As­sisted dy­ing laws: for­mer AMA head says 'life is not de­fined by a heart­beat'

The Guardian Australia - - News - Melissa Davey

Dr Brian Owler, the for­mer pres­i­dent of the Aus­tralian Med­i­cal As­so­ci­a­tion, has urged Vic­to­rian politi­cians not to waste an op­por­tu­nity to pass vol­un­tary as­sisted dy­ing laws, say­ing “life is not de­fined by a heart­beat”.

“Life is more,” the neu­ro­sur­geon told the Na­tional Press Club in Can­berra on Thursday. “It is the ex­pe­ri­ence of this world, of those around us, it’s the love and com­fort of our fam­i­lies.

“Some might say that suf­fer­ing is part of life, and I agree it is. But re­spect­ing life does not mean that suf­fer­ing is some­thing that must be en­dured by an in­di­vid­ual, par­tic­u­larly against their wishes.”

His speech comes as the Vic­to­rian par­lia­ment pre­pares to de­bate as­sisted dy­ing leg­is­la­tion on Tues­day af­ter­noon. The leg­is­la­tion has been two years in the mak­ing and was in­formed by an ex­ten­sive par­lia­men­tary in­quiry that in­cluded con­sid­er­ing 1,074 sub­mis­sions and ev­i­dence from 154 wit­nesses. Fol­low­ing this in­quiry the Vic­to­rian gov­ern­ment es­tab­lished a min­is­te­rial ad­vi­sory panel tasked with ex­am­in­ing all of the avail­able ev­i­dence on vol­un­tary as­sisted dy­ing from around the world. Owler was ap­pointed chair of that task­force, and the task­force find­ings were used to in­form the leg­is­la­tion now be­ing con­sid­ered by par­lia­ment.

Owler told the Na­tional Press Club that the re­sult­ing leg­is­la­tion was ev­i­dence-based, tai­lored to Vic­to­ria, and in­cluded 68 safe­guards to pro­tect against the laws be­ing abused. He added that in states like Ore­gon in the US, which has had vol­un­tary as­sisted dy­ing leg­is­la­tion for 20 years, the laws had not been weak­ened or ex­panded in all that time, which should dis­pel claims that pass­ing leg­is­la­tion was a “slip­pery slope” to more wa­tered-down laws.

“The prac­tice of vol­un­tary as­sisted dy­ing, which is also pri­mar­ily about the re­lief of suf­fer­ing, when prac­ticed within an es­tab­lished le­gal frame­work, is wholly con­sis­tent with good med­i­cal prac­tice and up­holds the fun­da­men­tal ob­jec­tives of be­ing a doc­tor,” Owler said.

He added that he strongly sup­ported pal­lia­tive care, which in the ma­jor­ity of cases was ad­e­quate to re­lieve pain and suf­fer­ing. But he added there were a mi­nor­ity of cases where pain and suf­fer­ing could not be re­lieved.

“Many of those most de­ter­mined to see this law pass have per­sonal anec­dotes of loved ones whose death has been ter­ri­ble,” he said. “Peo­ple in such ex­am­ples of­ten died of can­cer­re­lated ill­nesses. They ex­pe­ri­enced ex­cru­ci­at­ing bone pain or neu­ro­pathic pain re­sis­tant to med­i­ca­tion.”

Other con­di­tions in­cluded chronic or­gan fail­ure such as end-stage res­pi­ra­tory fail­ure or heart fail­ure, where peo­ple ex­pe­ri­enced a death akin to slow suf­fo­ca­tion or drown­ing, he said.

He de­scribed the pain of watch­ing his own fa­ther die a ter­ri­ble death, and of be­ing pow­er­less to ease his suf­fer­ing de­spite his med­i­cal cre­den­tials. His fa­ther starved to death, “lit­er­ally rot­ting in his bed as the ul­cer on his sacrum grew”, Owler said.

“I watched, pres­i­dent of AMA NSW and a con­sul­tant neu­ro­sur­geon, hope­lessly un­able to help him,” he said. “Re­sources and ac­cess were not an is­sue. I re­mem­ber my de­spair as I po­litely asked one of his doc­tors for help to ease his suf­fer­ing. He died a ter­ri­ble death.”

In clos­ing, Owler said that he wanted to ad­dress Vic­to­rian politi­cians and send them a mes­sage.

“I know that all of you went into par­lia­ment to make a dif­fer­ence,” he

told them. “As a doc­tor I un­der­stand this de­sire. It’s what mo­ti­vates doc­tors as well. For some of you, this may be one of the hard­est de­ci­sions you make in your po­lit­i­cal ca­reer.

“But to be able to make a de­ci­sion, the re­sult of which is to ease the suf­fer­ing of a per­son who is dy­ing, and those who love that per­son, to pro­vide them with the com­fort of a choice, not just for one day but for days into the fu­ture, that is a unique op­por­tu­nity for our par­lia­men­tar­i­ans to ex­er­cise.

“This is an op­por­tu­nity not to be wasted.”

Pho­to­graph: Lukas Coch/AAP

Brian Owler: ‘Re­spect­ing life does not mean that suf­fer­ing is some­thing that must be en­dured by an in­di­vid­ual, par­tic­u­larly against their wishes.’

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