On The Nation: Euthanasia Debate

On The Nation: Euthanasia Debate

Youtube clips from the show are available here.

Lisa Owen: I’m joined by Aussie TV and radio host turned pro-euthanasia campaigner Andrew Denton and Matthew Jensen, from lobby group Care Alliance. Andrew, if I could start with you first. You’ve basically chucked in your day job to campaign for this. Why are you bringing your message here to New Zealand?

Andrew Denton: I was invited by the Voluntary Euthanasia Society of New Zealand, and I believe the issues are the same here as they are in Australia, which is the research has shown that in your country, as in mine, the doctors are assisting people to die but without oversight and without guidance and without guidelines and scrutiny. In your county and in mine, elderly people are suiciding in desperate ways with terminal and chronic illnesses because they have no alternative. In your country as in mine, while palliative care is of a very, very high standard, they can’t help all people and deal with all pain. In your country as in mine, there are people who are killing their loved ones because they have terminal illness, being brought before courts, being given a conviction but been let off without a sentence – what are called mercy killings – which brings the law into disrepute and leaves those people in a situation they shouldn’t be in. So there are people who die needlessly cruel deaths in this country as there are in mine, and that’s why I’m here.

Mr Jansen, people dying needlessly cruel deaths?

Matthew Jansen: And there is the Andrew Denton technique. There is a lot of fear and a lot of misinformation. What people need to hear is that palliative care works. It’s not perfect, we need to improve it, but that’s what we can do. What we don’t need to do is to scare people into thinking that a natural death is going to be awful and slow and undignified. That’s simply not the case.

Mr Denton, palliative care, things have changed over the years. There’s different medications. It doesn’t have to be a fearful, painful death.

Denton: For most people, that’s exactly right. You know, New Zealand, like Australia, has one of the highest standards of palliative care in the world, and those that advocate for these laws, like myself, strongly support the contention that palliative care deserves more funding and more resources. But as Matthew says, palliative care isn’t perfect. By their own admission, Palliative Care Australia says even with optimal care, we cannot relieve all suffering and pain. Now, that is the bit that’s crucial, because what is it like to be like Lecretia Seales and dying of a brain tumour in a hospital? What is that suffering like? And it’s not just pain. I’ll give you a sense of what that suffering is like. It involves incredible physical pain, it involves incredible emotional pain, what’s called existential pain, and everyone I’ve spoken to in palliative care in Australia and overseas says that that is the hardest thing to deal with – the fear and the anxiety of the actual dying process. It involves nausea, and it involves breathlessness. Now, breathlessness at this stage of dying is not what you and I understand as breathlessness if we run up the stairs. It is this sense that every time you breathe you are drowning, and it creates a sense of panic that increases that breathlessness. Ultimately, the level of pain and suffering – because that’s the key word; it’s not just physical pain – gets to a point where palliative care themselves only have two ways of dealing with it, which is to terminally sedate a patient, put them into a coma and look after them until they die or allow them to refuse treatment.

Let’s give Mr Jansen a chance to respond.

Jansen: And once again, Mr Denton, you are spreading fear. You are talking to a lot of people who are hearing you say this is going to be terrible, and it’s not going to be terrible, because palliative care works. And there are many techniques that the palliative care doctors have. And we don’t use the phrase ‘terminal sedation’. If it’s necessary, it’s called ‘palliative sedation’, and it’s reversible at any time. You need to allow people to hear that they should get to their palliative care specialist, because that is what will overcome their fear, okay? And, yes, there is suffering, and I absolutely agree that it’s not simply about pain, because physical pain is the thing that doctors can treat with drugs. What hospices and palliative care people do is they deal with the whole person, and they walk that journey with them, and that’s what we should be doing, not giving them a lethal injection.

Mr Jansen, if Mr Denton is right and this is about alleviating suffering, you can’t alleviate all pain, so why not let people choose where that line is for them?

Jansen: Okay, there are two issues in there. First there’s choice, okay? If you want it to be about choice, all right, that means everyone at any time, okay? You can’t draw a line on choice. If it’s going to be about relieving suffering, the problem that Mr Denton and his proponents have is that wherever they draw their line – and Mr Denton would say a bit of Oregon, a bit of Belgium, Netherlands – wherever you draw your line, there’s someone just over the line, isn’t there, where who you say, ‘No, your suffering isn’t enough for me. I’m going to give a lethal injection to these people, but to you, no, you carry on, because your suffering doesn’t meet my standards.’

