THE Greens have introduced legislation to the South Australian
Parliament to allow voluntary euthanasia.
Greens Upper House MP Mark Parnell said his Bill would stretch
existing laws on medical treatment rather than create new,
stand-alone, regulations.
“I have watched closely previous debates in South Australia and
interstate and have attempted to allay the concerns of opponents,” Mr
Parnell said.
“I am introducing a fresh approach to balance the need for protection
for the vulnerable with the right to die with dignity.”
The Greens Bill adds voluntary euthanasia provisions to the existing
Consent to Medical Treatment and Palliative Care Act.
It will also provide safeguards, including the introduction of a
five-person board, involving medical and palliative care experts,
which would need to give final approval before a physician could act.
The board would have the power to investigate, seek further
psychiatric or other medical testing and hear from concerned family
members.
“It’s well and truly time for a fresh debate in SA,” Mr Parnell said.
“Worldwide, there is increasing support for similar laws.”
Mr Parnell said South Australia was once a trailblazer on social
reform and it now had a great chance to again take a lead.
“Overwhelmingly the SA community wants the law to change,” he said.
“It’s time for the SA Parliament to once again have this debate.”
Previous attempts to introduce voluntary euthanasia laws in SA by the
Australian Democrats and by independent MP Bob Such faltered, despite
the issue being subject to a conscience vote.
A woman convicted of the manslaughter of her partner, an Alzheimer’s sufferer, after helping him take a lethal dose of a drug has been sentenced to 22 months in weekend detention.
Justins, 60, was last month found guilty in the Supreme Court of the manslaughter of Graeme Wylie, 75.
Mr Wylie, her partner of 18 years, was killed with a lethal dose of the veterinary drug Nembutal at his Cammeray home in Sydney in March 2006.
Justins will be released on parole in September 2010.
Her friend, Caren Jenning, a euthanasia advocate, was convicted of being an accessory before the fact of manslaughter.
Jenning, 75, who had terminal breast cancer, killed herself using the same drug in September.
The two women said they were helping Mr Wylie fulfil his wish to die.
In October, Justice Roderick Howie said he was affected by the statements of Mr Wylie’s daughters, who had cried in court when they described how their father’s sudden death deprived them of a chance to say goodbye.
While the Crown prosecutor, Mark Tedeschi, QC, said the prosecution did not push for Justins to serve a full-time prison term, Justice Howie said he was certain he would impose some punishment, possibly prison, when he sentenced her.
Justins did not show any emotion when the sentence was handed down, and did not say anything as she left the court.
In his sentencing today, Justice Howie said Jenning was the dominant of the two women. She drove the option of obtaining the Nembutal in Mexico, where it is legal.
Jenning also wanted to get the drug for herself and, the jury found, knew that Mr Wylie could no longer decide for himself that he wanted to die, Justice Howie said.
Justins, however, was motivated by the belief her partner of 17 years wanted to die and she did not realise the extent to which he lacked mental capacity, he said.
But he said a message had to be sent to the community that this was a crime and not a conviction to be worn as a badge of honour.
Justins had to be sentenced to time in prison to send this message, he said.
But because of her prior good character and because she was unlikely to offend again, weekend detention was an adequate punishment.
Mr Wylie’s daughter Tania Shakespeare said today that she was pleased with the sentence and said Justins had deceived her father and the entire family.
“I didn’t have an opportunity to say goodbye,” she said.
“He didn’t have a dignified death.”
Outside the court, Exit International founder Philip Nitschke applauded the “lenient sentence”.
The message for people who might want to kill themselves was to plan ahead and not involve loved ones who stood to pay the price, he said.
Jenning’s daughter, Kate Jennings , said her mother spent her entire life helping others and would have accepted being portrayed as the mastermind of Mr Wylie’s death if it helped Justins get a lighter sentence.
Footnote: I feel so sad to learn that because the law refuses to accommodate the needs of those who wish to die earlier rather than later, good people are sentenced as if they’ve committed the crime. The crime is that society allows one aspect of peoples right to choice to dominate over another. The law should make provision for those of us who don’t want to suffer either physically or mentally. We will continue to commit suicide with or without the sanction of the Court. If we are smart enough to have survived a life time of decision making surely to goodness, we are capable of our own end of life decisions!!!
