Telehealth consultations continue to be illegal.
Contact your incoming Federal MPs and ask them
to push for a change to restrictions on Telehealth for
VAD which continue to disadvantage people in
remote rural areas and those unable to travel to
appointments. The AMA has also asked the
Government to act on this issue. Lack of Medicare
benefits for VAD also disadvantages poorer
patients, but this is at last starting to be addressed.
Go Gentle Australia has recently released a paper
about the burning issue of Dementia and VAD that it
commissioned Dr Kylie Ladd to research. GGA
Dementia Paper. Go to their website
www.gogentleaustralia.org.au if the above link
doesn’t work.

Awareness – Doctors in Victoria and South Australia
are still not allowed to mention VAD to patients, but
a recent survey in Queensland has shown that many
people are not aware that VAD is now a legal option.
In conjunction with U3A Southern Highlands, DWD
NSW and a local Death Doula, I was pleased to give
a short talk about our group. The vital importance of
preparing an Advance Care Directive (ACD) and
nominating an Enduring Guardian was also
mentioned. Maybe you are involved in a group
which could host a guest speaker from the DWD
organisation in your state.

Go Gentle Australia organised a conference of all
the DWD Organisations in Australia and New
Zealand (VADANZ) in Brisbane late October, which
was well attended.

The President of DWD Victoria, Jane Morris
announced at that conference that DWDV
awarded me the Rodney Syme Medal for 2024.
This Medal recognises distinguished effort in
pursuit of the Dying with Dignity cause. I was very
honoured to receive this award which recognises our
group’s significant input to the VAD campaign.
We continue to regularly receive requests for
information via our website.

Overseas.
The Isle of Man was the first jurisdiction in the UK to
pass an Assisted Dying Bill in late March, and it has
been forwarded for Royal Assent. There was an
historic win in the House of Commons at the Second
Reading of the Terminally Ill Adults (End of Life) Bill
in November 2024. Their Committee stage has just
completed, during which they studied the Australian
and New Zealand VAD models. It is now due to go
back to the Commons for debate. There has been
the predictable opposition by religious groups.
Debate is continuing in Scotland and Jersey.

MAiD (Medical Assistance in Dying) in Canada
continues to provide a painfree and peaceful
compassionate end of life choice and Quebec has
recently allowed access to MAiD by people suffering
from Dementia via an Advance Request. This is
creating controversy, but highlights this vitally
important unresolved issue.
Countries currently allowing Assisted Dying:
Australia (excluding the Northern Territory), Austria,
Belgium, Canada, Germany, Luxembourg, Portugal,
Spain, Switzerland, The Netherlands, USA
(California, Colorado, the District of Columbia,
Hawaii, Maine, New Jersey, New Mexico, New Zealand, Oregon,
Vermont, and Washington. Montana’s Court has
ruled that Assisted Dying is permissable, but the
State has not legislated for it.
The constitutional courts of Colombia, Ecuador and
Italy have legalised Assisted Dying, but their
governments have not yet legislated or regulated
the practice.

Donations: Donations are gratefully received and
can still be made by direct deposit to Christians for
VE – BSB: 105003 A/C: 119890940.

Sadly, many Church hierarchies continue to be vocal
in their opposition. Because of this continued
opposition and the need to have the laws passed in
the Northern Territory, it is hoped that you will
continue to be a member of our group. Please
contact me if you have any questions.
Best wishes,

Ian

Jane Morris, President of Dying With Dignity Victoria, when announcing Ian’s award at the dinner of the Trans-Tasman Voluntary Assisted Dying Conference on Monday 28 October, 2024, stated :“There would be very few people who have not heard of Dr. Rodney Syme. Rodney spent the latter part of his life selflessly and totally committed to ensuring the successful passage of VAD legislation in Victoria. Since 2007, DWDV has awarded The Rodney Syme Medal in recognition of the outstanding and distinguished effort by an individual/s in pursuit of the Dying with Dignity cause. Dying With Dignity Victoria is delighted to award the 2024 Rodney Syme Medal to Ian Wood, Co-Founder of Christians Supporting Choice for Voluntary Assisted Dying.

