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Magic Talk: #DefendNZ Bioethics Professor outlines key ethical flaws with euthanasia in exclusive interview

Magic Drive with Ryan Bridge.

With today marking assisted dying becoming legal in Victoria, and with David Seymour’s euthanasia Bill to be debated in Parliament on Wednesday 26 June, Ryan Bridge spoke with an euthanasia expert from Australia who featured in the #DefendNZ documentaries, Professor of Bioethics, Margaret Somerville.

Ryan Bridge: Well today in Victoria assisted dying becomes legal – in the state of Victoria in Australia – and next week on Wednesday as I understand it, the ACT MP David Seymour's End of Life Choice Bill will be debated for a second time in Parliament.

Ryan Bridge (cont.): And there's a very interesting woman – her name is Margaret Somerville. She's with the University of Notre Dame in Australia. She is a bioethics professor and I spoke to her a short time ago about this issue. Began by asking, putting a scenario to the Professor, “I have a terminal illness. I'm in great pain and I would just like the suffering to end. Who are you, Professor Margaret Somerville, to tell me otherwise?”

Professor Margaret Somerville: Well, you know, when you’re talking about putting people to death, which is what we’re talking about here, with euthanasia, (Euthanasia is a lethal injection, or physican assisted suicide is where the doctor gives you the medication knowing you are going to use it to kill yourself), you’re not just talking about an individual, you’re also talking about what is our societal – what we call – ethos, the tone of our society. And also you’re talking about, “I this ethical?” and in particular, “Is it an ethical thing for doctors to do?” My field is looking at medicine and the ethical and unethical use of medicine. And I believe that doctors acting with an intention to shorten somebody’s life, and by that I mean intentionally do that and not for any other purpose, that that is ethically wrong. And I would also...

Ryan Bridge: But in the case…

Professor Margaret Somerville: I’m sorry. Can I just…

Ryan Bridge: But in the case of assisted dying, they are not having the intention of ending somebody’s life, they are simply empowering an individual to do that for themselves, are they not?   

Professor Margaret Somerville: Well, they are giving people the means to end their life, knowing that’s what they will do. I mean if you look at what’s happened here in Victoria, in Australia, starting today, there’s a pharmacy in the, I think it’s the Alfred Hospital in Melbourne, and two pharmacists there have volunteered to produce the drugs that are needed for somebody to commit suicide. And those drugs will be put in a locked kit, and those pharmacists will deliver those drugs to the person who has had permission to obtain them. Now I mean that’s very clearly participating in helping a person to end their own life. And that’s what we’re talking about. I just want to say something about what you said in your introduction statement, nobody should be left in terrible pain. And we now have a declaration – an international declaration, called the Declaration of Montreal – that establishes that for a healthcare professional to leave somebody in serious pain is a breach of fundamental human rights. So you shouldn’t be needing euthanasia to deal with pain. And in fact, when you look at the statistics, and you do a list of reasons why people want euthanasia, do you know where pain comes on the list?

Ryan Bridge: No?

Professor Margaret Somerville: It comes in number 14.

Ryan Bridge: And I understand that, but not withstanding there are people in great pain and they can be in pain for many years. You'd like to turn them essentially into drug addicts for the final years of their lives. I mean that's what some people are having to go through.

Professor Margaret Somerville: If you are in pain, you don't become a drug addict.

Ryan Bridge: Well you do.

Professor Margaret Somerville: No you don't.

Ryan Bridge: I've seen it. I've seen it in people who are in the final stages of life, and they’re just hooked on morphine.

Professor Margaret Somerville: Well if they're in pain, they need the morphine, and I wouldn't call that “hooked on morphine”. I think that’s necessary medical treatment, and I've got no problem with that at all. But it's very different for a doctor to act with a primary intention of killing the patient. And that's what euthanasia involves.

Ryan Bridge: I'm just wondering though, Professor, whether you are trying to impose your moral compass onto people who just want to make a decision for themselves in the final stages of their life. I mean, who are you to tell them otherwise?

Professor Margaret Somerville: Ryan, what you're arguing there, is the ‘dominance to exclusion of all other considerations’ of individual autonomy or self-determination. But we're not islands. We exist in communities and we have laws to establish the most important basic values in our communities. And what we're doing here is legalising intentional killing. Now up until you've got some legislation that allows that, as you just have in Victoria, that is first degree murder! And so you know, is this something that we should be doing? And also we've got to look at the consequences of this. And I've had quite a lot of experience in following that. Canada legalised euthanasia two years ago. The original prediction of a very prominent pro-euthanasia doctor that I used to debate with, was that in Quebec – which is a large province in Canada – there be a maximum of 100 cases of euthanasia a year. The latest figures are, within the first two years just under 8,000 people have been euthanised [in Canada]. So we have to look at what happens with this – it gets normalised. It becomes a normal way to die. Between 1 in 4 and 1 in 5 deaths in The Netherlands are by euthanasia – and that's the ones that we know about – and we know that there's a big under-reporting problem. So we have to think about is that what we want to introduce into our society. What you're arguing when you're argue ‘pain’ and you argue ‘individual autonomy’, those are the strong arguments to support euthanasia. But you can't just look at those, you have to look at a wide spectrum of consequences of this – and what it says about us.