“Respecting Patient Choices” has been introduced in one of Glen Eira’s aged care facility at Warrawee .
It is a document that states what the patient wants for themselves should they lapse into a coma and be unable to speak for themselves when health issues become life threatening.
The Glen Eira News November copy of the Council’s own paper provides layman’s coverage on the subject. It is a softly softly approach to impending death. People are invariably afraid to bring death into conversation. Some want to cling regardless of the long term prognosis as illness and time take its toll, while others yearn for the relief from pain and suffering.
While mostly the chronically and terminally ill, sick frail elderly consider these matters, RPC is also a document for mainstream Victorians.
Had Maria Korp, the lady of the boot for four days in an attempted murder, (Alfred Hospital) completed a similar form, she would not have been kept on life support for six months, until the Victorian Advocate made the decision for her. The Right to Life lobby groups had a field day until even the Catholic Church had to admit, her life no longer and never would be, the same again. Her brain was dead.
The document takes individuals through a series of processes where should a health emergence occur, a pre existing condition worsens, eg heart attack, stroke, cancer what type of treatment would you choose for yourself?. Aggressive treatment in an attempt to stall the inevitable or palliative care, which frankly means, letting nature takes it course while being palliated and kept pain free as much as is humanly possible.
Five years ago at least RPC was introduced into the Box Hill Hospital, but when I attempted to see if it was available at Monash Hospital it had not (at that stage). I understand it is now commonly known around medical fields.
Respecting Patient Choices is a similar documentation of a person’s individual preference for how they want to be treated near death, to that of the older style forms that were known as Advance Directives and Living Wills. Not all near death experiences will include a Do Not Resuscitate requirement.
A funny scenario happened many years ago when contacting one local Upper House politician, when I asked him about his attitude to Advance Directives, he thought it may have been a procedure within the Australia Labor Party’s Annual Conference!!! So we can still smile even when discussing such serious topics…..
The one most vital piece of information the article refrained from sharing is that the document has no legal status in law.
The attending doctor may over ride the wishes of the patient, if in their opinion they see the medical implications as treatable. This is particular of concern when a person is being treated by a doctor who believes in life at any price. (Suffering can be seen as beneficial in ticking up points in this life in expectation of a better life in the next). A Right to Life doctor believes that absolutely everything that could be done should be done to conserve life. Their religious beliefs can make this their crusade.
These past 8 years I have worked hard lobbying politicians to legislate to enable Living Wills, Advance Directives and Respecting Patient Choices to be a legally binding document on the care givers. I want the patient’s wishes to be the sole deciding factor when dealing with chronically and terminally ill people.
I believe the phrase “terminally ill” applies to when a person is expected to die with 6 months.
Just yesterday I was talking to someone whose father was “expected to live” six months but stayed breathing for a further eight years during which time, he had a further five strokes, could not feed, wash, talk, walk, read, fluid on the brain - and remained a “vegetable” unable to recognise family or time…. A Seriously stressful time, for both the father, and the family. The on again, off again, nature of a protracted dying process is extremely health challenging. The $2000 dollars per month it costs the family to maintain his care was an additional burden, never complained about, but obviously a financial drain on families with young children. Most importantly the man had no quality of life whatsoever, but had refrained from making his final rational thoughts public through a Living Will, RPC or Advance Directive.
Health Legislation is a State issue and just recently the Physician Assisted Dying Bill was defeated by the Labor Party. Introduced by the Green’s Colleen Hartland, unsuccessfully, after 34 years of lobbying by Dying with Dignity Victoria. The vote would normally have been a conscience one, but the powerful lobby of the Right to Life prevailed. We older folk look to the young for change! Religion and State should be kept separated for the wellbeing of Australians and ultimately it is about choice for the individual!
Ms Ann Barker, Member for Oakleigh, Mr Rob Hudson, Member for Bentleigh and Ms Helen Shardey, Caulfield, will all have some recollection of being approached perhaps 20 times in an attempt to have Living Wills/Advance Directives and Respecting Patient Choices legalized, not merely treated as an indication of your wishes, which may be overridden by distraught relatives or a medical professional that does not share your views on a managing your impending death. Not their death! But yours!