For the past 20 years, Ian has worked tirelessly, advocating for Voluntary Assisted Dying as an additional, compassionate end-of-life choice from the aspect of Christian support.

Congratulations Ian, and wholehearted thanks from all of us at Dying With Dignity Victoria for your invaluable efforts.”

After being presented with the Rodney Syme Medal by Michelle Hindson Board Member of Dying With Dignity Victoria, Ian responded:

“I’m delighted to accept this, and I do sincerely thank Jane Morris and DWD Victoria for presenting me with this Rodney Syme Award. Rodney was actually the person who I considered as one of the dozens and perhaps hundreds of people who have both mentored me and motivated me in my efforts to counter the mainly religious lobby who sought to impose their outdated views on all Australians.

I have really thought that Voluntary Assisted Dying should be a basic human right. We are Christians who believe that, as a demonstration of love and compassion, those who are terminally or hopelessly ill should have the option of a pain free, peaceful and dignified death with Voluntary Assisted Dying.

Thank you to Frances Coombe, President of VADSA, who back in 2008 spoke to me and my colleague, Reverend Trevor Bensch and suggested that we co-found our group; and I would also like to thank Reverend Dr Craig de Vos for his continued support of our

group as Patron. Thank you.”

Dear Member/Supporter,
15 Years! It hardly seems possible that it is now 15 years since our group was formed, and I am delighted that all States in Australia have debated and passed Voluntary Assisted Dying laws enabling the choice of a compassionate end of life for those nearing death. Time and again I find it so rewarding to read reports of the peace of mind that getting the green light to access VAD gives people, and family often describe the passing of their loved one as peaceful and beautiful.
The Victorian VAD legislation has now been operating for five years. We are hopeful that the Australian Capital Territory will pass their legislation later this year. The Northern Territory has had a consultation process and may debate a bill after their next election. It is disappointing the NT had the first assisted dying legislation in the world with their Rights For The Terminally Ill Bill until it was overturned by the Howard Liberal government a year later.

Many of us have witnessed a loved one die with Dementia and would not want to go down that path themselves. Accessing VAD is not possible because mental capacity is required through the whole process of being assessed for VAD. One of the few other options available is to refuse administration of food and fluid using an Advanced Care Directive. This is an issue which can hopefully be addressed in the future.

Dr Rodney Syme discusses this situation in his book “A Completed Life” and it is available online from
https://www.dwdv.org.au/store/

How you can prepare:
1. Be informed of eligibility criteria in your state by checking out your local Dying with Dignity website or by contacting the Navigator Service in your state.
2. Be prepared : Have an up to date Advance Care Directive (ACD) which you have discussed with family, a valid will, Enduring Power Of Attorney and Enduring Guardianship in place.
3. Ask our own doctor if any doctor in the practice has done, or will do the VAD training course.
4. Contact your Federal MP and ask them to push for a change to restrictions on Telehealth for VAD which continue to disadvantage people in rural areas and those unable to travel to appointments. Lack of Medicare benefits for VAD also disadvantages poorer patients.
5. Consider attending a Death Cafe where the aspects of dying can be openly discussed, often with input from a Death Doula.

Overseas. Belgium, Luxembourg, Switzerland and the Netherlands, Canada, Portugal, Spain and NZ all have active VAD laws. VAD is currently legal in ten USA states plus the District of Columbia, and another 16 states are considering a bill.
An Irish parliament committee inquiry has heard from witnesses, both for and against a bill, including VAD experts from Australia.
Progress is being made in Iceland, New Jersey, Isle of Man, Scotland and France. While in UK 74% of the population are in favour of VAD but the parliament is lagging behind!

Sadly many Church hierarchies continue to be vocal in their opposition. Because of this continued opposition and the need to have the laws passed in the territories, it is hoped that you will continue to be a member of our group. Please contact me if you have any questions.
Best wishes,

Ian

This book presents Dr Syme’s views on the plight of people with dementia, and his suggestion for further legislative change. The book’s title reflects a life that has been long, and where all that was possible has been achieved – and so is in a sense ‘complete’. There follows consideration of the problems that may follow, and what may be a reasonable response.

