In my last blog entry, I began by quoting former US Vice President Hubert Humphrey on the moral test of a good government. I argued that the only true measure of a just society (not just of government) should be how we treat those who “live at the margins”, experiencing poverty, dysfunction, disability, homelessness etc.
This disability question is extremely and personally important to me for a number of reasons. Firstly, I have a young son with Down Syndrome and my wife’s brother lived his whole life with a significant disability. My Upper House running mate, David McCabe’s brother also lives with a disability. I know that Dave would agree with me when I say that the profound and immeasurable privilege of sharing in the lives of these wonderful individuals in all their pains and their joys makes progressing justice and dignity for those with a disability ‘deeply personal’.
Secondly, as some of you will know, I am a long time campaigner against euthanasia and assisted suicide. When I read the literature, it is blindingly obvious to me that the mere legalization of voluntary euthanasia (VE) or Physician Assisted Suicide (PAS) in places such as the Netherlands, Switzerland and some US States, at the very least, becomes the ‘elephant in the room’ for those living with a disability in those places.
As many disability activists have noted, it is not that they feel their lives at imminent risk. It is more about the eventual extension of who qualifies for VE and PAS to more and more groups of persons. It is about doctors, trained to save, who become desensitized to the value of life once they begin down that path. Think about questions of scarce and expensive medical resources and a judgement about who is worthy to receive them and who isn’t. And, closer to home, once society accepts that some lives are of more value than others, it is not difficult to foresee the beginnings of a subtle shift away from principles of equity and justice for the disabled.
This is scary stuff indeed, but it is also the reality in some places and it might be where we’re heading too.
As many of you will recall, SA Greens MLC, Mark Parnell’s recent euthanasia bill was defeated in the Upper House by one vote not two months ago. The closeness of the debate shocked me, especially considering the flaws in the bill and the clear risks associated with it.
I was also shocked, and deeply dismayed by the references in speeches by Mr. Parnell and the Hon Ann Bressington to a talk given by Dr. Paul Collier on the steps of Parliament House on the 28th of October at a rally in favour of this bill organised by the SA Voluntary Euthanasia Society.
As Mr. Parnell mentioned, Dr. Collier was a candidate at the last State Election for Dignity for the Disabled (now Dignity for Disability) and may stand again for the March 2010 election.
Let me say, at this point, that I respect every person’s right to hold and promote their views. I also know something of Dr. Collier’s work and admire his advocacy and passion. The fact that by his appearance at the SAVES rally and by the references to what he is reported to have said (appearing in Parliamentary Hansard), it is obvious to me that he supports a right to choose euthanasia and would, I imagine, therefore support pro-euthanasia legislation. That’s his right.
I do question, however, the fact that, by the wording of the SAVES leaflet for the event, he spoke as a representative of Dignity for Disability. Even if he were to have made it known (and he may have) that what he said that day in favour of euthanasia was his own private view and not necessarily that of Dignity for Disability I would seriously question the right of anyone to formally represent any organisation whilst espousing a view on something so fundamental as life and death, where the organisation had no policy position on the issue and where, in all probability, the membership had not the opportunity to express their views.
As for Dr. Collier’s candidacy at the next election, I would suggest that his public position on such a contentious issue, (particularly for those with a disability, as I have already discussed) has the potential to fracture the organisation and to dissipate support. If the candidates have yet to be chosen, I urge their selection committee to give this matter serious consideration.
Ultimately, if Dr. Collier is a candidate for the Upper House, then I respectfully suggest that South Australians who want a fair go for disability have a clear choice: support for the Democratic Labor Party is representative advocacy that respects life – what we call true human dignity.
Your views are welcome. I would love to hear from people living with a disability and those who represent the various peak bodies.
Note: anyone who wanted to follow up literature supporting my position vis-a-vis disability and euthanasia and assisted suicide would do well to read the online version of the US Disability and Health Journal this month, particularly the article by Diane Coleman.
(Go to: www.disabilityandhealthjnl.com/current) You can also read a summary article at: www.mercatornet.com/articles/view/is_death_better_than_disability.
Hi Paul
ReplyDeleteCan you tell us what the flaws were in the legislation proposed by The Greens?
I think a lot of elderly people would like to have the choice of voluntary euthanasia, and when I asked an aged care nurse how she felt about it, she said she would also like to have a choice.
