A woman is currently standing trial for assisting in the death of her partner Graeme Wylie:
Alzheimer’s sufferer Graeme Wylie would have been unable to get and ingest the drug that killed him without the help of his partner, Shirley Justins, and friend Caren Jenning, Justins told the Supreme Court yesterday.
Justins acknowledged she stood to gain financially and had been relieved of the obligation of “caring for a sick and difficult man for several more years” when he died.
But she rejected suggestions that she had a conflict of interest or had placed her interests above his in organising for Jenning to obtain the drug Nembutal from Mexico. (Source.)
If euthanasia became legal, how would it be possible to separate ‘genuine’ cases of euthanasia (whatever that means!) by a close and loving relative (who incidentally would benefit from the terms of the will) from murder by a close relative who stood to gain financially?
Prominent Australian euthanasia advocate Dr. Philip Nitschke is a witness, due to his assistance in offering advice to the woman who is being charged. He has been offered legal protection in his role as witness in the case.
For some reason, people who argue the case for euthanasia invariably offer an overwhelmingly sunny view of the motives of those who want to pursue euthanasia. That’s not wise, is it? Jeremiah interrogates such people, and us, with these words:
The heart is deceitful above all things,
and desperately sick;
who can understand it?(Jer 17:9)
You pose the question
“If euthanasia became legal, how would it be possible to separate ‘genuine’ cases of euthanasia (whatever that means!) by a close and loving relative (who incidentally would benefit from the terms of the will) from murder by a close relative…”
If legalised, there could be some controls built in. Some ‘checks and balances’ which don’t exist at the moment. And you should ponder on whether there is a difference between rape, and loving consenting sexual acts. The physical act might be the same, but the intent, and the voluntary nature of the participation, isn’t.
I’m sure your God wouldn’t want to ban the act of procreation just because an ignorant onlooker might think that rape was occuring???
Good palliative care and easy access to it is essential. I’m curious to know what avenues are explored before these people and their families look to assisted suicide. Alzheimer’s is a tricky case in how to treat the sufferer though…
Lynda, I’m slightly alarmed by the analogy you offer! I take it you are suggesting that euthanasia is an acceptable form of killing, not to be prevented just because it looks a lot like unacceptable killing.
That’s not a question I’m addressing in my post, although I do happen to believe that euthanasia is morally unacceptable.
But what checks or balances would offer satisfactory assurances that murder was not occurring, in a case similar to the one described in this court case? Off the top of my head, I can’t think of any.
I imagine this court case has arisen partly because there isn’t a legal avenue for people to seek voluntary euthanasia in this country.
The Northern Territory law allowed for mentally competent terminally ill people to request assistance to die, with controls such as multiple medical and psychiatric assessments.
‘Living wills’ which already exist in at least some States of Australia, allow for a patient, when still well and mentally competent, to say in advance what treatment, or withdrawal of treatment, they want in the future if they’re unable to make the request for themselves.
If Voluntary Euthanasia were legal, and people nominated in advance whether they did, or did not, want help to die under possible future scenarios, then much of the uncertainty could be removed.
I’ve heard that a number of cases of ‘voluntary’ euthanasia occur at the moment on the basis of a ‘nod and a wink’ between the doctors and the patients relatives and we never hear any more about it.
Surely that’s much more open to abuse than would be the case in an open legal VE system where there was evidence that the patient made the decision?
Please note, that although I support the principle of legalised voluntary euthanasia, my emphasis is on voluntary. Voluntary for all parties including the doctors, as well as the patient. No-one should be compelled, or feel obliged, to participate if it’s against their religious or moral beliefs.
Likewise, I think it’s important that those with religious or moral beliefs shouldn’t try to influence the decisions made by people who don’t share those beliefs.
Tolerance and understanding by all could allow for a future where it is much harder for murder to occur in the guise of compassion, and easier for compassion to rule without the threat of punishment for murder.
Thanks Lynda, but I’m trying to work out how any part of your post addresses the question I asked, namely:
<i>But what checks or balances would offer satisfactory assurances that murder was not occurring, in a case similar to the one described in this court case? Off the top of my head, I can’t think of any.</i>
I thought I’d addressed your question quite fully Gordon. Perhaps you don’t understand me?
I made a point earlier about the checks and balances when referring to legalised voluntary euthanasia. If that legal VE environment existed, there would not BE a similar case to the one you refer to.
The patient would have been able to legally, and in writing before independent witnesses, declare his wishes before his dementia/altzheimers became too advanced for legal decision making.
The law would allow for intervention causing death by a willing medical practitioner or whatever other person allowed for under the law.
