other letters

Dear Editor

It is with reference to the article as published in the Courier Mail dated April 12th 2007 by journalist Michael Madigan
Re; “ Laws to die for” that motivates me to respond and expand on his article as follows.

With the article in focus on balance being complementary of the legislated Qld Advanced Health Directive (AHD) I feel it appropriate and timely to reveal some back-ground plus a forensic reality check on short-comings associated with being a signatory to a (AHD) document. As a fundamental holistic approach, what must be factored into the whole end of life equation is, what’s best for the patient and to listen and respect what the patient wants in conformity with confidentially between, doctor – patient relationship.

In order to address the vagaries of past indecisive politics and with Labor having represented governments of traditional social reform, I wish to convey the following.

Suspecting that it may not be generally well known, however an interesting review of the past reveals how Qld Labor at their 1999 State Conference, following considerable debate at strong Party grass roots level, resulted in an estimated 2/3 majority support for upholding Voluntary Euthanasia as valid Party policy.

For the awareness of all concerned, set-out below verbatim is the policy wording.

With the passing of time the above resolution can be seen to vindicate the results of past and most recent community surveys that now indicate an approximate 80% upwards in favor of self-determination in end of life decisions.

With the Qld Cabinet subsequently confronted with the expectation of having to introduce Labor Party VE policy and with Voluntary Euthanasia being considered a sensitive political issue, it is difficult to escape the conclusion that the government, in lacking the political will, avoided the (V.E) issue via a circumventing strategy of legislating the “Guardianship and Administration Act of 2000” that governed the (AHD) document.

Relative to the Advanced Health Directive, doctors have stated that for many people the Directive is not worth the paper it’s written on. The reason being, that by refusing drugs as life sustaining medical support, the patient can be worse off and as an example, a case-in-point being suffers of diabetes and associated gangrene.

As a procedural consideration, it’s interesting to note how there is no mention of the “Guardianship and Administration Act” or it’s inter-related principles anywhere within the (AHD) document. As such I suspect that very few who full-fill an (AHD) would ever get to read the principles within the Act and when reading same, one could be forgiven for thinking how the cited principles have a correlation with a declaration of Human Rights”.

With an eye on social justice issues, I have always harbored strong convictions that if the principles in question were ever tested in a court of law that it is possible, they may be interpreted more liberally than at present in support of people’s autonomous choice for self-determination.

Set out below for consideration by all concerned are the cited principles enshrined within the “Guardianship and Administration Act” that governs the “Advanced Health Directive” legal document

(2) Human Rights:- Regardless of the decision making capacity, everybody has the same rights, including the protection of individual liberty and access to services. Decisions must recognize the importance of encouraging the adult to exercise his/her rights.
(3)Individual Value:- Each person is valued as an individual and his/her human worth and dignity are respected.
(6)Encouraging Self-reliance:- Decision makers must recognize the importance of encouraging an adult to be as autonomous and self-reliant as possible-physically, emotionally and intellectually.
(8) Maximum participation in decision making:- The adult has the right to participate to the greatest practical extent in the decision making affecting his/her life. (These decisions, the development of policies, programs and services for people with impaired decision capacity). The application of this principal entails:-
(1)	Giving the adult any necessary support and access to information to help him/her to participate in such decisions.
(2)	Seeking and taking into account, to the greatest extent practicable, the adult’s views and wishes, whether they are expressed orally, in writing or through interpreter’s or other communication systems.
(9) Substituted judgement:- If it is possible to work out, what the adults previous his/her views and wishes would be, then these must be taken into account in any decision.
(13) Confidentially:- The decision makers must recognize the adults rights to confidentially in relation to personal information.

In focusing upon the above principles, it will be noted under Section (3) – “Terminal, incurable or irreversible conditions” within the (AHD) how the latter, lawfully provides for passive euthanasia via the turning off of both life support systems and the refusal of life sustaining medical treatments. Whilst the (AHD) provides for this supposed passive approach, there is no such provision for a merciful end of life decision by way of an active medically assisted termination option.

Contrary to the best interest of those patients who invoke their legal rights, the (AHD) consequently allows those in authority to sit by and cruelly watch as the suffering terminally ill endure a slow drawn-out agonizing death. Such an unconscionable situation may also be legally viewed as discrimination against the dying and if so, could a case exist to be pursued under the Equal Opportunities and Anti-discrimination Act. To engage with life is to engage with death and it should be an inalienable civil right of all citizens to autonomously decide what makes life worth living for them.

With the (AHD) empowering the patient to lawfully have somebody turn off his/her life support device, must surely be seen as not passive, but actively assisting that person to die. This situation creates a very fine line indeed between a law that allows a patient to dictate in order to hasten death as opposed to the archaic Assisted Suicide law that decrees it a serious crime to even be in the same room as a person committing suicide, which is legal. In my humble opinion and as a hypothetical, if a more equitable and liberal interpretation in law were to prevail, via a successful High Court appeal for instance, such a judgment could possibly render the (AHD) document, null and void.

In view of the above exposure, such deficiencies could be adequately addressed via appropriate legislation in accord with Qld Labor’s V.E. policy.

Subsequent to this, a compassionate option for the informed terminally ill, who so desire, to freely choose a medically assisted death, as a shorter more merciful path to the same end could possibly have their wishes facilitated under Section (3) – page(11) of the (AHD) via the last question Re;- “Other treatments”.

RB

(1)	Labor believes that Voluntary Euthanasia should be available as a legal treatment Option, for a person of sound mind suffering from a terminal illness, which has diminished the quality of life to the extent that, that person requests termination of their life.
(2)	Conference resolves to:
	(a)	Adopt a conscience vote on the question of euthanasia consistent with the decision of the National Executive.
	(b)	In the event that a Private Members Bill is introduced on euthanasia, all member’s of the parliamentary party shall be free to exercise a conscious vote on that Bill.