The proposal to legalise physician-assisted suicide raises complex questions. When an individual requests another to assist them terminate their life, there is a need to balance the good of autonomy and self-determination with the wider community risk of changing fundamental societal ethic of not to take the life of another.
At a community level, physician-assisted suicide puts at risk accepted sanctions against suicide and exposes the elderly and disabled to potential coercion.
Proposed legislation includes 68 safeguards it argues will manage this risk.
As a doctor pondering physician-assisted suicide, I must also balance risk. Doctors will always aim to meet the needs of an individual patient, especially near the end of life.
However, by sanctioning doctors to intentionally end the life of another person, the trusted role of the doctor as healers is undermined. Trust is a powerful healing tool, especially when treating the elderly and severely ill.
In these circumstances, where individual beliefs vary widely and are potentially at odds with community good, considered collective opinion is important and it is here we have guidance.
Among doctors, the issues surrounding physician-assisted suicide have been carefully and widely considered.
As a geriatrician, I am influenced by my professional society, the Australian and New Zealand Society for Geriatric Medicine, which voted against physician-assisted suicide after debate across the membership.
I am also influenced by the opinion of other doctor groups whose work, like mine, often involves end of life care such as palliative care and intensive care physicians. They both say no to physician-assisted suicide.
An even broader collective of doctors, many of whom will never have to consider end of life issues, represented by the AMA says no.
Furthermore I am influenced by the the most ethnically and geographically diverse representative group of doctors,the World Medical Association, which also says no. In fact, there is no Australian medical college that states support for physician-assisted suicide.
To tap into the representative community view, we need to move away from the opinions of individuals garnered at supermarkets to the considered decisions of elected parliaments.
Physician-assisted suicide and euthanasia legislation has been proposed 30 times and, after lengthy debate, Australian parliaments on all but one occasion said no.
This breadth of opposition is heartfelt, carefully considered and represents the advice from doctors and communities of diverse ethical and spiritual perspectives. Only a self-obsessed atheist could argue it is just the work of the Pope!
So, my advice to any MP considering Victoria's approach to better dying is to hold off giving a lethal poison to a fundamental societal ethic and say no to physician-assisted suicide. Vote instead to treat the underlying condition – poor access to high-quality geriatric and palliative medicine.
