Mar 31 2007
What are our Rights when it Comes to Dying?
“What are our Rights when it Comes to Dying?” (SBS Tuesday April 3rd. Insight TV Program) A fair question which boils down to another question which impacts directly on the answer. It depends on who one believes owns your life….Do you own your own life or does “God” own your life? and again the answer is dependent on a belief system which cannot and never will be substantiated:
I’ve tried to cover the question briefly across a range of viewpoints but in no particular order of importance:
(1) The Right to Life Christian viewpoint, loosely explained:
When we receive “communion” that is the body and blood of Christ (an act of faith in itself) Christian believe their bodies becomes the Host or the Hostess of God himself. That the piece of bread is actually the body of God in mystery….The priest says the words “The Body of Christ” while reverently distributing the bread, to which the recipient responds “Amen” (so be it!)…It comes down to faith that a person believes their body is a vessel in which God himself now resides. Heavy stuff - which places a great burden on the individual to them look after that body which is now sharing itself with the most holy of holies, “the Body of Christ”
That explains in part and perhaps the most important reason why some Christians do not believe in a hastened death. The human body is a cradle for the Sacred Body of Christ. And Christian cannot hurt “The Body of Christ” within, to relieve their own bodily distress. Hence, the “All for Thee, Oh Lord, all for Thee” so often heard recanted by people in severe pain.
In addition, people who believe in an after life regardless of which “hat” they wear….believe that to hasten death is to defy “fate” What is meant to be, is! Buddhists, Hindus, Christians are among the predominant religions that believe we live our life for a purpose to be served regardless of our own selfish wants and needs… We are merely passing through this life to somewhere else, so we need always to be respectful of the disastrous consequences of not adhering to the strict teachings of our particular “belief” system.
So, in theory, serious religiously inclined people have no rights when it comes to dying.
It is always left to God to decide death, according to the RTL. To hasten death is against God’s Will, even though Christ himself is recorded as having hung on the cross for some six hours, not six days, six weeks, or six months….And Christ had God as his father…
And medical intervention denies God’s Will be done, by technology preventing the death itself from occurring, but we conveniently forget that aspect of God’s Will because it is human nature – not to want to experience pain unnecessarily and death can be a very painful experience…….
“life” itself is always precious by all human beings but we hold varying differences on what constitutes “a life”.
The sanctity of a life is selective depending on your ethnicity and “friendship of Governments”, yet the value of a frail Anglo Australian can’t be more valued in the eyes of God than an Iraqi Muslim. Bombs kill people! just the same as an injection!
Faith alone has been known to heal the physical body in some “believers” but I don’t have this gift granted to me, that is the gift of faith….I lost it many years ago and have ceased to rely on its possibilities for myself. Every fiber of my being denies the doctrine taught by the Christian Churches.
I strongly believe that “ownership” of my own body in this one human life is more important to me in the here and now, than any possibilities in other lives….I remember nothing of previous existences and expect nothing of any more to come. So simple for me to concentrate to live, love and enjoy this life without any fear of retribution in another life if there one! I try to live by the maxim of “doing unto others as I would have them do to me” to keep me reasonably ok with liking myself, and I don’t sexual abuse small children….. I am very comfortable with a Humanist lifestyle.
(2) The Slippery Slope Mentality: Sometimes you’ll come across a person who fears a hastened death because they genuinely believe in the “slippery slope” concept of the hackneed Nazi Germany. They believe the Government will start “knocking people off” to cut down on the budget…If one looks at some folk in nursing homes even today…it could be agreed that they have “already died” in every sense of the word except they breathe. The quality and purpose in life has long ago left their tired, weary and mostly unconscious body…..And there is no reversal possible along that road to death. It is the intention of Mother Nature that we humans died usually about three score years and ten – give or take a decade. Choice for the individual by the individual should be the legal position to adopt.
(3) My (Humanist) Viewpoint
Then there are the Rest of Us…the Heathen, Atheist, Agnostics, lapsed and cancelled Christians, and the non conformist religious.
We don’t hold the same views as the Religious person…..we mostly don’t believe that God in her infinite mercy would want any living thing to suffer unnecessarily. It is the reason why animals have more protection against maltreatment in law, than a human being.
We believe it is our Right as a free thinking or an indoctrinated group of people to make decisions about our lives, for ourselves.
A thousand times I’ve stated “doing nothing, means nothing happens” but if I say I want, Do Not Resuscitate, written onto my medical file, I don’t expect to be treated as if I am stupid, ill-informed or depressed. Even if I was all of those, I still believe it is my decision to make. My life, my choice. If I do nothing then I am delegating responsibility for my life to another person, and this I cannot do willingly.
Thousands of people ignore risk management when they take on death defying feats….like walking across the Antarctic, jumping out of an airplane, or joining an army which trains one specifically to take lives of others but the Right to Life Lobbyists ignore those specific healthy people who do everything to ensure their life is at risk for fame and fortune. Do the RTL genuinely believe God meant us to continually go to wars and kill innocent “enemies”, in these days of enlightenment where diplomacy and education are meant to work?
