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Nick Goiran on euthanasia


Nick Goiran on Euthanasia


On Thursday, 10thApril 2014 the Hon Nick Goiran(South Metropolitan Region) addressed the members of the Western Australian Legislative Council. Below is a slightly edited version of his speech.

I move — “That this House—

(a) noting that —

(i) the Belgium Parliament has recently authorised the direct killing of children through euthanasia;

(ii) euthanasia or assisted suicide is now routinely performed in Belgium and the Netherlands on persons with no terminal illness but with psychiatric disorders such as anorexia or depression or with disabilities such as blindness; and

(iii) Dr Philip Nitschke during a recent visit to Perth offered instruction in methods of suicide including how to illegally obtain pentobarbitone, a schedule 8 poison, and how to use nitrogen as an undetectable means of ending life;

(b) condemns the practice of child euthanasia;

(c) commends palliative care as an appropriate response to terminal and chronic illness;

(d) affirms the value of every human life including those with mental illness or disability; and

(e) endorses suicide prevention as the appropriate response to all those who for whatever reason may think life is not worth living.

[Since] I last spoke on the issue of euthanasia and assisted suicide ... on 17 October last year ... Belgium has legalised the killing of children by euthanasia, and Dr Philip Nitschke has brought his travelling circus to Perth, touting his latest deadly toy—the nitrogen cylinder.

I turn to the issue of Belgium, where deaths by euthanasia have increased sixfold since it was legalised in 2003, from 235, to 1,432 in 2012. In Flanders in 2007, nearly one-third of deaths by euthanasia were brought about without any explicit request from the patient. Although the law only authorises doctors to perform euthanasia, nurses administered the legal drugs in 12 per cent of cases involving an explicit request, and in 45 per cent of cases without an explicit request. Belgium allows organ donation after euthanasia, including from people with psychiatric disorders, such as a woman suffering from automutilation, which is cutting to cause self-harm. Her consent was accepted as valid, despite her mental illness. Tom Mortier, whose mother was euthanased in April 2012 for chronic depression, wrote in an article on 4 February last year that —

I was not involved in the decision-making process and the doctor who gave her the injection never contacted me. ...

How is it possible that people can be euthanased in Belgium without close family or friends being contacted? Why does my country give medical doctors the exclusive power to decide over life and death? How do we judge what unbearable suffering is? ... Can we rely on such a judgment for a mentally ill person?

After all, can a mentally ill person make a free choice? ... How can a medical doctor be absolutely certain that his/her patient doesn’t want to live anymore?

In December 2012, deaf identical twin brothers were euthanased for distress at learning they were going blind. Dr Marc Maurer, president of the US National Federation of the Blind said —

This disturbing news from Belgium is a stark example of the common, and in this case tragic, misunderstanding of disability and its consequences. Adjustment to any disability is difficult, and deaf-blind people face their own particular challenges, but from at least the time of Helen Keller it has been known that these challenges can be met, and the technology and services available today have vastly improved prospects for the deaf–blind and others with disabilities. That these men wanted to die is tragic; that the state sanctioned and aided their suicide is frightening.

In late 2012, 44-year-old Ann G was euthanased for unbearable psychological suffering. She had been treated for anorexia since her teenage years by psychiatrist Walter Vandereycken. In 2008 she accused him of sexually abusing her under the guise of therapy. In October 2012, Vandereycken admitted to sexually abusing his patients. Following this, Ann G spoke of temporary relief from the “cancer” in her head, but subsequently persisted in her request for euthanasia. Sadly, she will not be able to testify against her abuser if charges are laid.

In September 2013, Nathan Verhelst was euthanased for unhappiness following a sex change operation. Nathan, who was born Nancy, had been rejected by a family who hated girls. Verhelst’s mother was quoted in the United Kingdom’s The Telegraph at the time as saying —

When I saw Nancy for the first time, my dream was shattered. She was so ugly. I had a phantom birth. Her death does not bother me.

Dr Wim Distelmans, who euthanased Verhelst, is co-chairman of the Belgium Euthanasia Control and Evaluation Commission, which examines all reported cases of euthanasia but has never reported a single case to the police for investigation. Distelmans has commented on how the commission handled the case. He said —

... we didn’t discuss about the case for one minute. It was just passed like that,... We already have a tradition of 10 years. Should Nathan’s case have been 10 years ago, maybe we would have discussed some time about the case. Now, it’s like [just] another one.

When there is not a terminal illness or specific psychiatric disorder, the reason for euthanasia is given as polypathology, which simply means that the sum of ailments and limitations is held to be unbearable. Last month it became legal in Belgium for emancipated minors to request euthanasia on the same terms as adults, including on mental health grounds, and for other children with the capacity for discernment to request euthanasia for a hopeless medical situation likely to result in death. For unemancipated minors, one parent must consent.