I was privileged to be one of the people asked to review this book prior to publication and I can thoroughly recommend it.

You can order your copy from https://www.dwdv.org.au/store/a-completed-life-paperback/

Ian Wood

Bowral, NSW

There are many forces that differentiate us in the world: politics, religion, beliefs to name only a few. One thing that unites us is the desire to die with dignity. Asunción Alvarez, president of the World Federation of Right to Die Societies said, “Around the globe, many people fight to make a death with dignity possible for themselves and those they love. It is these people that we would like to put in the spotlight for World Right to Die Day 2022; the Champions, who through their support, activism, fighting, writing, willpower, vision and strength, are advocating to make right to die legislation possible all over the world.”

Rob Jonquière, Executive Director said, “The World of Champions tells the stories of the parents, siblings, activists, doctors, supporters and volunteers who are working to make dying with dignity possible from all the corners of the earth. It is a testimony of their struggle and the complexities they face in championing the right to die with dignity. In some areas, the map is empty, and while there are certainly Champions in each of these countries, their efforts are shrouded in silence without right to die societies to support their cause and tell their story. We hope that they will join us in time.”

Click here for a map of world champions

It is truly humbling to find my name included in this 2022 list of Champions supporting Voluntary Assisted Dying legislation world wide.   To be next to names from Australia such as Dr Rodney Syme, Shayne Higson, Mike Gaffney MP and my friend Tanya Battel……….

My sincere thanks go to all those who have mentored and encouraged me to lobby for compassionate end of life choice.

Ian Wood    2.11.2022

By clicking on the above link for a map of world champions, a short summary of each ‘champion’ can be found.

An outstanding group of experts gave us the facts in this Forum on voluntary assisted dying support. Essential viewing!

The emotional plea by Jan, wife of Tim Edwards, and their daughter, Jessica, who spoke at the meeting about the torturous death of Tim from mesothelioma certainly bought tears to my eyes! I just cannot understand why our MPs continue to ignore such futile suffering, especially those who profess to be Christian. Where is their compassion?

I had the privilege of meeting Tim not long before he died, and together we went to lobby our local MP, Jai Rowell.

Every MP who is against this choice, and all members of the ‘ACL” (Australian Christian Lobby) and the ‘HOPE no euthanasia’ group should watch the complete forum and become familiar with the truth behind the issue, and then perhaps understand why up to 85% of Australians support voluntary assisted dying.

Ian Wood

Sincere thanks to Dying With Dignity Victoria and the team, Andrew Denton and the Go Gentle Australia/Stop Victorians Suffering team for your unstinting efforts and to every MP who voted for compassionate choice.

Shame that we failed by one vote in our NSW upper house a week earlier.

Ian Wood on behalf of all the members Australia-wide of Christians Supporting Choice for Voluntary Euthanasia group.

http://www.dwdv.org.au/news/vcat-rules-in-favour-of-dr-rodney-syme

Quebec Province in Canada in 2014, and California in USA in 2015 have shown Australia how it can be done in 2016!

Meanwhile if you would like to read more of the facts supporting CHOICE for assisted dying and/or voluntary euthanasia, please check out the following books…..

They are not in any particular order –

NEW “Your final choice. Hastening your death when terminally ill – eight questions to ask yourself”, by Kenneth Ralph. Kenneth changed to an accepting point of view from a position against after realising there has been Christian support for this choice for many years, plus being actually at the bedside of dying people as part of his job at the time.

“Is there a Christian Case for Assisted Dying?” by Prof. Paul Badham, (YES, there is a Christian case!)

“A Dignified Dying” by Hans Kung, (A Catholic viewpoint)

“The Dying Process. Patient’s experiences of Palliative Care” by Julia Lawton This book contains some graphic real life descriptions of what dying can be like in a worst case situation.

“A Good Death” by Dr Rodney Syme. Surely a ‘must read’ and available in many public libraries.