Ryan Bridge: Okay, given that your concerns, Professor, are around the ability of a health professional or a doctor to assist somebody in their dying, in their later stages of life, and that that seems to be an ethical problem for you – given that we know that guns, knives, ropes have been used by individuals to take their own lives, should we ban the sale of them as also unethical?

Professor Margaret Somerville: But we don't sell them with the intention that they'll be used to kill somebody else.

Ryan Bridge: Well they can be and they often are...

Professor Margaret Somerville: But yes, if you knew that somebody, I mean like a terroist, if you were gun dealer and you knew that this person was probably going to use this for terrorism, of course you can't sell that ‘arm’ to them, that gun – I mean that's just the same sort of very good example. Also you used the term, “a doctor is assisting somebody in their dying”. I've got absolutely no problem with a doctor assisting somebody in their dying. In fact, I think they have ethical obligations to do that – I just don't think it includes killing them. I mean, palliative care is a whole discipline of medicine devoted entirely to practice and research in assisting people who are dying so that they do die without pain, with the minimum possible suffering. I mean, there are some kinds of suffering we can't treat, what we call ‘existential suffering’: People who agonise over past mistakes and worries, they’re alienated from someone in their family and that, but you know we can't treat that with medicine. We do try to treat it with other kinds of care, but it's not always easy. But I don't think the answer is to give doctors the power to give a lethal injection.

Ryan Bridge: And just finally before you go, Professor, and thanks for speaking to me, I have enjoyed it...

Professor Margaret Somerville: (Laughs) I doubt that very much.

Ryan Bridge: No, no, no, I enjoy discussion, and I enjoy it when somebody is as well-versed as you are. Can you tell me just finally how you feel about what's happening in Victoria from today. As an Australian, as an academic as you are, how are you feeling?

Professor Margaret Somerville: I am totally appalled and my deepest feeling is grief and sadness – not anger. I believe people are well-intentioned, and that's something that we all have to realise. You know, we all belong in the same moral universe when we say we want to care for people, we don't want them to suffer, we want to do everything we can to help them. And there's a lot of really great new research going on that shows the people most likely to want euthanasia or assisted suicide are people who are, they've lost the will to live – they're what the psychiatrists are calling ‘demoralised’. And also another strong feature is they've got no hope. There’s nothing, absolutely nothing to look forward to. Life doesn’t seem worth living. And I think where we’ve got to put our efforts, are to try to correct that. And we know that when we do, even though the person is dying, that we try to help them to live as well as they can until they die a natural death, and that really, cutting short life, even if it's what that person wanted, and maybe even if it was the best thing for that person, we can't afford it. Because even to think the message it sends about people with similar disabilities? We're telling them, “We see your life as so not worth living, that we are prepared to give you a lethal injection.” I mean we just can't do that. It's a terrible thing to do.

Ryan Bridge: Bioethics Professor Margaret Somerville at the University of Notre Dame in Australia. Thank you very much for your time this afternoon.

Professor Margaret Somerville: It's my pleasure, Ryan, and thanks for asking me and I'm sorry I gave you an ear-bashing!

Ryan Bridge: (Laughs) I always enjoy an ear-bashing, Professor. Have a nice afternoon!

Professor Margaret Somerville is Professor of Bioethics at the University of Notre Dame Australia. Prior to that, she was Samuel Gale Professor of Law at McGill University in Montreal, Canada, and the founding director of the McGill Centre for Medicine, Ethics and Law. Professor Somerville is a Member of the Order of Australia for service to the law and to bioethics, and a Fellow of the Royal Society of Canada. Professor Somerville lends her vast expertise and experience in bioethics and the euthanasia experience around the world to #DefendNZ. She sees the legalisation of euthanasia as the crossing of an ethical and legal Rubicon, after which it becomes impossible to contain the application and practice of euthanasia. Professor Somerville speaks out to #DefendNZ ethics in the documentaries ‘A deadly double standard’, and ‘A life in chronic pain’, from #DefendNZ released this year featuring NZ former euthanasia advocate Claire Freeman and disabilities advocate Dr John Fox who lives with spastic hemiplegia, a form of cerebral palsy .

Watch Claire’s documentary in widescreen and read her complete story here.

Watch John’s documentary in widescreen and read his complete story here.

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