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‘P-qo’ h‘Name at end of quote’ here

1 ju 2011MEDICAL

WHEN Don Flounders and his

wife, Iris, entered a Mexicanpharmacy in 2008, it was Val-entine’s Day and they considered

their purchase of Nembutal justanother act of love in their 60years together.

On the evening of 28 April thisyear, Don, 81, terminally ill withmesothelioma, and Iris, 88, took

the Nembutal. They were founddead the next day, holding hands.

A video, later posted at their

request on YouTube, captured

their last thoughts as they spoke of 

their decision to end their lives.Originally from London, the

Flounders and their two childrenhad made the Victorian town of 

Warragul their home.In 2007 Don was diagnosed

with mesothelioma, and the fol-lowing year, with the help of euthanasia advocate Dr PhilipNitschke, he and his wife travelled

to Mexico to purchase the barbit-urate commonly used to euthanise

animals.

“When we got the drugs, Ithought I might not want to live

on without Don. Three yearson, my thinking is the same. Wedecided this together,” Iris, who

had no reported terminal illness,told the camera.

“I knew that I would want tohave the choice at the end as tohow and when I die,” said Don.

“I have reached the pointwhere my quality of life is dread-ful. I am dependent on Iris andmy world has shrunk to this small

bedroom. This is no life.”The couple also said they resent

the fact they had to travel halfway

round the world to have the choice

of a peaceful death.They hoped their video would

help force a change in Australianlaws, preventing prosecution of 

those who attend or assist sucha suicide.

Recent court cases have high-lighted the very real threat of pros-

ecution and, with public support

for voluntary euthanasia poll-ing at 75% to 85% and attemptsby state Greens to legalise it, the

euthanasia debate is again in thepolitical and media spotlight.

In May, a NSW Supreme Court

judge ruled in a retrial of a woman

sentenced to manslaughter forassisted suicide that she would

serve no further jail time.Shirley Justins, 62, had already

served a 22-month periodic deten-tion sentence after she had placedan open bottle of Nembutalwithin the reach of her late part-ner, Graeme Wylie, 71, who had

Alzheimer’s disease.The manslaughter charge was

quashed last November and shepleaded guilty to aiding and abet-ting a suicide in the retrial.

On leaving the court, her only

comment to the waiting mediawas: “It is a relief.”

For the medical profession, the

euthanasia question sits within awider debate about end-of-lifecare.

Last year a survey of 500 doc-tors by Exit International foundthat 60–70% of GPs in Victoria,

SA, NSW and WA were in favourof euthanasia laws.

AMA president Dr Steve

Hambleton says the organisationrecognises the divergent viewsabout euthanasia among the med-

ical community and even withinits own ranks, but it does not sup-

port the push to legalise it.“We believe that medical prac-

titioners should not be involved in

interventions that have their pri-

mary intention of ending the per-son’s life.”

With technology allowingdoctors to keep people alive for

longer, the question of choiceraised by the euthanasia debateshould focus more on the unneces-

sary prolongation of life, he says.“We have to give people back

the ability to make that decision,

but we don’t want to do it at fiveto midnight; we want to do itmuch earlier,” he says.

“It may be that we’re pushingpeople into desperate places.”

Dr Hambleton acknowledges

that even with greater controlsome patients will find themselves

in that desperate place where

euthanasia is seen as the answer.“We do hear about the

extremes but the reality is thatthe majority are not

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     o     m

eutanaia:

the medical divideThe political debate is heating up, but is the medical

profession in favour of legalised euthanasia? Jane Lyons reports.

s

8/3/2019 Euthanasia: the medical divide - Medical Observer

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4 mo opppo  clinical review

going to be in theextremes,” he says.

Dr Scott Blackwell, the presi-dent of the Palliative Care Asso-

ciation, agrees.He points to the rate of eutha-

nasia deaths in the Netherlands,

arguing that at 2%, they under-

line the small role of euthanasiain the bigger issue of quality end-

of-life care.“Euthanasia is a common

preference but a rare choice,” he

says.“Our experience is that even

[with] those people who ask, the

question goes away with good pal-

liative care.”He is concerned that providing

what he calls an easy solution will

stop the search for real answers.“We need to maximise funding

of palliative care services in thiscountry, and euthanasia doesn’t

change that.”While the association neither

supports nor opposes legislation,Dr Blackwell admits: “In someways I think let’s legislate it and

let it just find its place.”Dr Roger Hunt, the director of 

Western Adelaide Palliative Care

and an ambassador for advocacygroup YourLastRight, believes it’s

time for voluntary euthanasia to

find that place.He says too much has been

invested in the myth of its incom-patibility with palliative care andits ability to undermine good end-

of-life care.“The [euthanasia] debate is in

fact a vehicle for promoting pallia-

tive care,” Dr Hunt says.Nor can palliative care manage

all suffering and ameliorate thedesire for euthanasia, he says.

“We can’t eliminate all suffer-ing no matter how good palliative

care becomes… To expect to elim-

inate all requests for a hasteneddemise in people who are dying is

setting an impossible task.”He points to his own surveys of 

patient requests done at Adelaide’s

Daw House Hospice from 1991to 1993. Out of 323 patients, 35stated “I wish it would hurry up”,19 said “could you hurry it up”,

and 20 said “please do something

now”.But whatever the views of the

medical profession, the politicalwheels are starting to turn in theeuthanasia debate.

The Greens believe that doc-tors and people such as Ms Justins

should not fear the threat of pros-

ecution any longer.They want Australia to fol-

low in the footsteps of Belgium,

the Netherlands and the US statesOregon, Washington and Mon-tana, and enact voluntary eutha-

nasia legislation.In Tasmania, Premier Lara

Giddings has announced that sheand Nick McKim, the Greensleader, will introduce a privatemember’s bill seeking to legalise

euthanasia, early next year.In NSW, Greens MP Cate

Faehrmann will do the same

within the next 12 months.In South Australia, Greens

MLC Mark Parnell has co-spon-sored a bill with the Labor MP

Stephanie Key, which provides alegal defence for doctors involvedin medically assisted suicide.

It has been defeated in the Leg-

islative Council but is still wait-ing for a House of Assembly vote.

The West Australian euthanasiabill was defeated in September.

But what has perhaps ruffled

the most political feathers is thepush by federal Greens leaderBob Brown to repeal the legisla-tion preventing territory govern-

ments from legalising voluntaryeuthanasia.

In 1997 the Federal Govern-ment overrode the Northern Ter-ritory’s Rights of the TerminallyIll Act, the country’s first eutha-

nasia law, only eight months afterit was enacted.

And with some doctors already

acquiescing to these requests, it’s

better to bring it out from underthe carpet and make it safe with

legislation, says Dr ChristopherRyan, a psychiatrist and honor-ary associate at the University of Sydney’s Centre for Values, Ethics

and the Law in Medicine.

“People worry about it – that’sfair enough... so you have safe-guards in place,” says Dr Ryan,who was instrumental in ensur-

ing the NT euthanasia legislationincluded a psychiatric review.

It’s not a slippery slope to

“Nazi Germany”, as opponentswould have us believe, he says.

“In Oregon, twice as many

people get the tablets as actuallyuse them. They didn’t need tobecause all they needed was the

choice.”

 page 22

“i som ys i hk ’s gs

js s p” Dr Scott Blackwell

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