“Death by Choice vs Religious Dogma” by Hani Montan

“Doctor, Please help me Die” by Tom Preston, MD

“Death with Dignity” by Robert Orfali. Also available as an e-book

“Being Mortal” by Dr Atul Gawande

“I want the choice of a peaceful death” by Ian Wood. Our own booklet that effectively rebuts the Christian argument against assisted dying. Can be downloaded from this website, or if you prefer a hard copy, please email contactus.

I have a large number of supportive articles on file. If you would like to read some of these, please email me with your request via this website.

Governments constantly say that there is no need to revise laws on assisted dying because palliative care deals with all those problems very effectively.
What is the response from palliative care to this rhetoric? Only to confirm that it deals very effectively with pain in the terminal patient. There is no public discussion of how this terminal pain, or other suffering is relieved. It consistently evades any public discussion of other aspects of suffering.
Careful examination of this literature reveals the extent of suffering in the terminally ill, and the difficulty in measuring and relieving it. The inordinate focus on the successful relief of pain is contested by Professor Michael Cousins, who stated in 2010, that “10% of cancer pain was so difficult to treat at the end of life that some patients were given drugs to sedate them to unconsciousness, culminating in death over several days to a week”. But breathlessness, cachexia, (wasting, weakness, immobility, dependence), anorexia, nausea and vomiting, incontinence, ulceration, discharge and odour are common, and far more difficult to palliate, and all impact on dignity. And this does not begin to address psychological, social and existential suffering, described by Francis Norwood as “social death” [i] . For an erudite discussion of medical suffering read Eric Cassell.
Is it surprising that palliative care does not entirely succeed with the palliation of suffering? Not at all – it is a monumental task, when you consider these further self-evident truths –
first, that intolerable and unrelievable suffering is common in terminally ill persons, and often escalates as death approaches;
and second, that some suffering is only relieved by death.

