41. Euthenasia

1.
Euthenasia debate
The World Today Archive - Tuesday, 23 January , 2001 00:00:00
Reporter: Eleanor Hall

COMPERE: Police are this morning investigating the death of a Sydney woman who committed suicide at the weekend.As reported on the 7.30 Report last night Norma Hall was facing death by crippling cancer and no longer wanted to live.Euthanasia campaigner, Dr Philip Nitschke, attended her death and is now at the centre of renewed debate over the right to die.And the risk doctors take in helping their patients to die at the time of their choosing has been starkly laid bare in Western Australia in the last month with the country's first euthanasia related murder trial.Joining us now to talk about this difficult ethical and moral question Dr Christopher Newell, Senior Lecturer in Medical Ethics at the University of Tasmania. Dr Newell has written two books on the issue - Managing Mortality and Death, Dying and Euthanasia, and he argues against legalising euthanasia.And Dr Peter Baume, Euthanasia Society Patron, former Federal Health Minister, and a former Professor of Community Medicine at the University of New South Wales.First to you Dr Peter Baume. You were involved in Mrs Hall's case. What's your reaction to the fact that the police are now investigating her death?
DR PETER BAUME: Well I think the police have got to do what is their job, and I hope they do it well, but I can't imagine that there's any aspect of the case which leads to a charge of anything against anyone.
COMPERE: And, Dr Baume, again, knowing the situation as you do, how much easier would it have been for her if euthanasia was legal?
DR PETER BAUME: Well I think it would have been a bit easier for her, and I just wish it was legal.
COMPERE: Dr Christopher Newell, why do you say we shouldn't legalise euthanasia?
DR CHRISTOPHER NEWELL: Well firstly of course we all want a good death and we all seek to know that we actually will have our rights respected at the end of life. The real question of course is can we create euthanasia legislation which is actually safe public policy, and I have some significant concerns about creating a category of person via legislation who may die or indeed who where we actually say it's desirable for that person to die.COMPERE: Why, what sort of dangers are you concerned about?
DR NEWELL: Well the real devil, shall we say, or the difficulty is in actually codifying or creating the categories of people where we actually say who merits death and who doesn't merit death.When we have this debate we all think about the person in the end stage cancer, for example, but if you look at the Northern Territory legislation, for example, then you find that it's actually very difficult when you actually try and draw the line as to who merits it, who doesn't, and of course you have to include, and it's not just people who, you know, are a couple of days away from death but in the Northern Territory's case you've got legislation which includes people who are, which could cover people such as people using insulin, who are dependent upon medical care, and if you go down the autonomy or the self rule line then of course you actually have to include really anybody.So the real issue is actually how do we actually safely create categories?
COMPERE: But Dr Newell, I mean, people who want to choose to die should be allowed to do so shouldn't they? I mean what sort of pressures could there be on people that would be intensified by legislation?
DR NEWELL: Well I think we all have a right to choose to die. The question is what sort of rights do we have and what sort of society should we have as far as supporting people in terms of death, and the real issue . can I give you a couple of examples for example? People who have spinal chord injury, for example, who it's quite common that immediately after they've sustained that they would definitely want to die, and most people who sustain disabilities who are actually under life support for a significant period of time they definitely want to die. A few years down the track when we've actually as a society supported them through that sort of experience, where we could all think, oh yes I definitely wouldn't want to live through that, but a few years down the track when we've actually supported people they will actually say well yes I'm actually glad that I'm now alive.
