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There is nothing modern about euthanasia

Helen Andrews | ABC The Drum | 25 July 2014

The decision by the Medical Board of Australia to suspend Dr Philip Nitschke, who has been the target of multiple inquiries by the Australian Health Practitioner Regulation Agency over the past few years, is long overdue.

It is doubly welcome in that it sends a clear message that Nitschke's actions are not consistent with medical ethics, and also provides an opportunity to highlight the radical and false ideas underlying Nitschke's position on suicide.

The first of these fallacies is the idea that modern medical advances have made euthanasia more justifiable now than in previous eras.

In announcing his appeal of the Medical Board's decision, Nitschke cited "the context of longer lifespans and the ability of medicine to prolong the quantity but less the quality of life almost indefinitely" as a factor rendering "the existence of rational suicide" more plausible.

But in the 100 years that euthanasia has been a matter for public policy debate, technology has driven the conversation much less than people assume. Euthanasia advocacy has waxed and waned according to changes in politics and culture, not medicine.

The first time that a legislator in an English-speaking country introduced a bill to legalise physician-assisted suicide was in 1906, when a member of the Ohio state legislature in the US tabled such a bill on behalf of a woman whose mother died from cancer. The British Parliament saw its first euthanasia bill introduced in 1936. The Euthanasia Society of America was founded in 1938.

None of these landmark pushes occurred in response to advances in medical technology. Certainly they predated the explosion in life-prolonging technologies like artificial respiration that occurred in the 1960s.

Early euthanasia advocates were moved by the same problem we face today: the existence of incurable diseases that leave patients hopeless and suffering. Whatever your opinion on the morality of assisted suicide, no one can claim that this tragedy is unique to the modern era.

Indeed, earlier debates on euthanasia are almost identical to those conducted in the press and in parliaments today. One reason for this is that 20th century proponents of assisted suicide proposed the same safeguards as their modern heirs: verification that the patient truly wills his or her own death voluntarily; confirmation that the patient is of sound mind; and professional consensus that the case is truly hopeless.

The 1906 Ohio bill, for example, required the physician to ask the patient "in the presence of three witnesses, if he or she wants to be killed". It also called for "three other physicians" to "agree that the case is hopeless".

These precautions were nevertheless found to be insufficient. There was felt to be too much potential for abuse and error - by unscrupulous relatives, by doctors with imperfect judgment, and by others. These concerns apply with equal force to modern bills that rely on similar safeguards.

The second fallacy that Nitschke's downfall has highlighted is the misconception that Christian groups are behind public opposition to his advocacy. On Twitter earlier this month Nitschke spoke of being "attacked by rabid Christians and journalist jackals".

It is true that deeply held religious beliefs have led many Australians to oppose the legalisation of euthanasia. However, it is equally true that religious groups have historically been staunch defenders of the right to a peaceful death.

In the first right to die case to become a cause celebre, the legal battle over the fate of Karen Ann Quinlan in the US in 1975, it was her Catholic parents and their priest who called for doctors to unplug the young woman's respirator after it became clear that she was unlikely to emerge from her coma. Mr Quinlan spoke of this act not as euthanasia but as "turning our Karen's life to the loving Lord".

The first "living will" law passed in the United States, the California Natural Death Act, which protected the right of incapacitated patients to refuse lifesaving treatment, was passed with the support of the state's Catholic hierarchy. From the 1950s to the present, the Catholic Church has defended the right of patients to refuse medical treatment if they do not wish their lives prolonged unnaturally.

Back in 1972, euthanasia proponent Florence Clothier blamed public opposition on the "Judeo-Christian obsession with prolonged existence". This was false then and it is still false. Even the staunchly pro-life Catholic Church considers death a natural event that no one is morally compelled to avert by any and all possible means.

The debate over assisted suicide is likely to heat up in the coming weeks, with the House of Lords in the UK poised to debate a bill to legalise euthanasia under certain circumstances - a move that, according to one survey, has two-thirds of disabled Britons "concerned".

As we prepare for this difficult discussion, Australians should banish any idea that this dilemma is anything new. Previous generations confronted the same dilemmas, considered the same potential safeguards against abuse, and came to the conclusion that euthanasia should not be made legal. Technology has not fundamentally altered the shape of the moral and pragmatic questions involved, no matter what proponents like Nitschke claim to the contrary.

Helen Andrews is a policy analyst at The Centre for Independent Studies.