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Tag Archives: euthanasia

The time has come, the walrus said…

We are told we have an aging population that we cannot afford to support so we must all get off welfare and work longer. We are told we can no longer afford universal healthcare and that we must all pitch in. We are told that we have a financial crisis (cough). We are also told that “all things are on the table”.

That being the case, I feel it is time to reopen the discussion about euthanasia. I understand that this is an extremely sensitive debate where no-one should ever try to dictate what opinion should be. But surely it is time to consider giving people the option of avoiding suffering and dying with dignity at a time of their choosing.

Euthanasia and assisted suicide are legal in the Netherlands. When dealing with a patient’s request for euthanasia, doctors must observe the following due care criteria. They must:

a. be satisfied that the patient’s request is voluntary and well-considered;

b. be satisfied that the patient’s suffering is unbearable and that there is no prospect of improvement;

c. inform the patient of his or her situation and further prognosis;

d. discuss the situation with the patient and come to the joint conclusion that there is no other reasonable solution;

e. consult at least one other physician with no connection to the case, who must then see the patient and state in writing that the attending physician has satisfied the due care criteria listed in the four points above;

f. exercise due medical care and attention in terminating the patient’s life or assisting in his/her suicide.

Two thirds of the requests for euthanasia that are put to doctors are refused. Experience shows that many patients find sufficient peace of mind in the knowledge that the doctor is prepared to perform euthanasia and that they ultimately die a natural death.

The ability to refuse a request for euthanasia or assisted suicide guarantees doctors’ freedom of conscience. The basic principle underlying the legislation is that patients have no absolute right to euthanasia and doctors no absolute duty to perform it.

Experience shows that in practice the vast majority of cases of euthanasia (almost 90%) relate to patients with terminal cancer. Three percent of deaths in the Netherlands are the result of euthanasia or assisted suicide. Of those, 7% were done without the explicit request of the patient.

A 2002-3 study on hospital costs of older people in New South Wales in the last year of life found that

  • Care of people aged 65 years and over in their last year of life accounted for 8.9% of all hospital inpatient costs.
  • The average costs per person of those who died aged 65–74 years was $17 927 with cancer as the most frequent cause of death (41.2%)
  • Average inpatient costs increased greatly in the 6 months before death, from $646 per person in the sixth month to $5545 in the last month before death

A lot of the money being spent may not only be not helping, it can cause the patient to endure more bad experiences on a daily basis. The patient’s quality of life is being sacrificed by increasing the cost of death. For some families, that last year/month can be a genuinely awful experience for all concerned.

The discussion has to be about quality of life, not just length of life, and of course, religious, moral and uncertainty issues are involved. Many families have a DNR (Do Not Resuscitate) order put on the patient record, and the health care proxy (usually a close relative) thinks that takes care of the problem. Yet a DNR does not address quality of life satisfactorily. You can only do that by having a discussion early on with the patient about how they want to live their life to the end in the best possible way. Most of the current physicians, family members and provider institutions really dislike that conversation simply because it can be hard on the person initiating the discussion.

With the process frequently driven by the medical system’s focus on performing aggressive interventions at any cost — and the reluctance of families to talk about death — many people who are dying do not get the care they want.

Worse, they often suffer through unnecessary, even harmful treatments. When patients have a terminal illness, at some point more disease treatment does not equal better care. Ending up in the hospital often means aggressive, high-cost treatment at the expense of quality of life. A 2010 Dartmouth study of elderly cancer patients nearing death found that 9% had a breathing tube or other life-prolonging procedure in the last month, and at most academic medical centres, more than 40% of the patients saw 10 or more doctors in the last six months of their lives.

A 2013 report by Australia21 – a non-profit body dedicated to analysing complex issues – found even though voluntary euthanasia and assisted suicide were unlawful, they occurred ”not infrequently” in Australia with no oversight and rarely any prosecutions.

It said Australia’s laws were ”deficient and unequal” as people with the right knowledge or connections could be helped to die while others had to suffer.

Launching the report, co-author Emeritus Professor and former Fraser Government Minister Peter Baume said: ”Voluntary euthanasia goes on every day – but without supervision, without advice from colleagues and without rules.”

The report recommendations state governments should legislate now to protect patients and doctors and the Federal Parliament should restore powers to the territories so they may do the same.

As I have mentioned before, The Northern Territory briefly legalised euthanasia until our current Social Services Minister had it overturned in 1996. Considering the future, it is perhaps time for Mr Andrews to revisit the cost of the imposition of his Christian beliefs in denying people choice about their own lives.

