January 30th 2016


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Articles from this issue:

COVER STORY Dyson report only partial answer to union problems

CANBERRA OBSERVED No urgency but Turnbull will want to make his mark

NATIONAL AFFAIRS SA pays price of solar and wind generation

FRENCH POLITICS AND ISLAM Kepel scathing of French elites, Salafists and far-right Islamophobes

ENVIRONMENT New bushfire tragedies: when will we ever learn?

RELIGION IN RUSSIA Betrayal: Curia no friend to Russian Catholics

HISTORY OF TAIWAN From pivot of Dutch trade to Japanese outpost

LIFE ISSUES Victoria enacts law based on lies told to Parliament

LIFE ISSUES Euthanasia: a false start to end-of-life issues

ETHICS Book traces foundations of true civilisation

RELIGION AND SOCIETY A welcome in truth for the same-sex attracted

CINEMA The beauty beyond fear: The Good Dinosaur

BOOK REVIEW Secularism mars insights

BOOK REVIEW A novel for the remnant

LETTERS

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LIFE ISSUES
Euthanasia: a false start to end-of-life issues


by Lucy Sullivan

News Weekly, January 30, 2016

Today’s proponents of euthanasia fail to apprehend that the proposal has passed its use-by date.

The problem in the practice of medicine that resulted from its increasing power to prolong the life of the intrinsically failed or failing human body has been resolved, and in a manner that incorporates both the traditional ethic that eschews the taking of human life and the contemporary one of autonomy of the individual. Euthanasia, by contrast, fails on both these counts.

A friend died last month in a church nursing home. Five years ago, in her mid-60s, she suffered a series of strokes that left her unable to speak or write with any clarity, with very limited mobility, but with her cognitive faculties unaffected. (She could text-message perfectly, and I was surprised that her carers did not make use of this ability for communication.)

She essentially confined herself to her room, spending her days watching television and listening to music, but rejecting outings and sociability within the nursing home, although she established her personality with respect and amiability among staff members.

But it seems that at some point she decided she had had enough of this restricted life, and she ceased eating and refused all medical attention. Six weeks later she also ceased drinking, and died within a few days. Thus she brought her life to an end by her own decision, one must assume without great pain; and without invoking the intervention and influence of a second party, which defines euthanasia.

The freedom to reject life-sustaining medical intervention was not freely admitted three decades ago, nor likewise was the cessation of life-prolonging medical treatments in cases of terminal illness. The power of the medical profession to enforce “futile” treatment against the wishes of the patient, or of the relatives of an incompetent patient, held sway, and was even, for example in some states in the United States, upheld by law.

The medical profession had, in fact, still to come to grips with the need to modify rules of conduct that held sway in continuation of the “immemorial” ethic to prolong life and “do no harm” – goals which till then, given limited medical efficacy, were rarely in conflict.

But by the passing of the mid-20th century the balance had been lost. In the late 1960s the change was forcibly brought into public awareness by the case of a brain-dead young woman whose body was kept alive for many years against the pleas, including legal appeals, of her parents.

At this time, medical treatment of the well and competent could also be enforced by law or carried out without their knowledge. In the U.S. there was obligatory immunisation of children, blood transfusions were forced on patients whose religious beliefs forbade it, and there were cases of Caesarean sections being forced on unwilling pregnant women, police attendant. While in this country pregnant women were involuntarily given inoculations against syphilis during prenatal visits.

In the 1970s and ’80s patient groups lobbied for the implementation of the now familiar “informed consent”, and won. But by the 1980s a satisfactory consensus of profession and public in the changed circumstances of dying had still not been achieved, as witnessed by a “worst case scenario” presented in Johnny Got His Gun, a film about a World War I casualty who had lost arms, legs, vision, speech and hearing, but was fully conscious. A nurse managed to communicate with him by touch. Her attempt at his request to turn off his life support was defeated and the film ended harrowingly with him repeatedly tapping in Morse code with his head, “Kill me, kill me”.

This ethical stalemate, a problem with no evolved solution, was fertile ground for the promotion of a previously roundly rejected movement to eliminate less than perfect humanity – namely euthanasia, the hand-maiden of early 20th-century eugenics. Majority public doubts about its impact on respect for human life, and its containability if legalised, however, held back its implementation.

This provided the breathing space for the evolution of a less dangerous solution, and some time in the 1990s or early this century it seems to have become clear to both the profession and the public, without the need for the inflexibility of legislation, that the terms of the ethical consensus had changed, and end-of-life decisions, as well as middle-of-life treatment decisions, became the right of the individual (or proxy) as far as acceptance or refusal of treatment were concerned.

The medical profession retained the right to authorise specific treatments. The right to refuse life-sustaining treatment ceased to be ethically problematic, and the Hospice movement provided for patients’ dying days.

My friend’s achievement of self-determined dying brought it home to me how completely this ethical dilemma has been resolved by the evolution of a consensus of the community and the medical profession over the course of several decades without the need for legislation nor of much in the way of inflexible regulation – which is probably the best process for resolving novel ethical dilemmas. This freedom is now not uncommonly faced and exercised, for example by kidney dialysis patients who make their own quality-of-life decision when they voluntarily withdraw from treatment.

The project of euthanasia was a false start, seeking to put power into the hands of doctors willing to exploit the well-known phenomenon of patient-doctor dependency. Its proponents continue to promote the fallacy of the necessity for active medical intervention, rather than palliative care, in human dying.




























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