Poll: would you dispense Voluntary Assisted Dying drugs?

Debate about Victoria’s Voluntary Assisted Dying legislation is dividing the country… but what do pharmacists think?

AJP.com.au

Megan Haggan

Victoria’s controversial Voluntary Assisted Dying bill – which would introduce legislation that would be the most “conservative” of its type in the world – has passed the State’s lower house, bringing the process one step closer.

Under the legislation, pharmacists would be part of the process, supplying lethal medicines in a locked box to eligible patients. . . [Full text]

 

Victoria, Australia: Voluntary Assisted Dying Bill 2017

Comment

Sean Murphy*

euthanasia and assisted suicide bill introduced in the Parliament of Victoria, Australia, includes several provisions that pertain to legal protection of freedom of conscience.  Concerning these:

  • Freedom of conscience provisions concern only individual practitioners, not health care facilities.  Freedom of conscience presumably includes acting upon moral or ethical beliefs grounded in religious teaching.
  • Statements of principles that require encouragement and promotion of an individual “preferences and values,” that people should be “supported” in conversations about treatment and care and “shown respect” for their beliefs, etc. can be interpreted to require affirmation of moral or ethical choices.
    • While the principles may have no direct legal effect, they could be cited by professional regulatory authorities against those who refuse to encourage, promote, or affirm the acceptability of euthanasia and assisted suicide.
  • Registered medical practitioner is not defined, but all would be encompassed by the definition of health care practitioner.
  • All health care practitioners are protected by Section 7.
  • Section 7(b) allows for refusal to participate in the request and assessment process and Section 7(c) protects refusal to be present when lethal medication is administered, but Section 7
    • does not include protection for refusal to participate in the administration of lethal medication, by, for example, inserting an IV line in advance, or by other means
    • does not include protection for refusal to participate in dispensing lethal medication
  • “Participate” in Section 7(b) is broad enough to encompass referral.  However, the bill would be improved by providing protection against coerced indirect participation in administering or dispensing lethal medication.
  • The bill does not require falsification of death certificates, but does require the falsification of the cause of death in the registration of deaths.  The bill includes no protection for a registrar who, for reasons of conscience, is unwilling to falsify a registry entry.

The great divide where religious beliefs and the law meet

Faith is accommodated In Australia, but there is piecemeal protection for religious freedom.

The Conversation

Michael Quinlan*

Australia is a multi-faith society. The 2016 Census shows that, while the mix of beliefs has changed over the years, Australia remains a pretty religious place.

In the last census, nearly 70% of Australians self-identified as religious. The number of Australians who have self-identified as Christian in the census has fallen from 88.2% in 1966 to 52.1% in 2016.

The number of Australians identifying as being of another religion has grown from 0.8% to 8.2%, with Islam (2.6%), Buddhism (2.4%) and Hinduism (1.9%) being the largest non-Christian faiths.

The number who self-identified in the category of “no religion” has grown from 0.8% to 30.1%. This category includes having secular beliefs, other spiritual beliefs or having no religion. This makes it hard to be sure what these Australians believe. . . [Full text]

Doctors divided over voluntary assisted dying legislation in Victoria

Australian Broadcasting Corporation

Lauren Day

You may think you have to make some pretty tough decisions at work, but it doesn’t get much tougher than choosing whether to help someone die.

Doctors are grappling with their personal and professional beliefs about death and their role in it as politicians in Victoria consider assisted dying laws.

Opinion polls show the majority of people support voluntary assisted dying, but those who would have to administer it are divided.

Polls suggest around 75 per cent of people support assisted dying for the terminally ill, but only 40 per cent of doctors agreed in a recent survey by the Australian Medical Association. . . [Full text]

 

New Zealand Attorney General apparently confused on issue of referral for euthanasia

Sean Murphy*

Chris Finlayson, the Attorney General of New Zealand, has issued a report on a euthanasia bill that has been introduced by Member of Parliament David Seymour, the leader and only sitting member of ACT New Zealand.

This bill includes protection of conscience provisions that were considered by Mr. Finlayson in his report (paragraphs 62-65).  The Attorney General stated that the provisions require an objecting medical practitioner to refer a patient to another physician for euthanasia, and acknowledged that this infringed freedom of conscience guaranteed by New Zealand’s Bill of Rights.  However, he believed this to be consistent with the Bill of Rights:

I consider that the limit is justified for the effective functioning of the regime for assisted dying created by the Bill.  In particular, I consider that the requirement to identify another medical practitioner is necessary to meet the objective of the Bill and is the most minimal impairment of the right possible.(para. 64)

The Attorney General appears to be confused on this point.