It is an especially difficult task when you maintain, as a matter of integral philosophy, that palliative care does not hasten death; and you are battling a constantly accelerating target, using a relatively poor tool kit. As evidence of the latter, let me cite a recent paper by Rowett and Currow –
“Patients receiving palliative care are at high risk of adverse effects from drugs. As these effects can be difficult to distinguish from the symptoms of the terminal illness, harm from medicines is often not recognised. Adverse effects contribute to the burden of symptoms at a time when good control of symptoms is paramount. Adding another drug to treat the adverse effects can compound the problem”.
This paper effectively indicates that, even 50 years after the establishment of palliative care, a level of experimentation goes on in treating terminally ill patients.
Palliative Care Australia acknowledged in 2008 that it could not relieve all pain and suffering, even with optimal care, but it was being a little disingenuous because it did not disclose its trump card, terminal sedation. In the 1980s the Graseby pump was developed, and Midazolam became available, which was compatible with morphine in a common syringe. First reported in 1988 by De Sousa and Jepson for ‘terminal restlessness’, terminal sedation was described by Burke et al as providing “a readily available means of controlling symptoms and overcoming patient distress where no feasible alternative existed previously”. In 1990, Ventafridda reported its use in 52% of palliative outpatients, to howls of anguish from others who stated they never, or very rarely, did so. Billings and Block described it as “slow euthanasia” to more howls of dissent. They famously defined ‘slow euthanasia’ as “the clinical practice of treating a terminally ill patient in a fashion that will assuredly lead to a comfortable death, but not too quickly”, and included terminal sedation in this definition. They were challenging the soft defence of intention, and focusing on outcome. They also asked “Why should a patient who requests a quick death be subjected to a slow dying?”
Its use has subsequently expanded to refractory pain, breathlessness, and extreme fatigue, psychological and existential distress. It is very clear that palliative care has the tools to relieve any intolerable suffering, but I have never heard or seen this made evident to the public. It remains the ‘Achilles heel’ of palliative care because it is used in exactly those circumstances where other doctors might provide assisted dying if they were asked. And this very process is only associated with patient consent in up to 50% of deaths, with no opportunity to say goodbye.
Far from acknowledging terminal sedation, palliative care has been assiduously arguing, that neither it nor morphine alone, if used in a proper palliative way, ever hastens death. Terminal sedation is justified for the treatment of ‘refractory’ or ‘intractable’ symptoms, as determined by the clinician, not the patient. Maltoni and colleagues stated that “Despite the huge progress made in palliative medicine in terms of symptom control, many are intractable symptoms, either because the treatment is ineffective or because the treatment itself is intolerable”.
However, in order to demonstrate that hastening of death is not the intention, the treatment is slowly titrated to a level where consciousness is suppressed, and thus, in association with withdrawal of hydration, death inevitably follows. I would have thought that if symptoms were intractable, and death clearly imminent, there would be an imperative to provide maximal relief of any pain and suffering as soon as possible. But no, even though, in law, there is no problem with hastening death if the intent is to relieve suffering (Devlin in R v Adams, Victorian Medical Treatment Act), titration is obligatory under the ‘palliative model of care’ – suffering continues until unconsciousness ensues, which may take days. And this occurs despite senior consultant Robert Twycross stating “nothing short of deep unconsciousness could provide relief and that inadequate sedation makes matters worse”. For a profound analysis of terminal sedation read Prof Erich Loewy – he wrote “Terminal sedation, we would claim, differs from some form of voluntary active euthanasia mainly in that it has not been and is unlikely to be legally challenged”.
Despite the availability of terminal sedation, eminent British geriatrician and ethicist Professor Raymond Tallis reports the opinion of a PC physician that 15% of deaths are ‘bad deaths’, and that it the opinion of the doctor, not the patient. In a Lancet Editorial Janet Hardy wrote “the concept of sedation causes considerable unease in many palliative care workers, most of whom are ardently opposed to any form of euthanasia or patient-assisted suicide. There is concern that sedation as the best means of symptom control in the dying patient is underused because of fear of employing ‘terminal sedation'”.
Jessica Corner wrote in the BMJ “the easing of death, as an intentional double effect, is common in palliative care and general practice. … Palliative care needs to take the lead by making clear the strategies it employs for managing difficult situations at the end of life, and, when the double effect is used with a view that death is a likely and welcome secondary consequence, to be open about this”.
Palliative Care Australia acknowledges that patients do make rational and persistent requests for a hastened death – Roger Hunt found 25% of his palliative care patients did so. Yet Ben Rich found it is “the view of a prominent segment of the palliative care professional community that almost without exception maintains that patients who receive state-of-the-art palliative care, including psychosocial and spiritual interventions almost invariably cease and desist from their desire for a hastened death.” Surprising – no – who has all the power is such discussions? Could this not be seen as duress?
The inherent “goodness” of the enterprise, and the essentially closed nature of hospice, has allowed the rhetoric of palliative care to escape examination. * As palliative care specialist Derek Doyle wrote ” a metaphorical halo shines over specialist palliative care and its practitioners with the result that some of its claims and assumptions have gone unchallenged by all but a few”.
Palliative care specialist Fiona Randall is one of those few.