Denton: It’s very interesting when Matthew and people like Matthew talk about this, because, in fact, the number one strategy of people like Matthew is exactly what he’s accused me of, which is to spread fear. When you actually look at what’s happened overseas – and it’s not just me saying this; it’s inquiries in Canada; it’s an inquiry that’s just reported after 10 months in Australia, who’ve gone to these jurisdictions and looked overseas, and I’d be very happy to send you, Matthew, because I doubt you’ve seen it, a report that an Australian palliative care physician who doesn’t support these laws did a Churchill Fellowship where she went to these jurisdictions – is that that there is no credible evidence that the kind of people that Matthew is suggesting are being abused or are being led to their deaths is happening. The elderly that we are told are being abused…

But what about the pressure that might go on, say, older people or disabled people, or the pressure that goes on because someone wants Mum and Dad’s wealth, or Granny’s getting a bit too bothersome? What about that pressure?

Denton: That is the number one question I get, and it requires an understanding of how these laws work. The only way you can access these laws is to have an extreme medical condition. You have to have two doctors independent of each other to verify that, and those doctors come under review, which can lead to prosecution.

Jansen: How many prosecutions have there been in Belgium, the Netherlands or Oregon?

Denton: There is one prosecution in Belgium. There’s been none in Oregon and none in the Netherlands.

Jansen: One referred.

Denton: There is one right now.

Jansen: Okay, so that means either everything is fabulous or they are not looking. Just this last week New Zealanders were reminded that governments get things wrong, and Teina Pora spent 21 years in prison because they got it wrong. Pretty good that we didn’t have the death penalty.

Denton: Okay, let me put this to you. Right now in your society as in mine, we have a situation where doctors are assisting people to die, but there is absolutely no—

Jansen: You just changed your language there.

Denton: Let me finish. No, no, no. Let me finish. Doctors are assisting people to die, but there is absolutely no oversight, no review, no scrutiny.

Jansen: Absolutely not true. You changed your language. You started talking about assisting dying, not assisted dying. In New Zealand, as in—

Mr Jansen, do you refute the fact that this is going on already?

Jansen: Absolutely. What is lawful and ethical right now in New Zealand—

But doctors are giving out morphine.

Jansen: It’s legal and ethical right now for doctors to give pain relief with the intention of relieving your symptoms even when they know that it might – might – have a secondary effect of shortening life by a little bit.

Denton: Matthew, what I was talking about was doctors acting outside the law, and that is happening in this country.

Jansen: You give me a name of doctor in New Zealand who’s doing that, and I will go straight down to the police station and report them for murder.

Denton: What I suggest you do is speak to the New Zealand Medical Journal or New Zealand Doctor, both of whom gave reports last year reporting that between 4% and 12% of doctors—

Jansen: Whose reports were those based on?

Denton: One was Phillipa Malpas.

Jansen: You want to tie your credibility to her research?

Denton: I’m more than happy to do that. What I suggest you do, Matthew, is because there will be doctors watching this morning who have assisted patients to die, and, in fact, when I was sitting in make-up this morning, one of your other guests told me exactly that situation with her brother had died of cancer.

Mr Jansen, I suppose the point is that why not bring it into a regulated domain rather than letting people kill themselves in their back room alone because they’re worried about their relatives going to court, forcing people – good people, as Andrew Denton would say – to die badly. Why not regulate it?

Jansen: This, to me, is the absolute key. Mr Denton’s podcasts all started with a one line at the top of the show saying, ‘This programme is not about suicide.’ Yes, it bloody is. And what they are doing is encouraging people to think that when they are suffering, they are better off dead. And that’s a disgraceful thing to tell our young people.

All right. We could talk about this for a very long time, but we’re out of time.

Denton: I do have to step in there and say this has nothing to do with young people suiciding. This is people who are already dying, who are seeking a compassionate way to die, and that is a disgraceful conflation—

We will carry this conversation on in the break.

