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Euthanasia: we can live without it

 
In February this year we reported that the South Australian branch of the Australian Medical Association (AMA) had written to all South Australian lower house MPs roundly criticising this and another end-of-life related bill proposed by The Hon Bob Such MP.
 
The February letter was unprecedented in as much as it used very direct and unambiguous language that seemed to this writer to contain an element of some frustration at yet-another euthanasia bill.
 
The letter, in referring to both bills jointly said that, “(T)he AMA(SA) strongly opposes both Bills, considering them to be fundamentally and irretrievably flawed.”
 
They further observed:

“It is of significant concern that these Bills appear to have major elements that are ill-conceived, indicate a fundamental lack of understanding of current concepts in end-of-life care, and show a confusion in understanding of the critical difference between palliative care and euthanasia. They have the potential to confuse and compromise the provision of good end-of-life care, with resulting distress to patients and their families. We do not believe that these Bills have been the products of an acceptable level or period of informed community and stakeholder consultation and engagement and consider that they would bring divisiveness and confusion.”

One would have thought that this would have sealed the bills fate. Apparently not.
 
Such was quick to defend his bill, calling into question various aspects of the AMA statement. One comment was to observe that the letter was signed by the AMA’s Chief Executive Officer – a lawyer – and not the AMA President. This is perhaps a little lame given the fact that the AMA nationally have a policy opposing euthanasia and that the CEO is hardly likely to issue an edict without referral both to the policy and the state executive.
 
It is not exactly clear why the AMA decided to communicate to MPs via a second letter at this time. However, if there was any doubt about the AMA’s strident opposition after the first letter, this latest missive should leave no room for question at all.
 
Signed on this occasion by the AMA(SA) President, Dr Patricia Montanaro, in addition to repeating the statements already quoted, please consider the following:

“Even for individuals who may support euthanasia, the AMA(SA) regards these Bills to be in the realms of dangerous folly which have the potential to damage the basic tenets of clinical practice in ethical and compassionate end-of-life care. We recognise that there are divergent views on euthanasia and that the voluntary euthanasia bill proposed may go to a conscience vote. However, these Bills would simply create bad, and damaging, legislation.”

“The assistance that good palliative care can provide is not well understood, and we have a crucial need for good, well-resourced palliative care. Euthanasia must not be the end point of poor resourcing of end-of-life care.

“We urge Members of Parliament to turn your valuable attention, time and advocacy in the House to the critical need for a health system that strongly supports good end-of-life care.

Introducing fundamentally flawed voluntary euthanasia legislation is not the way to do this and in fact will produce the opposite effect, with resulting distress and harm.”

The letter also made reference to interventions by the SA Law Society and the Palliative Care Association of South Australia who clearly raised similar concerns.
 
What more needs to be said? If the medical association is saying that they don’t want euthanasia laws to be passed (and especially not this bill), why is the debate continuing and why do some MPs still support such legislation?
 
Firstly, there should be no real objection (apart, perhaps from fatigue!) in having these debates. Mr Such is as entitled as any MP to table bills. As a consequence, MPs should be entitled, if the opportunity arises, to speak on the bill (note: something that was denied them in Such’s previous bill in 2012) Well-researched and well-crafted speeches can definitely enhance understanding and can raise to tone of debate.
 
And of course, there are those who really do want to see such legislation passed.
 
But what kind of legislation would it be if the medical body representing doctors across the state say that they don’t want it? After all, it will be these doctors who will be asked to carry out a patient’s request.
 
It reminds me of a story told by eminent Australian academic, Margaret Somerville in her book Death Talk where she suggested to an audience of her colleagues that perhaps euthanasia should be performed by lawyers rather than doctors; adding that at least the lawyers would understand the law!
 
The question remains to be answered in the debate on Such’s euphemistically titled Ending Life With Dignity Bill 2012. Will the parliament impose a system which is clearly not wanted or will they continue to endorse the status quo in the knowledge that to do so protects the vulnerable as it always has done. Moreover, will they continue to look for ways of improving end-of-life patient care in the knowledge that, as the AMA suggest, it is really an either-or situation; that euthanasia acts to undermine patient-centred care.

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