The only document relating to health issues for the individual, that is legally binding, is that which is known as a Medical Enduring Power of Attorney. The fundamental difference between this and the previously addressed documentation is that the Medical Enduring Power of Attorney requires another person to be making decisions on your behalf.
Robbed of the chance to say goodbye: judge calls death an affront
Geesche Jacobsen
October 25, 2008
THE killing of an Alzheimer’s sufferer was not a test case for euthanasia or a person’s right to commit suicide, but an “affront to normal society” which required punishment, the judge presiding over the case said.
Justice Roderick Howie of the Supreme Court said he was affected by the statements of Graeme Wylie’s daughters, who yesterday cried in court, where they described how their father’s sudden death deprived them of a chance to say goodbye.
Mr Wylie died in March 2006 from a dose of the drug Nembutal, illegally imported by his friend Caren Jenning and handed to him by his partner, Shirley Justins. Justins was convicted of his manslaughter and Jenning - who committed suicide last month - of being an accessory before the fact.
While the Crown prosecutor, Mark Tedeschi, QC, said the prosecution did not push for Justins to serve a full-time prison term, Justice Howie said he was certain he would impose some punishment, possibly prison, when he sentenced her next month.
However, he said Jenning had been more criminally responsible than Justins because she knew Mr Wylie was no longer capable of making his own decisions. She had been a criminal and “an out-and-out liar”, who had “manufactured evidence” and “never accepted the slightest moral or criminal responsibility” for her role in Mr Wylie’s death.
She had accepted money from Justins to go to Mexico to buy the Nembutal for Mr Wylie and herself, he said.
“She got a free trip to Mexico to buy her own drugs as well, which we now know she lied about in the witness box,” Justice Howie said.
He criticised media coverage of the case, as did Mr Wylie’s daughters, and said some people in society, and the spokesmen of the euthanasia movement did not want to see Justins punished.
“The court will impose punishment for this affront to normal society. The simple fact is this was a serious crime and is nothing to do with a person’s right to take his or her own life.”
Justins had planned to change Mr Wylie’s will to improve her inheritance, he said.
Mr Tedeschi also argued that Justins had also deliberately not taken Mr Wylie to his usual doctors to prevent any doctor interfering with her plan to kill him. One of his doctors in later life, Omprakash Gupta, would be referred to the appropriate authorities, Justice Howie said.
Mr Wylie’s daughter Nicola Dumbrell, who praised the commitment of police and prosecution staff, said she was “angry and extremely hurt” that the women had taken advantage of his vulnerability and given him “such an undignified end”.
Her sister, Tania Shakespeare, said it was “heart-wrenching” to have been misled about her father’s wish to die “to serve a financial gain and to further the ideology of Exit International”.
Her father was happy when last she had seen him, and demonstrated his capacities by standing on one leg. But now she was struggling to explain to her children how he had died mysteriously and without her realising how advanced his Alzheimer’s had been.
________________________________________
Weren’t the children visiting over many years before to see the mental deterioration of their father for themselves. Exit is merely an organisational vehicle that sick and frail people facilitate because governments consistently avoid the unpleasantness of acknowledging that we die. We’ve become sanitised about the grimness that old age bring with it in terms of quality of life….when we can’t fed ourselves, wipe our bums, comb our hair, dress ourselves. Personally I would like to believe my children would rather I suffered no more loss of dignity in the way i would have wanted to live my life - than the opportunity to say “good bye”….afterall “goodbyes”, tea and sympathy do not the solve the dilemma the membership of Exit and Dying with Dignity Societies seek to address.
When governments ignore solutions, by offering platitudes, people will rebel in spite of the law and precisely because of the law as it stands in Australia!
Writer Angelique Flowers, who died from cancer last month, at Oscar Wilde’s grave at Pere Lachaise cemetery in Paris in 2006.
JUST a month shy of her 31st birthday and half a lifetime since she was diagnosed with the debilitating Crohn’s disease at 15, Angelique Flowers was told she had colon cancer. It was so advanced and so aggressive, she was given only months to live.
That was in May. She would have dearly loved to have spent her last days with those closest to her, but another desire was overwhelming.
