Assisted suicide - a counsel of despair

The Age newspaper reports barely a week before the Victorian Parliament's Report into 'end-of-life' choices that it expects the committee to recommend some form of legislative change. A form of assisted suicide is widely rumoured.

Whether this suggestion is taken up by the government or by a backbencher as a private member's bill is yet to be seen.

The Age journalist concludes by saying that, '(w)hether Parliament agrees that it's time for reform is yet to be seen, but one thing is certain: the evidence to the inquiry has been compelling.'

Compelling it certainly is. More than one thousand submissions is a significant public response to what is clearly a vexing and polarising issue for the community. In addition, the committee heard from about 100 witnesses who appeared before them over a number of months at forums held across Victoria.

Of those 100 or so witnesses, many were from professional bodies such as palliative care units, regional health centres, institutes of study, public interest groups and academic institutes. The vast majority of these, something like nearly 80%, were either against euthanasia (about 10%) or were focussing on other issues such as improving care, improving regional services, reform and improvement of advanced care planning and the like. This latter cohort overwhelmingly did not mention euthanasia or assisted suicide at all.

It was a similar situation with the submissions: approximately 78% of substantive submissions (submissions of detail and from health providers, institutes, lobby groups etc.) were either against euthanasia and assisted suicide or were neutral and preferring to focus on end of life care more generally.

Overall, the total submissions were about 56% in favour with the remainder either being opposed (approx. 35%) or neutral (approx. 7.3%). It must be said that some of the personal stories of difficult deaths were very hard to read and cannot be ignored. The question that needs to be asked is how to help all Victorians have a 'good death' and not just those who have some notion about wanting to be made dead? The professional submissions, setting aside the lobby organisations both pro and con, spoke magnificently to that end.

If the rumours about the committee's recommendations for some sort of assisted suicide legislation are proven true, I expect that they will also comment about these professional submissions that point to the need for improved care with a 'yes but…' type of summary. It is the 'but…' part that points to the problems associated with assisted suicide and euthanasia legislation, as evidenced in The Age article mentioned above, and the submission by the Victorian Coroner, John Olle and his colleagues.

Olle's evidence before the committee, cited in the above article, focussed on the Coronial data of suicides by people who they defined as people 'with 'irreversible decline', so terminal disease; death was foreseeable; incurable, chronic disease but death not imminent; permanent physical incapacity and pain. But the cohort did not include mental ill health or feared imminent decline.'

The numbers were defined as '50 cases per year between 2009 and 2012. It is a small cohort, but a significant number. We are looking at 8.6 per cent of suicides that meet this criteria set out in our definition of our cohort.'

A panel question from The Hon James Mulino MLC has Mr Olle respond with what I consider to be a counsel of despair:

Mr MULINO - "I am just wondering whether, firstly, even within that subset that you have looked at you feel that there are instances where there is the potential to help people feel less alone and more supported and, secondly, whether in the data that you have looked at there is any change over time as palliative care perhaps improves. Have you noticed that that cohort is changing the composition of the overall rate of suicides over time?"