The issue that most concerns me is that if euthanasia is legislated as "voluntary", it could have the potential to be flauted or changed at any time of the government's choosing.
A friend of mine who is a chaplain said he was very distressed by his mother-in-law's suffering when she was dying of cancer. She lived in High Care in a church run aged care centre, but the RNs did not give her the necessary priority when administering her medication. Sometimes she didn't get it until nearly lunchtime.
She was on morphine injections for pain, but the problem was resolved by a switch to morphine patches.
Surely all aged care centres should be required to prioritise the order of administration of medications according to need. I think that would be a move in the right direction.
Hi Lorikeet,
ReplyDeleteThe Greens Bill had the loosest criteria descriptions of any VE bill I've worked against.
When people have proper access to palliative care experts tell us that thoughts of euthanasia or suicide disappear in more than 90% of cases and in virtually 100% of cases when any underlyng issues are resolved.
I know what you're saying about nursing homes. People in Mother Theresa's hospice in India get better personal attention and care!
There's no doubt that any euthanasia law that is passed, no matter how well constructed, it will be abused. We have to think a little harder about what woudl happen to our society when those trained to care become killers. You know there's virtually no palliative care at all in the Netherlands.
Hi Paul,
ReplyDeleteI wondered if any of the following could be an issue.
Are doctors afraid of being sued if they bump up a terminally ill patient's morphine to a level that is needed to control pain, and then the patient dies?
Might some relatives see it as a chance to make money through a law suit?
Then we have the opposite problem. I have seen a public hospital doctor on TV who said that relatives wanted him to keep trying to "resurrect" elderly people instead of allowing them to die with dignity.
I think we all know that our public health system is in a parlous state, partly because federal governments have not considered infrastructure needs before adding enormous numbers of migrants and visa holders to the population.
To my knowledge, there are times when doctors have to prioritise patients according to their age, family responsibilities and chance of recovery.
Sometimes people are left on gurneys in public areas for more than 24 hours, because there are no beds available.
What do you think is the solution to these problems?
You said that there's virtually no palliative care at all in The Netherlands. No doubt this is a cost cutting measure to get rid of people considered to be nothing more than depreciating liabilities.
According to a chaplain I know, 50% of cases of "voluntary" euthanasia in The Netherlands are carried out without the patient's consent.
Lorikeet,
ReplyDeleteStarting with the last comment 50% is the accepted figure.
Doctors well understand the double effect principle and are not concerned about any legal ramifications for applying it becuase it is acceted, ehtical mendical practice.
The mamangement of relative's needs and desires is one of the advantages of good palliative care becuase palliative care includes the family and time is taken to explain things properly.
I seriously doubt that migtrant numbers has any negative effect per se on the health service generally. The problem is two-headed: less tax take available for the budget with more demand and, chronic duplication and wastage with the dual State/Feberal control and funding. Solution: Federal take over? Perhaps.
Palliative Care (lack of) would ahve been one of the contru=ibuting factors int eh decision to legalize VE in the netherlands - now they simply don't see the need.
It is my belief that Labor (and Liberals before them) are deliberately making the State governments look bad in order to wipe them out.
ReplyDeleteI think infrastructure issues are considerably worse here in Queensland because we get $2000 new people from interstate and overseas every week.
I think the federal government should work with the states more, taking into account infrastructure issues (housing, education, health and public transport) before unloading more population. I think this is a grossly irresponsible act designed to empower huge corporations.
I'm afraid that I agree with the Federal Leader of the DLP who doesn't want the State governments wiped out i.e. bigger is not better.
I am told there are huge issues in Queensland with young doctors working exceedingly long shifts, during which they make mistakes due to tiredness. Then people sue, which costs a lot of money.
I think our hospitals could supply more beds and employ more medical staff if they got rid of some of the bureaucrats and office space.
We certainly need more money put into Health & Aged Care. This might reduce the number of law suits.
Many people are exceedingly unhappy with the Queensland State government's decision to turn the Royal Children's Hospital into little more than a "crutches and bandaids" operation, especially considering Labor wants to double the population of SE Qld to 6 million. How stupid is that?
This will also increase the number of law suits, because northside parents will have to take their children to the southside for treatment.
I think there is a big problem with private hospitals and aged care providers siphoning off the money.
Today a spokesman for private hospitals said they needed more government funding and more money being made available by health funds.
He said Health & Aged Care were both supposed to be "not for profit".
After hearing that, I laughed until I cried.