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The Di Gribble Argument 2015: key points from Andrew Denton’s case for voluntary assisted dying in Australia

Read Friday, 30 Oct 2015

For the Di Gribble Argument 2015 this week, broadcaster and interviewer Andrew Denton laid out his case for the legalisation of voluntary assisted dying in Australia. The result of eight months of research, and hundreds of hours speaking with ‘nurses, doctors, politicians, lawyers, academics, priests, surgeons, palliative care specialists, and activists on both sides of the debate’, Denton has put forward a model for a law which would allow patients to self-administer medication in situations of unbearable and untreatable suffering.

Catch up on key points from Denton’s argument (and your tweets in response); or read the full transcript of the Argument.

Please note: this article is not about suicide. If you are interested in increasing your understanding of suicide and how to support someone experiencing suicidal ideation, visit the Conversations Matter or beyondblue websites.

If you (or someone you know) require immediate assistance, contact one of the following 24/7 crisis support services: Lifeline (13 11 14), Suicide Call Back Service (1300 659 467), MensLine (1300 78 99 78), beyondblue (1300 22 4636), Kids Helpline (1800 55 1800) or eheadspace (1800 650 890).

Andrew Denton in conversation with Sally Warhaft (Connor O'Brien)
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On the accusations commonly made against models of permitting voluntary assisted dying – viewed against the reality of systems already implemented overseas: 

‘Belgium, Netherlands and Oregon, I was told, were societies weakened at their moral core; a slippery slope where the number of people seeking to die was sharply on the rise, and the reasons for their legalised deaths ever-expanding. At its heart lay two key accusations: that the safeguards don’t work, and that the elderly and disabled were threatened. I took careful note of it all, then took off overseas to see if their warnings held true.

What I found was almost the exact opposite of what I’d been told: Long-running systems, based on years of open research and debate, with multiple safeguards, and overwhelming acknowledgement that they work, from across the spectrum – the public, medical bodies and political parties of every hue.’

On Denton’s proposed model of ‘voluntary assisted dying’ – and how it differs from euthanasia:

Denton argues for a system, not of euthanasia, but of ‘voluntary assisted dying’. The key point in this definition is the assurance that ‘the fact that only the patient can end their own life is number one of many safeguards.’

Andrew Denton presents his Argument (Connor O'Brien)

On borrowing the best of assisted dying legislation from the US and Europe:

Denton’s suggestions for the introduction of a voluntary assisted dying law in Australia are based on combining what he sees as the most effective elements from systems already implemented in Europe and the US:

‘I discovered that there are key differences between the laws in Europe and the US, both of which, I believe, have relevance to us,’ said Denton. He proposes, ‘As in Oregon, [a model of] voluntary assisted dying – where you are given the medication, but only you can administer it. The only exception being if … you are physically incapable and then a doctor can give you an injection. As in Belgium and the Netherlands, [a model in which] the entry point is unbearable and untreatable suffering.’

On the most important safeguards to prevent abuse of the law:

‘[The] greatest safeguards? That only a competent adult can ask for help to die; and that they are voluntary. As one doctor put it to me, “you are under no obligation whatsoever to do this. That is the essence of the law. It does not give a right to a patient; it protects the doctors. It is something that can be asked. It is something that can be given, but it is not something that can be demanded.”‘

On the definition of what might constitute ‘unbearable suffering’:

‘Doctors in Belgium and the Netherlands end their patients lives by injection – and the entry point for eligibility is unbearable and untreatable suffering … It is not the illness that determines whether or not a request for euthanasia is granted, but the suffering. This is an acknowledgement that unbearable suffering doesn’t just come in packages marked ‘cancer’ and ‘heart failure’. It can come in such things as MS, motor neurone disease, profound stroke, chronic unrelenting arthritis, or multiple, irreversible disorders often seen in the elderly. It also acknowledges that, sometimes, terrible, untreatable illnesses can strike children, even babies – and there are special provisions in their laws to treat such rare cases.’

On the difficulty in determining what constitutes ‘unbearable suffering’, especially when it comes to psychiatric illnesses:

‘I discovered that there is debate within the medical community about some of the more difficult cases such as dementia and psychiatric illnesses. But it is debate in the true sense – an ongoing conversation between medical professionals about how best to treat the many different examples of suffering that come before them. To me this was proof of a healthy system, not one out of control.’

Andrew Denton presents

On the number of people who use assisted dying laws:

‘As with Oregon, the greatest proof I found that these laws work was in the numbers: a huge percentage of people support them, but only a tiny fraction use them. In Belgium, it’s less than 2% of all deaths. In the Netherlands, it’s less than 4%.’

On Australian doctors assisting patients to die, in spite of the law:

‘A survey of Victorian doctors in 2007 showed that, of those who had experienced requests from patients to hasten death, 35% had administered drugs with the intention of doing so … So assisted dying is happening in Australia. Only we don’t really know how much. Or whether it’s being done well, or for the right reasons, or with the consent of patients – as they do overseas – because the absence of a law here means we have no guidelines, no reporting mechanisms, and no system of review.’

Photo by Connor O'Brien
Sally Warharf in conversation with Andrew Denton

On the need for Australia to legislate for such a law:

‘It is not time that we had a law for assisted dying in Australia. It is well past time. I’m not talking about a right to die – as one Dutch doctor told me “death is not a right, death is a fact at the end of life” – but, instead, a right to ask for help if the suffering becomes unbearable and untreatable. A right to have a choice about what happens to us at the end of our lives. When someone is suffering, how can we ask them to suffer more?’

Better Off Dead: Podcast tile

Coming in January 2016, go deeper into Andrew Denton’s Argument – through conversations with doctors and nurses, lawmakers, activists, gravely ill patients and their loved ones on all sides of the debate – with Better Off Dead, a new podcast co-produced by the Wheeler Centre. Keep an eye on, or subscribe to the Wheeler Weekly for updates.

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