ill, offering to inject them with lethal doses of barbiturates and curare. But Dutch euthanasia has its sinister side, too. Involuntary euthanasia of sick and elderly people is commonplace in the Netherlands, and that when patients do opt for euthanasia, it is frequently out of fear of being a nuisance rather than to avoid unnecessary physical suffering.

The details are alarming. At least a third of the 5000 or so Dutch patients who each year receive lethal doses of drugs from their doctors do not give their unequivocal consent. About 400 of these patients never even raise the issue of euthanasia with their doctors. Moreover, of those who willingly opt for euthanasia, only about 5 per cent do so solely because of unbearable pain.

The magazine concluded that “these revelations strike a blow at the two central canons of the worldwide euthanasia lobby: that euthanasia should be used only as a means to end pointless physical suffering, and that the patient alone should make the decision.”

As one Dutch doctor put it: “Everywhere doctors are terminating lives. The only difference in Holland is that here we talk about it.”

Is this the morality for Australia?

Even though it is clear from this Dutch example that it is impossible to control VAD, is this the right kind of morality Australia should follow? By looking to the end results, this is a system of ethics called utilitarianism. It simply means that a “good” result (for example, relieving pain of a cancer patient) justifies the means (killing the person–euthanasia). This is a dangerous view.

Two examples show us how bad this view of right and wrong can become. In Germany during World War 2, Hitler’s goal was to develop a more perfect race. A pretty good goal one could think? But his way to attain it was evil (killing six million Jews and millions of others).

President Richard Nixon’s goal was a noble one, national security. But the criminal activity of Watergate was not justified to reach it.

The popularity of this view of morality

( Photo courtesy Wikipedia: Hartheim Euthanasia Centre in Upper Austria is where over 18,000 people were killed in the Holocaust).

There are droves of Australians who support the VAD view of morality. We are in deep trouble if this nation follows such an ethical system. The end never justifies the means; the means must justify themselves. An act is not automatically good because it has a good goal.

How do we know what is good? We need a fixed standard of good by which to judge right and wrong, rather than a person’s opinion of what is good. This fixed standard for euthanasia needs to be: murder or assisted murder is always wrong. This is the morality of universal standards of the 10 commandments (the Judeo-Christian world view).

I have taken this lengthy look at why I do not support euthanasia, based on the end justifying the means, because it is a view of right and wrong that could lead to chaos in our lucky country. Those who support VAD and some of those who oppose euthanasia both follow this system of morality.

The Australian Medical Association’s position

In its position statement, “the AMA (Australian Medical Association) maintains that doctors should not be involved in interventions that have as their primary intention the ending of a person’s life.

“This does not include the discontinuation of treatments that are of no medical benefit to a dying patient. This is not euthanasia,” says AMA president Dr Michael Gannon.

The AMA has grave concerns about the VAD Bill now legislated by the Victorian Parliament. It opposed it.

Why I do not support VAD

As a Christian minister I reject VAD for these reasons:

1. The Guardian Australia Edition (2019) summarised one point: “As this generation [baby boomers] enters its final years, the precept that life is precious irrespective of one’s medical condition is being called into question as never before“.

Human beings are unique and special. God’s view is that we are not higher animals but made “in the image of God” (Genesis 1:27). If human beings are not special, we can do to them what a doctor advocated to me: “We put down dogs, why shouldn’t we offer the elderly in a vegetative state the same?”

Human life is sacred throughout life and in all circumstances, whether one is strong, independent and healthy or weak, dependent and handicapped.

When we reduce human beings to animals, it logically follows that a whole range of horrendous evils could eventuate. God has forbidden that any life be murdered. There is no need for a commandment that says, “You shall not commit euthanasia.” All deliberate, premeditated killing (abortion, infanticide, euthanasia, homicide–war raises some other issues) is covered by the one commandment, “You shall not murder” (Ex 20:13; Matt 5:21).

2. Secondly, we already know the consequences of a permissive approach to euthanasia. We have glaring examples before us of where permissive euthanasia laws will lead us. The Netherlands, Belgium and Canada are examples, but don’t forget what happened in Germany.

In Germany in 1920, there was a publication by a lawyer, Karl Binding, and a psychiatrist, Alfred Hoche, called The Permission to Destroy Life Not Worth Living, that opened the floodgates and led to open discussion and legislation to permit euthanasia in Germany in the 1920s and 1930s.

Initially, it was seen to have a beneficial social effect in dealing with the so-called “useless” sick.

Why did they do it? For the very same reasons that are being advocated today: compassion, quality of life, and to cut the cost of caring for these so-called “useless people”. They stressed the cost of caring for the handicapped, the disabled (retarded) and the mentally ill. They were called “useless eaters”.

(Photo courtesy Wikipedia: Soviet POWs in the Mauthausen concentration camp, Austria)

This led to experimentation on human beings and genocide. It was a small step from euthanasia to the Nazi killing fields of 6 million Jews, and it is estimated that about 6 million others also were killed.

3. It is a strange paradox that VAD is being strongly promoted at a time when the medical profession has made great advances in the treatment of pain. This is not the time to recommend assistance in the killing of the terminally ill or others.

According to Dr. Bob Allan, president of the ACT branch of the Australian Medical Association, “Modern palliative care ensured that patients should never have to consider euthanasia on the grounds of severe pain. Treatments are available to ensure death with dignity and without pain” happens (The Canberra Times, 3 February 1993, p. 5).

4. VAD degrades the medical profession and has harmful effects on the doctor/patient relationship. It violates the doctor’s pledge to not harm patients, according to The Hippocratic Oath (created by the Greek physician, Hippocrates, ca. 460), which in its common form is taken by many medical doctors upon graduation, dating back to the time of the Greeks, states:

I will follow that system of treatment which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is harmful to them. I will give no deadly drug to anyone if asked, nor suggest any such counsel; and in like manner I will not give to a woman an abortive remedy. With purity and with holiness I will pass my life and practice my Art.

Some medical schools modify this oath.

5. There is a better alternative: promote life and become actively involved in compassionate care for the dying, people who have a disability and other sufferers in our society.

6. I reject euthanasia because I support the 10 commandments and believe it is always wrong to murder or assist with the murder of anybody. The foundation of Australian society has been built on this view.

I also reject euthanasia because it is an attack on the sovereignty of God. We must answer two fundamental questions: Who are human beings? Whose right is it to terminate human life? Jesus Christ said, “I have the keys of Death and Hades” (Revelation 1:18).

At the time of preparing this article, only 2 Australian states had legislated VAD. However, Queensland is considering following the Victorian legislation and is currently engaged in a round of forums and have made a call for submissions.

(Image courtesy Wikipedia: Euthanasia legislation status in Australian states and territories (as of 2020):  Voluntary euthanasia and physician-assisted suicide illegal red Voluntary euthanasia and/or physician-assisted suicide legal blue.)

Copyright © 2020 Spencer D. Gear. This document last updated at Date: 19 March 2020.

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