Debate Hijacked Says Melbourne Writer

The pro-euthanasia lobby has hijacked the concept of dying with dignity, Jan. 30 2007

ABOUT 10 years ago my sister was arguing with my mother. They were having a play-fight about euthanasia, the kind of friendly stoush that keeps your wits sharp around the teacups. My mother looked her straight in the eye and said, humorously, but very clearly: "Well, don't let them do that to me, even if they're saying 'Poor old thing, let her go'."

It was one of the last, precious, lucid chats we remember. At 84, and after severe illness, Mum is now very forgetful, needing total support in the most basic self-care. She lives with my sister and we all help out. Her optimism about being cared for is something that honours us.

Such statements are living wills, choices about life's end. But in our privileged and highly serviced Western societies, living wills are often about giving up on being cared for. Margaret O'Connor, Vivian Bullwinkel Professor of Nursing, Palliative Care, at Monash University, says end-of-life choices are too often narrowed down to just one — death.

"There are so many other rights we should be advocating," she says. "What about the right to die with my symptoms managed, with access to the best care, in the place I want to die in?"

Palliative care in Australia helps many people to make choices from a wider range than the one offered by the euthanasia lobby. Many people don't even know that it exists, yet it offers ultimate care and dignity to anyone who uses it. Annually, 64,000 Australians die from various terminal illnesses, with 37.5 per cent receiving specialist palliative care. Community care is available for those who don't need specialists.

Strangely, some people feel that to request support right up to the moment of death is too demanding, and so may well ask for death instead of "being a burden".

It's even stranger that there is a push to make euthanasia and assisted suicide look like the only dignified option at a time when pain management has never been better and continues to improve.

It's a well co-ordinated push worldwide. Pro-euthanasia societies here and overseas have rebadged themselves as "dying with dignity", as though only an intentional death can be dignified. But, as Bernadette Clear argued in a letter to The Age last week, control, not dignity, is the issue here. Who would have real control if the laws were changed?

How much control, for instance, should depressed and suicidal people have if they ask to die? Should death be among the treatments available for depression, as it is now in the Netherlands, and where even non-voluntary euthanasia is increasingly common?

In April last year, Ora Mae Magouirk, an 81-year-old in the US state of Georgia, underwent emergency heart surgery. She had previously made a written living will stipulating that she should not be deprived of fluids or nourishment unless she were comatose or in a vegetative state.

Magouirk was recovering when her granddaughter, Beth Gaddy, claiming (falsely as it turned out) to have medical power of attorney, directed that she be transferred to a hospice and denied food and water.

Magouirk was too sedated to speak. Her brother had to fight Gaddy in court for her life. After nine days, a dehydrated Magouirk was declared treatable by three cardiologists and flown to a hospital.

Her control had been reasserted only after a legal battle by determined relatives. What would have happened if her only relative had been the one who wanted her dead?

Once there is a culture of actively promoting death, choices other than the patient's come into play, as left/libertarian ideology plays to far-right stinginess: care costs more than lethal injections.

The Netherlands is often cited as a place where euthanasia is widely accepted, but, to try to increase choices, the Dutch Health Ministry is trying to bring its palliative care services up to the standards that exist in Australia and in Britain, where a bill to allow euthanasia was recently defeated.

In June, California also rejected a bill that would have allowed physician-assisted suicide.

The reasons behind the rejections were complex, and did not come down to a simple battle between the secular left and the religious right. Many groups of disabled people fear that if such bills were passed, a culture would arise that would make it increasingly difficult for them to choose to live.

After all, it is much cheaper to institutionalise death than to attend fully to the physical and emotional wellbeing of frail and vulnerable people.

The US disabled advocacy group Not Dead Yet is suspicious of both the PC left and the religious right. They often have to fight the former for their very lives, while being undermined by the sanctimonious hypocrisy of the latter, which proclaims "sanctity of life" while removing the means for care in its support for economic-rationalist cost-cutting.

Florida's Governor, Jeb Bush, after embracing the religious right in the Terri Schiavo case, removed from public funding the liquid nourishment that keeps such people alive.

The fact is that nobody needs to die in hopeless agony in a country such as ours. No one here must be kept alive in pain against their will or forced to eat when they refuse food; normal medical practice, let alone palliative care, precludes such barbarism.

And in the last analysis, some delicate, careful, individual decisions about end of life may well be made, decisions that fall into grey areas. It is right that such decisions be difficult, because if we opt to make death a choice cast in harsh black-letter law, then, as in the Netherlands, a culture will arise that makes it too hard to choose to be cared for, as my mother is, when life is difficult.

Juliette Hughes, The Age

Juliette Hughes is a Melbourne writer.

Ms Hughes is also a well-published and active member of the Catholic faith. Many of her other articles are moderate and carefully reasoned. See here... and here...