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SA Medical Defences bill returns debate to voluntary euthanasia

By Philip Nitschke - posted Monday, 10 October 2011

How the wheel turns. The AMA's indignant objections to Steph Key's courageous Medical Defences bill has strong echoes of their same willful behaviour in the mid 1990s in the Northern Territory.

Surprise readers as it may, one of the main reasons I became involved in the voluntary euthanasia (VE) debate (apart from thinking it made good common sense) was that I couldn't stand the paternalistic rejection of the Rights of the Terminally Ill Act by, you guessed it, the AMA. Back then as now, polling showed strong community support for VE but the political apparatchiks of the medical profession thought they knew better.

When then President of the NT branch of the union said "no doctor will support this law" with 20 other doctors, I took out a full page newspaper advertisement stating that the AMA did not speak for us. The AMA was wrong back then, just as they are wrong now.


Everyone knows that euthanasia goes on in hospitals, hospices and aged care institutions every day in this country. Under the guise of terminal sedation or "slow euthanasia" as it is often called, pain medication is upped until lethal levels are reached.

As long as the doctor holds the line that they were only treating their patient's pain, a relatively peaceful if rather slow death will take place and the doctor will experience no legal consequences. I engaged in this semantic sophistry when I administered terminal sedation to retired nurse, Esther Wilde, in Darwin in 1997. Esther had qualified to use the ROTI Act. After all, she was terminally ill with cancer of the small bowel, carcenoid syndrome.. She knew what awaited her.

However, when then Governor General Sir William Deane gave royal assent to the Euthanasia Laws Act (known as the Kevin Andrews Bill) on Good Friday, Esther's plan to go quietly over Easter was thwarted. In desperation, she begged me to administer drugs to relieve her pain.  We both knew full well that too much of the drugs would cause death.  I gave her morphine and then I gave her more morphine and then a bit more.

Steph Key's bill is not about voluntary euthanasia.  It is not about a strictly guarded qualification process where terminally ill patients can request assistance to die. What the bill is about is ending the precarious legal position which doctors can find themselves in when they administer terminal sedation and this is why the bill should be passed.

Yes, I wanted to help Esther Wilde to die.  This was her decision to make. But did I do it? Did I intend to kill her? If I tell you "yes", I'll not only lose my medical registration but could well end up in jail. So let's just say I treated her pain.

This is the status quo that Steph Key's bill will address. The ambiguity of the current predicament means Key's bill makes good practical and moral sense.  It's good for doctors because we gain legal coverage. It is good for patients because, for the first time, there will be a legal framework where patient honesty is rewarded instead of shunned. The saying used to be "get your rosaries off my ovaries".  Maybe now it should be "get your grip from my drip".

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About the Author

Dr Philip Nitschke is director of EXIT(Australia). He assisted four patients to die under the short lived NT voluntary euthanasia legislation. Today, he is director of Exit International.

Other articles by this Author

All articles by Philip Nitschke

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