The family members or others who might benefit from the estate would not be involved.
I trust you’ll agree that this isn’t a suitable forum for either of us to develop the details of a hypothetical law, to cover a hypothetical situation. But I do believe that some controls properly legislated are a darn sight better than no controls at all.
Sorry, you did provide some examples, I agree.
But I don’t see that these examples are particularly compelling. Numerous potential problems come to mind. The person concerned may feel a certain level of duress to proceed in a particular way, especially if they are depressed and dependent on a small number of carers. They may change their mind after signing. How might the independence of the witnesses be verified? How can the person make decisions about refusing medical treatments that may not exist?
Not to mention that legal statements regarding medical treatments, and which ones are desired or not desired, shouldn’t be confused with legal statements regarding euthanasia. The decision to refuse medical treatment is not the same as a decision to allow euthanasia, and we are dealing with an ethically different area here.
I understand that you don’t want to get into an extended discussion of this, but it seems to me that there are a range of questions about these ‘checks and balances’ that need to be answered.
I agree with you Gordon when you say “…it seems to me that there are a range of questions about these ‘checks and balances’ that need to be answered”
Of course there are. If drafting complex legislation and getting it right were as easy as exchanging a few messages on the internet, wouldn’t the world be simple?
Happily there are lawmakers more competent than myself who are paid to develop draft legislation, and our elected members of parliament who can debate and implement (or not) laws on our behalf.
Just because something is difficult doesn’t mean it shouldn’t be done.
And where are the checks and balances at the moment? Sure, an occasional case ends up in the courts to be challenged under murder or manslaughter laws, but many many more do not.
Personally if I’m going to die by someone’s action or inaction, I’d like to have some legal say in it. Not just leave it to some friend, relative, or Doctor with or without the prompting of self interested others, to make the decision for me.
Thanks for an interesting blog subject to comment on. I wish you well.
<i>Personally if I’m going to die by someone’s action or inaction, I’d like to have some legal say in it. Not just leave it to some friend, relative, or Doctor with or without the prompting of self interested others, to make the decision for me.</i>
At the moment, of course, you have as much legal say in it as anybody. We all have the ability to lobby parliamentarians to change (or not change) the law, and this is a good thing.
You ask, “And where are the checks and balances at the moment?”
The legal situation with regard to euthanasia is that it is murder, so don’t do it. Which is possibly the finest check or balance currently available to us within the legal system—hence the court case I refer to in the original post. I think you acknowledge something like this in your comments when you say that the “occasional case ends up in the courts to be challenged under murder or manslaughter law”. But the exceptions you then allude to are an issue with the <i>enforcement</i> of law, not with the law itself. And any complaint that law enforcement is ineffective or inefficient will cut both ways—which is the point I’m making in the original post. At least our current law in this matter operates with the (biblically correct) assumption that human beings operate from base and unpleasant motives, and I don’t see that making changes to legalize euthanasia could possibly recognize this as effectively. Indeed, they open up new possibilities for people to operate in line with their wickedness.
There are legal possibilities with regard to the refusal of medical treatment as well, but as this is an ethically distinct area from euthanasia, we don’t need to discuss it in this place.
[edit: Oh, and thank you for your comments and good wishes! I appreciate our interaction]
Lynda,
are you saying if I consent to being killed then the state should allow that?
(Assume that consent is real & not coerced, not the product of mental disease etc etc)
You may find some thoughtful reflections on this matter by Andrew Cameron of the Anglican Diocese of Sydney’s Social Issues Executive here.
It repays reading since it spells out Gordon’s concerns at a little more length, with some referencing.
You might also like to read Dr Megan Best’s paper on this topic here.
If you can’t read the whole thing, then note this extract of her comments…<i>And for this reason, legalisation of euthanasia carries the following risks:
Firstly, we cannot be sure that euthanasia, once legalised and socially accepted, would remain voluntary. Vulnerable and burdensome patients may be subtly pressured to request termination of their lives in ways which are not sufficiently overt to be avoided by this legislation.
Consider the difficulty of having a relative in hospital long term. The stresses of daily visits can be enormous. These patients aren’t stupid. They know the burden it is for you. They don’t need to be told, and it is unfair to introduce this pressure, this option of euthanasia into their environment.
A second risk is that doctors may not be able to resist the extension of euthanasia to those who don’t, or who are unable to, request or consent to termination of their lives. Government reports from the Netherlands regularly show that a significant number of cases of euthanasia are performed without patient consent. The Remmelink Report from 1991 showed that 1000 reported cases were non-voluntary. This is not speculation, this is observation. There are stringent guidelines in place in the Netherlands, but they have not stopped the abuses.
