Following are some points you might like to consider when preparing your letter:
Too many people in NSW are dying bad deaths, despite the best medical care available. With no law to help them, terminally ill elderly people, in particular, have been taking their own lives, alone and in violent ways.
The reality for some people who are at the end of their lives is that even the best palliative care will not relieve pain and suffering. Those close to them are powerless to help.
A cross-party working group of MPs from all political parties have produced a draft Voluntary Assisted Dying Bill to allow mentally competent people suffering a terminal illness the right to seek medical assistance to end their lives.
The Upper House of the NSW Parliament will hold a conscience vote on this Bill in a matter of weeks. If the law is passed in the Upper House it will go before the Lower House for approval before the end of this year.
Each member of parliament must make their own decision about how they will vote. When making that decision, they should consider the views of the community and their constituents.
In NSW today, it is legal, if you are dying and suffering beyond medical help, to end your suffering by committing suicide, often violently and alone.
It is legal to refuse all medical treatment, food and water, and to die slowly of starvation and dehydration while your disease takes its course.
It is legal for a doctor to slowly drug you into a coma while your family waits for days, or weeks, for you to die. This can happen without your consent.
But it is not legal if you are dying and suffering beyond medical help to end your suffering painlessly and quickly with the help of a doctor.
As a patient, you do not have any legal right to insist that a doctor gives you more, or faster, pain relief. That decision is entirely up to the doctor whose personal beliefs you may not share.
This is why we need a law. So that we all have a legal right to be protected from unnecessary suffering at the end of life – so doctors have a legal right to help us – and so there can be more compassionate choices if we’re dying and suffering than starving ourselves to death, being slowly drugged into a coma, or taking our own lives, violently and alone.
Some organisations, like Right to Life and others, assert that voluntary assisted dying laws are not safe. They warn of vulnerable people being coerced to end their lives for other peoples’ gain.
Numerous independent inquiries have found no evidence that this has occurred. These include:
• Australian palliative care physician, Dr Linda Sheahan whose 2012 Churchill Fellowship study of how these laws work overseas concluded: “The slippery slope in terms of risk to vulnerable groups has not been demonstrated by the data.”
• The Victorian Parliamentary Inquiry Into End of Life Choices in 2015: “We found no evidence of institutional corrosion or the often cited ‘slippery slope’”.
• The Journal of the American Medical Association in 2016, which concluded: “In no jurisdiction was there evidence that vulnerable patients have been receiving euthanasia or physician-assisted suicide at rates higher than those in the general population.”
Representatives of peak elderly and disability groups in Belgium, The Netherlands and Oregon also report no abuse of their members under these laws.
The proposed NSW law is designed for those at the end stage of a terminal illness whose suffering is beyond meaningful, medical help. It is very hard to coerce a vulnerable person into a terminal illness they don’t have. Even harder to coerce two doctors and a psychiatrist, whose work will be subject to review, to agree with them. That’s why the safeguards work.
It is well known that some doctors already practice unlawful assisted dying, but they do so ‘without regulation, support, transparency or accountability’ according to the recent 2015 Victorian Parliamentary Inquiry.
For those doctors currently faced with the agonising choice of helping a patient to die and breaking the law – or abiding by the law and leaving that patient to die with great suffering – a voluntary assisted dying law provides protection. More than protection, it provides guidance and the opportunity to consult with colleagues and also the family of the person who is dying.
Those who oppose this law refer to voluntary assisted dying as ‘patient killing’ or ‘state sanctioned killing’.
This dishonestly avoids the central fact that the law is to help those already being killed by an incurable disease. Being voluntary, it is entirely up to the patient whether or not they choose to end the suffering caused by that disease.
Neither are doctors being asked to ‘kill’ a patient. In reality, what they’re being asked to do is what they already do – make a careful diagnosis that a patient’s condition is terminal and their suffering intolerable and go through with them their treatment options.
If the patient meets the legal requirements for assistance to die, they write them a prescription for a life-ending medication. After that, it is up to the person whether or not they use it.
Only one person is being asked to make a life and death decision. The person who is dying.
Australia has one of the best palliative care systems in the world. However, it is a fact that they can’t help everyone. In Palliative Care Australia’s own words: “Even with optimal care not all pain and suffering can be relieved”.
By their own estimates, the numbers of people truly beyond their help are about 4%. Their suffering can be severe and very distressing for the patient and their loved ones.
This is no criticism. It simply reflects the reality of modern medicine, which can keep us alive longer but which still has no cure for diseases like cancer and Motor Neurone Disease.
The question is: why should those who palliative care can’t help, be left to suffer when we have the means to help them?
In the words of the ‘father’ of Australian palliative care, professor Ian Maddocks: “If compassionate and loving care towards patients and families is what palliative care is all about then assisted dying is part of that. It is time the profession dealt with it”
While even the best palliative care cannot relieve all suffering, the benefits of palliative care are profound and it is important that good palliative care is available to everyone in NSW.
An assisted dying law should work hand-in-hand with increased resources for good palliative care. We strongly support that.
Voluntary assisted dying is not intended to replace palliative care. It is adding one more end of life option alongside palliative care for doctors and their patients to explore.
The NSW Voluntary Assisted Dying Bill is based on the regime which has been in place for 20 years in Oregon where, nine out of ten patients who choose a doctor’s help to die are also enrolled in hospice care.
According to the Australian Medical Association’s code of ethics, doctors are obliged to: “Respect the right of a severely and terminally ill patient to receive treatment for pain and suffering, even when such treatment may shorten a patient’s life”
Some doctors object to voluntary assisted dying on the basis of the Hippocratic Oath which instructs ‘do no harm’. Others see leaving a dying patient to suffer as the opposite of ‘do no harm’.
A voluntary assisted dying law is voluntary for everyone. It respects and protects the rights of those doctors who object. Just as it protects and respects the rights of those doctors with a different ethical view.
The extreme rhetoric being used by Right to Life and other faith-based objectors – such as ‘patient killing’ and ‘murder’ – is designed to inflame emotions. It does not acknowledge, or address, the clear evidence of suffering in the community.
The rhetoric being used by Right to Life and others seeks to trivialize the genuine suffering and trauma being faced by people suffering a terminal illness.
This is an issue which requires thoughtful and respectful debate based on facts and not fear. Opposing voluntary assisted dying simply on religious grounds and with emotive language is not an answer to this suffering.