Volume 199 - Issue 2
Doctors in support of law reform for voluntary euthanasia
Authors: John O Willoughby, Robert G Marr and Colin P Wendell-Smith
Med J Aust 2013; 199 (2): 97-98. || doi: 10.5694/mja13.10480
Published online: 22 July 2013
Published online: 22 July 2013
In reply: We thank Dunne and Woodruff for comments on our Perspectives article.1 Both colleagues firmly expressed their opinions. However, we find it telling that neither mentioned consideration of their patients’ opinions and both referred to euthanasia, not voluntary euthanasia (VE), which was the subject of our article.
We agree with Dunne that “it does not seem reasonable for euthanasia to be legalised so that doctors ...
In reply: We thank Dunne and Woodruff for comments on our Perspectives article.1 Both colleagues firmly expressed their opinions. However, we find it telling that neither mentioned consideration of their patients’ opinions and both referred to euthanasia, not voluntary euthanasia (VE), which was the subject of our article.
We agree with Dunne that “it does not seem reasonable for euthanasia to be legalised so that doctors can avoid the scrutiny of the law”. However, we are at a loss to understand his logic in suggesting that legalisation of VE would enable doctors to avoid scrutiny. Scrutiny would be enhanced by defining legal and open processes to be followed, thus satisfying Dunne’s own requirement that doctors should have their actions “subject to scrutiny to protect the public and their own moral and ethical standards”.
We accept Dunne’s personal view that titrated administration of morphine and other drugs is “safe” (notwithstanding a known failure rate with palliative care2). Indeed Dunne acknowledges that the presence of underlying pain may be required to act as an antagonist to respiratory depression and the sedative effects of opioids. However, emphasis on pain alleviation ignores that it is loss of autonomy, dignity and all life enjoyment, rather than pain, that provokes persistent and rational requests for assistance to achieve a peaceful death at a time of one’s choice, surrounded by loved ones.3
Woodruff refers to a book of essays to argue that VE laws cause non-voluntary euthanasia (NVE). He ignores published peer-reviewed research,4 any reading of which suggests that end-of-life practices in the Netherlands are transparent and safe, exposing the rate of doctor NVE in Australia as five times the Dutch rate at the time4,5 and establishing that the Dutch rate of NVE has dropped considerably since legislative reform.4
We believe that VE laws would fulfil a need in Australian medicine without the sequelae that concern Dunne and Woodruff.
Competing interests
No relevant disclosures.
References
- Willoughby JO, Marr RG, Wendell-Smith CP; Doctors for Voluntary Euthanasia Choice. Doctors in support of law reform for voluntary euthanasia. Med J Aust 2013; 198: 190. 0_BABHDJFC
- Paice JA, Muir JC, Shott S. Palliative care at the end of life: comparing quality in diverse settings. Am J Hosp Palliat Care 2004; 21: 19-27. 0_i1142879
- Oregon Public Health Division. Death with Dignity Act. http://public.health.oregon.gov/Provider PartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/index.aspx (accessed Apr 2013).
- Onwuteaka-Philipsen BD, Brinkman-Stoppelenburg A, Penning C, et al. Trends in end-of-life practices before and after the enactment of the euthanasia law in the Netherlands from 1990 to 2010: a repeated cross-sectional survey. Lancet 2012; 380: 908-915. 0_i1142883
- Kuhse H, Singer P, Baume P, et al. End-of-life decisions in Australian medical practice. Med J Aust 1997; 166: 191-196. 0_i1142886