10 out of 100 wrongful deaths from medical errors: doctors warn

Thoracic physician, Dr Luke Garske and Professor Paul Glare, Specialist Physician, Pain medicine have warned that under Queensland's Voluntary Assisted Dying Bill 2021 an estimated 10 out of 100 Queenslanders who access assistance to suicide or euthanasia will end their lives based on a wrong belief that they have a terminal illness.

As euthanasia enthusiast, comedian Andrew Denton admits "there is no guarantee ever that doctors will be 100% right".

Dr Garske and Professor Glare explain:

The Queensland Bill simplistically assumes that doctors can accurately predict how long patients with severe life limiting disease will live. It requires two doctors to agree that a patient is expected to live for less than 12 months (compared to less than 6 months in four other states). It is known that doctors are very poor at accurately predicting whether you will live less than 12 months. 

At least 10% of patients predicted to live less than 12 months would have still been living in three years.

If the Queensland bill is passed, we estimate that 10 out of 100 Queenslanders who choose assisted suicide will have done so based on the wrong belief that they had a terminal illness. In contrast, in the four other states, which offer assisted suicide when you are expected to live less than 6 months, we estimate that 1 out of 100 patients will have chosen to have an assisted suicide, based on the wrong belief that they had a terminal illness.

Is it acceptable for Queenslanders to have so many extra wrongful deaths, because of an arbitrary extension of an eligibility criterion that isn’t based on expert medical advice? Why is this extra 6 months even necessary, when the assessment process takes only 9 days, and we are supposedly doing this to prevent suffering at the end of life?

Professor Paul Glare, Specialist Physician, Pain Medicine

They also note that:

The Queensland bill does not require the doctor to have any expertise in predicting death, or expertise in identifying depression. And it is very loose in its requirements to assess decision making capacity. We should identify and treat depression to relieve the desire to suicide, rather than promoting your suicide if this is caused by mental illness.

The bill also assumes that an accurate diagnosis will always be made of an incurable disease, and doctors will never miss the diagnosis of a condition that could have been treated. Yet it allows doctors in training, without any knowledge of the condition you have, to make a diagnosis that they have not been trained to make, and certify you for [assisted suicide or euthanasia]. This compares to other states, which have the advantage of specialists with experience in the disease you have. People with curable diseases have been wrongly assisted to suicide in other jurisdictions, because of a wrong diagnosis. The inexperience of the Queensland doctors would cause more wrongful assisted suicides based on incorrect diagnoses of treatable diseases.

The two experienced physicians warn of the impossibility of always identifying coercion and elder abuse and the inevitability that some Queenslanders will die wrongful deaths after being coerced by others to "request" assistance to suicide or euthanasia.

Everald Compton is a longstanding campaigner for [euthanasia], who has stated that he “has faith” that this law won’t be abused. This is a fantasy land where no-one lies, cheats or steals; in the real world, this law will be abused. It is naïve to believe that doctors, family members and others will not sometimes pressure vulnerable patients to have an assisted suicide. Elder abuse is common and the Queensland Bill would create the perfect scenario for this.

The people charged with detecting coercion are time pressured doctors, who unlike judges and lawyers, have no expertise or skills to detect coercion. If a loved one pressured you to have an assisted suicide, or you felt such a burden that you felt obliged to choose it, would you tell your doctor, or would you “go quietly”? Based on our professional experience, we strongly disagree with the “faith” that Everald Compton has, that the Queensland bill has any realistic ability to prevent or detect abuses.

For example, Queensland doctors would be able to initiate the conversation about assisted suicide. In other states the patient must initiate the discussion. It is fanciful to believe that a doctor would not sometimes guide a patient to have assisted suicide because of their own prejudices or opinions. Many patients will trust their doctor and follow their advice, and these conversations will be occurring within private non-recorded medical consultations. The fact that this change has been allowed into the legislation underlines the lack of medical experience in guiding the supposed attempts to protect the vulnerable.

Dr Luke Garske, Specialist in Thoracic (Respiratory) Medicine

Dr Garske and Porfessor Glare call for the Parliament to reject the Bil, and instead to adequately fund palliative care for all Queenslander.

We know that in overseas jurisdictions where assisted suicide has been going for about 2 decades, there is an ongoing rapid growth of numbers, and a gradual extension of indications to less serious conditions. With all of the unsafe aspects of the Queensland legislation being proposed from the outset, how can we have any confidence in how many Queenslanders will have wrongful and coerced deaths in 10-20 years? The only reliable safeguard is to keep the current law, and reject the bill.

Let’s instead focus on properly resourced palliative care. Why is it good enough for Premier Palaszczuk to provide only a fraction of the funds required to provide all Queenslanders with access to quality palliative care - when billions can be found for the 2032 Olympics?  Why doesn’t parliament just properly fund palliative care for all? This is the far more compassionate option, which in clinical reality will relieve suffering for many more people. Properly funded palliative care can terminate the suffering, which is far safer than terminating the sufferer.