Yet, those same moralist folk, so bent on denying a terminally or chronically ill person a good death, are silent when it comes to the waste of a good and healthy life. The Right to Life Campaign appears to target people who want to die because of ill health, yet does nothing to lobby governments about record seeking athletes or our participation in wars of invasion!
Who could not understand Steve Guest’s reasoning throughout the recent SBS Documentary, DO NOT RESUSCITATE.?
Legislated protection for the individual would solve everyone’s problems, without offending anyone. I own my body for me alone.
I want to leave the world a better place for my having been here at all. A Catholic or two, have told me bluntly I belong in Hell…but fortunately those same Catholics don’t get to make the rules about my possible assignations in the next world…..I want no part of their bigotry and bloody compulsiveness about telling others how to live their lives. I want only control over my own life.
4. The Legal Response to the question “What are our Rights when it comes to Dying?”.
In Victoria we have the Medical Treatment Act 1988: (an abbreviated cut and paste effort on my part)
How the Act works (http://www.health.vic.gov.au/mta/works.htm)
Refusal of medical treatment certificate: Competent Person (180k, pdf)
In the course of treatment for a medical condition, a patient may decide that having a specific or general course of treatment is not wanted. If a patient determines they do not want a procedure or medical treatment for a medical condition or illness they currently have, they may create a refusal of treatment certificate as a safeguard for both themselves and their medical practitioner in order to make their wishes known and followed.
The patient must:
- be informed about the nature of his or her condition to the extent that they can make a decision about treatment,
- be of sound mind without clinical signs of cognitive impairment or potentially reversible conditions such as depression,
- be over eighteen years of age and
- nominate whether their refusal of treatment is specific or general.The certificate to refuse medical treatment must be witnessed by two people - one must be a medical practitioner and may also be the treating doctor.
Enduring power of attorney (medical treatment) (88k, pdf)
Refusal of medical treatment certificate: Agent or guardian of incompetent person (296k, pdf)To appoint an agent to make medical decisions on their behalf, a person makes a provision for an enduring power of attorney (medical treatment). The enduring power of attorney (medical treatment) names the agent, and an alternative agent if required, whom the person trusts to carry out their wishes about having or refusing medical treatment.
An enduring power of attorney (medical treatment) requires both the person appointing the agent and the agent to be of sound mind and over eighteen years of age. If a person is not able to appoint an agent, the Victorian Civil and Administrative Tribunal (VCAT) may appoint a guardian to act as an agent.An agent or a guardian appointed by VCAT may enact a refusal of medical treatment certificate on behalf of a person if the agent believes the person would make a similar decision about refusing medical treatment when presented with complete information about their condition or if the agent believes the medical treatment would cause unreasonable distress to the person.
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Limits of the Act and instruments created under the Act (http://www.health.vic.gov.au/mta/limits.htm)
The refusal of medical treatment certificate ceases to operate once the circumstances that gave rise to it are no longer relevant. As the refusal of medical treatment certificate applies only to a current condition and not to an illness or condition that may occur in the future, it may not be used as an “advance directive”.
In addition, the refusal of medical treatment does not cover medical procedures or other procedures that would be considered palliative care. Palliative care includes reasonable treatment for the relief of pain, suffering or discomfort and the provision of food and water.
When a patient cancels a certificate or their medical condition has changed to such an extent that the specific or general provisions in it no longer apply, the refusal of medical treatment certificate is no longer in force.
The enduring power of attorney (medical treatment) does not allow an agent to make decisions about a person’s affairs other than those about medical treatment. A general power of attorney, an enduring power of guardianship and an enduring power of attorney (financial) are all created and administered by other laws.
An enduring power of attorney (medical treatment) does not come into effect until the patient is no longer able to make their own decision. A patient retains the responsibility to make their own decisions if they are able to do so.
An agent can only refuse medical treatment on behalf of a patient when the medical treatment would cause unreasonable distress to the patient or they believe that the patient, if they were still competent, would refuse the treatment.
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Supreme Court decision on the Medical Treatment Act (http://www.health.vic.gov.au/mta/decision.htm)
On 29 May 2003 Justice Morris of the Victorian Supreme Court handed down a landmark judgement in a case brought by the Public Advocate. It clarifies a contentious part of the Medical Treatment Act that deals with the refusal of medical treatment and ensures that people with a disability are not treated as having lesser rights than competent persons who can refuse treatment.
The case involved a woman (known as Mrs BWV) with severe disabilities, including a lack of cognitive capacity, as a consequence of a progressive form of dementia. Before she became unwell she had told members of her family that should she ever become so disabled she would not want medical treatment that would artificially and unnecessarily prolong her life.
The Court proceedings were initiated to obtain a definitive ruling on whether Artificial Nutrition and Hydration delivered through a PEG tube (which is surgically inserted in to the stomach) is either:
- “medical treatment” which may be refused, or
- “palliative care” which may not be refused. The definition of “palliative care” Act includes “the reasonable provision of food and water”.
The Court decided that it was “medical treatment” and could be refused by a guardian or an agent holding an Enduring Medical Power of Attorney on behalf of a person with a disability that prevented them from making or expressing a decision.
