I think the harder question you could ask me is whether people who are suffering from illnesses or conditions that are not terminal, and who are determined to end their lives – such as Tony Nicklinson, the locked-in patient who took his case to the UK Supreme Court – should be allowed to end their lives. Tony was not terminally ill and would not have qualified under the proposed legislation in Queensland (or under the legislation in Victoria and in Western Australia). It was clear that his decision would have been truly voluntary, and that he would have been acting on his own conscience. So my answer to you above is not available to me here.

But allowing Tony to end his life would, in my view, have been to allow assisted suicide rather than assisted dying. Although we might claim that, in this case, the default position should be to allow people like Tony to end their lives, we would not be allowing a VAD regime but a VAS regime, and we can reasonably claim that legitimate State interests in protecting vulnerable people could justify not allowing assisted suicide, and so not allowing Tony to end his life. Although whether this is true is partly a matter of empirical evidence, it is not exclusively so. If the State has a policy on minimising suicides, then it could reasonably claim that allowing VAS rather than VAD would undermine this other policy and so the policy balance should fall in favour of restricting any legislation to VAD and excluding VAS.

Thanks again for pressing me to clarify JP.
Andrew

The bottom line is
"whose life is it?"

ASSISTED DYING AND ASSISTED SUICIDE ARE BOTH THE SAME THINGS! With the exact same end result, a dead patient! REPEAT, A CLINICALLY DEAD PATIENT! END OF STORY AND ANY POSSIBLE DISTINCTION! BECAUSE THERE ISN'T ANY! Murder by any othe name, definition or distinction, that intentionally stills a beating human heart, remains a crime and always will!

And given it is proffered instead of miracle cancer cure in the bulk of the intended assistance?

Able to avoid forever any real discussion of miracle cancer cure, alpha particle, bismuth 213!

Currently, there are only 2 methods of creating the alpha particle, bismuth 213, by bombarding radium with accelerated particles in a linear accelerator or as a decay byproduct of MSR thorium> U233.

The first inordinately expensive and energy expensive.the second as a virtually free byproduct of nuclear energy via MSR thorium!

Given the trillions big pharma make annually fro chemo and the afterwar palliative care, little wonder, neither it nor its puppet practitioners, Andrew, will have a bar of it or quite incorrectly albeit as complementary or alternative medicine. And should the cap fit? No offence intended!

Refuse as if their business model depended on it to look at the many successful trails of the alpha particle, bismuth 213, in otherwise death sentence cancers. And over half a century Andrew. You looked at all? Did you?

That includes, according to published reports, over half a century, myeloid leukemia, pancreatic cancer, ovarian cancer and some very nasty, inoperable brain cancer, to name some.

None of which seems to trouble doctor death or his excuse-making and distinction drawing acolytes. If the cap fits?

Q: Incidentally, Andrew, do you know the Irish cure for water on the brain?

A: A wee tap on the head.
Alan B.

Thanks for replying Andrew.

I would take issue with your attempt to draw a (meaningful) distinction between VAD and VAS. Whenever a person deliberately, and indeed voluntarily, ingests a lethal dose of poison, whether by their own hand or by that of another, they are killing themselves. They are not simply dying. To say otherwise is to abuse the English language.

When a person intentionally kills themself, they are committing
suicide. This remains so regardless of whether or not the person is “dying”. I say “dying” because obviously in a very real sense we are all dying; some are just apparently closer to death than are others.

No, VAD and VAS is a distinction without a meaningful difference.

You favourably cite proposals to make VAD available only to people who are terminally ill, defined as in the last six months of their lives or, if suffering from a neurodegenerative condition, the last 12. Yet you make no attempt to try and justify these particular time limits. Essentially these limits, or any variation of them, are completely arbitrary.

Nothing special happens when the six month line is crossed, so one month, 24 months, or 100 months could be substituted instead. On what principles basis could you argue against these alternatives? It is because the lines that are drawn in relation to VAD are completely arbitrary that it opens the door for the circle of those who can gain access to VAD are widened over time, as has happened in countries that have legalised this.

If, when it comes to VAD, the person’s conscience is to be king then there is no way to hold any of the arbitrary lines that may be drawn. If a person has some sort of right to claim assistance to kill themselves in one instance then it will only be a matter of time before everyone will be able to claim that right.

You may not like Philip Nitschke's position but once we accept any killing, he will eventually win.

Hi JP
Many thanks for following up. These are all good points, but I believe they can be answered.

I used to be suspicious myself when I saw the shift in language from voluntary assisted suicide to voluntary assisted dying. But it seems to me now to be an important and defensible distinction. When we know that someone has been diagnosed as terminally ill, there is an obvious sense in which, unlike those who have not been so diagnosed, they are dying. Accepting the reality of this, it seems meaningful for these people to then claim that they want their death to be as comfortable as possible, and to avoid having it drawn out. These points cannot apply to people who are not dying. So, to my mind, that’s an important distinction.

You say that “in a real sense” we are all dying. But it’s important to understand that when you make a remark like that, you are using “dying” in a broader sense. It would be as if I objected to the clinical definition of insanity by responding that, “in a sense” we are all a bit insane. That may well be true, but it does not undermine the clinical definition of insanity. We can make the same claim about dying. While it is true that we are “all dying”, that does nothing to undermine the category of people who are ‘terminally ill’ and the distinction we draw between these people and those of us who are not dying.

Your points about prognosis, and an ineliminable degree of arbitrariness of these statutory time frames, are well known. They are the subject of considerable debate, and some experts think we should have a “death is reasonably foreseeable” clause instead. But this alternative has its own challenges. My colleagues Ben White and Lindy Willmott suggest that legislation should state that a person’s condition should be incurable, advanced, progressive and be one that will cause death. This might well be a better alternative, but it may not appeal to those who want sharp lines.

Andrew

And similar remarks about arbitrariness of these sharp lines can be made about ‘adult’. That’s a sharp line, but it has served us well. I think terminal illness as defined in Victoria and WA could be workable enough, but I admit that my colleagues’ suggestion is also attractive.

Andrew