‘Let me die with dignity Mr Rudd’
Angelique recorded a video, addressed to Mr Rudd, Australia’s Prime Minister, in the final months of her life, pleading to be allowed to die with dignity.
Frightened of a slow, painful death from a total bowel obstruction, this softly spoken Melbourne writer wanted her life to end peacefully and on her own terms.
It wasn’t to be. She regretfully turned away from her loved ones and spent her final weeks searching for information about euthanasia and a dose of the lethal drug Nembutal. Her final hours were robbed of the dignity she had wanted as she died vomiting the content of her bowels.
Flowers’ quest dominated her dying days, and her frustration at Australia’s current legal situation led her to film a passionate appeal to Prime Minister Kevin Rudd.
“I don’t believe in stoicism. I freely admit to not being a brave soul who grins and bears the pain and soldiers on,” she says in the video, filmed during one of her last day trips from her hospice bed.
“I deeply admire people who rise above the adversity and their suffering. But I haven’t grown from my illness or become a better person from its torments. All I want after 16 years of painful Crohn’s disease and now cancer is to die a pain-free peaceful death.
“Because euthanasia was banned in Australia I am denied this right …
“We finally have in Kevin Rudd a prime minister who is a person as well as a politician. A man who had the conscience to say sorry to our indigenous people, the integrity to ratify the Kyoto Protocol.
“I beg the Labor Government to continue beating with the heart it has shown and to ensure euthanasia is made legal once again.
“The law wouldn’t let a dog suffer the agony I’m going through before an inevitable death. It would be put down. Yet under the law, my life is worth less than a dog’s.”
In the film, Flowers says the stress of having to hide her activity from her family, friends and medical staff made her even more ill, and her composure cracks as she relates how she contemplated violent ways to end her life such as jumping off a building.
“I have been robbed of both my living and my dying,” she says, her large eyes peering out from her pale face.
“At a time when I want to spend what good days and precious moments I have left having meaningful time with the people I love, I’ve had to cut myself off, writing questions and notes, making inquiries, doing research.
“If euthanasia was legal, I could have ended my days as I chose, finding peace before leaving this world, not panic and more pain.”
The video is one of two she filmed in her final weeks; in the second she explains to those she loved how her excruciatingly painful Crohn’s disease had meant she couldn’t spend more time with them.
For half of her life, the illness had at its worst, left her bedridden in agony, and at best, anxious and socially withdrawn. As her friends studied and celebrated and spent summers at the beach, Flowers stayed at home, too often sapped of the health, energy or confidence to join them. She was a private person, and kept her disease a secret from many of her extended family and friends for a decade.
She is scathing of the medical profession — her trust eroded by conflicting advice, poor bedside manners, and unbearable pain.
Flowers gave the films to Philip Nitschke and his group Exit International, which she encountered in her search.
It was through them that she learnt Federal Parliament overturned the Northern Territory’s world-first euthanasia law in 1996. She also learnt about Nembutal, a lethal drug often used in euthanasia, but the idea of an arduous trip to Mexico to obtain it was quickly discarded.
So, on Dr Nitschke’s advice, she used that very generation X tool, YouTube, to broadcast her appeal for Nembutal.
Flowers did obtain a dose , but she never used it. No one knows why — perhaps the fear of implicating family members, or the need to also take anti-nausea drugs to keep the Nembutal down.
She suffered the bowel obstruction she had feared and died on August 19.
Her older brother Damian, 34, was with her, and believes she was still in pain despite massive doses of morphine and other painkillers. In her last hour, he held a bowl under his sister’s chin as she vomited faecal matter.
“The peaceful ending wasn’t there,” he told The Age. “From the death she could have had, taking the Nembutal, saying her goodbyes to friends and family, having everyone there for her and being where she wanted to be, compared to what she did actually go through, it just doesn’t bear imagining.
“How can that be right? How can society believe terminal patients should be put through awful agonising deaths? Angelique wasn’t afraid of dying; it was more the way she was going to die that she feared.”
While Flowers may not have believed she was brave enough, her family credit her inner strength with helping them through the ordeal.
Damian and older sister Michelle hope her public appeal brings about legal change. The Victorian upper house this week voted down a private member’s bill giving terminally ill people the right to die with the help of a doctor.