I am concerned to read in a recent study in the Medical Journal of Australia that more than a third of 683 Australian surgeons surveyed report giving drugs with the intention of hastening death, often in the absence of an explicit request. Apart from the worry that they did not consult the palliative care team, if these doctors do not follow the law now, what guarantee do we have that they will do so once euthanasia law is in place? It is distressing for doctors to watch their patients die. Don’t tempt them.
Thirdly, with euthanasia legalised, would we be a caring society ready, in times of financial constraints, to invest money and resources in continued attempts to improve the care of the terminally ill. The Health dollar is being stretched, but I believe western medicine has progressed as far as it has because we have valued all human lives and continued to seek cures for the diseases which afflict us.
Lastly, with legalisation of euthanasia, would we avoid the intolerable abuses that other civilised countries have slipped into before us. We all reject the notion that the Nazi euthanasia programmes could happen again, but at the Nuremberg trials it was established beyond doubt that they had their origins in the promotion of mercy killing by German doctors in the 1920’s. Once you accept that some lives are not worth living, what will happen?
In the Netherlands, euthanasia was legalised last year after 20 years of widespread practice under legal guidelines. By the time that law was passed, the courts had already legitimised the death of patients not terminally ill. Shortly after the law was passed, the Dutch Health Minister suddenly widened the debate by advocating the use of suicide pills by old people who are ‘tired of life’. The campaign to legalise suicide pills is now underway and the Dutch Voluntary Euthanasia Society is hoping for a successful conclusion soon.</i>
Michael Kellahan said
“Lynda,
are you saying if I consent to being killed then the state should allow that?
(Assume that consent is real & not coerced, not the product of mental disease etc etc)”
No, I am not saying that Michael. ‘Consent’ is something you do in response to someone else.
But I am saying that if YOU initiate a REQUEST to be killed, and if you meet whatever criteria is specified in future legislation which allows VE, then YES, the state should allow it.
I would support any future legislation which allowed that, because there are much more humane and compassionate ways to die than to use methods such as hanging, poisoning, cutting your own throat, or whatever other measures you might resort to.
The State already allows you to kill yourself. At the moment though it doesn’t allow you access to more humane methods, and/or the assistance of someone else to help you (with say prescription or injection).
If you choose to suffer and not seek death the State allows it.
If you choose to kill yourself by jumping under a train, hanging yourself, poisoning yourself, cutting your throat, shooting yourself, or whatever, the State allows it.
But if you would prefer to ask for help from someone, to have a quicker and more humane and peaceful death, the State currently doesn’t allow it.
I believe it should.
What if you sign a document saying that you would like to be euthanased if things get crook, but you change your mind, but don’t have the capacity to tell your family or doctor?
There was a case that didn’t get this far, discussed on the Margaret Throsby interview program. A woman was recounting how her partner had told her he wanted to have his life terminated if things got to a certain stage.
As his illness progressed, the woman wondered if he still felt the same about euthanasia as he had when he was not so incapacitated.
One day she queried him with “Things are different now, aren’t they?” and he agreed, which she understood to mean that he did not want his life taken from him.
But what if she had not been so sensitive, or if he were unable to articulate his feelings?
Lynda,
how should the state decide the criteria on who can be killed?
is it a quality of life standard so that you reach an eligible ‘quality of life’ measurement and make a request, then it’s ok to kill that person?
You’ve pointed out the legislative difficulties and messiness of putting this into practice but I’m more interested in trying to understand what ethical principles you think should guide us.
Presumably you wouldn’t think killing people is normally ok so I want to know why you think it could be for VE.
The essence of this argument is very simple. Gordon Cheng has expressed very clear views on the matter of euthanasia, I imagine well ahead of any terminal or unbearable illness appearing, and I would strongly defend his rights to have that view respected regardless of the circumstances. But I have also expressed strong views the other way. How dare anyone suggest that their view should prevail over mine, concerning my own life and death? Why do you not defend my right to my view even if you might disagree with it, as I do for you?
The line that rules canot be drawn up that will provide sufficient protection is a furphy, covering an authoritarian view by some that their decisions about what is good and bad should prevail over all others. The Northern Territory rules were well thought through and would have been effective had they been allowed to stand. If I express a view strongly, over a long period of time, while of sound mind, without any undue influence, no abuse can occur, and my view should prevail.
Hi John. We have just joined those who are about to be beneficiaries of a will. And we are hearing of the disputes and greed that often accompany the decease of a loved one, especially one whom you think is going to leave you money, or who you think should be.
