The facts about Dying With Dignity

Surveys show that AT LEAST 75% of Australians support the legalisation of voluntary ASSISTED DYING to allow for better choice at the end of life, but despite this there’s still no law. Here's our guide to some of the FACTs that surround the debate for voluntary ASSISTED DYING laws. misinformation AND DISTORTION OF THESE FACTS has encouraged politicians not to act in a way voters clearly want them to.

FACT: "Palliative care canNOT alleviate all suffering..."

Australia has one of the best palliative care systems in the world, and we should be proud of it. But even Palliative Care Australia admits that it “cannot relieve all pain and suffering even with optimal care.” For that small percentage of patients who they can’t help, the suffering at the end of life can be savage.

The legalisation of voluntary assisted dying would give patients experiencing such suffering another choice. It should be used here just as it is used overseas: An option of last resort, when all other treatments have failed.

fact: "there is no slippery slope..."

Opponents argue that once voluntary assisted dying legislation is introduced, it will inevitably be broadened to apply to those for whom it was never intended. They call this the ‘slippery slope’.

Over the last decade, numerous, wide-ranging, official inquiries into these laws have rejected allegations of the ‘slippery slope’ - most recently, a cross-party Victorian parliamentary inquiry. In its June 2016 report, handed down after 10 months of investigation, they found “rigorous safeguards, monitoring procedures and high levels of compliance” and “no evidence of institutional corrosion or the often cited ‘slippery slope’”.

Often opponents refer to the European laws, especially in Belgium and The Netherlands, to suggest that laws written to apply only to the terminally ill have since been broadened to provide access to those without terminal illness. This is incorrect – the laws in Europe were never written purely for the terminally ill, but for those with a ‘medically futile condition that causes unbearable suffering’. The overwhelming majority of people who use these laws have cancer, but they also allow people with degenerative and chronic illnesses, such as Motor Neurone Disease, Multiple Sclerosis, and Chronic Rheumatoid Arthritis, to ask for help to die. In very rare instances, people with long-term and extreme psychiatric suffering have also been helped. All of this is consistent with how the laws in Europe were written. In the USA, access to voluntary assisted dying is restricted to people with a terminal illness and 6 months or less to live. In more than 20 years of operation this law has never changed.

fact: "The disabled will not be vulnerable..."

Some opponents have suggested that people with disabilities will be placed at risk if assisted dying is legalised. This is not true. Voluntary assisted dying laws come with strict eligibility criteria and strong safeguards to ensure they apply only to those for whom the law is written. To qualify a person has to have an extreme medical condition which, in the assessment of two doctors, independent of each other, is clearly leading to their death and which can no longer be treated in a way that will meaningfully ease their suffering. Disability, on its own, does not make a person eligible under this law.   

Further, the request for voluntary assisted dying cannot be made by anyone but the patient, who must be deemed to be mentally competent. Exhaustive, peer-reviewed evidence about how these laws operate overseas has not shown any increased threat to people with a disability, a fact confirmed by leading disability rights groups in those countries.

fact: "The elderly are not at risk of abuse and coercion..."

Some opponents have suggested that family members or carers could pressure an elderly patient to request assistance to die, for instance so that they may access an inheritance or the family estate sooner. Voluntary assisted dying laws come with strict eligibility criteria and strong safeguards to ensure they apply only to those for whom the law is written. To qualify a person has to have an extreme medical condition which, in the assessment of two doctors, independent of each other, is clearly leading to their death and which can no longer be treated in a way that will meaningfully ease their suffering. There is far more involved in the decision than a patient merely requesting it. The opinion of medical professionals that the patient’s condition meets strict criteria is required. Failure by doctors to follow the law means they risk losing their license or going to gaol.

As with the slippery slope argument, research in jurisdictions where voluntary assisted dying is legal demonstrates no evidence of elder abuse as a result of these laws, a fact confirmed by leading elderly rights groups in those countries.

fact: "Suicides do not increase..."