COMPERE: You talk about the pressures of society, the type of society we want to create, are you concerned that we will create a society where financial pressures are even on people, they feel sort of oh I'd better sort of nod off a little quicker because I'm too much of a burden?
DR NEWELL: Well that's already applying in the US if you think about the fact that we've got the recent reports in the US of having to take legal action to extend the six monthly funding for palliative care. In Australia, one of the real difficulties that we've faced has been getting adequate levels of palliative care in this country and that's been a real benefit of the euthanasia debate. I think we've actually got politicians who've actually put money where their mouths are and that's really good.But there is a . people take their own time to die, and in a case mix funding environment that's a lot more difficult to actually fund. There are a lot of financial pressures - we don't live on an equal playing field.
COMPERE: Dr Baume, you know a lot about public policy. You were Health Minister in the Fraser Liberal Government, is that a risk worth taking, the risk of that pressure on people, whether financial from hospitals or indeed from their own families?
DR BAUME: It's important that there is legislation and I do believe in autonomy and I do think the Northern Territory legislation worked well and Australia has been the loser and people should be aware that coercion is occurring every day in every Australian jurisdiction but it's out of sight because it's illegal.
COMPERE: What sort of coercion are you talking about?
DR BAUME: Coercion on relatives to die a bit quicker, sometimes so that people can get inheritances, certainly coercion by others anyhow.
COMPERE: And you're not concerned that that coercion could indeed increase if we have legislation?
DR BAUME: Dr Newell is quite correct when he says that it is difficult to draw legislation, but they showed in the Northern Territory it's not impossible and they did it well, and very few people availed themselves of that legislation in the nine months it was operative.
COMPERE: And, Dr Baume, are you concerned too that if we don't legalise euthanasia you'll leave doctors, who are only trying to help their patients, at the mercy of the legal system as we're seeing right now in Western Australia?
DR BAUME: And the legal system will consistently acquit people who've acted in a way which people approve of.
COMPERE: Dr Newell, isn't that an equally worrying public policy problem, that doctors have to go to court to do what they believe is part of their duty as doctors?
DR NEWELL: Well I think we certainly need to recognise, for example, I think the issue of coercion, the issue of the fact that the matters are going on now, euthanasia does go on now, there's no doubt about that.My concern, however, is for example if you look at the Northern Territory legislation then you end up with the sort of doctor shopping type situation where you go to a psychiatrist who you know will actually be sympathetic to your views.There was . unfortunately the Northern Territory doesn't show us necessarily a particularly helpful model because of the enormous politics and can I say this is one of the concerns. We all want a good death, I'm not convinced that the four people who died under the Northern Territory legislation really actually had the good death that was desired because of the adverse commentary that was being provided and because we really were struggling about the sort of life and death issues that we want, you know, for a society, what sort of dying do we actually want. Do we want to see dying as part of living or do you want to see dying as something that we wish to avoid by a public policy and by the technological fix.COMPERE: And on that very difficult question we'll leave it. Dr Christopher Newell from the University of Tasmania, thank you very much, and Dr Peter Baume, thank you too.



