November 24th 2012

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Articles from this issue:

EDITORIAL: Obama's re-election: what it means for Australia

CANBERRA OBSERVED: Behind the collapse in the Greens' vote

IMMIGRATION: European crisis should open door to new migrants

LIFE ISSUES: Assisted suicide rationalised by misguided motives

EXPORTS: Restarting Australian agriculture: what needs to be done?

PRIMARY INDUSTRY: US grain giant's $2.7 billion bid for Australia's GrainCorp

ECONOMIC AFFAIRS: Dow chief's plan for rebuilding Australian manufacturing

POLITICAL IDEAS: Hilaire Belloc's The Servile State: a centenary reflection

QUEENSLAND: Will LNP reverse Labor's council amalgamations?

SCHOOLS: Asia white paper used as pretext to push radical agenda

OPINION: Need for self-control and civility in politics


CINEMA: Violent journey into the heart of darkness

BOOK REVIEW: Marital status the most reliable social indicator

BOOK REVIEW A unique historical record

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Assisted suicide rationalised by misguided motives

by Paul Russell

News Weekly, November 24, 2012

Recently, I was discussing suicide with a new acquaintance. He was surprisingly open about his views, which, as it happened, largely coincided with my own.

The conversation then turned to the question of assisted suicide.

I proffered the opinion that, if someone was, say, standing on a precipice and about to leap to their death, I had an obligation to try to stop them. My acquaintance agreed, but qualified his answer by offering the example of someone who was severely disabled, such as a quadriplegic, and who had no “quality of life”. He suggested that such a person should be allowed to kill themselves (how exactly we did not discuss).

When I later reflected on our conversation, it occurred to me that this kind of argument essentially justifies a form of discrimination. We’re okay with stopping someone from attempting suicide if they’re fit, young and otherwise well. But if they have some chronic disease or condition or else have “had a good long life and simply want to go”, then somehow we’re inclined to look upon their suicide attempts differently. This is discrimination on the basis of age, disability and/or diagnosis.

ABS suicide chart

It is derived basically from “I’m-really-glad-I’m-not-in-their-shoes” thinking. It works in some strange way to suppress our otherwise natural instinct to help, and at the same time we rationalise our attitude by convincing ourselves that we are motivated solely by compassion.

“My life — my choice!”, many people defiantly declare. And, yes, suicide has been decriminalised. But there are dangers in giving unqualified assent to decriminalisation and the principle of personal autonomy. It can lead to a situation where we are no longer willing to care for others, or will only care selectively on the basis of our own perception of the quality of someone else’s life.

None of us should presume to judge in that way — it is arrogant and offensive to do so.

I mentioned to my acquaintance — as we continued discussing the subject he had raised about disabled people and suicide — that I had known of quadriplegics who, although their mobility and freedom were more limited than his or mine, were nonetheless enjoying life to the fullest. Once again, his retort was to return to the principle of autonomy and freedom of choice. Although this is quite a popular line of thinking, it really does lack logic.

If choice is the highest principle we can imagine, then why would we want to stop anyone from killing themselves? After all, the hypothetical young person on the precipice might be suffering from some unseen physical or psychological difficulty — how would we know?

Should we simply walk away because of this person’s choice, no matter whether the exercise of that choice has been compromised or distorted or whether or not he or she might feel better in the morning?

And what about the implications of adopting the “some suicides are okay” approach (which is precisely what legalising assisted suicide would do)? This would be more than just sending the vulnerable a “mixed message”; it would become a pretext for downright double standards that could only serve to confuse the issue further.

Australia has made a significant contribution to cutting the rate of youth suicide over the last decade and more. This success can be seen in the statistical data where the most significant drop in suicide, by age category, is evident in the 25-to-39 age ranges (see chart on this page) — that is, those who were aged between 15 and 29 years a decade ago. Yet from a statistical low of 2,098 reported deaths from suicide in 2004, the total number of annual deaths from suicide has risen to 2,361 in 2010.

As the graph shows, virtually every five-year increment from ages 35 to 39 onwards shows an increase in the number of deaths (2010 compared to 2005). I cannot offer an explanation, only an observation that the movement in the graph curve to the right does reflect the five-year gap (2005 to 2010). While that accounts for the maintenance of the shape of the curve, it does nothing to explain why suicides are increasing from middle age onwards.

What this should tell the health authorities is that there probably needs to be an increasing focus on prevention in the later years of life. I recently searched a number of suicide prevention websites and found only one that had a section specifically devoted to this older age cohort. (That’s not to criticise any of the other worthy initiatives, which all have their place albeit with a different focus).

All of the prevention websites have a healthy approach to mental health. The “R U OK? Day”, launched in 2009, is one such initiative — there are many others.

But what do we know of them and could you or I find these sites in a hurry if we needed help for ourselves or for others? World Suicide Prevention Day occurred this year in mid-September. Did you notice? I know I didn’t see much in the way of media reporting. All forms of media have a crucial role to play here.

This is why I found it objectionable in the extreme that SBS television should choose to show a pro-suicide documentary on the evening of September 23 — less than two weeks after World Suicide Prevention Day.

Produced by British fiction-writer and assisted-suicide advocate, Sir Terry Pratchett, the documentary, “Choosing to Die”, features the assisted-suicide death of a British businessman in the Swiss Dignitas death facility. It shows the death of British hotelier, Peter Smedley, who is seen to choke and ask for water as he dies holding the hand of his wife.

I said at the time, “In deciding to air this macabre program, SBS is acting as a cheerleader for the pro-suicide brigade.” There’s really no other way to look at it, and no posting of suicide prevention hotlines after the program changes that view.

All media outlets have a responsibility to adopt and follow the World Health Organisation guidelines on suicide portrayal. Of the 11 “dot points” in the WHO guidelines, the airing of “Choosing to Die” by SBS is in breach of at least five by my reckoning.

WHO cites over 50 published studies that draw the same conclusion: media reporting of suicides can lead to imitative suicidal behaviours.

In fact, two separate news reports from the United Kingdom in September pointed clearly to the Pratchett documentary as having influenced the decisions of two men to die by assisted suicide. We can only hope that the same effect does not occur in Australia and that those in need will seek help from our excellent suicide prevention services rather than from the likes of Exit International.

Returning to the Australian statistics, it is true, as pro-euthanasia campaigner Dr Philip Nitschke points out, that hanging is the single largest means of death by suicide and has been so for the last decade at least.

Whereas Nitschke’s point is to say that hanging is undignified (pointing to the methods he proposes as being somehow more dignified), is it not better by far to observe that this statistic screams to us that more needs to be done to prevent such deaths?

By the way, what Nitschke fails to tell us is that, included in the “hanging” category, are also deaths by asphyxiation, which might include people who have used Nitschke’s death bag method. So much for a dignified death!

This brings me back to my first observation about discrimination — about the tacit acceptance that perhaps some suicides are okay. And I wonder at what impact the seemingly constant attempts at legalising euthanasia have in this respect — not to mention the macabre media grandstanding on suicide by the likes of Dr Nitschke, which seems to pass without criticism in our national media.

We all have some responsibility here because we will all, at some time, know someone who is contemplating suicide. We need to reject the subtle and not-so-subtle messages that might over time blur our minds to the reality that, regardless of circumstances, no suicides are all right.

We should constantly remind ourselves to keep on asking those who may be vulnerable: “R U OK?”

The answer to that question always matters.

Paul Russell is director of the national network, HOPE: Preventing Euthanasia & Assisted Suicide and vice-chairman of the Euthanasia Prevention Coalition International.


Australian Suicide Prevention Agencies


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