Some opponents have suggested that the legalisation of voluntary assisted dying will lead to an increase in suicides, referred to as 'suicide contagion'. Suicide is entirely distinct from voluntary assisted dying. The first is an irrational impulse, acted on in secret, in response to a problem that, with treatment, could most likely be fixed. The second is a rational response, taken in consultation with doctors and family, to a condition that cannot be fixed. 

This difference was clearly understood by the Chief NY medical examiner, Charles Hirsch, when investigating the deaths of office workers who jumped from the Twin Towers on 9/11. Faced with a terrible choice – a slow, agonizing death by fire, or a quick death by jumping – many chose to jump. Seeing this as a rational choice to avoid needless suffering, Hirsch refused to classify their deaths as ‘suicides’.

There is no credible evidence of increased suicide rates as a result of assisted dying laws overseas.

fact: "Children are not at risk..."

Opponents to voluntary assisted dying laws sometimes refer to Belgium, which does have legislation allowing a child in a 'medically futile condition', and who is experiencing constant and unbearable suffering that cannot be alleviated, to request voluntary assisted dying. However, this law carries even greater safeguards, and stricter criteria, than the already strict laws relating to adults. Along with two doctors, a child psychiatrist has to confirm that the child knows what they are requesting. The child’s parents must also participate in, and approve of, the request. Passed into law by a two-thirds majority of the Belgian parliament, this is a recognition that even children can die from illnesses which, in spite of the best treatment, cause terrible suffering. Use of this law is extremely rare.

All the laws being proposed in Australia apply only to competent adults.

fact: "Not all Doctors are opposed..."

It is correct that the Australian Medical Association currently opposes to voluntary assisted dying laws, although their membership is divided. However, the AMA represents only 29% of Australia’s doctors. There has never been a comprehensive survey of all Australian doctors on the issue, but the few that have been done show close to 50% support for a law for assisted dying. Some doctors have left the AMA because of its opposition to voluntary assisted dying. Others, such as the ‘Doctors for Assisted Dying Choice' group strongly support voluntary assisted dying legislation.

fact: "Doctors will not be forced to comply..."

Voluntary assisted dying is voluntary and is about choice, and this applies to medical professionals as well as to patients. By law, there is no mandatory requirement for a doctor, who is ethically or morally opposed to voluntary assisted dying, to assist a patient in their request. Everyone involved, including doctors and nurses, has the right to opt out at any time.

fact: "Not all christians are opposed..."

A 2012 Newspoll survey showed that 88% of Anglicans and 77% of Catholics agreed that a doctor should be allowed to meet a request from a hopelessly ill patient for help to die.  

The 2013 ABC Vote Compass policy tool found that out of 1.4 million Australians, 75% supported the legalisation of assisted dying for the terminally ill. 

It also provided a breakdown based on religion, and the rate of support among Catholic respondents was 69.8%. 

While the Catholic Church hierarchy is opposed to voluntary assisted dying, it does not speak for a majority of Australian Catholics.

fact: "‘Terminal’ is not hard to define..."

'Terminal' is already a legally recognised term in Australia. Australian insurance companies accept a prognosis of less than 12 months to live for the payout of a life insurance policy. This is a long-standing practice and is considered uncontroversial.

fact: "assisted dying is not what the Nazis did...”

During World War II, amongst many other atrocities, the Nazis conducted a program, described as euthanasia, known as the Aktion T4 program. It was not voluntary, nor does it have anything to do with voluntary assisted dying legislation. 

Voluntary assisted dying is voluntary, and is about giving better choice to those who are suffering beyond meaningful medical help. This choice can only be granted to a person found by medical professionals to fit strict criteria, who is mentally competent, and who has made the request themselves.

There is no link between voluntary assisted dying and what happened in Nazi Germany. To compare people who are needlessly suffering and seeking the choice of a compassionate end to their life to the thousands of souls who were murdered in the Aktion T4 program is not only a lie, it is also highly inflammatory and offensive to the memory of those who died and their descendants.

Facts kindly provided by Go Gentle Australia