She describes “the inflated and often contradictory claims made in the literature of palliative care – its rhetoric ….. which cannot, in reality, be enacted in clinical practice”. The language of palliative care offers an ‘impeccable’ assessment and treatment of pain and other symptoms and ‘exquisite’ and ‘meticulous’ nursing care. Randall says “This is embarrassing rhetoric”. “Palliative medicine claims to alleviate emotional, psychological, social and spiritual suffering, in addition to physical symptoms. There is no other speciality which claims to do all these.”
“Moreover, palliative medicine claims to be able to alleviate these forms of distress and improve quality of life, even in the context of dying. Dying is generally perceived to be associated with great distress, yet in palliative care it is held that we can apparently achieve relief of symptoms, including those of a psychosocial and spiritual nature”.
“The goal of impeccable relief of pain and other symptoms is unachievable, and the expectations generated by the philosophy statement are unrealistic. Setting unachievable goals for one set of people and promoting unrealistic expectations which will not be met in another group of people is unfair to both and likely to lead to harm for both”.
Ben Rich stated in 2014 that “Others have raised concerns about an authoritarian streak, or a form of hard paternalism, in the philosophy and practice of hospice. Those concerns denote a perception that some in the hospice movement maintain a rigid and monolithic view of death: one size fits all; it’s the hospice way or the highway.”
Sociologist Julia Lawton, who was embedded in British palliative care for 10 months, wrote “The research highlights the difficulties of matching modern hospice movement’s ideological goal of enabling patients to ‘live until they die’ with the realities of the ways in which many patients, cared for in hospices, bodily degenerate in practice”.
Palliative care has been described as a ‘model of care’ which has become more and more defined and specialized, into which the patient must fit. The Liverpool Care Pathway was an example of such a model, but failed because it did not treat people as individuals and ask what care they wanted. It led to abuse of autonomy. We are all individuals, shaped by our own experience and values. For government to suggest that we should all fit into a specific ‘model of care’ is extraordinary.
RELIGION –THE ELEPHANT IN THE ROOM
Ian Maddocks, the first Australian Professor of Palliative Medicine, states that “The roots of modern palliative care are of course to be found in religious orders concerned with the care of the dying”, and that “Palliative care usually has adopted a confrontational position against voluntary euthanasia, partly because of the historical association with Christian (Catholic) concern to preserve life”.
Assoc Prof Alex Broom spent 6 months embedded in a Catholic hospice, interviewing doctors, nurses and patients. He found an atmosphere of tension, with death in the air, a place of unbounded and hopeless bodies. Patients had a sense of impotence; they were subdued within the hospice’s ideological frame, with a sense of entrapment.
He found among the patients virtually unanimous support for assisted dying, but the hospice was totally opposed. A desire for a hastened death was seen as a call for help; the patient ‘just needed more time’ to adjust, their request was met by spiritual and social support. The assessment was that it was ‘not his time to go’. Assisted death was not part of hospice care, which had an ideological model of dying, based on religious contexts.
He also found an underlying Catholic influence in the hospice; although it was a site of medical care, it had Christian underpinnings, and an interplay of religiosity which was rarely explicitly acknowledged. The care was precariously placed between care of the body and care of the soul.
Cardinal George Pell proudly states that 57% of Australian palliative care is provided by the Catholic Church. There is no other area of Australian medical practice which is so infiltrated by a specific moral framework. There can be no doubt that the religious origins of palliative care and this religious dominance in its provision has a profound effect on how people die.
Palliative Medicine Professor Sam Ahmedzai , a critic of euthanasia, but a supporter of assisted suicide, wrote “It is patronising to say that a few people should suffer unbearable distress and indignity because palliative care preaches that it values all lives – regardless of how meaningless they have become to their owners. It is inconsistent for palliative care to boast how it enables people to face the reality of dying and decide about place of care but then to deny choice for timing of death. Moreover, it is hypocritical to deny competent patients who are acknowledged to be dying, the right to die in a manner of their choosing, while allowing doctors and nurses to place them on a so called care pathway, which often entails increasing sedation and withdrawing fluids – unintentionally leading to a protracted form of assisted dying, but one that is medically determined.”
Let us consider the above in the light of my final self evident truths. First, that a doctor has a duty to relieve suffering. Sir William Osler wrote over 100 years ago that a doctor’s duty was to ‘ease death’. Second, that a doctor has a duty to respect his patient’s autonomy.
Given these fundamental ethical obligations, should a doctor, treating a patient with intolerable and unrelievable suffering who asks for assistance to die, simply offer refusal of treatment, or slowly progressive sedation, or the option of refusing food and fluids? – as is suggested by the American Association of Hospice and Palliative Medicine.
Some people listening to me may think I am violently opposed to palliative care. Not so. I support the open and frank communication between dying patient and doctor, of supporting your patient to go as far with their life as possible, and encouraging the acceptance of the reality of dying, the maximal relief of pain and suffering, giving them a sense of control over the end of their lives, respect for patient autonomy and encouraging dialogue between dying patient and family with the important object of allowing them to say goodbye – all good palliative principles. But I do not accept the rigid imposition of a particular model of care, and a limited choice at the end of life which condemns some people to die in a way that is anathema to them, in order to satisfy the moral view of their doctor.