SAVES is not affiliated with Exit International / Dr Philip Nitschke and opposes the public availability of a 'peaceful pill'.

The primary objection to Legalised Voluntary Euthanasia (LVE) comes from the religious doctrine that deliberately ending human life is contrary to God's will and thus always wrong. It is now used less openly because:

• Many believers reject the doctrine when they cannot reconcile it with their understanding of a God of love and compassion.
• Religious belief is not admissible as an argument in a free society where the consequences of that belief are imposed on those taking a different view.
• LVE is by definition permissive. There is no requirement for anyone to become involved in any way against conscience or religious belief.

The Common Good Argument (CGA) claims LVE will lead to:

• collapse of respect for the inherent worth of human life - leading eventually to horrors such as the elimination of the handicapped or those said to be undesirable or unworthy,
• tragic errors of judgement in providing VE inappropriately, loss of trust in our doctors because they would be thought to be free to end our lives as they wished, and
• failure of our legal system to protect the most vulnerable in the community.

The CGA is often presented as self-evident, requiring little or no explanation or justification. A good example of this approach is provided by the presentation to the South Australian Parliament in October 1999 of a report on a proposed VE Bill. The Chairperson of the parliamentary committee charged with examining and making recommendations on the Bill made a lengthy statement which closed as follows:

"In conclusion, I would like to repeat that the majority of committee members are opposed to the legalisation of voluntary euthanasia and physician assisted suicide because we do not believe that individual autonomy should have precedence over the greater good. We also believe, in the words of one of our witnesses , Dr Ian Olver, Clinical Director, Royal Adelaide Hospital Cancer Centre, who has a PhD from Monash University on end of life decisions, that:

'The idea of having rights that are absolutely paramount can apply only if we live on a desert island and our actions affect no-one. If we live in society, we voluntarily give up some of our rights for the good of society.'

"Another explanation that summarised the majority view was that of Dr Bernadette Tobin of the Plunkett Centre who, paraphrased, said:

'We recognise that in our justice system guilty people go free, but we tolerate that because we think it would be worse for one innocent person to be incarcerated. I think you have the same sort of thing with legalised euthanasia. I believe it should not be legalised, but I accept that there will be people who want their lives ended who will not have their lives ended. That is the moral cost of keeping it illegal. I recognise that and we should acknowledge it more than we do and try to respond to those people's needs better but in the end I think it would be worse if we legalised it, because we would have the corollary moral cost, which is that ... some people will have their lives ended who should not have their lives ended.'

"In my view - and it is that of the majority - that cost is just too great."

Unfortunately for the opponents of LVE, the CGA just does not withstand scrutiny. Consider, for example, the arguments against LVE listed by the Committee in their report. Of the 23 arguments listed, 7 are variations of the CGA. (There is no religious argument on the list and no corresponding list of arguments in support of LVE.)

The 7 CGA variations are:

1. legislation is too blunt an instrument to protect others from the (unspecified) consequences of changing society's formal view of killing.

BUT ---- the proposed legislation does not change society's formal view of 'killing'. Far from permitting any act of violence, it allows for compassion and respect for individual values in prescribed circumstances of last resort. There is no killing.
2. it would be difficult, if not impossible, to ensure that all acts of euthanasia would be truly voluntary.

BUT ---- under present law there is nothing at all to ensure this. Proposed legislation would require full medical documentation leading to proper monitoring and regulation. There would be parliamentary oversight and the opportunity to make amendments as necessary.
3. it would be impossible to protect the vulnerable, especially the frail old, the young, the mentally and physically disabled, the poor and members of minority groups without good access to medical services because it is not possible to devise adequate legislative safeguards to protect the vulnerable.

BUT ---- the implication that government is incapable of legislating to protect its citizens denigrates the authority and ability of parliament to devise legislative responses to meet the needs of its citizens. If it refers to families and others who would benefit in some way, eg from the distribution of their estates or by eliminating the burden of ongoing care, it ignores the safeguards proposed in the legislation, especially the key role of the medical profession.
4. it would be likely that people would become inured to death and dying and to deliberate intervention in hastening death and that this would have deleterious effects on the whole of society.

BUT ---- on the contrary, legislation would focus attent-ion on compassion for unwanted suffering in the incurably ill, to which people are inured by the present law.
5. it would create a category of people whose lives were excluded from being safeguarded because the current protection for life would be removed.

BUT ---- the assertion that 'the current protection for life would be removed' is absurd and repeats the unfounded allegation of lack of protection for 'the vulnerable'.
6. although compassionate support for the patient and family must continue, for a minority of patients whose pain and suffering cannot be eased by palliative care, the interests of the individual should not take precedence over those of society.

BUT ---- the proposition that society is better served by denying sufferers the choice of a distress-free death than by the current futile prohibition is devoid of compassion, and suggests an all-too-common disregard of the need for democratic protection of minorities.
7. it would be ill-advised to overturn the current criminal law principle that consent of the victim was no defense to a criminal act because of its (unspecified) effects on society.

BUT ---- there is no victim in voluntary euthanasia, nor would it be a criminal act.

When VE legislation is enacted:

• greater respect will be shown for the inherent worth of human life by making provision for:

-- lawful acts of compassion towards those suffering without hope of relief except in death, and
-- personal autonomy in decisions about VE in those circumstances.
• trust in our doctors will be enhanced when:

-- the dying process can be discussed openly between doctor and patient without inhibition by concerns about illegality, and
-- there are legally defined safeguards for the practice of VE reinforced by guidelines developed within the medical profession.
• confidence in our legal system will increase when:

-- doctors who accept that VE can be a rational option are not criminalised for responding compassionately to a justifiable request, and
-- the practice of VE is openly monitored rather than totally concealed as at present.
• many of our citizens, particularly the old and frail, will be greatly relieved to know that the option of LVE will be available to them should they be faced with the prospect of ending their days in intolerable distress, confusion, or total dependence on others. They will be better able to enjoy what time they have left, which may well be longer because of their reduced anxiety.
• there will be no need for older people who desperately want to die to choose extreme forms of self deliverance, such as jumping off high places; nor will they need to take such actions prematurely as a protection against losing capability.

Acknowledgement: I am indebted to Dr Harry Green and Dr Eric Gargett for valuable suggestions in the preparation of this article.