2.
Legal breakthrough for euthanasia campaign in Canada
Craig McMurtrie reported this story on Thursday, November 17, 2011 Listen to MP3 of this story ( minutes)
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NOTE:
TThe URL for this article is:
http://www.abc.net.au/pm/content/2011/s3369069.htm

This link contains SEVERAL excellent links...

Advocates of assisted suicide in Canada believe they may be close to a breakthrough thanks to a Supreme Court challenge in British Columbia. Sixty-three-year-old Gloria Taylor, who has a terminal neurological disease, is fighting for the right to decide how and when she will die. At the same time a study commissioned by Canada's Royal Society has called for euthanasia and assisted suicide to be legalised. -->
MARK COLVIN: Advocates of assisted suicide in Canada believe they may be close to a breakthrough, thanks to a Supreme Court challenge in British Columbia.Sixty-three-year-old Gloria Taylor, who has a terminal neurological disease, is fighting for the right to decide how and when she will die.Anti-euthanasia groups fear losing the case, and they're already promising to appeal.At the same time, a study commissioned by Canada's Royal Society has called for euthanasia and assisted suicide to be legalised.Craig McMurtrie reports.
CRAIG MCMURTRIE: Not so long ago Gloria Taylor was an active grandmother. She enjoyed life. But that was before she was diagnosed with amyotrophic lateral sclerosis or Lou Gehrig's disease.
GLORIA TAYLOR: And it seems in a year-and-a-half I went from walking to a cane, to a walker to a power wheelchair when I need it, to being pushed in a wheelchair.
CRAIG MCMURTRIE: In an interview with the Canadian Broadcasting Corporation she says she's in pain and can't even shower safely on her own anymore.The 63-year-old wants the option of a doctor-assisted suicide.
GLORIA TAYLOR: I'm fighting for the right to die with dignity so that I could die with the assistance of a physician if my life becomes so unbearable, with so much pain, that I can't go on anymore.
ALEX SCHADENBERG: I wouldn't be a human being if I didn't have great compassion for Gloria Taylor.
CRAIG MCMURTRIE: Alex Schadenberg heads Canada's Euthanasia Prevention Coalition. He says there are other options to ease Gloria Taylor's final days.He believes that if British Columbia's Supreme Court grants her wish, it would place too much power in the hands of a doctor.
ALEX SCHADENBERG: It's a physician that would have to approve it and in the case of euthanasia it's a physician who actually directly does it. So it's not about gaining new rights for me, it's about gaining new rights for a physician.
RUSSEL OGDEN: I'm really quite optimistic; the case is a formidable one.
CRAIG MCMURTRIE: Right to die campaigners like Russel Ogden of the Farewell Foundation believe this time Canada's courts might finally be ready to make the change groups like his have fought for for decades.
RUSSEL OGDEN: There's now abundant evidence that appropriate guidelines and safeguards can be crafted in order to prevent people from being induced into a suicide.
CRAIG MCMURTRIE: In Quebec a government committee examining assisted suicide is expected to release a report on dying with dignity; it's promising "a new model". Canada's Royal Society has released a two year study by an expert panel calling for decriminalisation of euthenasia.But in the country's capital of Ottawa there is little political appetite to take up the emotive issue and Alex Schadenberg is dismissive of the findings.
ALEX SCHADENBERG: Four of them were committed pro-euthanasia activists.
CRAIG MCMURTRIE: Not surprisingly the right to die lobby takes a different view. Russel Ogden again.R
USSEL OGDEN: It's calling for government to soberly look at the reality of assisted death in this country and start to measure it and start to take notice of it, rather than going with the don't ask and don't tell policy that has prevailed in this country.
CRAIG MCMURTRIE: The one thing all sides agree on is the need for clearer end-of-life clinical guidelines, specifically over terminal sedation where food and liquid are withheld from stricken patients.The court challenge in British Columbia was fast tracked for Gloria Taylor, who knows she's running out of time.
GLORIA TAYLOR: My body's been getting weaker; it's getting very much harder to do things, harder to just do my everyday functions.
CRAIG MCMURTRIE: The case is expected to continue until the end of the month. Gloria Taylor says it's her life, her body and should be her choice.This is Craig McMurtrie for PM.




3.
Euthanasia debate continues
Mark Colvin reported this story on Wednesday, October 6, 2010
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The World Federation of Right to Die Societies began a meeting in Melbourne today. It's put the question of euthanasia back in the headlines, but it was already being widely debate, with legislation being iscussed by some parties in several States. Membership of the voluntary euthanasia group Exit International has been growing, and polls indicate that many people have an increasingly open mind to the idea that the terminally and painfully ill should be able to end their own lives in their own time.

