December 15th 2018


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Articles from this issue:

COVER STORY The Christ child: a life lived for the whole world

WATER RESOURCES Murray-Darling management delivers the worst of both worlds

CANBERRA OBSERVED Libs fish around for explanations

ASIAN AFFAIRS Taiwanese agree to stick with nuclear power

EDUCATION In support of NAPLAN

VICTORIAN ELECTION Coalition collapse

ECONOMICS AND SOCIETY Mondragon Corporation: humanity at work

BREXIT December 12: D-Day for Britain's EU vote

EUTHANASIA WA Government ignores objections and lessons

TAIWAN Referendum stems homosexual tide

INTERNATIONAL AFFAIRS Free trade and the WTO in the Trump era

MUSIC Teacher teachers: The jarring note in music courses

CLASSIC CINEMA The Adventures of Robin Hood: The one and only

BOOK REVIEW A triumph of determination

BOOK REVIEW An escape from futility and addiction

POETRY

LETTERS

HIGHER EDUCATION Massification: it's the name of the game

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EUTHANASIA WA
Government ignores objections and lessons


by Hal G.P. Colebatch

News Weekly, December 15, 2018

The WA Labor Government is determined to ram a bill legalising euthanasia through State Parliament.

Labor has an overwhelming majority in the Legislative Assembly but it may have problems in the Legislative Council, where the votes of small parties, including One Nation, may be critical. The Liberal Party is expected to oppose it, but its numbers in the lower house have been savaged.

Labor presents its strongest argument in favour of killing:
the battering ram will show who is right.

The legislation is being drafted by a panel of 11 under former Governor Malcolm McCusker, in blatant defiance of the convention that Governors and former Governors be non-political.

The West Australian newspaper has described the panel as “experts”, though what makes anyone an “expert” in legalised killing is not explained.

Mr McCusker has made no bones about judiciously or objectively weighing up the pros and cons of legalised killing. He claims: “There are many people who have relatives or good friends who would have been assisted by this legislation.”

Yes, particularly those who stand to inherit a house or share portfolio. As a former criminal lawyer and judge, Mr McCusker must be aware that human beings sometimes act from less than the purest motives.

Health Minister Roger Cook indicated the starting point for the proposed legislation would be terminal illness but “all the medical conditions would be considered”, meaning presumably that people with non-terminal or even non-chronic conditions such as depression might be candidates for being killed.

Involuntary killing of vulnerable patients by medical staff, under the euphemistic name of “Liverpool Care Pathway”, has gradually become widespread in Britain. This is despite the fact that nearly all the medical bodies – the British Medical Association and the Royal Colleges – remain opposed to euthanasia.

Pressure for the legalisation of killing has been coming from several different directions, but the Liverpool Care Pathway appears to be the most insidious. It is a superficially legitimate medical procedure that could have been purpose-made for abuse: the abuse in question being nothing more nor less than murder.

Almost two-thirds of National Health Service (NHS) trusts using the Liverpool Care Pathway have received payouts totalling millions of pounds for hitting targets related to its use, research for The Daily Telegraph shows.

Figures obtained under the UK Freedom of Information Act suggest that about 85 per cent of trusts have adopted the regime, which can involve the removal of drink and food from dying patients.

More than six out of 10 of those trusts have received or are due to receive financial rewards for doing so, amounting to at least £12 million.

Withdrawal of fluids (and drugs) is one of the steps on the Liverpool Care Pathway, which has been adopted by 900 hospitals, hospices and care homes in England.

The intention was to help cancer patients to die comfortably. But there is growing evidence that patients who don’t fit the criteria are being railroaded on to the “pathway”, and into premature death.

Critics say it can actively hasten death. At many hospitals most patients who died had been placed on the “pathway”. In one case, the proportion of foreseeable deaths on the pathway was almost 90 per cent.

The UK Department of Health has insisted that the payments could help ensure that people were “treated with dignity in their final days and hours”. Opponents say that it is “absolutely shocking” that hospitals could be paid to employ potentially lethal treatments.

The “pathway” was originally developed at the Royal Liverpool University Hospital and the city’s Marie Curie Hospice, setting out principles for how dying patients were to be treated. It also involves the withdrawal of treatments or tests from patients that doctors believe could cause distress and do more harm than good.

Insofar as the Liverpool Care Pathway is a means of killing old and other expensive people by gradual hunger and thirst, with the withdrawal of food and water, it is similar to the “withdrawal diet” – that was the name – of vegetables from which the nourishment has been boiled out. This was used by Nazi doctors in the Third Reich as, principally, a means of killing mental patients.

A series of cases has also come to light where relatives said they were not consulted or even informed when food and fluids were withheld from their loved ones.

Some patients placed on the “pathway” because doctors judged they were dying went on to recover.

Arthur Oszek, aged 86, was admitted to Ayr General Hospital in Scotland after a fall. His stepdaughter claims that for several days Mr Oszek, a diabetic, had his food, drink and some of his medication removed. She was told he had been put on the “pathway” – including a “withdrawal of food and fluids” – in a bid “to let his body focus on medication to make his final days as comfortable as possible”.

