September 22nd 2018


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COVER STORY Water, water everywhere, but not for the farmers

EDITORIAL Power companies in clover after closures

CANBERRA OBSERVED Liberals in need of an internal peacemaker

ENERGY Solar, wind dependence will add $1300 to power bills, engineers, scientists warn

LIFE ISSUES Queensland life march busts media stereotypes

ENVIRONMENTAL POLITICS Unmask activists disguised as nature lovers

FOREIGN AFFAIRS China takes up challenge to imitate and overtake America

CHINA AND AUSTRALIA Paul Monk thunders at kowtowing former pollies

FOREIGN AFFAIRS Hawaii: Pearl of the Pacific

BOOK EXCERPT From Patrick J. Byrne's book, Transgender: One Shade of Grey

FREE SPEECH University of Western Australia blinks again

LIFE ISSUES Queensland law will open floodgates to sex-selective abortion

HUMOUR

MUSIC Pop and singing: A certain antagonism

CINEMA Christopher Robin: The best something comes from nothing

BOOK REVIEW A so-called industry with only a dark side

BOOK REVIEW Population see-saw changes direction

LETTERS

POETRY

EUTHANASIA No concoction can kill peacefully

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EUTHANASIA
No concoction can kill peacefully


by Terri M. Kelleher

News Weekly, September 22, 2018

In November 2017, the Victorian ALP Government of Daniel Andrews passed the Voluntary Assisted Dying Act to make it legal for health professionals to assist a patient on request to kill him or her self, physician-assisted suicide (PAS).

The catchcry of the proponents of assisted suicide/euthanasia is “death with dignity”, which implies that natural death is somehow undignified. But is the reality of assisted suicide/euthanasia a “dignified” death? Is assisted suicide/euthanasia a “good” death?

In his minority report (begins at page 287) to the WA End-of-Life-Choices Inquiry, MP Nick Goiran examined this issue. He quoted from the submission by Doctors for Assisted Dying Choices that the medical profession has the “means and skills to provide a gentle death” and “that the duration of (a patient’s) suffering is as short as possible”. This is the intention but how often is this not so?

Actual instances from the United States record how lethal injection does not always make for a peaceful death. The accounts make awful reading.

“April 29, 2014. Oklahoma. Clayton D. Lockett. Lethal Injection. … Three minutes after the … drugs were injected “he began breathing heavily, writhing on the gurney, clenching his teeth and straining to lift his head off the pillow”. Officials then lowered the blinds to prohibit witnesses from seeing what was going on, and 15 minutes later the witnesses were ordered to leave the room. Mr. Lockett died 43 minutes after the execution began, of a heart attack, while still in the execution chamber.

“July 23, 2014. Arizona. Joseph R. Wood. Lethal Injection. After the chemicals (midazolam and hydromorphone) were injected, Mr Wood repeatedly gasped for one hour and 40 minutes before death was pronounced.

“December 8, 2016. Alabama. Ronald Bert Smith, Jr. Lethal Injection. Smith heaved, gasped and coughed while struggling for breath for 13 minutes after the lethal drugs were administered, and death was pronounced 34 minutes after the execution began. He also “clenched his fists and raised his head during the early part of the procedure”. Alabama used the controversial sedative midazolam (a “Valium-like drug”) in the execution.

U.S. Commentator Tamara Tabo draws the link between the drugs used in executions and those used for PAS. She asks: “Observers might wonder how doctors can help terminally ill patients gently, painlessly, and quickly end their lives, while prison officials seem hard pressed to do the same for inmates sentenced to death. … Why can’t prisons use the same drugs that doctors in Oregon use? The answer is: they often do. Why then don’t Death With Dignity Act patients experience the same sorts of complications that some capital offenders have? The answer is: they often do.

“Fourteen states also began using a simpler single-drug protocol of pentobarbital. According to the Death Penalty Information Center, four of the six executions carried out in various states in January 2014 used the drug by itself. Unfortunately, when Oklahoma officials used pentobarbital in the execution of Michael Lee Wilson, witnesses reported the inmate saying aloud that he could feel his ‘whole body burning’ during the execution process. Tanya Greene of the ACLU called pentobarbital’s use ‘basically an experiment on human beings; the risk of extended, painful death is very high’.