 

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Kevin bloody Andrews

As a companion piece to Rossleigh’s excellent article, I thought it might be useful to have a closer look at our Social Services Minister, Kevin Andrews.

As a backbencher, Andrews authored the Euthanasia Laws Bill 1996 to overrule Northern Territory legislation that legalised euthanasia (the Rights of the Terminally Ill Act 1995).

Andrews also called for an end to trials of the RU-486 drug and voted against a bill that took away the Health Minister’s power to veto applications to allow the drug to be used.

In taking a stance against stem cell research in 2002, he stated that it was the “first time” that “human beings can be treated as a commodity.” He also took a stance against stem cell research during a debate in 2006, which resulted in the overturning of a previous ban on the research.

As the Minister for Employment and Workplace Relations, he was responsible for introducing the Howard Government’s major changes to industrial relations law in 2005, commonly known as WorkChoices.

Andrews is a member of the Lyons Forum, a socially conservative Christian faction within the Coalition. He has served as the Forum Secretary and is credited with suggesting the name for the faction.

As Minister for Immigration and Citizenship, Andrews attracted controversy after he revoked on character grounds the visa of Dr Mohamed Haneef, who had been granted bail on charges of aiding terrorists. After the Director of Public Prosecutions dropped all charges against Haneef, Andrews refused calls to reinstate Haneef’s visa, stating that his personal evidence was still valid. Andrews’ justification of his decision, on the basis that he had a reasonable suspicion that Haneef had associated with suspected terrorists and therefore failed the test of good character that a person must pass to keep a visa, was rejected in the Federal Court, and the revocation of Haneef’s visa was overturned. However in November, e-mails released under the Freedom of Information act appeared to indicate that Andrews’ office had a plan to revoke the visa before the case went to court, in the case that bail was granted.

Following Andrews’ criticism of irregularities discovered in the CV of an Indian doctor working on the Gold Coast, various media organisations carried reports disputing Andrews’ claim on parliamentary and ministerial websites to have co-authored three books, having contributed only a chapter to each. Andrews argued in his own defence that:

“In common, everyday parlance, as one of the authors (of a chapter) I presumed you called yourself a co-author – that’s all I’ve simply done. I wasn’t aware, to be frank, of some publishing convention that someone’s referred to (that suggests otherwise). If that offends people’s sensibilities well so be it, basically.”

Andrews’ 2007 decision to cut Australia’s refugee intake from African nations was branded by some critics as “racist”, and pulling out the race card before the 2007 Australian Federal election. Andrews defended the decision, saying: “Some groups don’t seem to be settling and adjusting into the Australian way of life as quickly as we would hope.” Andrews accused Sudanese refugees of fighting in bars and congregating in parks to drink alcoholic beverages, but did not provide statistics to back up his claims.

In 2009, Kevin Andrews declared his candidacy against Malcolm Turnbull in a vote for a leadership spill, in opposition to Turnbull’s support for the government’s emissions trading scheme. He had declared himself a climate change sceptic, saying that ‘the jury is still out’ on human contributions to global warming. The party room however voted down having a leadership spill 41 votes to 35 and the Andrews challenge did not eventuate. After continued leadership speculation, a second Party Room meeting was held, at which point the leadership was declared vacant. Tony Abbott, Joe Hockey and Malcolm Turnbull all stood for the leadership, and Tony Abbott was ultimately successful. Following his election as Leader, Abbott promoted Andrews to the Shadow Cabinet as Minister for Families, Housing and Human Services.

A member of the Catholic Pontifical Council for the Laity, Andrews is an Adjunct Lecturer in Politics and in Marriage Education in the John Paul II Institute for Marriage and Family in Melbourne.

Andrews is an advisor to the Board of Life Decisions International (LDI), a (non-denominational) religious pro-life group that is primarily concerned with opposing the pro-choice Planned Parenthood organisation. LDI campaigns for chastity, boycotts corporations and names individual celebrities who support abortion, euthanasia, or embryonic stem cell experimentation or who, in their opinion, support sexual promiscuity. These include GlaxoSmithKline, Johnson and Johnson, Time Warner and Disney.

Andrews made a speech to the Endeavour Forum on 9 April 2003, a group focusing on women’s issues, opposing abortion, equal opportunity and affirmative action.

He has also spoken at the Family Council of Victoria, an organisation which regards homosexuality as the manifestation of a psychiatric disorder. The Family Council of Victoria also opposes sex-education and anti-homophobia policies in public schools, which it claims is “pro-homosexual indoctrination” of students.