In fact, Section 7(2) of the bill requires only that the patient be told that he may contact the “SCENZ Group” (euthanasia coordination/facilitation service) to obtain the name of a euthanasia practitioner or physician willing to assist in the process.  It is up to the patient to initiate contact with the SCENZ Group, and the bill does not require a physician to assist the patient to do so.  This does not amount to referral to a euthanasia practitioner.

The distinction is important because physicians who object to euthanasia for reasons of conscience often refuse to refer patients for the procedure on the grounds that doing so would make them parties to homicide.  This issue is the focus of an important constitutional challenge in Canada, where the College of Physicians and Surgeons of Ontario is attempting to compel unwilling physicians to make effective referrals for euthanasia and assisted suicide.

116 Victorian patients refuse lifesaving treatment

The Advertiser

Grant McAurthur

FOUR Victorians a week are taking legal action to prevent doctors giving them lifesaving treatment, with the number expected to multiply next year when new regulations make refusing care easier.

As the Victorian parliament prepares to debate voluntary euthanasia laws in coming months, the Herald Sun can reveal 116 patients have already used legally binding certificates to ban hospitals prolonging their lives this year; however, the measures stop short of assisting them to die.

The issue arose last month when a failed suicide pact saw emergency doctors at Monash Medical Centre forced to save an elderly patient against her wishes because no legally binding Refusal of Treatment Certificate had been lodged to reinforce the demands. . . [Full text]

 

When doctors say No

A law professor defends physicians’ right to conscientious objection

MercatorNet

Michael Quinlan*

As abortion, euthanasia and other controversial procedures become more widespread, conscientious objection for healthcare workers is becoming a flashpoint for controversy throughout the Western world. Some doctors and ethicists have argued that conscientious objection itself is unethical because doctors are required to fulfil any legal request that their patients make.

MercatorNet interviewed Professor Michael Quinlan, dean of the law school at the Sydney campus of the University of Notre Dame Australia, about this contentious issue. He has just published an article on the situation in Australian jurisdictions. [Full text]

New South Wales assisted suicide/euthanasia bill permits refusal, protects practitioners

Euthanasia debate: NSW Parliament to consider drafted legislation on assisted dying

Australian Broadcasting Corporation

Ashleigh Raper & Andrew Griffits

New South Wales is a step closer to allowing terminally ill people to voluntarily end their lives, with a draft bill with cross-party support being released today.

The Voluntary Assisted Dying Bill has been drafted by a parliamentary working group made up of members from the Coalition, Labor, Greens and an independent.

The draft bill would give a person over the age of 25 the right to request assistance from a medical practitioner to end their life. . . .[ Full text]

  • The bill does not include a protection of conscience provision per se.  However, Sections 6, 24 and 25 permit a practitioner to refuse to participate for any reason, making no distinction between refusal for reasons of conscience and refusal for other reasons.  It also equally protects both participating and non-participating practitioners from criminal and civil liability.

New England Journal of Medicine publishes “attack on medical conscience”

Pro-Lifers: Get Out of Medicine!

First Things

Wesley J. Smith

Doctors in the United States cannot be forced to perform abortions or assist suicides. But that may soon change. Bioethicists and other medical elites have launched a frontal assault against doctors seeking to practice their professions under the values established by the Hippocratic Oath. The campaign’s goal? To force doctors, nurses, pharmacists, and others in the health field who hold pro-life or orthodox religious views to choose between their careers and their convictions.

Ethics opinions, legislation, and court filings seeking to deny “medical conscience” have proliferated as journals, legislative bodies, and the courts have taken up the cause. In the last year, these efforts have moved from the relative hinterlands of professional discussions into the center of establishment medical discourse. Most recently, preeminent bioethicist Ezekiel Emanuel—one of Obamacare’s principal architects—coauthored with Ronit Y. Stahl an attack on medical conscience in the New England Journal of Medicine, perhaps the world’s most prestigious medical journal. When advocacy of this kind is published by the NEJM, it is time to sound the air raid sirens. . . [Full text]

 

Politicians wrestle with doctors’ consciences in Victoria

Conscientious objection needs to be protected

MercatorNet
Reproduced with permission

Paul Russell*

As the Victorian Ministerial Advisory Panel on “assisted dying” makes ready to release its interim report sometime in April, The Age newspaper turned its attention to the matter of conscience whether a doctor may refuse to take part in any action that would bring about the premature and deliberate death of a person.

Conscience – or the ability to draw upon one’s own personal belief system in making a decision about an action – plays out at different levels in any debate on euthanasia and assisted suicide. . . [Full text]