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

At the general meeting held on 7 November 1999, SAVES members had the privilege of hearing Professor Alnus Vedig, Head of the Department of Critical Care Medicine at Flinders University, give a talk entitled 'Non-Voluntary Euthanasia - A Model of Dying in Hospital'. In recounting several case studies, he illustrated the tension between patient autonomy and current medical practice. While autonomy has been enhanced through education and legislation, it continues to be constrained by arbitrary and discriminatory decision making.

Professor Vedig stated quite categorically that euthanasia is frequently practiced in hospitals. Deaths are allowed to occur, through non-treatment decisions, or are assisted by legal or 'passive' means. These deaths do not necessarily reflect the 'good death' commonly understood by the term 'euthanasia', and are at times difficult and protracted. This does not mean that patients always suffer pain, or experience awareness of their condition. The problem is that these deaths may be non-voluntary rather than as a result of discussions with the patient.

The direct removal of life support systems is classified as passive euthanasia and considered good practice within the medical profession, under certain circumstances. What concerns Professor Vedig is the possibility for arbitrary decision making, together with a denial of patient autonomy.

He expressed concern over inconsistent treatment between different hospitals and states, including entrenched aged based discrimination in access to treatment. Professor Vedig claimed that such decisions should never be the province of the medical profession alone, but the responsibility of government, in consultation with the community.

Arbitrary decision making and curtailment of the autonomy of the elderly have been justified on the basis of economic savings, 'intergenerational equity', and a belief that the aged could find greater meaning in life by accepting a 'natural life-span' (1). Yet such arguments lack consideration and justice (2). Age is one medical indicator, but there are others, including quality of life, the amenability of a condition to medical intervention and the expressed wishes of the patient (3).

Professor Vedig claimed that patient well-being and protection is better realised by recognising the important distinction between decisions which are made by the patient, and those which are non-voluntary. This is arguably preferable to the continuing focus on a distinction between passive and active euthanasia.

Professor Vedig also argued that if a law was passed allowing voluntary euthanasia, it would serve to highlight the current arbitrariness of end-of-life treatment options, as well as act as a catalyst for establishing greater patient autonomy in ongoing treatment plans.

1. Callahan, D. 1987, Setting Limits:Medical Goals in an Aging Society. Simon and Schuster.
2. Hunt, R. 1993, 'A critique of using age to ration health care', Journal of Medical Ethics, 19:21
3. ibid. p 22