Transcript provided by Able. www.able.co.nz

Youtube clips from the show are available here.

Lisa Owen: I’m joined by Aussie TV and radio host turned pro-euthanasia campaigner Andrew Denton and Matthew Jensen, from lobby group Care Alliance. Andrew, if I could start with you first. You’ve basically chucked in your day job to campaign for this. Why are you bringing your message here to New Zealand?

Andrew Denton: I was invited by the Voluntary Euthanasia Society of New Zealand, and I believe the issues are the same here as they are in Australia, which is the research has shown that in your country, as in mine, the doctors are assisting people to die but without oversight and without guidance and without guidelines and scrutiny. In your county and in mine, elderly people are suiciding in desperate ways with terminal and chronic illnesses because they have no alternative. In your country as in mine, while palliative care is of a very, very high standard, they can’t help all people and deal with all pain. In your country as in mine, there are people who are killing their loved ones because they have terminal illness, being brought before courts, being given a conviction but been let off without a sentence – what are called mercy killings – which brings the law into disrepute and leaves those people in a situation they shouldn’t be in. So there are people who die needlessly cruel deaths in this country as there are in mine, and that’s why I’m here.

Mr Jansen, people dying needlessly cruel deaths?

Matthew Jansen: And there is the Andrew Denton technique. There is a lot of fear and a lot of misinformation. What people need to hear is that palliative care works. It’s not perfect, we need to improve it, but that’s what we can do. What we don’t need to do is to scare people into thinking that a natural death is going to be awful and slow and undignified. That’s simply not the case.

Mr Denton, palliative care, things have changed over the years. There’s different medications. It doesn’t have to be a fearful, painful death.

Denton: For most people, that’s exactly right. You know, New Zealand, like Australia, has one of the highest standards of palliative care in the world, and those that advocate for these laws, like myself, strongly support the contention that palliative care deserves more funding and more resources. But as Matthew says, palliative care isn’t perfect. By their own admission, Palliative Care Australia says even with optimal care, we cannot relieve all suffering and pain. Now, that is the bit that’s crucial, because what is it like to be like Lecretia Seales and dying of a brain tumour in a hospital? What is that suffering like? And it’s not just pain. I’ll give you a sense of what that suffering is like. It involves incredible physical pain, it involves incredible emotional pain, what’s called existential pain, and everyone I’ve spoken to in palliative care in Australia and overseas says that that is the hardest thing to deal with – the fear and the anxiety of the actual dying process. It involves nausea, and it involves breathlessness. Now, breathlessness at this stage of dying is not what you and I understand as breathlessness if we run up the stairs. It is this sense that every time you breathe you are drowning, and it creates a sense of panic that increases that breathlessness. Ultimately, the level of pain and suffering – because that’s the key word; it’s not just physical pain – gets to a point where palliative care themselves only have two ways of dealing with it, which is to terminally sedate a patient, put them into a coma and look after them until they die or allow them to refuse treatment.

Let’s give Mr Jansen a chance to respond.

Jansen: And once again, Mr Denton, you are spreading fear. You are talking to a lot of people who are hearing you say this is going to be terrible, and it’s not going to be terrible, because palliative care works. And there are many techniques that the palliative care doctors have. And we don’t use the phrase ‘terminal sedation’. If it’s necessary, it’s called ‘palliative sedation’, and it’s reversible at any time. You need to allow people to hear that they should get to their palliative care specialist, because that is what will overcome their fear, okay? And, yes, there is suffering, and I absolutely agree that it’s not simply about pain, because physical pain is the thing that doctors can treat with drugs. What hospices and palliative care people do is they deal with the whole person, and they walk that journey with them, and that’s what we should be doing, not giving them a lethal injection.

Mr Jansen, if Mr Denton is right and this is about alleviating suffering, you can’t alleviate all pain, so why not let people choose where that line is for them?

Jansen: Okay, there are two issues in there. First there’s choice, okay? If you want it to be about choice, all right, that means everyone at any time, okay? You can’t draw a line on choice. If it’s going to be about relieving suffering, the problem that Mr Denton and his proponents have is that wherever they draw their line – and Mr Denton would say a bit of Oregon, a bit of Belgium, Netherlands – wherever you draw your line, there’s someone just over the line, isn’t there, where who you say, ‘No, your suffering isn’t enough for me. I’m going to give a lethal injection to these people, but to you, no, you carry on, because your suffering doesn’t meet my standards.’