In 2011, as a Liberal Shadow Cabinet frontbencher Andrews published a critique of the Greens policy agenda for Quadrant Magazine in which he wrote that the Australian Greens’ “objective involves a radical transformation of the culture that underpins Western civilisation” and that their agenda would threaten the “Judeo-Christian/Enlightenment synthesis that upholds the individual” as well as “the economic system that has resulted in the creation of wealth and prosperity for the most people in human history.”

In December 2013, as Social Services Minister, Andrews introduced to the House of Representatives a bill repealing almost all of the gambling harm-minimisation measures passed by the Gillard Labor government in November 2012.

“This is a straight capitulation to the power of the pokies lobby,” says Tim Costello, chair of the Australian Churches’ Gambling Taskforce.

When Australia is recognised as having perhaps the worst gambling problem in the world, with 41 per cent of poker machine revenue coming from problem gamblers, one must wonder about Andrew’s motivation. Could it have something to do with the sudden upsurge in gambling-industry donations to Australia’s major parties, which coincided with a deal between independent MP Andrew Wilkie and then-Prime Minister Julia Gillard?

Fittingly, Andrews’ amendment will also change the name of the law passed in 2012 – from the National Gambling Reform Act, to the National Gambling Measures Act. For now, meaningful gambling reform is quite literally off parliament’s books.

Andrews is a member of the Credlin-led decision-making Star Chamber which includes federal Liberal Party director Brian Loughnane – Ms Credlin’s husband – along with John Howard’s former chief of staff, Tony Nutt, and minister Michael Ronaldson.

He also has his gun sights set on the ABC. Speaking at Canberra airport on his way to a cabinet meeting, the Social Services Minister said that in a robust democracy, the media should be scrutinised as much as anybody else. ”I think the ABC should be open to constructive criticism about its performance as it would be about the performance of other people and other institutions in Australia,” he said. ”What goes around comes around.”

We then hear from our Social Services minister that the nation’s welfare system is “unsustainable” and large, urgent changes must be made to the disability pension and the general unemployment benefit.

He said the government was reviewing all welfare rules to see what could be done to decrease the number of unemployed on the dole, including the possibility of eliminating the ability of those on welfare to refuse to take a job if it was more than 90 minutes from their home and keep their income support payments.

Mr Andrews has already revealed the government is looking at changes that would see more people under the age of 40 on the DSP checked to see whether they could work and temporary payments for potentially impermanent conditions to prevent the number of those in the system from ballooning to one million.

Under Mr Andrews’ mooted change, disability pensioners who were assessed by their family doctors – before Labor tightened the system in 2011 – would be re-examined by medical experts at the Department of Human Services.

The minister is also considering giving a fixed higher payment for the most disabled pensioners, with lower payments for people with less restrictive disabilities, who might be able to work part time.

Disability Discrimination Commissioner Graeme Innes said the Abbott government was “punishing some of the most vulnerable people in society” by tightening checks on the disability pension.

Regarding the minister’s idea to reassess recipients, Mr Innes said: “To effectively move the test back a few years, it just seems a cruel way of penalising people who’ve been in receipt of a benefit. Introducing a quarterly or six-monthly check is just adding more complexity both for the Centrelink system and for people with disabilities,” he said.

Andrews is pushing the idea that pensioners suffering “episodic” illnesses such as depression should be given monthly or quarterly medical certificates rather than getting two-year “set and forget” pensions. This idea, he said, was particularly important given there were now more disability pensioners suffering from psychological conditions than suffering musculoskeletal problems.

Australian Council of Social Service chief executive Cassandra Goldie said she would support any measures by the government to “invest” in disability pensioners to help them return to the workforce.

But she was concerned that subjecting disability pensioners to more regular assessments could end up “exacerbating their mental health condition”.

“We don’t have a welfare crisis in this area, we have a jobs crisis,” Dr Goldie said. “We all want to work on decent reforms which will improve people’s pathways back to being well and getting paid work.”

Despite the financial crisis that apparently makes it necessary for us to send people suffering from depression ‘down pit’, Mr Andrews was able to find $20 million for marriage guidance counselling vouchers. This of course has nothing to do with the fact that he and his wife are/were involved in the marriage counselling business.

I have tried to remain factual in this snapshot biography of our Social Services Minister but hells, bells and cockle shells, it would be hard to find someone less suitable for the job.

 

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