Common arguments against Voluntary Euthanasia - and some answers

1. Patients would be frightened of their doctors if voluntary euthanasia was allowed.

Answer: With voluntary euthanasia, only the terminally ill patient decides if death is preferable to life. There would be no change to the principle that a doctor should act in accordance with the patient's wishes and in a way that is consistent with his or her professional duty.

There is a growing number of people who want more control over their dying and so appoint a medical agent, make a living will or join a voluntary euthanasia society. Many incurably ill patients say that they would have peace of mind if they knew that medical assistance to die was available if and only if their suffering became unbearable. Then they would feel able to fully discuss with their doctors their fears about the dying process, and the trust which should exist between patient and doctor would be enhanced, not destroyed.

2. The old, disabled and incurably ill would feel they should choose voluntary euthanasia so that they were not a burden on others, or they would be pressured by relatives to choose voluntary euthanasia.

Answer: Similar arguments were used by those who opposed the introduction of the Victorian Medical Treatment Act in 1988. There is no evidence that old, disabled and sick Victorians have refused treatment, or been persuaded to refuse treatment, for the wrong reasons. Similarly, there is no evidence that these problems would arise if voluntary euthanasia was allowed.

Any proposal to legalise voluntary euthanasia has confined it to those who are terminally ill, who are not choosing death over life, but are simply choosing the time of their inevitable death.

We should be careful not to treat the sick, the disabled and the elderly as though they were small children, unable to make important decisions for themselves. Life is about difficult choices and, as a society, we should not refuse adults the right to make decisions about their lives unless we have proof that they, as individuals, require protection. We certainly should not deny others the same rights that we expect for ourselves and, therefore, treat them patronisingly, even with the best of intentions.

Perhaps we could also ask why it is wrong to prefer an early death if the only other choices, when terminally ill, are to be a burden on others or an object of pity. Many of us see our independence and individuality as crucial to an acceptable life. We may be able to come to terms more easily with dying if we can continue to interact with others in ways that allow us to maintain our sense of personal worth.

Some of us cannot accept that we might, at the end of our lives, linger as little more than physical bodies, no longer able to truly interact with others, so that those we love can no longer remember us as we want to be remembered.

3. If good palliative care was available to all terminally ill people, there would be no demand for voluntary euthanasia.

Answer: The voluntary euthanasia movement fully supports the concept of palliative care (i.e. treatment which cannot cure but which is given to relieve pain and suffering) and believes that incurably ill patients should be offered all treatments possible to make their lives bearable. But even the Australian Association for Hospice and Palliative Care acknowledges that, "while pain and symptoms can be addressed, complete relief is not always possible in all cases, even with optimal palliative care."

Some terminal illnesses produce symptoms, such as persistent nausea, vomiting, double incontinence, extreme fatigue and paralysis, which do not necessarily respond to palliative care. Some symptoms are so severe that in order to relieve suffering, patients have to be fully sedated all the time (sometimes called "pharmacological oblivion") and are therefore unable to interact with people or with their surroundings.

4. There would be less resources given to palliative care if voluntary euthanasia was allowed.

Answer: In the Northern Territory the reverse was true. The Rights of the Terminally Ill Act included a clause about palliative care and these services were greatly improved in the Territory as a result.

Prior to the introduction of the NT's Act, it was frequently argued that, if voluntary euthanasia was introduced, resources for palliative care may actually be increased because doctors would certainly want to ensure that their patients had tried every alternative before deciding that death was the only answer to their suffering.

In fact, it is very probable that most doctors would be so reluctant to perform euthanasia that they, and the groups that represent them, would work even harder to ensure that the best possible palliative care was available for all who needed and wanted it.