If euthanasia were legalised, it is obvious that unscrupulous people would attempt to get rid of people quickly, and would use the law for their benefit.
It is nice to think that we can pull the plug when we want to, but it might well be that a group of people would be coercing you into doing so before you are ready to go.
Firstly may I give a belated brief reply to Michael Kellahan who is trying to understand what ethical principles I think should guide us.
I think that the over-riding ethical principal which guides ME, is respect for the autonomy of the [competent] individual.
To quote a statement by Hans Wehrli, president of Exit Deutsche Schweiz “A dignified death can only be assessed by the individual. Neither lawyers not doctors not politicians have the moral right to decide for the individual, because it would be paternalistic and a violation of Human Rights”.
I personally would temper that statement with acceptance of some practical realities which are the subject of the current court procedings. On the late news tonight I heard that ‘euthanasia supporters’ were outraged over the verdict of manslaughter.
I am NOT outraged. I support the legalisation of voluntary euthanasia, not the breaking of the current law.
It seems that in this case, the man who died was deemed not to be legally competent to make a decision to end his own life. That is the law. I accept it.
I will continue to try to change the law, so that an enduring and persistent request (written, witnessed… whatever is necessary) before ‘incompetence’ occurs, can be respected.
In doing so, I will also try to ensure that any revised law seeks to protect individuals by detecting, preventing, or punishing, those who have ulterior motives in assisting in VE.
Some will say that the law of murder and manslaughter as it stands protects everybody, but it doesn’t. By default it sentences many, many people to a death they wouldn’t allow their dog to face.
Surely only the Die-Hards in our society could believe that was the right thing to do?
David Mackay, I think we agree on almost everything. Your posting seems to say that you would like to see euthanasia allowed (“It is nice to think that we can pull the plug when we want to”), but you don’t want any possibilty of coercion. That is exactly my position. I also agree that some “unscrupulous people would attempt to get rid of people quickly” and so the law must protect against that. Lynda Cracknell has pointed to some of the ways to achieve that (“enduring and persistent request” etc) and the Northern Territory law provided a good model. It is possible to draft a law. What is needed is for those who reject the whole idea for themselves on religious or other grounds to stop simply repeating unsustainable arguments about the impossibility of drafting adequate laws and to accept that others have a right to differ from their view.
“Respect for the autonomy of the [competent] individual” as Lynda puts it, is a core requirement of a humane and civil society. Now that slavery, corporal and capital punishment, child labour and so on have been eliminated, it’s time for the last major humanitarian reform; the removal of the compulsion to endure a lingering, painful death when all the possibilties of a bearable life have gone.
Hi John
I am not in favour of euthanasia, despite a drawn-out process in my own mother’s decline and death.
I don’t think legalising euthanasia and providing protection against coercion would be possible. You could only punish the perpetrators after it was proven they “done her in” to get their hands on her loot.
In my mother’s case, she did want to die and it did take a few years, but she also experienced the love of her family, and was always aware that she was loved by God and belonged to him and was in his care.
I realise that this might not always be the case and would be exceedingly difficult for family members to go through.
David, You admit that your mother had a drawn out death over a few years, against her wishes. And you call it love.
I call it cruelty.
Our views on this subject are very different and no matter how often I reflect on it, I fail to understand the religious view that suffering is good for you. Especially since you claim to worship a merciful God.
Hi David,
This will be my final post, as I’m not sure we will make much progress in this debate. You have introduced the case of your mother, and I’m happy to talk about that. You feel that her last years were worthwhile because of the love of her family and her god. The trouble is,from my point of view, that she seems to have disagreed with you. She wanted to die. My point is that my view should prevail in respect of my life, your view should prevail in respect of yours, and your mother’s in respect of hers.
We can argue all day about whether euthanasia is or is not justifiable in any particular case; whether people are loved; or God objects; or palliative care is adequate. But what happens when our conclusions differ? What leads you to think that your view, no matter how justifiable you think it to be, should be imposed on me or anyone else in respect of our own lives and deaths?
The argument about only being able to punish perpetrators after the event is not a good one. Wherever the boundary is drawn between legal and illegal behaviour, unlawful behaviour can only be punished after the event. So what? The proposal is that people of sound mind, who express a wish many times to have assistance with suicide, who are in desperate circumstances, who are not being pressured or coerced, should be allowed that assistance from people who are willing to provide it, without legal repercussions. Laws can and have been drafted that ensure that the necessary conditions are met. The real problem, as I say, is not in drafting adequate laws, which has already been done in NT, but in this impulse for people to want to impose their own values and views on others.