I turn now to the situation in the Nether-lands. Euthanasia was legalised in the Netherlands in 2003. The number of deaths there has more than doubled from 1,815 in 2003, to 4,188 deaths in 2012. Euthanasia now accounts for nearly three per cent of all deaths in the Netherlands. Euthanasia is routinely carried out for dementia, depression and other mental health issues. In 2012, there were 42 notifications involving patients with dementia, and 14 involving patients with psychiatric problems. The Royal Dutch Medical Association states that as the elderly experience —

... various other ailments and complications such as disorders affecting vision, hearing and mobility, falls, confinement to bed, fatigue, exhaustion and loss of fitness take hold, ... The patient perceives the suffering as interminable, his existence as meaning-less and — though not directly in danger of dying from these complaints — neither wishes to experience them nor, insofar as his history and own values permit, to derive meaning from them.

... such cases are sufficiently linked to the medical domain to permit a physician to act within the confines of the Euthanasia Law.

In 2013, a woman was killed by euthanasia because of her blindness. She was distressed at not being able to see whether her clothes were stained or to see new clothes when shopping. She refused a guide dog on the grounds that she wanted to walk a dog, not be led by one.

Case 15 of the Dutch Regional Euthanasia Review Committees: 2011 Annual Report concluded that the attending physician failed to accurately diagnose a woman’s back pain and prescribed only limited pain-relief medication. Consequently, it could not be said that the woman’s pain was definitively unrelievable. This woman is now dead from euthanasia and can get no relief from this finding of error.

What has been the response to this around the globe? I will start with the Council of Europe, the Parliamentary Assembly of which, in response to the out-of-control situation in Belgium and the Netherlands, resolved 41 to nine on 25 January 2012 —

Euthanasia, in the sense of the intentional killing by act or omission of a dependent human being for his or her alleged benefit, must always be prohibited.

In April 2013, The World Medical Association in April 2013 noted that —

... the practice of active euthanasia with physician assistance, has been adopted into law in some countries. ...

The World Medical Association reaffirms its strong belief that euthanasia is in conflict with basic ethical principles of medical practice, and The World Medical Association strongly encourages ... physicians to refrain from participating in euthanasia, even if national law allows it or decriminalizes it under certain conditions.

I turn now to the situation with the Australian and New Zealand Society for Palliative Medicine, which endorsed the World Medical Association’s position in October 2013. Its position statement on this issue reads, in part —

The discipline of Palliative Medicine does not include the practice of euthanasia or assisted suicide ...

ANZSPM opposes the legalisation of both euthanasia and assisted suicide.

The World Health Organization’s definition of palliative care, which has been adopted by Palliative Care Australia and on page 8 of its 2008 Glossary of Termsspecifies that palliative care “intends neither to hasten or postpone death”, also states —

Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.

... this coming Monday Dr Patsy Yates, president of Palliative Care Australia, will present the new position statement on paediatric palliative care which, in sharp contrast to the Belgian approach of offering to kill children who are terminally ill, states on page 3 that it —

... aims to provide the best quality of life through an holistic approach which supports the physical, emotional, social and spiritual aspects of the child and their family. The goal is to add life to the child’s years, not simply years to the child’s life. ...

Children and adolescents need to experience the best life possible regardless of their prognosis, and especially if their time is limited.

I will now briefly turn to the issue of elder abuse and people at the other end of life. Just last week the Minister for Seniors and Volunteering, Hon Tony Simpson, MLA, announced funding for an elder abuse hotline to assist the 12,500 seniors who are exploited or abused in Western Australia each year, mainly by their own children, partners and family carers. Financial abuse is the most common form of elder abuse, but emotional, social, physical and sexual abuse can also occur. Elderly people would be put at further serious risk of abuse by a law permitting euthanasia or assisted suicide, which could allow others to subtly coerce them into agreeing to die to free up the inheritance or rid others of a burden of care.

I conclude by asking: Suicide promotion or suicide prevention? In a 2001 interview when asked who should be given help to kill themselves, Dr Philip Nitschke answered that someone needed to provide this knowledge, training or recourse necessary to anyone who wanted it, including the depressed, the elderly bereaved or the troubled teen. He said that if we are to remain consistent and we believe that the individual has the right to dispose of their life, we should not erect artificial barriers in the way of sub-groups who do not meet our criteria.

During his visit to Perth on 24 February 2014, Nitschke gave Western Australians detailed instruction in methods of killing, including how to illegally obtain the schedule 8 poison pentobarbitone and how to use nitrogen as an undetectable means of bringing about death. I am mindful of the prolonged and tragic death of Western Australian mother Erin Berg who, while suffering from postnatal depression, followed Nitschke’s detailed instruction manual and travelled to Mexico to purchase and self-administer that drug, dying 12 days later in a Mexican hospital. Nitschke dismisses the deaths of those with mental illness who follow his detailed suicide instructions as mere collateral damage. He said that while young people and those with mental illnesses could access Exit’s instructions on the internet, the risks of this had to be weighed against the benefits for many others. He said that there will be some casualties, but that this had to be balanced with the growing pool of older people who feel immense wellbeing from having access to this information.

This is a cult of suicide and death that I want no part of. In response to the challenges of suffering and despair there is always a better way than killing.

Nick Goiran’s full speech can be read at http://www.parliament.wa.gov.au/Hansard/hansard.nsf/0/f1cb3a4131dd885f48257cb6003ffbfd/$FILE/C39+S1+20140410+p15b-24a.pdf


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