Denton: It’s very interesting when Matthew and people like Matthew talk about this, because, in fact, the number one strategy of people like Matthew is exactly what he’s accused me of, which is to spread fear. When you actually look at what’s happened overseas – and it’s not just me saying this; it’s inquiries in Canada; it’s an inquiry that’s just reported after 10 months in Australia, who’ve gone to these jurisdictions and looked overseas, and I’d be very happy to send you, Matthew, because I doubt you’ve seen it, a report that an Australian palliative care physician who doesn’t support these laws did a Churchill Fellowship where she went to these jurisdictions – is that that there is no credible evidence that the kind of people that Matthew is suggesting are being abused or are being led to their deaths is happening. The elderly that we are told are being abused…

But what about the pressure that might go on, say, older people or disabled people, or the pressure that goes on because someone wants Mum and Dad’s wealth, or Granny’s getting a bit too bothersome? What about that pressure?

Denton: That is the number one question I get, and it requires an understanding of how these laws work. The only way you can access these laws is to have an extreme medical condition. You have to have two doctors independent of each other to verify that, and those doctors come under review, which can lead to prosecution.

Jansen: How many prosecutions have there been in Belgium, the Netherlands or Oregon?

Denton: There is one prosecution in Belgium. There’s been none in Oregon and none in the Netherlands.

Jansen: One referred.

Denton: There is one right now.

Jansen: Okay, so that means either everything is fabulous or they are not looking. Just this last week New Zealanders were reminded that governments get things wrong, and Teina Pora spent 21 years in prison because they got it wrong. Pretty good that we didn’t have the death penalty.

Denton: Okay, let me put this to you. Right now in your society as in mine, we have a situation where doctors are assisting people to die, but there is absolutely no—

Jansen: You just changed your language there.

Denton: Let me finish. No, no, no. Let me finish. Doctors are assisting people to die, but there is absolutely no oversight, no review, no scrutiny.

Jansen: Absolutely not true. You changed your language. You started talking about assisting dying, not assisted dying. In New Zealand, as in—

Mr Jansen, do you refute the fact that this is going on already?

Jansen: Absolutely. What is lawful and ethical right now in New Zealand—

But doctors are giving out morphine.

Jansen: It’s legal and ethical right now for doctors to give pain relief with the intention of relieving your symptoms even when they know that it might – might – have a secondary effect of shortening life by a little bit.

Denton: Matthew, what I was talking about was doctors acting outside the law, and that is happening in this country.

Jansen: You give me a name of doctor in New Zealand who’s doing that, and I will go straight down to the police station and report them for murder.

Denton: What I suggest you do is speak to the New Zealand Medical Journal or New Zealand Doctor, both of whom gave reports last year reporting that between 4% and 12% of doctors—

Jansen: Whose reports were those based on?

Denton: One was Phillipa Malpas.

Jansen: You want to tie your credibility to her research?

Denton: I’m more than happy to do that. What I suggest you do, Matthew, is because there will be doctors watching this morning who have assisted patients to die, and, in fact, when I was sitting in make-up this morning, one of your other guests told me exactly that situation with her brother had died of cancer.

Mr Jansen, I suppose the point is that why not bring it into a regulated domain rather than letting people kill themselves in their back room alone because they’re worried about their relatives going to court, forcing people – good people, as Andrew Denton would say – to die badly. Why not regulate it?

Jansen: This, to me, is the absolute key. Mr Denton’s podcasts all started with a one line at the top of the show saying, ‘This programme is not about suicide.’ Yes, it bloody is. And what they are doing is encouraging people to think that when they are suffering, they are better off dead. And that’s a disgraceful thing to tell our young people.

All right. We could talk about this for a very long time, but we’re out of time.

Denton: I do have to step in there and say this has nothing to do with young people suiciding. This is people who are already dying, who are seeking a compassionate way to die, and that is a disgraceful conflation—

We will carry this conversation on in the break.

Transcript provided by Able. www.able.co.nz

ENDS

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