But hopes are higher for a private member’s bill introduced by Greens leader Bob Brown in Federal Parliament. That bill, on which debate and a vote is expected to be held in the life of this Parliament, seeks to restore the right of the Northern Territory or the Australian Capital Territory to legislate for voluntary euthanasia.
Dr Nitschke, who met Flowers twice and intends to send her video to Senator Brown and Mr Rudd, described her as an eloquent advocate who was able to distance herself from her own plight.
“I found her an amazing and intriguing person … it’s certainly a very powerful voice,” he said.
In her videos, Flowers talks of happier times and her achievements — the fact she rated in the state’s top 7% of students in year 12, and her pride at completing a degree in professional writing despite her illness.
She recalls “one of the most wonderful experiences of her life”, a four-month trip to the United Kingdom and Europe in 2006, where she travelled to literary sites including Oscar Wilde’s grave.
Before she was diagnosed with cancer, she wrote three books of inspiring and humorous quotes — a tough task when, at times, she could hardly hold a pen — that her family now hopes to have published.
“I just want you guys to know that I have no regrets … I would have liked to have done more things in my life but the things I was able to do I am proud of,” she says.
Footnote: As I’ve always said, until you’ve walked in my shoes, please don’t judge me. But I was judgemental of Angelique! I was shocked to learn that Angelique had the drug Nembutal and yet did not use it for whatever reason! Would she have vomited it up because of her medical condition? In her shoes, I most certainly would have tried! and I would haunt any medical person who chose intervention as the way to deal with my plight, if after trying Nembutal, I “survived”…… Surely any ambulance medico worth their salt would have overdosed the woman immediately the circumstances of her suffering became clear.
No law enforcement officer in Australia would have charged the family of a woman who was described thus “
In her last hour, he held a bowl under his sister’s chin as she vomited faecal matter.”…I know the law can be harsh, but firstly those who administer it are mostly human beings with compassion.
I still remember the first time a patient with a debilitating illness asked me if I would help her commit suicide.
I was in residency training, and Jack Kevorkian was in the news. All that month, my friends and I had heated arguments about whether it was legal to insert the IV if the patient administered his own lethal dose.
Was it still wrong if you didn’t know that your patient intended to kill himself?
One friend (an engineer before going into medicine) drew on a burrito-smeared napkin designs for his own Rube Goldberg-like device that let a patient administer her own dose - for pain relief or for suicide. Of course, this was all theoretical - interesting discussions among doctors in training.
But that afternoon, when this middle-aged woman walked into my examining room, carefully closed the door behind her, and asked me in a low voice if I would help her end her life, I perfectly executed that response for which my many years of state-of-the-art American medical education had prepared me: I squirmed.
One of the hardest things for me to learn was how to talk to someone about death. I thought about all of this yesterday when my wife called from Italy, where she is visiting her sick aunt, Luigina. Once a vibrant woman, Luigina is now in the most advanced stages of dementia, unable to speak, lying in the fetal position, only able to cry in pain.
The doctor in the nursing home arranged a feeding tube without talking to the family. (Apparently, things are done differently in Italy.) When my wife said that Luigina wouldn’t want a feeding tube, the doctor became indignant, saying “I’m her doctor. I make the medical decisions.”
It is clear to me that for Luigina’s doctor, it was far easier to stick to the things he knew: nasogastric tubes and intravenous fluids, rather than to deal with the uncomfortable issue of dying, which my wife, ultimately, made him confront.
Similarly, the patient who asked me about suicide forced me to confront my own discomfort with the issue. I didn’t just squirm. I also did lot of hemming and hawing until it suddenly came to me that maybe my patient didn’t really want to deep-six herself, but that what she really wanted was to gain control - not to let the disease get the last word.
”Why kill yourself now?” I asked. She said: “I don’t want to do it yet, I just want to be ready, to have options, so
that I don’t lose control.”
In retrospect, it seems ironic that talking about dying is so difficult because we have no control over it. And yet, the more we are able to talk about it, the more empowered we feel to take control of it.
Jon Gaudio is a cardiologist practicing in New London. You can e-mail him at doctor@theday.com.