Archbishop Anthony Fisher
Polding Centre,
133 Liverpool Street,
Sydney NSW 2000
Australia
Dear Archbishop Fisher
Firstly, my best wishes to you on your appointment as the ninth Archbishop of Sydney.
I am responding on behalf of the members of my Group to aspects of your article in the SMH, Oct 10, 2014. “Euthanasia: lethal dose has fearful consequences.” http://www.smh.com.au/comment/euthanasia-lethal-dose-has-fearful-consequences-20141014-115p18.html
It is grossly misleading to infer the Senator Di Natale Draft Bill is a community response to the “elderly, frail and disabled”. It is a response to those dying and faced with unbearable suffering.
If you read through the draft Bill, you find –
The objects of this Act are:
(a) to recognise the right of a mentally competent adult who is suffering intolerably from a terminal illness to request a medical practitioner to provide medical services that allows the person to end his or her life peacefully, humanely and with dignity;
You state “Now people who aren’t terminally ill, aren’t even physically ill, people who haven’t volunteered or can’t volunteer, can legally be killed”. This is simply emotive scaremongering! I ask would you please provide me with factual documentation for this claim. Belgian legislation has never been restricted to the terminally ill, but legislation does recognise an advance directive. It applies to “a patient in a medically futile position of constant and unbearable physical or mental suffering that cannot be alleviated, resulting from a serious and incurable disorder caused by illness or accident.”
You state, “It asks us all to agree that some people are better off dead and that our laws and health professionals should make them dead.” Again, this is emotive and simply not true. We are being asked to respect the right of a dying person to access medical assistance to relieve what they believe is unbearable suffering.
To quote Hans Kung, “As a Christian and a theologian I am convinced that the all-merciful God, who has given men and women freedom and responsibility for their lives, has also left to dying people the responsibility for making a conscious decision about the manner and time of their deaths. This is a responsibility which neither the state nor the church, neither a theologian nor a doctor, can take away.’ (Ref: A Dignified Dying)
This position is now publicly supported by Archbishop Desmond Tutu, and the former Archbishop of Canterbury, Lord Carey. Indeed, Desmond Tutu, one of the world’s most revered religious leaders, speaking in support of the Falconer Bill in UK says: “I have been fortunate to spend my life working for dignity for the living. Now I wish to apply my mind to the issue of dignity for the dying. I revere the sanctity of life – but not at any cost.” A position diametrically at odds with your own!
Presumably you are not aware of Dr. Marc Desmet, a respected Belgian
palliative care physician who is also a Jesuit priest? Dr Desmet, who in 2000 wrote a book opposing voluntary euthanasia, is quoted now as being in support. When Dr. Desmet is asked by the interviewer Alan Gilsenan whether his religious beliefs are not an obstacle to granting euthanasia, the physician points out that according to Christian tradition one’s conscience and compassion trump doctrine. He will entrust the patient to a colleague rather than performing the euthanasia himself, but he will accompany his patients “as far as he can go.”
Ref: http://www.worldrtd.net/sites/default/files/newsfiles/Bernheim%20artikel.pdf
There is increasing evidence that, for many terminally ill patients, having their request for an assisted death approved is of immense psychological and palliative value to them. Dr Erika Preisig, of LifeCircle, an assisted dying organisation in Switzerland, says, “Again and again it (my experience) shows that members find new energies to go on living when they know they have the green light for an assisted voluntary death.” It provides peace of mind, and in many cases they live longer than a person who does not request assistance! (Ref http://www.lifecircle.ch/)
You seem to believe that Palliative Care can provide all the answers for those dying.
Julia Lawton refers to examples where this is not true. Physical pain should not be the ultimate criteria for a rational request for an assisted death. Perhaps more important is the suffering endured when the body becomes “unbound”.
“ ‘unbounded’ includes symptoms such as incontinence of urine and faeces, uncontrolled vomiting (including blood and faecal material), fungating tumors, gross oedema causing the skin to burst, rupturing tumors”, states Julia Lawton.
(Ref: The Dying Process. Patient’s experiences of Palliative Care, Julia Lawton Page 127)
– Terminal sedation – slow euthanasia?
All members of my group would agree that the terminally ill need to be treated with compassion and care, supported by family, friends and the community, and treated as precious members of the human family.
We also believe that palliative care provides an essential service for the dying. However we know that the facts show even the best PC does not provide remedial solutions to 2 to 5% of those dying. Symptoms such as uncontrollable vomiting of blood and faecal material due to an inoperable blocked bowel, is an example where pain relief is not effective.
The last resort in palliative care, when all else fails, is to put the person into a medically induced coma, known as terminal sedation, where they gradually starve or dehydrate to death, a circumstance that family and the nursing and medical staff can find extremely distressing to watch.
Terminal sedation is accepted by the medical profession and the Catholic Church as an appropriate and ethical last resort, as the stated intention is ‘to relieve suffering’. No reporting is involved, and the patient need not even be asked.