MARK COLVIN: The World Federation of Right to Die Societies began a meeting in Melbourne today. It's put the question of euthanasia back in the headlines, but it was already being widely debated, with legislation being discussed by some parties in several states.Membership of the voluntary euthanasia group Exit International has been growing, and polls indicate that many people have an increasingly open mind to the idea that the terminally and painfully ill should be able to end their own lives in their own time.One US State that's changed its laws to allow euthanasia is Oregon. Associate Professor Barbara Glidewell is the recently retired hospital ombudsman in Oregon. Andrew Pesce is President of the peak doctors' body in Australia the AMA (Australian Medical Association), which opposes changing the euthanasia laws. I began by asking Barbara Glidewell to describe how Oregon had changed its system.
BARBARA GLIDEWELL: It's fairly simple from my perspective, once the law is passed, it's really incredibly important to have structure and to have safe guards and frankly in particular for the physicians so that they don't feel that they're having to plot their own course and reinvent a process.So the safe guards that were built in provided our physicians with a process by which to follow and it also provided for patients an understanding that one doesn't just visit one's physician and say alright I'd like a prescription please. That there is a process to respect them in their dignity and to determine if this is a true enduring value, something they've thought about and that they've given a perspective to their physician hopefully about their, the quality of suffering and what is intolerable suffering to them at the very end of their life.
MARK COLVIN: Well we'll come to the details of how that structure works a little later, but I want first to get Andrew Pesce's reaction. I mean basically the AMA's position is 'no' under any circumstances.
ANDREW PESCE: Well the AMA's position is underpinned by its code of ethics, it's consistent with the World Medical Association code of ethics, and that code of ethics is one which we offer to our doctors to help guide them in the way that they care for patients. That code of ethics recognises a very significant obligation of doctors to care for their patients as best they can, recognising that they often have to care for patients at the end of their lives, often when they're suffering from an illness which is not curable, often which causes great suffering.And a lot of people, both I suppose the public and doctors are distressed by the thought that such suffering may not be adequately relieved, sometimes that's because of the nature of the illness, sometimes that's because of the nature of the health services that we work in, and doesn't allow us to provide the ideal care that we'd like to and…MARK COLVIN: Is there a big difference between your code of ethics and the American doctor's code of ethics?ANDREW PESCE: Oh look, I think for the purpose of the conversation, no. I think it basically says that it is considered by our associations that ethical physician behaviour does not allow administering of a treatment whose sole purpose, fundamental purpose is to end a person's life.
MARK COLVIN: So Barbara Glidewell, how does the Oregon legislation get around that if you like?
BARBARA GLIDEWELL: In 1994 the bill was placed before the legislature and there was a vote, and Oregonians voted that they wish to have an opportunity for a physician aid in dying, in other words, to have a legal treatment option that included a prescription for a lethal dose of medication.There were many injunctions, many referendums and the vote was put before the public again in 1997 and again in a wider margin it was approved. Thus the law was formed, it meant of course that no physician is required to participate in physician aid in dying and many, most do no actually.And that it was required that if a physician was participating that he or she would follow this conscripted set of regulations and would then provide feedback to the health division that would capture those statistics and report it to the public. So once the law was in place, there was no debate about whether or not a physician chose to participate or not, they simply did not have to, and those that did would be relieved of any prosecution.
MARK COLVIN: Andrew Pesce, would that give you any relief?
ANDREW PESCE: Well look, obviously the laws of the land are one thing, and that's up to governments and the people to, through whatever processes are available to make decisions on, and obviously we would say that the laws are things which stand separate to what our code of ethics would talk about. So, my response would be that we recognise that this is something that governments grapple with, the medical profession has grappled with it, it's come up with our code of ethics. We have our code of ethics as something which guides our profession, we recognise that just, as in the community there is a range of views on this, within the profession there is also a range of views. So we don't wish to sort of conscript anyone either, but you've asked us…