“Why don’t prisons use whatever concoction doctors prescribe to terminally ill patients then? Well, according to the state of Oregon’s “Death With Dignity Act 2013 Annual Report”, in 2013, 90.1 per cent of patients prescribed lethal medication under the DWDA received … pentobarbital”.

Which is the drug used under Oregon’s PAS law.

Tabo makes several further points: “Witnesses at executions are sometimes horrified by an inmate whose execution does not proceed as quietly or smoothly, or whose death does not come as quickly, as expected. Lethal drugs don’t necessarily spare patients seeking physician-assisted death from similar complications, unfortunately.

“Research from the Netherlands, where active euthanasia has been legal since 2001, reports patient self-administration of physician-prescribed lethal medication did not work as expected in 16 per cent of cases. In an additional 7 per cent of cases, patients experienced unexpected side effects.

“The study describes patients regaining consciousness after ingesting the drugs, vomiting, and gasping for breath, and seizures. In 6 per cent of cases, patients either regained consciousness or took significantly longer to die than expected. In the Netherlands, times between drug administration and death varied considerably, with a median range of 3.8 hours. …

“In 2005, a patient regained consciousness 65 hours after taking the medication, subsequently dying from the underlying illness 14 days after awakening. In 2010, one patient regained consciousness 88 hours after ingesting the medication, subsequently dying from underlying illness three months later. Another patient the same year regained consciousness within 24 hours, subsequently dying from underlying illness five days following ingestion.

“In 2011, a patient regained consciousness approximately 14 hours after ingesting the medication and died about 38 hours later. Another patient briefly regained consciousness after ingestion and died from the underlying illness 30 hours later. One 2004 prescription recipient became unconscious 25 minutes after ingestion, then regained consciousness 65 hours later. Oregon Public Health reports that the patient ‘did not obtain a subsequent prescription and died 14 days later of the underlying illness (17 days after ingesting the medication)’.”

In Oregon between 1998 and 2012, six out of 681 DWDA patients regained consciousness after ingesting the lethal DWDA medications. Tabo asks: “Would you ask for a refill of pentobarbital if this happened to you? Talking about an idealised version of euthanasia or physician-assisted death is comforting. Drinking prescribed poison, slipping into what you believe will be your final rest … then waking up? Not so comforting.”

Pro-PAS advocates have claimed that Nembutal is the answer, that it is the “gold standard” for oral use. In Australia, Nembutal is not allowed for use in humans, only in large animals in veterinary practice. Even Philip Nitschke of Exit International admits there have been instances of people waking up. But he says the overall instance of that sort of thing is very low. That may be so, but people have to know the truth – that PAS does not guarantee a peaceful, painless or prompt death.

In Victoria, an Implementation Taskforce is undertaking a range of projects to support the application of the Voluntary Assisted Dying Act, among which projects is “medication protocol development”. The aim of this project is to “identify best-practice voluntary assisted dying substances and develop medication protocols”.

Its task therefore is to decide on the lethal substance(s) to be prescribed for patients to kill themselves. The taskforce is to “engage a pharmacy department to undertake research into best-practice medications for use in voluntary assisting dying ... There will be particular focus on developing a safe and effective substance for use in self-administration.”

How will this be done? Will there be experiments on patients to find the cleanest, most efficient poison? How are poisons to be trialled to find out which is the most efficient?

The law will not be fully operational in Victoria until the lethal substance(s) are agreed to. Waiting on advice of the quickest, most efficient substance for a person to kill themselves highlights the reality of what the Voluntary Assisted Dying Act is about: enabling doctors to prescribe a lethal substance(s) for a patient to kill themselves. This is abhorrent.

Victorians (and residents of Western Australia and any other state where assisted-suicide/euthanasia legislation is under consideration) need to be aware just what a legal framework to allow doctor-assisted suicide/euthanasia requires: it requires a poison that will kill efficiently. Can people really turn their minds to this?

In Victoria, an inquiry should be held into the work on the development of the lethal substance(s). The public should know how the lethal substance(s) are being developed, why one is chosen over another, what the possible unintended effects are.




























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