WA MP warns of wrongful deaths under euthanasia bill

Speaking in opposition to the Voluntary Assisted Dying Bill 2019 in the Legislative Assembly of the Parliament of Western Australia on Wednesday 28 August 2019, Dr David Honey, the Liberal Member for Cottesloe, made several telling points.

Firstly, he noted that much of the drive for assisted suicide and euthanasia is based on observer accounts of a loved one’s death as “distressing”:

It is my observation that in many cases when people are dying of natural causes at an older age, it seems to be more distressing for the people observing the process than the person who is dying. I have met many older people who are reconciled with their imminent death and are satisfied that they have lived meaningful lives. I believe that the observer’s distress drives a lot of the emotion around legislating an alternative outcome, avoiding untidy or disconcerting outcomes with a certain outcome, being able to stage a good death. It is easy to confuse our own distress at seeing a loved one incapacitated and in pain for distress on their part. The dying person may sometimes be in less distress than those who cannot bear to watch them die.

Secondly, he pointed to uncertainties in prognoses with the consequence that, if passed, some Western Australians would die by assisted suicide when they still had “a good few years” to live.

This bill presupposes that a person can be reasonably known to be dying within a certain period—in this case, six months for a disease or illness, or 12 months for a neurodegenerative condition—and that they will be enabled to ingest a poison that will simply bring forward an inevitable outcome. Members will be aware from their own experience and the several briefings we have had that there is considerable uncertainty about when a person will die when they are in the final stages of a terminal illness. [There is] a large number of occasions when the prognosis is overly pessimistic. Many of us would know of instances when someone has had a prognosis of imminent death, often from cancer, and they have gone on to live for a good few years. One of the factors that causes suffering for many patients is the apparent imminence of death. It would be a dreadful unintended consequence of this bill if that distressing fact led to a person taking their own life early.

Thirdly, he expressed deep concern that a sense of loneliness and abandonment could fuel requests for assisted suicide and euthanasia.

Hon Ken Wyatt, who was the Minister for Senior Australians and Aged Care in the previous federal government, informed me earlier this year that 40 per cent of people in aged care do not have a single visitor in a year. Imagine that! You are in the final stages of your life and you have been completely abandoned by everyone you know—brothers and sisters, sons and daughters, relatives and friends. This is a very cruel and unpleasant fact. Would a person who has been completely abandoned in this way be in a fit mental state to make a decision to end their life if they also have a terminal illness?

Fourthly, he warned of the real danger that subtle coercion from impatient, greedy heirs on a person leading to access to assisted suicide or euthanasia could easily fail to be identified.

There is a considerable body of legal cases that look at the ability of people to make free and informed decisions, mostly relating to financial matters. In many cases, they involve close relatives or friends. In the case of a person dying, there are often significant financial implications associated with disbursement of their assets. Typically, close relatives are the major beneficiaries. Although we all like to think that we would not seek to influence a person to our financial advantage in such a situation, many legal cases indicate that this happens all too often.

Sometimes that influence is overt and amounts to bullying a vulnerable person. Sometimes it is unconscious influence, which can be caused, for example, when a pending recipient of an inheritance is suffering financial hardship. In these latter cases, the person responsible may be a genuinely loving relative or friend. Nevertheless, by their actions, they influence the vulnerable person to carry out an action that benefits themselves.

I find it very hard to believe that the option of hastening someone’s death through voluntary euthanasia will not become entwined with overt or covert pressure from a relative or friend who has financial issues or is greedy.

By its nature, identifying such influence is difficult. It typically occurs in private. The dying person may be embarrassed to disclose the coercion or not want to cause problems for the relatives or friends by disclosing the coercion. Identifying such coercion requires an intimate knowledge of the dying person. It requires that that person trusts someone enough to reveal the coercion.

Even more concerning than coercion is subtle manipulation and the improper use of influence. A dying person might be persuaded by someone whom they love or trust that an assisted death is best for them. This kind of coercion is extremely difficult to detect. Indeed, the dying person might not even know that their decision-making had been influenced. They would not realise that there was any abuse to report. Unfortunately, we know that coercion and undue influence of vulnerable people is extremely common.

While the bill sadly is expected to pass the Legislative Assembly by a comfortable margin it faces a much closer battle in the Legislative Council.

Read Dr Honey's full speech here