MARK COLVIN: Doctors are in danger aren't they? I mean you know and I know doctors who deal with people at the end of their lives who have given a lethal dose of a pain killer. Now in some circumstances that can put a doctor in a very dangerous position, can't it, in this country?ANDREW PESCE: As I said, doctors do have an obligation to care for patients at these very difficult times and they're obligation is to relieve suffering. Now the code of ethics recognises that in relieving suffering you sometimes have to administer treatments which will A) don't prolong life, and B) sometimes, although that wouldn't be the central intention, may hasten the person's death.Now your question is do such laws give comfort to the doctors who believe that they would involve themselves in these types of decisions, and I think they probably do, although I don't believe that the lack of access to such modalities of treatment is centred mainly on legislation. As I said I think that our care for people who are dying isn't what it should be, our palliative care models aren't as good as they could be, we would certainly hate to feel that this was seen as some sort of alternative to promoting the best palliative care and end of life care that doctors could provide for their patients.
MARK COLVIN: Barbara Glidewell, can you just give us a quick walk through the safe guards that are built into the legislation there.
BARBARA GLIDEWELL: Yes I can. If I may add one comment to the good doctor, in Oregon we also have a law that allows for a physician as you've just spoken to provide adequate medication, as a matter of fact it requires a physician to do so to relieve suffering even if it would have what we call the double effect. Without the intent of suppressing respirations, but inadvertently it has the effect, and it relieves them from prosecution for providing that adequate medication and in fact they're required.But let me go further because you've asked me to outline. It suppresses whereby a physician receives a request from a patient to discuss the concept of aid in dying. At the facility where I have worked, it was required that physicians work through the ombudsman's office in order to coordinate all the efforts in the interviews, and to have witness to those interviews.So indeed there's a day one where there's the first interview, it's a very sensitive, compassionate but probing interview to determine the nature of the suffering that would cause the patient to want to take a medication, how they have considered this and to look for signs of depression or a clinical depression that would need treatment, or any signs of…MARK COLVIN: But then there's another interview much later because you don't want to have caught somebody on a bad day as it were?
BARBARA GLIDEWELL: Exactly, and that's, then later, 15 days later is interview number two, day two, and we have to see if it's the still the same request, still the same value. During those 15 days, a second opinion physician reviews all the records, determines that indeed the patient does likely have less than six months to live, is acting voluntarily, does not have a depression and is not under duress, and the patient also signs a written request form as witnessed by two individuals, one who may not be related to him or her.Then 48 hours later, after the 15th day, then a prescription may be written, if the patient qualifies on all parts. Most patients ask to leave the prescription with a physician and they may ask for it later, or some choose to have it filled at the time and they keep it at home more or less as an insurance in their mind that if the time comes when they feel they want it, that they would be available to them.
MARK COLVIN: And many people don't, just don't use it in the end?
BARBARA GLIDEWELL: That's correct, that's absolutely correct.
MARK COLVIN: It sounds like a sane system, Andrew Pesce, you're not convinced?
ANDREW PESCE: Well as I said, our, our opinion and what we say is guided by a lot of deliberation which although we believe reflects some input of the values that we see in society is one that we feel is driven mainly by our sort of professional view, and our professional standards.I guess, everything I've heard is very credible and plausible and makes a lot of sense. I guess the proof in the pudding would be, I don't know, if somehow you could study Oregon as a state and for example New South Wales as a state, in which state is the quality of care for dying people better, I don't know. I mean, I don't even know if the studies' there.The fact that as doctors we would have a very strong obligation to do everything we could to dissuade most people who asked for our assistance to help them in their lives, in the vast majority of cases it's very difficult for us then to turn it around and say that when someone makes that request that might seem quite a logical request to say "oh yeah, on this occasion we will help you."I think it is something we see as an issue which, in which our response is rooted I suppose in our very strongly held values that our duty is to preserve and promote life, not walking away from our obligations to provide care for patients, even those that are dying.Even though there are always examples at the margins, I think our current system allows doctors to do that reasonably well.MARK COLVIN: Dr Andrew Pesce, the President of the peak doctors' body, the AMA. And before him Associate Professor Barbara Glidewell, recently retired hospital ombudsman in Oregon whose attending the World Federation of Right to Die Society's meeting in Melbourne.


