Discussions about euthanasia

by JUSTIN GLYN, SJ

The Victorian bishops have recently put out a trenchant response to the latest report of Victoria’s Voluntary Assistance in Dying Review Board (which monitors the workings of Victoria’s Voluntary Assisted Dying Act 2017). In it, they note the lack of information on, and access to, palliative care as an alternative.

Much of the bishop’s statement echoes criticism from elsewhere. The Canadian Society of Palliative Care Physicians has noted that in Canada, where euthanasia (“Medical Assistance in Dying”) has been legal since 2016, there is ongoing confusion between it and palliative care. There is evidence to suggest that many Canadians would not have chosen to take this option if high-quality palliative care had been available to them.

While the Victorian legislation was proposed as something of a measure of last resort, the numbers already tell a different story. In its first year of operation, 348 people were assessed for eligibility to access voluntary assisted dying. 272 eligible applicants applied for a permit. 231 permits were issued and 124 people died from taking the prescribed medications.

As the bishops point out, the US state of Oregon, with a population somewhat over 4 million, took 17 years to reach these kinds of numbers.

Unfortunately, many of us with a disability look at these figures (and at the proposed legalisation of euthanasia in New Zealand, which will be voted on later this year) with a weary mix of familiarity and horror.

The aged care and disability royal commissions both running [in Australia] at the moment point to a society in which older people and those with disabilities are already deemed surplus to requirements. As I pointed out in a previous article, the response to Covid-19 (and especially the way it has been allowed to tear through aged care homes and disability support settings [in Australia]) has done very little to dispel this impression.

It does not help that society has already largely internalised the narrative that a disabled life and — to a lesser extent, an elderly one — is not one worth living. Disability activist Samantha Connor has powerfully spoken of the occasion when she put up a sign in jest asking to raise money to send her to a Swiss suicide clinic. To her horror, she found people queuing up to donate with enthusiastic support, noting that if they were in a wheelchair, they would also want to die. No one asked about her feelings or whether she was in need of any assistance. The overwhelming message was that this was absolutely appropriate. Significantly, the context was her attendance at a protest against the film Me Before You (which tells the story of a banker whose quadriplegia inspires them to euthanise themselves). Unsurprisingly, given her experience, Connor is of the view that assisted dying legislation can never be made safe.

This fear appears to give weight to the Victorian bishops’ concerns over one of the report’s key recommendations: the proposed weakening of the current Victorian law which prohibits a doctor raising the possibility of euthanasia in advance. Many older people and/or people with disabilities are already reliant on the support of others — the suggestion that they may be a burden on others and hence better off dead (which is already a staple of mainstream discourse and which formed the subtext of Samantha Connor’s interactions with her would-be donors) is damaging enough without them hearing it from their medical practitioner.

Aside from the high take up and the fear for those whose lives is already undervalued, there is a long history of boundaries being blurred in practice in order to expand the scope of euthanasia laws. As long ago as 1998, Canadian disability advocate and biochemist Dr Gregor Wolbring noted the gradual widening of euthanasia categories from “terminal illness” to “incurable illness” (and thence physical disability) and from “physical” to “emotional” suffering.

Even more alarmingly, the empirical data from around the world suggests that the requirement for patient autonomy has also been relaxed. Wolbring already noted the rise in euthanasia of those with limited capacity (and the removal of obstacles to it) and a study by Irene Tuffrey-Wijne and others has confirmed the lack of safeguards in the Netherlands in such cases. Disturbingly, as the bishops note, there is nothing in the latest Victorian report on the mental health of those requesting euthanasia. There is also, one might add, nothing said about disability — cognitive or otherwise.

It is long past time for an honest discussion of how and when our society values human life. With any luck, the bishops’ letter will serve as a catalyst for this discussion.

 

• Fr Justin Glyn, SJ, has a licentiate in canon law from St Paul University in Ottawa. Before entering the Society of Jesus, he practised law in South Africa and New Zealand, and has a PhD in administrative and international law. This article was first published at eurekastreet.com.au It is republished here with permission. Fr Glyn is legally blind.