A Tale of Two Deaths

Both Bob Dent and Esther Wild had a terminal illness (cancer) causing severe pain and suffering; were fully informed about their disease, its prognosis, options for treatment, and of the ability of palliative care to minimise their pain and suffering; moreover, they were of sound mind, were making persistent enduring requests for assistance in dying, and were not acting from external duress. These facts were confirmed by at least two experienced medical practitioners. Further a psychiatrist had concluded that they were not suffering from treatable depression.

Bob Dent, after due consideration, pressed a button indicating his decision to end his own life, and went to sleep within 30 seconds, and died within 10 minutes. Esther Wild, unable to use this method due to Kevin Andrews' Act, acquiesced to be put into a coma, from which she fitfully awoke in pain during the first 48 hours, providing the justification for deepening the coma, which eventually caused her death after 4 days.

Bob Dent's death was legal at the time. Esther Wild's death was quasi-legal, because such deaths are not reported to the coroner (in contravention of the Coroner's Act), are not recorded on the death certificate as due to medical treatment, but as due to cancer, and are described as "good medical treatment" by the A.M.A. and by palliative care experts. Dr Philip Nitschke and Ester Wild reluctantly chose the PO method as the best available "legal" choice.

Kevin Andrews finds Esther Wild's death acceptable and Bob Dent's not, on the supposed basis that Bob Dent's death was intended by Dr Nitschke but Esther Wild's was not. Does anyone seriously believe that Esther Wild's wish to die humanely or Philip Nitschke's intent was changed by the passage of Kevin Andrews' Bill? All that changed was the method of assistance, from one that is now illegal to one which is quasi-legal and of which Kevin Andrews, the Catholic Church, the A.M.A. and the Federal Parliament approve.

The real facts are that the major difference between these deaths is time and method. When Kevin Andrews' spoke in the Federal Parliament he appeared to be arguing about morals - he approved of palliative care but not once did he or his supporters mention method. It seems that method as a distinction between good and bad medical practice is more important than morals. The longer the coma process takes, the less likely is it that an intention to hasten death can be alleged, and so the doctor's alibi is created. In short, the process of pharmacological oblivion is more of benefit to the doctor's conscience and legal protection, than it is for the patient and her family.

Currently, intention is the singular basis on which the law in relation to murder operates. Does anyone by now not understand Philip Nitschke's intent in the death of Bob Dent? It was to relieve his pain and suffering in the most humane way. Yet if he had been involved in Esther Wild's death in the same manner, he would probably have been charged with murder. Being aware of the alternative would anyone blame Esther Wild for wanting to choose VE rather than PO? Surely it is time, in respect of medical decisions at the end of life, that consent, necessity (to relieve pain and suffering), and absence of malevolence become paramount legal arguments.

A spokeswoman for Kevin Andrews said, after Esther Wild's death, "The object of the opposition to euthanasia was to protect the many vulnerable people from being euthanased without their consent". The Northern Territory Act did not allow for this, and there is nothing in current medical practice to prevent PO being used to end the lives of vulnerable people without their consent. She also said it was incorrect to describe what had happened to Ms Wild as "slow euthanasia" when it was the legal "palliation of pain with drugs which can hasten death". You could have fooled me!

* Rodney Syme is a Melbourne surgeon and, at the time of writing, was the President of the Voluntary Euthanasia Society of Victoria Inc.