4.
SA: MPs launch new push for voluntary euthanasia
Paula Kruger reported this story on Wednesday, September 15, 2010 18:34:00
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There's a new push in South Australia's parliament to try to legalise voluntary euthanasia. Four MP's - a Labor, a Green, a Liberal and an independent are supporting the new push which would see two identical bills introduced in both houses of Parliament.

MARK COLVIN: Political forces that usually compete have united in South Australia's parliament to try to legalise voluntary euthanasia.Four MP's including a Labor member, a Green, a Liberal and an independent are publicly supporting the new push which would see two identical bills introduced in both houses of Parliament.The MP's say there is broad public support for responsible voluntary euthanasia laws, but it is still a very sensitive issue.The latest attempt to change the law comes just days after a television advertisement supporting voluntary euthanasia was banned on the grounds that it promoted suicide. Paula Kruger reports.
PAULA KRUGER: Despite many attempts to legalise it in different jurisdictions around Australia, euthanasia is still unlawful.For those who oppose it, it comes down to the basic principle of no one has the right to take the life of another.But it appears many Australians are comfortable with balancing the right to die with the right to life, with polls showing that more than 80 per cent support voluntary euthanasia.And that is a figure that brought four South Australian MP's together to give a collective push to the state's effort to legalise euthanasia.Greens Leader Mark Parnell.
MARK PARNELL: We have always known that voluntary euthanasia has overwhelming support in the community but it hasn't had overwhelming support in the Parliament. What we're doing now is we are introducing on a cross-party if you like, or even a multi-party basis, a new bill into both the Lower House and that will be introduced tomorrow, and in the Upper House, which will be introduced in a fortnight. Bills to provide for dying with dignity.
PAULA KRUGER: It's not the first time the Green's leader has tried to introduced voluntary euthanasia legislation in South Australia.Last year his bill was narrowly defeated in the Upper House. The new legislation is similar but with added safeguards.Labor MP Steph Key will introduce one of the bills in the Upper House tomorrow.
STEPH KEY: When you have a public opinion and also a need for this as an option, I think we're all dedicated to keep campaigning.
PAULA KRUGER: Reflecting the unusual unity that comes with a conscience vote was Liberal MP Duncan McFetridge.
DUNCAN McFETRIDGE: I just hope that my colleagues who have concerns about this go back to their constituencies and ask them; what do they want them to do? Because as a representative of my electorate in Morphett, I know that over 80 per cent of my electors are behind me in supporting this motion.
PAULA KRUGER: Also standing up to support today's announcement was Geoff Brock, independent member for Frome.
GEOFF BROCK: I don't think people realise until they've been through it themselves with their own family, the trauma and the heartache and it's a very, very traumatic experience to see somebody who you know is going to die and they can't do anything about it.
PAULA KRUGER: But despite figures showing strong support for responsible voluntary euthanasia legislation, it is still proving to be a highly sensitive issue.On Friday afternoon permission to air an ad supporting voluntary euthanasia was withdrawn after the regulatory body responsible for approving ads ruled it promoted suicide.That has stirred a separate legal fight, this time involving Australia's freedom of speech laws.Greg Barns is a barrister and Director of the Australian Lawyers Alliance and has also done pro-bono work for Exit International, the organisation that made and paid for the ad.
GREG BARNS: This advertisement was not about telling people how to suicide, as the commercial television stations would have us believe; it was an information ad, it was an advocacy ad and it was a political advocacy ad. And it's very important that as the High Court has said on a number of occasions, that political communication be free. You'd certainly be able to challenge the decision if you had a charter. One of the problems in Australia is that there are no adequate protections for human rights and so people such as Exit International would be able to challenge this decision if there were a Human Rights Act or a Charter of Rights as exists in the UK or in Europe or in Canada.
PAULA KRUGER: Because Exit International can't legally challenge the ruling they may have to alter the ad if they want it to appear on Australian commercial television.
MARK COLVIN: Paula Kruger.


5.

