'Unproductive burdens' still have a right to live

There was a moment during the last national debate on euthanasia that deserves to be revisited by a new generation of legislators, a moment that crystallised fears that the so-called right to die would come to be felt by the frailest among us more as a "duty to die".

It was 1995 and our then governor-general, Bill Hayden, was addressing the College of Physicians during debate on the Northern Territory's euthanasia laws. The scene was significant, since the dual concern with euthanasia is the corruption of the relationship between the state and its most vulnerable citizens, and between doctors and their most vulnerable patients.

Our head of state urged doctors to support euthanasia not only as a right, but also as a positive duty towards society. He reflected on past cultures where the elderly would take their lives when their usefulness had passed, and declared of our own culture: "There is a point when the succeeding generations deserve to be disencumbered of some unproductive burdens."

The next day a retired state governor, Mark Oliphant, publicly supported Hayden's astonishing message to "unproductive burdens" that they should do the right thing by society. This is the callousing of social attitudes, the insidious pressure on the frail and demoralised, that we could expect within a culture of mercy-killing.

A year earlier in Britain, a House of Lords select committee on medical ethics completed the most thorough enquiry into euthanasia ever undertaken, and concluded in stark contrast to Hayden: "The message which society sends to vulnerable and disadvantaged people should not, however obliquely, encourage them to seek death, but should assure them of our care and support in life."

This committee began with a majority in favour of euthanasia, but ended by rejecting it as unsafe and corrupting public policy:

"It would be next to impossible to ensure that every act of euthanasia was truly voluntary. We are concerned that vulnerable people - the elderly, lonely, sick or distressed - would feel pressure, whether real or imagined, to seek early death."

Doctors have no illusions about the pressures that can be felt by vulnerable people.

One patient of mine, a woman with disabilities and minimal self-confidence, received a cruel letter from a close relative effectively telling her she should be dead, and demanding certain arrangements in her will. She then developed cancer.

Consider such family dynamics in a setting of legalised euthanasia, and ask what the "right to die" would mean to a cancer patient so isolated and intimidated.

And the public should have no illusions about the corruptibility of doctors if they are given authority to take life.

According to the Dutch government's own data, doctors in The Netherlands put to death several hundred patients a year without any explicit request, even where the patient is competent to give or withhold consent.