Raise your voice against killing people, urges medical ethicist

Medical ethicist Megan Best has urged the people of New South Wales to contact their local MPs to oppose the Voluntary Assistant Dying (VAD) Bill that is to be introduced into state parliament tomorrow.

“The first thing to say is that there are significantly less safeguards in this piece of legislation than in the one that was defeated in parliament in 2017,” said Best, who is Associate Professor of Bioethics at the Institute for Ethics and Society at the University of Notre Dame in Sydney.

“So it was previously rejected. There is a misconception that this is supported widely in the community and I would encourage people to contact their local member of parliament because killing innocent people is wrong, even when they’ve asked for it.

“When you have 12 months to live you are not in the process of dying – that’s premature death.” – Megan Best

She says it’s important to consider the terms of the private member’s bill put forward by independent MP Alex Greenwich.

“It’s important that the public understand this is not just helping people who are on the point of dying to speed their passing. Even if you have up to 12 months to live you will be eligible. When you have 12 months to live you are not in the process of dying – that’s premature death. So you are killing someone, not speeding up a process that is already happening.”

Best notes that whenever VAD legislation has been introduced, the criteria of who is eligible inevitably expand. “It starts as for people who are about to die and then is widened because it’s seen as discriminatory.”

“Christians should make the effort to contact their MP and let them know that not everyone is in support because the pro-euthanasia lobby is very well-funded and well organised,” says Best.

“It’s very good for them to visit their MPs as well, particularly if they’ve had a good experience with palliative care.”

She also urges people to speak about the need for conscientious objection for individuals and institutions in states where it is VAD legal – it’s active in Victoria and Western Australia and legislation has been passed in Tasmania and South Australia.

“I think that those who are against euthanasia should tell their parliamentarians that they want somewhere safe where they won’t be exposed to euthanasia. And I think we need to pray for our parliamentarians that they have wisdom because they are told a lot of figures that just aren’t true.”

Best, who has a clinical background in palliative care, is writing a book for Christians on how to navigate the ethical challenges in decision-making at the end of life.

“The pro-euthanasia lobby has become very good at changing language and confusing end-of-life issues so that no one really quite knows what we’re discussing. But if we understand euthanasia is a doctor killing a patient or helping a patient to kill themselves, I think, as Christians, we know that killing is not right – that’s God’s prerogative.

“It’s more common that people request euthanasia because of psychosocial reasons than because they’re in pain.”

She says euthanasia advocates make the idea more palatable by paying lip service to the notion of relieving suffering.

“Some people get confused by the perception that there’s a lot of suffering at the end of life. And I think that view’s being promoted by a lot of stories put forward by the pro-euthanasia lobby,” she says.

“In fact, I would say most deaths are quite peaceful in a palliative care unit. And in the places where euthanasia is legal, and this includes Victoria, it’s more common that people request euthanasia because of psychosocial reasons than because they’re in pain — pain would be a very unusual reason for someone to request euthanasia.”

What’s really driving the Australian debate, she believes, is that people don’t want to become dependent on someone for care, they don’t want to be lonely and isolated because of their illness.

“If you think about the timing of the euthanasia debate, we are discussing it when we have more medical cures than ever before in human history – it’s not because of the failure of medicine. It’s because of the growth of individualism in our society, that people are very uncomfortable with the thought that they would be dependent on someone else.”

Another ethical confusion conflates the compassion we feel when considering an individual case for euthanasia with introducing a law for the whole community.

“Part of our problem is that we tend to consider the individual case when the real question is, should we change the law so that doctors can kill their patients?”

“People are very uncomfortable with the thought that they would be dependent on someone else.”

Best says she has seen cases of people where death appears to be preferable to hanging on.

“I’ve seen people at the end of their life. I just don’t know why God keeps them alive. I can’t see any benefit for them to stay alive, and I think, ‘Why doesn’t God just take them now?’ Everyone’s said their goodbyes, everything seems to have been finished, but, you know, I’m not God,” she says.

“And that’s not what this is about anyway. What it’s about is should we change the law so doctors can kill their patients? It’s when you start to look at it on a societal basis that you realise you have this situation where it’s impossible to create legislation that won’t be abused. And so you have people at risk of being killed when they didn’t want to be.”

Best cites evidence that about a thousand people a year are killed in Holland without their knowledge or consent.

“There have been reviews of what’s happened in Holland showing that patients were killed because either the family and or the doctor thought the patient would be better off dead,” she says.

“Once you get this idea that some people are better off dead, sometimes if people don’t or can’t make that decision for euthanasia themselves, someone else makes it for them. And certainly, we’re seeing in Victoria relatives telling doctors that the patient wants euthanasia. But in fact, when you ask the patient, the patient doesn’t want it.

“So this issue of elder abuse, where families try to persuade a doctor to arrange euthanasia against the will of the patient is certainly a problem.”

Best, whose views are well known in the community, says she is being contacted by people saying ‘How do I make sure that I don’t get euthanasia if I don’t want it and how can I protect myself and where can I go where I’m not at risk?’

This is why she has been calling for institutions to declare their conscientious objection to euthanasia so that they are not forced to refer patients to a doctor who will grant their wishes.

“Under the legislation if individuals or if institutions don’t want to offer euthanasia services, the people who organise all the paperwork aren’t allowed on their premises to organise euthanasia and they are not expected to support the process of somebody being killed on them.

“This is one of the reasons we’ve been trying to get institutional conscientious objection, which has been resisted on grounds that it limits access. But what no one seems to have taken on board is that there’s a part of the community that wants a safe haven where they are protected from euthanasia. There’s an assumption that everybody wants access to it, but there are some people who want somewhere they can go where they’re safe, where the presence of the possibility of euthanasia is not coerced.”

“No one has to say anything for her to feel she’s a burden to the family.”

Another problem she identifies is that turning to euthanasia deflects attention from dealing with the real psychosocial problems that confront us at the end of our lives.

“This is because, you know, Granny’s in hospital, she knows the family has to try and find a parking space and come and visit them every day. The kids are doing homework on the floor of her room because they’ve been dragged in to see granny again.

“And no one has to say anything for her to feel she’s a burden to the family. And patients have told me that just knowing that they could choose euthanasia is stressful. And they don’t want that stress. And I don’t think it’s fair that that stress is in the room of a sick person at a time when they’re very vulnerable and there need to be places where people can go in that doesn’t exist.”