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The following article is from the SAVES newsletter, The
VE Bulletin, Vol 16 No 3, November 99
Position Statement on Euthanasia
The national peak body for palliative care, Palliative Care Australia,
issued their most recent Statement on Euthanasia (Why not voluntary euthanasia?,
one might ask.) in March 1999 at their National Conference in Brisbane.
While praise is due for trying, it contains flaws that ensure that it must
be replaced at their next annual conference if the organisation is to retain
credibility.
Dr Rodney Symes, President of VESV, explains why in the following report
in their August Newsletter, reproduced here with permission.
THE PRESIDENT'S MESSAGE
The most recent Position Statement on Euthanasia (March, 1999) of Palliative
Care Australia:
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'States that palliative care practice does not include deliberate ending
of life, even if this is requested by the patient.'
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'Acknowledges that while pain and other symptoms can be helped, complete
relief is not always possible, even with optimal palliative care', and
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'Recognises and respects the fact that some people rationally and consistently
request deliberate ending of life.'
There is a very obvious inconsistency in these statements which creates
a serious dilemma. It is exactly those patients whose pain and other symptoms
are not completely relieved and who rationally and consistently request
deliberate ending of life whom Voluntary Euthanasia Societies aim to help
by establishing legislation. Palliative care says it respects their views
but denies them assistance. Presumably it would continue to do so if voluntary
euthanasia were legalised because its objection is not based on legality.
It does not state what its objection is but I presume it is based on religious
dogma since the hospice movement was founded by Christian idealists who
wished to improve the very poor care provided to the terminally ill in
the 1960s. They should be applauded for that, but as palliative care becomes
the mainstream government supported model for the dying, religious dogma
should no longer underlie its fundamental principles.
It is pertinent to ask palliative care how it deals with patients
who fulfil (2) and (3). Is it respectful to deny them their request? These
patients are in fact offered either terminal sedation, or the opportunity
to dehydrate themselves to death.
Terminal sedation deliberately creates coma by morphine and sedatives,
a process which inevitably leads slowly to death, but which is justified
by the doctrine of double effect. This is a religious doctrine which justifies
treatment which hastens death if the intention is to relieve pain and suffering
and the possibility of hastening death, whilst foreseen, is not intended.
This doctrine provides moral and quasi-legal protection for the doctor
but "respectfully" commits the patient to some days of deliberate futile
undignified coma.
The concept of deliberate refusal of food and fluids based on a legal
right to refuse unwanted interventions is gathering force as a legitimate
response to requests for physician-assisted suicide. How a palliative care
physician can say "recourse to physician-assisted suicide, however,
seems less rational with the availability of such options as refusing oral
intakes" defies intelligence and compassion. Palliative care must address
this inconsistency and resolve this dilemma to retain ultimate credibility.
I doubt it can.
Rodney Syme
VESV Newsletter, August 1999
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