Profound words from a dying man
I cannot speak for all people who suffer from illness and disability, but think I can speak more credibly about suffering, illness and disability than those people who advocate for euthanasia presenting an ideological view of suffering and disability. Facing illness and disability takes courage and we do not need those euthanasia advocates to tell us that we are so lacking dignity and have such a poor quality of life that our lives are not worth living.
For several years, until I objected, I received from my health insurer a letter that tells me how much it costs the fund to maintain my health care. I dreaded receiving that letter and the psychological reasoning that would seem to have motivated it. Each year I was reminded how much of a burden I am to my community. The fear of being a burden is a major risk to the survival of those who are chronically ill. If euthanasia were lawful, that sense of burden would be greatly increased for there would be even greater moral pressure to relinquish one’s hold on a burdensome life. Seriously ill people do not need euthanasia. We need better provision of palliative care services aimed at managing symptoms and maximising function, especially as we approach death. Rather than help to die, the cause of dignity would be more greatly helped if more was done to help people live more fully with the dying process.
The proposal to make provision for a terminally person who is suffering to request, and a doctor to provide, assistance to die makes it less likely that adequate efforts will be made to make better provision for palliative care services. Legalised euthanasia would give those responsible for funding and providing palliative care a political “out” in that respect.
In Australia, too little is done to make adequate palliative care available to those who need it:
Current entry requirements for palliative care usually exclude people with chronic pain and is often limited to people who are in the last stage of cancer with a prognosis of less than eight weeks;
The pharmaceutical subsidies for the more effective forms of pain relief are often restricted to cancer patients;
People living outside major cities have little access to palliative care facilities. • Few doctors are adequately trained to provide palliative care.
Such palliative care services as exist are chronically underfunded and struggle to provide the complex range of services that are needed to assist a person to live with pain and disability.
Most pain clinics are over subscribed and have long waiting lists. For people who are left suffering, such waiting is unconscionable.
Medical research in this area indicates that the desire for euthanasia is not confined to physical or psychosocial concerns relating to advanced disease, but incorporates hidden existential yearnings for connectedness, care and respect, understood within the context of the patient’s lived experience. Euthanasia requests cannot be taken at face value but require in-depth exploration of their covert meaning, in order to ensure that the patients’ needs are being addressed adequately. In Australia, what is needed is often not available or not available in time. It is distressing to note that in the US State of Oregon in 2009, none of the patients who were lawfully killed at their own request were referred for formal psychiatric or psychological evaluation. It is also distressing to note that two thirds of people lawfully killed under euthanasia laws, in those jurisdictions that permit it, are women.
If euthanasia is a legitimate option with a determined structure, such as was the case in the Northern Territory for a brief period, and is now proposed for South Australia, then life for the chronically seriously ill would become contingent upon maintaining a desire to continue in the face of being classified as a burden to others. Essentially the Bill involves setting up a category for people whose lives may be deliberately ended. Their protected status as a member of the South Australian and Australian communities depends on a contingency. Passage of the Bill would imply that our community considers that our continued survival depends on us not succumbing to the effects of pain and suffering, depends on us not losing hope.