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]

 

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]

 

Doctors will have right to refuse assisted death requests under planned reforms

The Age

Farrah Tomazin

Doctors will have the right to refuse to help terminally ill patients who wish to die provided they don’t obstruct people from seeking support elsewhere, under assisted dying laws to be drafted by the Andrews government.

In a high-level report to be considered by cabinet, an expert panel is set to recommend allowing doctors to hold a “conscientious objection” to physician-assisted death – similar to the provisions that allow them to refuse abortions in Victoria.

But medical clinicians who are willing to help patients end their life may be required to have extra training, and anyone who tries to pressure someone to die could face criminal sanctions in a bid to ensure there are strict safeguards against exploitation. . . [Full text]

Tunnel vision at the College of Physicians

National Post

Sean Murphy

The College of Physicians and Surgeons of Ontario has adopted a policy requiring physicians who have moral or ethical objections to a procedure to make an “effective referral” of patients to a colleague who will provide it, or to an agency that will arrange for it. In 2008, amidst great controversy, the Australian state of Victoria passed an abortion law with a similar provision.

After the law passed, a Melbourne physician, morally opposed to abortion, publicly announced that he had refused to provide an abortion referral for a patient. This effectively challenged the government and medical regulator to prosecute or discipline him. They did not. The law notwithstanding, no one dared prosecute him for refusing to help a woman 19 weeks pregnant obtain an abortion because she and her husband wanted a boy, not a girl.

They obtained the abortion without the assistance of the objecting physician, and they could have done the same in Ontario. College Council member Dr. Wayne Spotswood, himself an abortion provider, told Council that everyone 15 or 16 years old knows that anyone refused an abortion by one doctor “can walk down the street” to obtain the procedure elsewhere.

So why did the College working group that drafted the demand for “effective referral” urge College Council to adopt a policy that so clearly has the potential to make the College look ridiculous? . . .[Full text]

Fundamental freedoms

 Why the right to conscientious objection must be restored

Presentation to the Life Dinner
Melbourne, Australia

David van Gend*

I feel a little out of place coming from Queensland to speak about the wretched situation in Victoria: coming from a State where it is always sunny, where the people are always nice, and where we don’t have oppressive laws that try to compel the conscience of free citizens.

But we are all in this together: an assault on fundamental freedoms in one State will become a precedent for similar abuses in other States.

Uncivil society

It was a Melbourne man, Julian Savulescu, now an ethics professor at Oxford, who declared that doctors who will not provide abortion should be “punished through removal of license to practice”. He wrote in the British Medical Journal in 2006:

A doctors’ conscience has little place in the delivery of modern medical care. What should be provided to patients is defined by the law… If people are not prepared to offer legally permitted, efficient, and beneficial care to a patient because it conflicts with their values, they should not be doctors.1

Crucial to his argument is that, “when society has already decided that a service is legal”, it is not for doctors to “compromise the delivery of services”. When Savulescu’s article was discussed in 2006 in the medical newspaper Australian Doctor, I was given as an example of the sort of doctor who, in his view, “should either get out of the specialty or the profession altogether.”2  I gave a different angle to Australian Doctor: that abortion as commonly practiced is not a medical service; it is a “medical abuse” which doctors are bound by their Hippocratic principles and humane conscience not to commit.

And no law, no professional board, has the authority to compel any doctor to violate the principles of their vocation or mutilate their own conscience by collaborating in intentional killing.

Yet in Victoria, under section 8 of the Abortion Law Reform Act 2008,3 that compulsion by the authorities is exactly what doctors and nurses face.

Not long ago society was a little more civil and did not contemplate using the force of law to compel the conscience of fellow citizens. . . [Full text]

Abortion law changes eyed as Dr Mark Hobart probed

The Sydney Morning Herald

Henrietta Cook

The Napthine government is not ruling out changes to Victoria’s abortion laws ahead of an investigation into a doctor who refused to give a couple an abortion referral because they wanted a boy.

The state government said it was interested in the outcome of the Medical Board of Victoria’s investigation into Mark Hobart, a pro-life doctor who has been accused of breaking the state’s abortion laws.

It comes as pro-life advocates run a concerted campaign to repeal a section of the Abortion Law Reform Act, which requires doctors who have a conscientious objection to abortion to refer a woman to someone with no such objection. [Full story]

Australian regulator misrepresents physician obligations

Claim that practitioner codes require referral disproved by Australian Medical Association

Sean Murphy*

According to a report in The Examiner, a representative of the Australian Health Practitioner Regulation Association told a Tasmanian legislative committee that physicians who object to a procedure for reasons of conscience are obliged by professional codes of ethics to refer patients to another physician.  Lisa McIntosh was addressing the Committee concerning a proposed Reproductive Health Bill.

Her assertion is contradicted by a submission by the Australian Medical Association Tasmania, which protested the section of the bill that would force objecting physicians to facilitate morally contested procedures by referral.  The AMA Tasmania submission included quotes from the AMA Code of Ethics and a document from the Medical Board of Australia Good Medical Practice to demonstrate that the draft legislation information paper falsely claimed that there was a duty to refer.

The Committee also heard from Catholic Archbishop Adrian Doyle, whose concerns about the proposed bill included the mandatory referral provision.

 

Australian Medical Association Submission to the Tasmanian Government

On the law governing termination of pregnancy

Introduction

The Tasmanian branch of the Australian Medical Association expressed qualified support for statutory legalization of abortion in a submission to the Tasmanian state government concerning its proposed Reproductive Health (Access to Terminations) Bill 2013.  However, the Association also emphasized its opposition to parts of the proposed bill that would suppress freedom of conscience among physicians.  Those parts of the submission are reproduced below. [Read more . . .]