She was furious that doctors had not asked permission to put him on the “pathway” and demanded he be taken off it. After 20 hours of discussions, doctors agreed to restore his food and drink. But by then it was too late and Mr Oszek’s body gave up the fight. He died 17 hours later.

According to responses from a sample of 72 trusts, at least £12.4 million has been paid out in the past two to three years to trusts which hit targets associated with use of the “care pathway”. But the full figure could be more than £20 million.

Under a system quaintly known as “Commissioning for Quality and Innovation” (CQUIN), local NHS commissioners pay trusts for meeting targets to “reward excellence” in care. These can range from simply recruiting a set number of people to classes to help them stop smoking to providing specialist end-of-life services on wards – such as the “pathway”.

The goals are set locally, and vary from area to area, but in some cases trusts are given specific targets to ensure that a set number of people who die in their hospital are on the Liverpool Care Pathway.

The Daily Telegraph reported: “But there must be many homes in this country where men and women are secretly hoping that their parents will die in a reasonable, timely manner – and, above all, that they will not consume their inheritance with endless care-home fees before they go.

“Unhappily, many of those parents may also be guiltily wondering if they should hang on to life when it means that the home they have bought over many years of careful saving may have to be sold to pay for their care, instead of being passed on to their offspring.”

Meanwhile, quite apart from the “pathway”, other patients are being starved to death in British National Health Service hospitals. One survey, for the respected Health Service Journal, found that only one in three hospitals bothered to weigh patients on admittance so they could ensure they were fed properly.

Recent figures show that hundreds have died of malnutrition in NHS hospitals and many thousands left hospital more malnourished than when they arrived.

According to an investigation by the Daily Mail, food is often so unappetising that patients do not eat it and 11 million meals are thrown away every year. Sometimes food is placed out of patients’ reach and taken away untouched, because nurses claim they are too busy to help them eat.

The Health Service Journal survey, which was carried out anonymously, involved 401 managers and health workers. Only 37 per cent of those who responded to the survey said nutritional care was a priority for hospital chief executives and boards. One said: “Based on my experience watching my grandmother being cared for, my opinion is very low. Nutritional care was almost non-existent.”

None of Britain’s last four Prime Ministers – Tony Blair, Gordon Brown, David Cameron and Theresa May – or their ministerial political heads has seemed interested in rectifying the situation, although a few telephone calls from No. 10 Downing Street might produce results.

Brown, a Presbyterian minister’s son, besides speaking out against legalising assisted suicide did nothing.

And, while the legislation is being touted in WA, as elsewhere, as legalising “voluntary” euthanasia, there is no sign that the Government is giving any consideration to the greatest objection to this. That is that, whatever safeguards are written into law, the experiences of other countries, such as Holland and Belgium as well as the NHS, show, without question or doubt, that voluntary euthanasia, once legalised, will not remain voluntary.

Already one Perth GP has admitted to giving a lethal injection to a terminally ill patient, without professional or legal consequences. But the present Labor Government in WA cannot be imagined launching any prosecution.

Previously, people with painful terminal illnesses have sometimes been given massive doses of painkillers that resulted in death, but the crucial difference was that death was not the object of the treatment. This is a different matter.

People have been killed in the euthanasia countries who could not possibly have given informed consent, including children and the severely mentally ill. Yet the killers have escaped any punishment. The Swiss “Dignitas” clinic, well down the slippery slope, has carried out euthanasia for relatively minor conditions: “a permanent solution to a temporary problem.”

However, the WA branch of the AMA and the Australian Christian Lobby are opposed to legalisation. The Catholic Church has, so far, also been adamantly opposed. But this is a matter on which believers and non-believers may unite.

It is a matter where the boundary between “voluntary” and “involuntary” is often blurred, and those who appear the most likely candidates are often the ones least likely to be able to give informed consent. Chemotherapy treatment for cancer, for example, often leads to disorientation and delusions.

How genuine is “consent” by a confused old person being pressed by heirs keen to inherit or busy doctors keen to free up a bed? I have even seen accep­tance of euthanasia being described as laudable and unselfish by a leading Christian ethicist.

Thus, while assisted suicide is put forward as a human right, its legalised practice is in fact the reverse: legalisation of a “right to die” is in the long run an attack on the right to live.

In what is possibly the most purely evil article I have ever read, Matthew Parris, a former British Tory MP and now a columnist for the British Spectator, suggested tax policies should be structured so that the cost of caring for old people would be taken out of their estates – deliberately in order to have their heirs pressure them to accept euthanasia before those estates became rundown! (As far as I know, Mr Parris has no children).

There is another, by no means unim­portant, point against euthanasia: if we had accepted euthanasia in the past, there would have been no advances in palliative care (which has now very largely removed severe pain from terminal conditions). And there would have been far less incentive to find new treatments for both pain and formerly incurable diseases such as cancer.

Thanks to advances in modern medicine, many cancers once 100 per cent fatal are now curable (I speak from personal experience), or treatable as low-level chronic conditions with minimal disruption of life. Euthanasia would tend to stop, or at least be a disincentive to, many advances in medical research.




























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TRANSGENDER: one shade of grey, 353pp, $39.99


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