• The Listener
  • North & South
  • Noted
  • RNZ

Euthanasia: Australia is on the move


Australian scientist David Goodall attends a press conference on May 9, 2018, on the eve of his assisted death in Basel. Photo / Getty Images

Anyone keen to see assisted dying laws passed in New Zealand will be heartened by the increasing momentum of campaigns across the Tasman.

It’s one of the oddities of New Zealand life that we pay so little attention to Australian politics — even though more than 500,000 of our citizens live and work there, it’s our favourite holiday destination and we often struggle with similar problems to theirs.

Mass immigration is one issue common to both nations and reforming laws around assisted dying is another but there is very little media coverage here of the wrangling going on in Australia on either topic.

Opponents of assisted dying in New Zealand should be worried about developments in Australia because it seems inevitable that more states will legalise assisted dying in the wake of Victoria’s reforms last year. And, given the similarities of both societies, that will make it even harder for conservatives in New Zealand to portray assisted dying as a concept foreign to the principles we hold dear here at the bottom of the South Pacific.

Now that politicians in Queensland — long a bastion of conservatism — have decided to include the controversial topic in an inquiry into end-of-life care, you know that change is accelerating.

Queensland is the only Australian state that has never formally debated the question of assisted dying and, until recently, Premier Annastacia Palaszczuk had been happy to avoid the issue, saying it wasn’t a priority for her government. However, in early September she announced an inquiry, acknowledging, “This is an issue we must confront.” 

The government’s change of heart has been widely attributed to the impetus provided by Victoria legalising assisted dying in November 2017. From mid-2019, Victorians will be able to access an assisted death if they have a life expectancy of six months or less (or 12 months with a neurodegenerative disease such as multiple sclerosis) and are in severe pain.

It’s a very restrictive regime but it has established a beach-head for reform in the country, and advocates of assisted dying in other states are forging ahead with their own campaigns in its wake.

Despite Queensland’s history of political conservatism, it’s surprising that a formal move has taken this long. Not only is public opinion heavily in favour of reform (and has been for a long time), but Clem Jones, the longest-serving Lord Mayor of Brisbane, who died in 2007, left $5 million in his will to promote the cause.

It was a successful new push by the Clem Jones Trust and Dying with Dignity Queensland that has finally ensured the issue will be directly addressed by the government.

Western Australia is even further down the same track. Last month, a cross-party parliamentary inquiry recommended the government implement a law legalising assisted dying and euthanasia. The committee’s proposed model is much less restrictive than Victoria’s (and, in fact, is very similar to the proposals of Act MP David Seymour’s End of Life Choice Bill currently before the Justice select committee).

The WA parliamentary committee recommended those eligible for voluntary assisted dying “must be experiencing grievous and irremediable suffering related to an advanced and progressive terminal, chronic or neurodegenerative condition that cannot be alleviated in a manner acceptable to that person.”

It put no time-frame on eligibility except that death would need to be a “reasonably foreseeable” outcome of the patient’s condition. They would also need to have “decision-making capacity” when choosing to die.

It also recommended that a doctor be able to euthanise a patient if they could not administer the lethal drug themselves. 

Public submissions to the year-long inquiry included an unusual plea by the head of the WA Police Union to legalise assisted dying after figures showed a person with a terminal or debilitating illness takes their own life every nine days in the state (making up more than 10 per cent of all suicides).

Union head George Tilbury told the committee that if there were a law change, “There would be less horrific suicides and first responders would be spared having to see as many graphic scenes, most of which stay with them forever.” 

The year-long inquiry was conducted against a backdrop of high-profile campaigns. The most prominent, which captured media attention internationally, was retired botanist Dr David Goodall’s trip from Perth to Switzerland to legally end his life in May.

Dr Goodall (aged 104) had deteriorating sight, hearing and mobility, and didn’t want to continue living in his enfeebled, diminished state. His final interview in Basel was attended by a throng of media representatives from around the world.

Despite the fact Dr Goodall was not terminally ill, media coverage was overwhelmingly positive. British-born Goodall had been a member of Exit International for 20 years and said he hoped his assisted death would spur a law change in his adopted country.

Another Western Australian doctor has also made waves, by putting her own career and liberty at risk. Dr Alida Lancee, a Perth GP, first came to public attention in 2016 when she announced publicly that, five years earlier, she had helped an 80-year-old woman with end-stage emphysema, who had already attempted suicide, to die by giving her a lethal injection at her request.

Police subsequently investigated Dr Lancee on a possible murder charge but couldn’t identify the patient and asked for her help with their investigation.

Dr Lancee was unwilling to identify the woman. As she said: “I’ve written death certificates truthfully and if they can’t find it [proof] then that’s not my duty to help them charge me with murder is it?”

She made the point that doctors regularly help terminally ill patients to die, including via terminal sedation.

Dr Omar Khorshid, who is the president of the Western Australian branch of the Australian Medical Association, backs his organisation’s opposition to legalising assisted dying. Nevertheless, he acknowledged: “We [doctors] shorten patients lives regularly if that’s the right thing to do at the very end of life.”

Dr Lancee has also been investigated by the Medical Board, which cleared her of wrongdoing. But in July this year, she said the board had mistakenly investigated the case of a different terminally ill woman to the one she had helped to die.

She now says that, in coming months, she will reveal publicly who the woman was, with the backing of the family.

“I am prepared to face a criminal charge to expose the problems with the current legal framework that doctors work under when they care for the dying.

“Fear of being seen to hasten a patient’s death causes doctors to under-dose their dying patients and this, in turn, causes needless end-of-life suffering. This has to change.”

Australia, of course, has already had direct experience of assisted dying legislation. Although Victoria is the first state to pass such laws, the Northern Territory passed a law allowing assisted dying in 1995. Four terminally ill patients were helped to die before the federal Parliament overturned the legislation two years later.

Marshall Perron, who was the Northern Territory’s chief minister at the time and a driving force behind the legislation, has since moved to Queensland, where he is lending his considerable authority to the campaign to get the law changed there.

The question of whether voters in the Northern Territory and Australian Capital Territory should be able to decide whether to adopt assisted dying laws was reignited by a bill introduced by Senator David Leyonhjelm that would have restored their rights. It was defeated by two votes in mid-August after two parliamentarians who had previously indicated their support switched sides but the issue won’t go away with two ACT MPs drafting their own private member’s bill to allow the territories to decide.

At the moment, Western Australia looks as if it may be the next state to approve assisted dying, with draft legislation likely to be ready next year. Change is supported by 88 per cent of the population — the highest figure for any Australian state — and that includes the Premier, Mark McGowan.

The law change in Victoria was also a government initiative. Slowly but surely, politicians across Australia are realising that ignoring the long-standing wishes of a big majority of their voters for assisted dying is political suicide.

As Seymour’s End of Life Choice Bill progresses towards a second reading, New Zealand politicians should take careful note.