WHAT are the definitions?
Palliative care is defined by the World Health Organisation as ‘‘an approach that improves the quality of life of patients and their families facing the problem 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, psychological and spiritual’’.
Medically assisted dying is the right of mentally competent consenting adults to seek medical assistance to end their lives if they are enduring intolerable suffering from a severe and incurable medical condition. The former is allowed in Australia by law and the latter was allowed in Canada recently, by a historic 9-0 ruling of the Canadian Supreme Court.
What is the difference?
The former palliative care process must occur slowly by accumulation of drug effects allowing death when it comes to be dignified and loving; whereas the latter is to actively and deliberately end a life quickly with dignity, love and medical assistance.
Which is preferable?
There is currently no freedom of choice in Australia. Palliative care is legal but medically assisted dying is not legal. The conversation is current but conservative and confused. It was a similar conversation in Canada, but recently the law was settled by the Canadian Supreme Court to reflect the right to life, liberty and security of the person in accordance with the principles of fundamental justice to be expected in a free democratic society like Canada.
Who are the opponents?
In Australia, the powerful opponents of medically assisted dying are the churches and the Australian Medical Association. It was the same in Canada but in August 2014, the Canadian Medical Association altered its long established opposition to physician-assisted dying. Its new policy allows physicians, within the bounds of laws, ‘‘... to follow their conscience when deciding whether to provide medical aid in dying’’.
How can the law be changed?
Federal politicians in Australia should legislate immediately, to allow medically assisted dying to be legal from the end of 2015. The powerful opponents of medically assisted dying could then test the law in the High Court of Australia.
The rule of law is supreme when in accordance with the principles of fundamental justice and will have to be respected by all advocates of the change in a free democratic society like Australia. I do plead with federal politicians of substance to listen and learn: there is somewhere between 72per cent and 80per cent public support in Australia for medically assisted dying.
Canada, along with several European countries and 15 states of the US have introduced dying with dignity laws or have pledged to do so by the end of 2015. Isn’t it time Australia caught up with the rest of the world and the winds of change?
Brian Winship is a retired lawyer and co-ordinator of media and political lobbying for Dying With Dignity NSW Inc for the Port Macquarie Group