This decision does not affect everyone with a disability but only those who have previously expressed wishes about their medical treatment. The Judge stressed the many safeguards in the Act that protect the interests of people with a disability. They include, most critically, the fact that a guardian or agent can only refuse treatment if there is evidence that the person with a disability would themselves, when fully informed, have considered that the treatment was unwarranted. (Treatment could also be refused if it would cause unreasonable distress.)
The decision, which carefully balanced the competing moral and ethical values of the sanctity of life and the right to self-determination and dignity, is important because:
- It allows Mrs BWV’s wishes to be respected and for her to be treated with dignity.
- It ensures that people with a disability are not treated as having lesser rights than competent persons who can refuse treatment.
- It should provide for greater clarity for doctors and therefore greater consistency in the way treatment is provided.
A copy of the full judgement in the case which is cited as Gardner;
re BWV may be obtained from – Full judgement in the case, cited as, Gardner; re BWV
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5 The Political Viewpoint according to Labor: (page 37 of Labor: Listens then Acts)
The dignity of life and death:
4.33 In keeping with the existing bi partisan policy, Labor will allow terminally ill people to refuse active treatment intended to prolong life.
Labor has:
o Improved funding for palliative care services across the state; and
o Ensured that Victorians have the right to a say, directly or indirectly, in every decision that affects their lives.
Labor will undertake an education and information campaign targeting health professionals, to improve knowledge of the workings of the Medical Treatment Act.
Choice comments: The article above was received in response to my asking for a copy of Labor’s Policy on Voluntary Euthanasia.
I am advised that recently the State Government has completed an educational program on the MTA and I will be very curious to see what mechanism is in place to ensure the education is resulting in more patient’s being heard to the exclusion of the Healthcare Workers and the patient’s relatives.
Furthermore, I will follow the Minister for Health up on this matter, remembering a nurses’ comment that dead people can’t sue and they don’t vote……Litigation Fears - that is why so much focus in on what every one wants before the patient themselves. Russian Roulette in Health.
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6 The Resolution . Withdrawn at the recent March 3, 2007 State ALP Conference due to an incorrect “error” not explained to the audience, and now subject to questioning of the Administrative Committee of the Vic ALP , and its Executive….A copy has been provided to my ALP Representative and Member, The Premier, The Health Minister, and the two Labor incumbents in the Southern Metro Upper House. I am yet to receive a formal response from any of them but will keep my readers fully informed.
Attachment (1 of 1)
Health Policy Committee
Terrie Seymour addressed the Conference
Heather Wellington spoke Medicare Treatment act and amendment put
“To make appropriate provision for people’s wishes about the management of their future medical
conditions to be respected. Labor will
a) Give statutory recognition to enable competent Victorians to refuse treatment, or request treatment, for a future condition by way of an advance healthcare directive;
b) Limit Statutory recognition of advance healthcare directives to apply solely to patients in the terminal phase of a terminal illness or who are in a persistent vegetative state and who are incapable of making decisions about medical treatment when the question of administering the treatment arises.
c) Create a register recording medical enduring power of attorney and advance healthcare directives completed by Victorians;
d) Provide for regular reviews of advance healthcare directives and validation every twelve months. This process must include advice to individuals on advancements in medical technology.
e) Require all heathcare institutions to record any existing medical enduring power of attorney and advance healthcare directives on admissions of patients;
f) Require all healthcare institutions to advise patients, in consultation with their GP, of their rights under the Medical Treatment Act 1988 and of the option completing an advance healthcare directive, informing patients that there is no compulsion to complete an advance healthcare directive; and
g) Labor will consult with key stakeholders and the community concerning amendments to the Medical Treatment Act 1988.
Moved: Terrie Seymour Seconded: Heather Wellington
Motion was put as amended CARRIED
7 Public Opinion On the question of “numbers.” in achieving an 80% “in favor of medically assisted dying with strict guidelines”
“The Newspoll survey was conducted nationally over 2423 respondents.
Newspoll are in the business of polls and their results should be very representative of the population. The respondents are carefully randomly
selected to give a good overall representation and the questions are as neutral as possible.
Newspapers & TV polls cannot be said to be as accurate because there is no control over the selection of respondents and may often be associated with an emotional article. Also, certain groups can hijack them if they have a good phone network. However, they can be a good guide”.
In addition recently, The Age conducted a similar poll and the response was 89% and the SBS survey underway as I write is 75% so any figure one chooses to look at is strongly in favour of regulated dying for those who wish to end their lives without undue and unnecessary suffering.
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Choice comments: Delaying tactics is in place! One could think Politicians would be happy to see the back of people like me just to shut me up and allow me my legislative protection to ensure I don’t get Rusticated by mistake. The sooner they listen to us, the sooner they’ll they be free to do other important tasks on behalf of the broader healthier community that don’t have an impending ‘used by’ date zooming in on the horizon…..I want to be remembered as a person who lived and died well – unlike the memories I hold very close some 25 years after my mother’s own death. Mum lived well, and died badly! -that is what I remember. I just want the law changed to protect my rights to die well. Is that so difficult to achieve?