Yet if the dying patient requested, “Rather than starve me to death in a coma, with the trauma of having my family watch this slow death, please give me the next few days medication in a single dose so that I can die immediately”, this would be illegal.
As Christians. I and our Group members ask you, why the slow death procedure can be morally acceptable but not the other alternative?
We respectfully ask that you clarify your position on terminal (palliative) sedation.
“A review of the literature has found great variability in the prevalence of palliative sedation, ranging from 2% to 52% among terminally ill patients. The study conducted by Ventafridda et al found that more than 50% of cancer patients dying at home die with physical suffering that is only controllable by means of sedation. Between 10% and 50% of patients in programs devoted to palliative care still report significant pain 1 week prior to death. The most common symptoms experienced by these patients were dyspnea (uncomfortable shortness of breath), pain, delirium, and vomiting. Most symptoms are reported to be physical in nature. In a retrospective analysis by Kohara et al, 54% of patients were found to have more than one uncontrollable symptom.”
( Ref : http://www.medscape.com/viewarticle/550666_2)
Alzheimer’s – a difficult situation and the need for compassionate choice
Alzheimer’s would be without doubt the illness most feared by the members of Christians Supporting Choice for VE!
We note that Belgian legislation does permit a person with Alzheimer’s to use an assisted death, during the window between a confirmed diagnosis and the lack of ability to make a rational conscious request.
The assisted death of Hugo Claus, an Belgian author who had Alzheimer’s, as described by his wife, Veela Claus-de Wit, in the Terry Pratchett documentary, “Choosing to Die” 2011.
“After we had shared champagne and he had a cigarette, he said I think I want to lie down. I lie down next to him and I hold him and I sing a song to him and he started singing with me – he died singing. It was so intense and warm – how can people be against it?”
I could do without the cigarette, but would love to die singing! My personal comment.
Compare this death of Hugo Claus, with the more typical situation described below.
A visit to any high dependency nursing home in Australia will show patients suffering from dementia, Alzheimer’s, severe Parkinson’s disease, massive stokes and other demeaning and crippling conditions.
Bedridden, needing to be fed and changed like babies, incontinent lying in napkins soiled with urine and faeces despite the best efforts of dedicated nursing staff, unaware of their surroundings and close relatives unrecognised, would they want this if they could choose?
In lucid moments rather do they plead ” God take me, please let me die “ ( Ref: Letter from a doctor on file)
My Mother died, essentially from starvation when she ‘forgot’ how to eat, after 8 years with Alzheimer’s, in much the circumstances described above – (I would prefer to die like Hugo if I had the same illness)
The Truly Vulnerable. You, and others opposing assisted dying often allege concerns about ‘vulnerable’ groups, the elderly and those with disabilities. Yet you do not talk about another major group others consider truly vulnerable. Those who are actually suffering with a terminal or incurable illness, who are vulnerable to futile treatments being needlessly inflicted on them by doctors who refuse to face the FACT that the patient is going to die and in many cases the side effects of this futile treatment are worse than the illness itself.
“Up to 70% of people now die in acute hospitals, surrounded by well meaning strangers, inflicting all that medicine has to offer; often resulting in a painful, distressing and degrading end to their life.” and “Clinicians themselves are often complicit in refusing to face the inevitability of dying and death.” states Dr Ken Hillman, Professor of Intensive Care at the University of NSW in Sydney.
( Ref : Vital Signs 2009.)
To quote former Dominican Jacques Pohier: voluntary euthanasia and assisted suicide are not choices between life and death, or of death against life, but choices of a certain way of dying.
Pope Leo XIII, around 1900, is quoted as stating; The death sentence is a necessary and efficacious means for the Church to attain its end when rebels act against it and disturbers of the ecclesiastical unity, especially obstinate heretics and heresiarchs, cannot be restrained by any other penalty…… History has shown the Church has had no hesitation in killing ‘heretics’ such as Dominican Giordano Bruno, the Cathars, and believers in adult baptism at the time of Zwingli. I would be interested in learning from you why the burning at the stake of Giordano Bruno, for questioning doctrine such as Transubstantiation and cosmology, can be justified theologically, yet assisting a terminally ill person to die, at their request, can never be justified according to your doctrine?
I have attached the following –
– Chantal Sebire and why I personally support choice in assisted dying for the terminally or hopelessly ill
– The conclusions of the Quebec, Canada, Parliamentary Inquiry that led to the passing of the Act respecting End of Life Care this year by 94 votes to 22. (Interestingly in what would have been the most Catholic province in Canada!)
– RIP Keith Smith. A letter typical of why Christians support choice on this issue
– A statement from Dr Ann McPherson, before she died from cancer, and her reasons for the need for compassionate law reform.
– “Why I changed my mind on assisted dying’. An article in support by Prof. Raymond Tallis.
Thank you for taking the time to read this letter. Obviously we would not presume to hope your position on this issue would change to that of Desmond Tutu – but we do hope this will help you to understand that we are not “all grizzly Dr Deaths” and we do request that you respect our views.
On behalf of my Group I look forward to your response to the questions and points raised.
Yours sincerely