Philip Nitschke is running for election as an Independent Candidate in my electorate. He is pro euthanasia. He believes that doctors should be authorised to assist people in physical and mental distress to die.

What do the rest of you think?

This might seem unusual from me.. a 'conservative evangelical protestant' but if a person has made their peace with the Almighty, is convinced on sound medical advice that they are going to soon be 'gathered to their fathers'.... then to assist them with pain relief, and at their request help them along the road doesnt seem such a bad thing.

Phil 1:21ff
>>For to me, to live is Christ and to die is gain. 22If I am to go on living in the body, this will mean fruitful labor for me. Yet what shall I choose? I do not know! I am torn between the two: I desire to depart and be with Christ, which is better by far; but it is more necessary for you that I remain in the body.<<

Moses was told "Go up to the mountain, there you will die" after his earthly work had been completed.

Pauls words seem to suggest 'choice' in the matter. I don't have any idea what he meant about the means of 'departing' to be with Christ, but I'll err on the side of caution and suggest it might have been not worrying about being martyred.

In terms of the question "Do the terminally ill have the RIGHT.....to death"... well again this raises the issue of "where to 'rights' come from" in contrast to 'privileges' based on the powers to be.

There is no such 'right' for anything (outside of God) unless we actually have a 100% consensus on it.... but I highly doubt there would ever be 'consensus' on such a controversial issue. Even a consensus would only last until the next generation decided they didn't like the idea.

Its a hard question. One thing I do know and am assured about. Put the option of 'killing' the terminally ill in the hands of moral relativists and/or atheists, and the issue could go off in any 'interesting' direction.

"Lets improve the human race by cloning"...err..yeah...right.
"Lets improve the human race by KILLING weak and burdensome"...yep.. not that far away eh?

Dear BD,

Thanks for your comments. I watched the interview of Philip
Nitschke on Andrew Denton (Monday evening) and I found it rather disturbing, to say the least. I had presumed that this man (doctor) was for helping the terminally ill to end their lives. However he was talking about 18 year olds as well who wanted to die - which troubled me greatly.
So now I'm having a re-think about the whole issue. My girlfriends' mother died of cancer - and watching her mum suffer for so long was heart wrenching. But as I sad after watching Nitschke's interview on Monday night - I'm not quite as sure about things as I was earlier.

Foxy, I tend to see the debate as more about making safe, clean mechanism's available to those who medicine is no longer able to help.

Many people in such a situation take their own lives and because we don't provide clean ways of doing it close relatives/passers by/emergency services workers are left to find the bodies and deal with the emotional impacts of that.

Others who no longer have the physical capacity to end their own lives are left to linger on until their medically assisted bodies finally give up.

There is some truth in the idea that medically assisted suicide opens up a can of worms hinted at by Boazy.

What about people who lack the mental capacity to make the decision?
What about those who may be given wrong advice by medical people or who face pressure from relatives to end it because the rellies can't cope any longer?

I guess given the history of people of Boazy's ilk (and I don't use the Scottish clansman meaning ;) ) to always make perfect ethical and moral decisions based on their ever so perfect interpretations of the bible we can be sure that there will never be any bad calls from them, as for the rest of us we will have to tread carefully trying to find a balance between compassion and safeguards.

R0bert

Dear RObert,

What you say is so valid. I thought that to help terminally ill people end their lives was a compassionate and obvious humanitarian thing to do. But it's a far more complicated issue then I'd realized.
Especially when you carry (religious) baggage with you - as I admit I do. And as I said, after watching Nitschke on TV Monday night - I'm even more uncertain about what I'd do - if a decision had to be made concerning a family member.

Foxy, "Especially when you carry (religious) baggage with you - as I admit I do." - my impression is that you are thoughtful regarding your religious baggage.

We all come with the baggage of some kind of belief/non belief system (or a mixture). Some carry it with care, checking on the contents from time to time and trying to ensure that the contents are still relevant, others have tossed away the keys to the bags and stomp through life bludgening others with their baggage.

Those in the former category pose little threat to others.

I stuggle with this issue, I'd have no qualms if someone close was in terrible main with no valid hope of remission wanted to end their life. I'm undecided about other forms of assisted suicide but I don't like the consequences of the current approach which leaves innocents to deal with the consequences. There are few perfect answers in life.

