Euthanasia in Victoria — Part Three
The Arguments ‘For’ and ‘Against’
This is the final instalment in a three-part series exploring Victoria’s voluntary assisted dying laws.
In the previous two articles in this series I looked firstly at the dry details of the Voluntary Assisted Dying Bill, and then at the way a very similar law has worked in practice in Oregon. Together, these pieces offer a pretty good idea of how the law will look in Victoria if it is passed by parliament.
With debate beginning tomorrow in the Victorian lower house, it seemed like the perfect moment to analyse some of the arguments from the pro and anti sides of the debate — some fact checking might be in order:
“The current laws inflict suffering, trauma and harm on those with a terminal illness”
This is a central argument of groups like Dying with Dignity and Andrew Denton’s Go Gentle. While there is an element of truth to it, the argument is misleading. The law doesn’t inflict suffering and harm on anyone, and while there will be some terminally ill people who will have access to assisted dying if the new law is passed, there will also still be many who are ineligible.
“Assisted dying will reduce the suicide rate among elderly Australians”
Two Australians over 80 take their lives every week. Men over 80 have the highest rate of suicide of any age group. Assisted dying advocates argue that having a legal option will mean that these elderly people won’t have to die alone and away from their families. This seems intuitively true, but in reality the impact of assisted dying on elderly suicide rates is likely to be minimal. Many of those who are currently taking their lives would not meet the strict criteria set out in the law. This isn’t a reason not to pass the law — after all a small number would be able to access assisted dying — but it almost certainly overstates the impact the assisted dying law would have.
“People should be able to choose how they die”
This is a normative, moral argument, so it’s more difficult to assess objectively — it depends on what you believe. It is, however, a strong argument in a first world democracy like Australia for two reasons: 1) Most Australians now reject the strict religious morality of previous generations in favour of a more individual rights-based philosophy — therefore they believe people should be able to choose how they die; 2) Even if they don’t personally believe in assisted suicide, it is hard to justify why those who do should be therefore be prevented from having it.
“There is a ‘slippery slope’ and once assisted suicide is normalised and culturally acceptable, it will be expanded to more and categories of people that were never originally intended”
Most people making the ‘slippery slope’ argument point to The Netherlands, where the law has widened eligibility criteria for accessing euthanasia. As mentioned in Part Two of this series, the Victorian law is closest to Oregon’s, where there hasn’t been any change to eligibility in the twenty years since the law was passed.
“Euthanasia is fundamentally incompatible with the role of physician as healer to be involved in assisted suicide”
This is a difficult argument to assess because it assumes that the physician’s only role is as a healer. Palliative care is also fundamentally incompatible with the physician’s role as a healer, since it does not actively treat the patient’s disease. The best way to look at the physician in an end-of-life context is as a carer. When considered as a carer it is plausible that both palliative care and assisted dying are compatible with the physician’s role.
“It will destroy the doctor-patient relationship”
There is an abundance of anecdotal evidence from euthanasia opponents that supports the idea that euthanasia creates fundamental distrust between the doctor and patient. Studies of euthanasia practices in Europe and North America have shown, however, that the doctor-patient relationship is very rarely harmed. These studies have shown that it is far more common for the doctor-patient relationship to improve in places where euthanasia or assisted dying is practiced, though in most cases no difference was noted.
“Money and effort should go towards better palliative care, not euthanasia”
This has been the most widely circulated argument from the ‘Against’ campaign in the Victorian debate. It is unquestionably a red herring. Palliative care has always been very well funded in Australia, which is consistently in the top two countries in the world for end-of-life care. Furthermore, none of the money potentially going into assisted dying is coming out of palliative care, funding for which has been increasing steadily. In March this year the state government created a new $5 million fund to boost palliative care services in the state.
“Suicide is wrong”
This is the obverse of the ‘For’ campaign’s argument that “people should be able to choose how they die”, and the same reasons that make the latter argument strong make this one weak. Most people, even if they don’t think that suicide is wrong, think that it is something that society should combat. But the thing is: most people don’t think of assisted dying as suicide, regardless of whether it technically is. Assisted dying is generally seen as an option that is available, but not forced on anyone who doesn’t want it. The typical response to people saying “suicide is wrong”, is: “you’re entitled to your view, you don’t have to request assisted dying, but why should this mean that nobody else can have it either?”