Assisted suicide - a counsel of despair

Mr OLLE - "I do not think it is an issue in this small cohort we are referring to, where very tight criteria are applied. The numbers might be far greater than the numbers we have found - very tight, very conservative. No, to my knowledge the people we are talking about in this small cohort have made an absolute clear decision. They are determined. The only assistance that could be offered is to meet their wishes, not to prolong their life." (emphasis added)

So, the only intervention Mr Olle sees in helping these people who want to suicide is to help these unfortunate people to die.

Olle's colleague, Dr Dwyer follows offering support to Mr Olle's point but then, curiously, seems to contradict him:

Dr DWYER - "On that point, at the time when they have made the decision to suicide, I completely agree that the potential for intervention in a number of these cases would be a long time before that. There are some well-documented issues that coroners have been discussing repeatedly, particularly around the management of pain and the need to get more pain specialists involved earlier rather than it being like the mental health system, which devolved to where you could not get into the mental health system unless you were in crisis. It appears to be that way at the moment with pain treatment, and this has been pointed out by all kinds of organisations involved in pain treatment and so on."

Dwyer makes it clear that there may well be opportunities for intervention – even if it needed to be far earlier. Mr Mulino follows up with a request for confirmation:

Mr MULINO - "So in some cases, by the sound of it, intervention earlier might have been possible."

Dr DWYER - "I think so. In a lot of these suicides there is a trajectory over time. It is not like something suddenly happens and they make a decision. There is this trajectory, and there are attempts to engage in treatment. It would be interesting to get some kind of review of whether earlier and different treatment might have made a difference, but by the time they are at the point where they are suiciding, as Coroner Olle has indicated, these are not people where you can say 'Oh, if we just switch medications, everything will be okay'. It is a long way past that."

Setting aside the sad reality that people do and probably always will take their lives in response to difficult circumstances, as Dr Dwyer makes clear, there are issues of intervention that have not been explored here that may well have made life more bearable for these people. There is more assistance that can be offered.

Olle and Dwyer are clear, this is not about the kind of suicide prevention that we normally would think of. Rather, it is about a system failure that did not or could not care enough earlier on so as to foresee possible problems and to provide better care.

It is also true that some simply do not want the kind of care on offer, for their own reasons. We all have that choice. But that does not mean that because people refuse genuine and effective care options that we as a society have any obligation to provide death as the answer. But it would be a very sad day if we did not provide the very best of care and timely interventions and people chose suicide for lack of genuine choice which, I suggest, is precisely the counsel provided by Olle.

The Age's portrayal of the Coroner's submission is that it argues the case for euthanasia and or assisted suicide. In their testimony, Olle and his colleagues seemed to shy away from formally supporting such a program, though it is hard not to conclude that this was at least partly their intention.

The article concludes, in part, that the Coroner's information is, 'the kind of information that many would rather ignore – shocking, sad, hard to fathom – but in the context of an inquiry into end-of-life choices, it's the kind of data you just can't avoid.' It should not be ignored. The question is, as always, how do we respond?

The fact that Olle seems to be writing off any other solution to this cohort of suicides than death is, unfortunately, loading the information. It is also a snap shot of the reality of euthanasia and assisted suicide from the perspective of disabled people who oppose euthanasia; the characterisation of a subset of humanity who are constantly rebutting the implicit and even explicit message that they would, indeed, be better off dead. It would seem that they are not the only ones…

The Committee Report is due to be tabled on the 7th of June.