R0bert

Voluntary Ethanasia?

What a hypocritical society we are! We can send off our prime young men and women to kill and maim other human beings, all at the stroke of a pen, or the fall of a marble, ....this in the name of "defence" (which in recent times seems to have been simply to back up the irrational actions of megalomaniacs in their bid to attain world conquest, or create a name memorable to history!).....and at the same time that we are accepting these obscene and devastating commitments, to indiscriminately kill upon request in the name of war, we have the audacity to deny our fellow human beings the right to determine when to end their own lives?

Come on you so-called human beings out there, accept reality!

For some people and for varying reasons, this world may not be a very nice or hospitable place to live, and for some it can be a living hell each and every passing day! Who then has the right to refuse a calm and relatively dignified demise from a world that views them purely as a religious or financial statistic?

The bit about 18 year olds didn't bother me so much. It seemed like a bit of an ambit claim, but then, 18 year olds can suffer horribly painful and slow deaths as much as 80 year olds can. You wouldn't contemplate it if, say, an 18 year old was depressed, but you'd certainly want to help an 18 year old dying of a horrible and painful disease.

There's no way anybody is going to legislate to allow 18 year olds to access assisted death for anything but extreme cases.

The thing that stuck with me was the thought of the elderly trying to hang themselves. The practicalities of it. The loss of dignity. To me that's far more extreme than helping them die in a humane way.

Nitchke did admit that he had changed his views on 18yos, and allowed that "life experience" was important in being able to make a sensible decision to end one's own life in the face of terminal illness. His workshops are for 55+ yo's only.

My bet is that voluntary euthanasia is going to be eventually pushed through as the health costs of supporting the current crop of baby boomers in their final months become unmanageable. In other words, it will be a stark choice between allowing those who wish to to end their lives peacefully, and having everybody else suffer as the healthcare system is stretched past its limits, which will tip the moral argument too heavily in favour of V.E. for their to be any serious objectors. As I understand it, the cost of keeping people alive in the last 6 months of their lives is often as much as the healthcare costs accrued during the rest of their lives.

On that basis, I'd expect to see it legal within 10 years, 15 tops.

Having worked in the geriatric industry for seven years, anything would be preferable to the thought of a vegetable like existence.

I'm nearly seventy and have to face the fact that my body is deteriorating while my mind thunders on at a great rate.

Nursing homes are my greatest nightmare. Please don't make me live just to give the medical profession another patient; to give Centrelink another pensioner to mess around with.

Quality of life should be considered.

foxy, the rights you have are those you can enforce. notice the 'force'. unlike most human rights, this one is hard to take away.

old people, indeed anyone, not radically incapacitated can die when they want. what this discussion is about is arranging that their death not be painful or unnecessarily inconvenient to bystanders, that the time and place be a dignified 'good-bye' among friends and family rather than a disruption of blood and flesh among strangers.

life is a death sentence. people who choose to appeal by prolonging life at great expense through ever more sophisticated medical procedures haven't caught on that the best part is behind, never to return.

more admirable, i suggest, is a choice to get off the stage and leave more space and resources to the next lot.

Yes, we should have the right to end it on our own terms when it would be preferable over the reality of many diseases. Not having the right is just ANOTHER example of the hangover of religion's influence on politics in our society.

Let people be responsible for their own decisions. Just because some religions believe it's a sin, everyone has the adhere to those personal beliefs. Same is said for stem cell research. IF you have an issue with it. Don't use it.

We're humane to animals, but not humans. Go figure.

Hi Foxy, thanks for this discussion.
I thought that perhaps this brochure might be of interest to you and others; it's about the euthanasia rules in the Netherlands.

http://www.minvws.nl/en/folders/ibe/euthanasia_the_netherlands_new_rules.asp Click the link at the bottom for the euthanasia brochure.

"This brochure provides information about Dutch legislation on
euthanasia. On 10 April 2001, the Dutch parliament passed a new Act
on euthanasia, the Termination of Life on Request and Assisted Suicide
(Review Procedures) Act. ... Thanks to the new Act, doctors and terminally ill patients now know exactly what their rights and obliga-tions are."

