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

From September 30th to October 3rd 2004, I attended the 15th conference of the World Federation of Right to Die Societies in Tokyo. There are currently forty member groups in the World Federation, including three new organizations added at the conference - ‘Libera Uscita’ of Rome Italy, Final Exit Network of Atlanta USA and SAVES of Durban South Africa (re-admitted after lapsed membership). Such strength of membership shows there is no doubt about the eventual success for gaining legal assistance to die around the world; a triumph for common sense and compassion.

The conference was most generously hosted by the Japan Society for Dying with Dignity, being the third time that this biennial meeting has been hosted in Japan. I am sure all members would agree that the Japan Society has paved the way with distinction, facilitating challenging and informative discourse while encouraging respect and solidarity.

The major topic for this conference was the ‘living will’, also known as an advance directive or anticipatory direction; a document that allows individuals to state the type of medical care they would prefer if they become no longer mentally competent to direct this. A survey of living wills in the World Federation member areas was compiled and reported by Michio Arakawa, the Executive Director of the Japan Society, and I was pleased to help by co-ordinating the Australian responses. Not all countries have Living Will legislation, but in South Australia there are two acts under which a will can be made; the Consent to Medical Treatment and Palliative Care Act 1995 and the Guardianship and Administration Act 1993.

As with the past conferences, many speakers unfolded a wealth of information and inspiration. To name but a few, Rob Jonquiere, CEO of Right to Die Netherlands (NVVE), reported on the Life Cycle of Living Wills in the Netherlands, and presented the general reports from member societies. Michael Irwin, outgoing President of the World Federation, talked about Pro-Choice Living Wills and gave a gracious closing address of special note. Richard MacDonald, Medical Director of the Hemlock Foundation and End of Life Choices, Canada, spoke on ‘A hastened death - who makes the choice?’ Hidaya Sakurai, Vice President of the Japan Medical Association, spoke about the attitudes of that association towards terminal care. Derek Humphry, President of ERGO, who was named as an honorary World Federation Board member in recognition of his twenty five years service to the Federation, directed our thoughts towards ‘The Future of the Right to Die Movement’.

The George Saba Medal was awarded to the Japan Society, in grateful recognition of its contribution to the World Federation, and the first Marilynne Seguin Award was given to Beatriz Gomez, founding member and long-time President of Fundacion Pro Derecho A Morir Dignamente (DMD) of Columbia. Richard MacDonald presented Beatriz with her award, saying that she, like Marilynne in her many years of leading Canada’s Dying With Dignity Society, ‘displayed compassion and caring as well as dedication to the goal of bringing legal changes that might permit control and choice for patients as death approached’.

Jacob Kohnstamm (chairman of NVVE) was elected President of the World Federation, with Jacqueline Herremans (President of the Association for the Right to Die With Dignity in Brussels) as Vice President. Libby Drake who is a member of our SAVES committee (in absentia), was duly elected as Secretary, a position she has filled with dedication and expertise for six years now. (A full list of Board members, plus more information about the conference, can be seen at the website of the World Federation, (www.worldrtd.net.) It is fitting to mention at this point, the generosity of NVVE in administering the World Federation website for the next two years and providing valuable financial support through covering travel and clerical expenses for the President. The following statement was issued at the conference in the form of the Tokyo Declaration:

‘Health professionals attending the 15th World conference of the World Federation of Right to Die Societies, in Tokyo in October 2004, declare their support for all patients having living wills and other advance directives, documenting their treatment preferences when near the end of life. Also we believe that physicians, nurses and others caring for patients must acknowledge and follow the directives provided in these documents, even when the choices made by the patient lead to what may be an unintentionally induced hastened death.’

Decisions made at the conference included:

• a working group to develop uniformity on end of life terminology and definitions, to report at the 2006 conference;
• new maximum annual membership fees US$1000 and minimum US$50;
• a new category of Associate Membership for organizations which support the World Federation but are mainly active in related fields such as human rights;
• the enabling of emergency motions to be presented by a member society at the biennial meeting if it has the support of the Board Executive and its debate has the support of at least two thirds of the members present;
• provision for urgent decisions affecting Federation by-laws.

Sidney Rosoff, the first World Federation President, gave a stirring speech about the origins of the Federation in 1980. He reminded us that it was the Japan Society for Dying with Dignity which led the way when it invited five countries to meet in Tokyo for the first international conference in 1976. Sidney said:

'Just think! One man, Dr Tenei Ota, changed the history of this social movement, moving it from one of isolated national concern to an international one, thereby strengthening and broadening the impact of our insistence that individual end-of-life choices become a matter of individual choice, in every country, world-wide!’

Jacob wisely advises us all to work together - ‘unity in variety’. The conferences give us a unique opportunity to learn, to network and thereby meet the challenges of our quests. I will next see my friends and colleagues at the 16th conference in Toronto Canada, 2005