Dr Death pushes for voluntary euthanasia to be legalised

PM - Monday, 5 May , 2008 Reporter: Edmond Roy

PETER CAVE: The man described as Victoria's Dr Death is hoping to start a new dialogue on physician-assisted dying by publishing his own experiences.Dr Rodney Syme has practised medicine for 45 years and in the past few years he's been actively campaigning for a change in the law to make voluntary euthanasia legal.He is also campaigning for a private member’s bill on physician-assisted death that is set to go before the Victorian Parliament later this year.Dr Syme spoke to Edmond Roy and admitted that he was being deliberately provocative in an attempt to change the law.
RODNEY SYME: Yes, that is one aspect of it although I originally decided to write the book in order to try and educate the public about the context in which decisions are made by a doctor to help patients to die.Although there was very strong public support for this concept I didn't think the public really had very good understanding of the issues involved, so I set out to write a book that described the context of these issues.And that's why there are a number of patients stories in the book but as I went further and further I realised that the law was unclear, opaque, that it wasn't being prosecuted and where you've got a bad law sometimes the only way to change it is by being provocative.
EDMOND ROY: So who is your view, is the law protecting?
RODNEY SYME: Well the law is protecting both doctors and patients, because if you think about it, if a doctor is prosecuted for providing humane and sympathetic treatment to a patient at the end of their life, it would knock the guts out of all palliative care, decent palliative care, because all decent palliative care has an intrinsic risk of hastening death.
EDMOND ROY: But as you put it in your book, there is an unofficial conspiracy of silence within the medical profession, how does that tally with what you're doing?
RODNEY SYME: Yes, well doctors are very, very loath to talk about this. One of the unusual things about this book is that it gives two people a voice.It gives patients a voice because throughout the book I've been able to use letters and comments from patients who are faced with these terrible predicaments and it's also probably almost a unique book in being a book written by a doctor about his experiences in this area.Doctors are very, very loath to talk about the things they do. I'm very, very far from being the only doctor whose helped patients at the end of their life by hastening their death but doctors naturally because of the opaque nature of the law are very, very loath to talk about these things. As such, the medical profession doesn't talk about it, the prosecutorial authorities don't talk about it, the police don't look for doctors to charge, and so it all goes on under the table, under the carpet and who knows what things are happening there that are not being exposed to the light of day.It would be far, far, far better if doctors had some guidelines, some regulations it was out in the open and we would have far better practice, far safer medical practice than we have at the present time.
EDMOND ROY: You talk in your book about the idea of a natural death, dead so to speak. Is that true? I mean, have we reached a point in 2008 where you cannot die naturally?
RODNEY SYME: Well, people do die naturally if they have sudden death. They might be having a shower and die of a heart attack or some people do die in their sleep but most people who are dying have a death in which there is considerable medical influence. Very few people who do die do so without some administration of drugs. Drugs which inevitably are going to have some influence on how that person dies. Natural death would be one in which there is no medical intervention at all and that's actually very, very uncommon unless it's a very acute death.EDMOND ROY: How do you as a doctor make the decision about who should or shouldn't get advice on how to organise their death?
RODNEY SYME: I don't make the decision, the patient makes that decision. All I do, I'm a facilitator, I like to think that I conduct a dialogue with the patient and that dialogue is involved in finding out exactly what it is that they are concerned about, what suffering they have, addressing the question of is there any way in which that suffering can be relieved.My aim is to get people to go as far with their life as they possibly can. I'm concerned to make sure that they are suffering from any mental illness which would be impacting on their decision.I'm concerned to see that nobody is putting duress on them to make their decision but if after that dialogue it is absolutely clear that the well-informed patient is making a rational and clear and persistent decision that they do want to bring their life to an end - in order to end their suffering, in order for them to end their suffering - then I'm prepared to assist them. And that assistance is in the form of medication which they then control. This is the nature of the legislation which has been put before the Victorian Parliament in a private member’s bill which will empower patients, it won't empower doctors. Patients are empowered by them having control of their medication.They will decide when they when they need to use it or if they need to use it, and that is the best possible control you can have against any possibility of abuse.
PETER CAVE: Dr Rodney Syme speaking to Edmond Roy. His book, A Good Death: An Argument for Voluntary Euthanasia, is out this week.