Personally, I find it quite cruel to force a suffering, terminally ill patient to suffer unnecessarily.
When criticising euthanasia, please keep in mind that medical doctors make the ultimate decision, not the patient.
Euthanasia is only permitted when there is no more relief available and the only thing left for the patient is a few more weeks or months of intense suffering.

"It is almost
always possible to provide terminal patients with a high standard of care,
even if there is no cure for their condition."
Palliative care in the Netherlands is said to be the best in the world.

I don't often give credit to Christian parties; but I have to admit that the Christian Democrats and Christian Union parties have played a very positive part in the development of palliative care in insisting excellence in this kind of care before adopting Euthanasia.
(Same for legal abortion but that's a different issue).

Personally I believe that a country is ready only for a Euthanasia act when there is also top-quality, freely available, easily accessable palliative care available.
Only then we can speak of euthanasia as a last resort.

Thank you for all your inputs. I hope that I may never be faced with having to make the decision on either my own or a relative's behalf.
But inevitably the day will come. Palliative care sounds very appealing at the moment though.

Yes palliative care is of uttermost importance.
But the point of euthanasia is that while the patient requests euthanasia, the doctor and counsellors have to make the decision if his/her request can be granted. They look at all other possibilities to improve the life of the patient, however short.

If the medical doctors involved have tried all available possibilities and can see no other way of relieving the suffering, only then will the patient be accepted as a euthanasia case.

The euthanasia rules should only allow the patient's own request to be considered. No one else has the right to request euthanasia for their loved ones.

When euthanasia is legal, people must make up their mind and legally organise a euthanasia form requesting that they'll be euthanised in certain situations. They need to do this when they are still of sound mind- one can do this at any time. People must make their wishes clear.
Once a patient's health is deteriorating and the patient is no longer of sound mind, it is too late to request euthanasia.

What I find interesting is that about 70% of patients who have been accepted to be euthanised suddenly seem to cope much better and never make use of the service.
The idea that they no longer HAVE to suffer, that they can end their lives peacefully, seems to relax them about the pain and especially their death.
I can imagine that it must be very scary to know that your only outlook is to suffer an agonising death.
To know that your death will be quick and peaceful, whenever you are ready, and to be accompanied by loved ones, is an extremely relaxing and calming idea.

Dear Celivia,

Thank you so much for your input. You have no idea how much it's helped me. I have two elderly parents (my mum and my mother-in-law).
Both have the beginnings of Alzeimers ...

What is particularly worrying about Philip Nitschke is that he and a couple of his "patients" have engaged in a public circus. Mental health care workers and the police know that every time a suicide is publicised, there are a rash of others that follow. This is why we don't see suicides reported in the media.

Also, what does Nitschke mean by "mental distress"...! The risk of those sufferring depression is that they do suicide, instead of seeking treatment. Alzeimers ...? Whilst extremely distressing for those close to a sufferer, is it distressing for the patient?

Celivia as always, and other writers here put forward very thoughtful insights; and I agree that good palliative care is always necessary.

As I understand it, when people are in pain, doctors will increase pain relief even if it shortens the life of the patient.

I think that the religious issue can really “go overboard”. I recall that when my son-in-law was working in a public hospital he mentioned that one of the patients was dying from a brain tumour. Being a devout Christian, the patient refused pain relief as it might hasten death. His death was prolonged and agonising.

I am sure that Christianity, indeed all religions, would not expect this, nor endorce unnecessarily “heroic” methods by doctors in saving lives.

What issue has not been addressed was that debated by the Hastings Center (bioethics) some years ago: whether some of our medical interventions are actually prolonging life, or prolonging the dying process.

Recently, I was told by a nurse from a private hospital that a patient marked NFR was recuscitated twice because his doctor was away for a long weekend. Apparently, the doctor had to be there to “see him off”. The patient, incidentally, was not pleased. I found this situation rather ludicrous, however, I don’t know the normal protocols - perhaps someone would like to comment ...

In regard to the religious parts the bible does have an example with some relevance to this issue - the account of the suicide of Saul - 1 Samuel 31:4

From http://bible.cc/1_samuel/31-4.htm
New American Standard Bible (©1995)
"Then Saul said to his armor bearer, "Draw your sword and pierce me through with it, otherwise these uncircumcised will come and pierce me through and make sport of me." But his armor bearer would not, for he was greatly afraid. So Saul took his sword and fell on it."

R0bert

Dear Danielle,

You raised a good point about alzeimers. Is it distressing to the patient? I guess I'll cross that bridge when I come to it.

In the case of my two relatives. They are only at the very early stages and on medication (that is helping). However both have made it clear to family members that they don't want to live - once their minds go.

I don't want to think about that time (when and if it comes). Instead, at present I'm concentrating on making sure that they both lead full and active lives, and use their brain as much as possible.
The rest I'll deal with as it happens.

Foxy,

Alzeimers is very much at the top of the agenda of medical research, because of the aging populations particularly in the West.

Let's hope there is a breakthrough in time for for your relatives. It must be quite stressful to feel responsible for them. My feelings go out to you.

Danielle, to be fair to Dr Nitschke, the "circus" only exists because the current legislation forbids medical practioners from assisting patients end their lives, a situation that he views as unacceptable, and has worked tirelessly to change. Further, everything I've seen indicates that he has a genuine desire to help terminally ill patients find options to end their suffering, to the extent that current laws permit.
Once euthanasia is finally legalised, there will be no need for such a "circus". I do hope he lives to see that day.

By the sounds of it, the main pain relief that doctors use to hasten death is morphine. I am not sure if there are alternatives that both relieve pain, and hasten death without causing major complications. My concern about this stems from my family's tendency towards allergy to morphine. Luckly I havent yet developed this allergy, but many family members are allergic and suffer terribly if they have it administered to them.

Another concern with this is whether doctors are able to up the dosage enough for people that have long-term morphine use enough at the end to be lethal. One relative (on another family branch) has taken morphine for years and current dosage is high enough that it would kill most people.

I certainly think voluntary euthanasia is something that should be legalised.

It was in NT until Kevin Andrews poked his nose in and repealed it with the damn Andrews bill. I actually think that was even more objectionable than the whole Sudanese fiasco, and that was pretty damn objectionable.

I just don't see what logic there is in prolonging people's suffering - I do understand that there are numerous implications which need to be carefully looked at, though I don't see why are politicians aren't discussing possible solutions.

This next reason may sound cold, but it's also a fact that we have extensive medical resources tied up assisting people who don't want to live.

This is something I'm conflicted on... though I just brought it up, I'd be wary of actually submitting that as a reason for voluntary euthanasia, even though from a pragmatic standpoint it is amongst the most compelling.

CountryGal
The lethal drugs that doctors, working in a functional, legal euthanasia system, would have available to administer to their patients are far superior to morphine.

Morphine is quite unreliable and quite unsuitable as a euthanasic. Other drugs are kinder and softer. But it is the only drug used in countries where euthanasia is illegal since the purpose is to relieve pain, not to cause death.

There’s a small range of different euthanatica available. Doctors taking part in euthanasia programs undergo some education about the different options to be able to make the best choice for their patients since this is quite specialised area. Patients have input also about drug choice.

Curare (a few kinds of muscle relaxants) is by far the most common and reliable intravenous form of euthanatica used for a quick (5-15 minutes), painless and peaceful death. Usually, patients receive some general anaesthetic as an induction before the lethal dose of muscle relaxant is given.

For patients who prefer taking oral euthanatica rather than injection, there are some options also.
Often, these patients will be pre-medicated with anti-vomit medication the day prior to taking these lethal tablets or liquids.

TRTL
yes as far as I know, Amanda Vanstone was the only senator last year who wanted to bring back the debate on euthanasia.
I agree that there is no reason why terminally ill people who want their suffering to stop should be forced to live their last weeks or months in agony and be forced to suffer a scary, painful and undignified death.

RObert,
that’s interesting info about Saul.
What about Jesus’ death? I understand that God sent his son to be killed, and Jesus had a death wish.
I wouldn’t exactly call it euthanasia because this word means ‘good death’, but it seems to have been a voluntary death.

Cevilia,

Good point about Jesus. LOL.