The big social morality issues facing our nation currently, as all readers of the Daily Declaration will know, are Euthanasia/Physician Assisted Suicide (EPAS), now re-titled as Voluntary Assisted Dying (VAD); abortion, now re-titled Reproductive Health Care Reform; transgenderism; the absent care of babies “accidentally” born alive and left to die; and freedom of speech.
Medicine is involved in each one of these, including the freedom to declare truth and to argue ethically. Doctors have already been investigated and charged for expressing views contrary to an “established” view.
But medical graduates in particular have a responsibility to the community to educate on issues of medical relevance, and also to have a voice to Members of Parliament, especially where such issues affect the practice of Medicine.
A prime example of this need for a community medical voice was the 2008 Abortion legislation in Victoria, compelling a doctor to either perform an abortion procedure or to refer to an abortion doctor.
As most West Aussies would know, debate on the VAD bill has already started in WA, and is unfortunately likely to pass through the Lower House readily, with the real debate due to occur in the Upper House.
The West Australian on three occasions has splashed front page headlines and pictures promoting VAD:
- The Essence of Humanity “I watched my 73 yr-old mother die”
- 86% of a survey said to be in favour of legislation
- “Let me die with dignity” written by an emergency medicine physician
With all three missing important issues, that can be argued at great lengths.
Very briefly, these are that:
- If the right survey questions are asked, the 86% falls dramatically.
- Patients as they go through their last illness ask for euthanasia less and less.
- Palliative care specialists know that requests for euthanasia fall away with good care.
- Pain relief is always possible.
- There are consequences to society when euthanasia is legalised, particularly to the elderly, the disabled, the marginalised, the suicidal.
These matters have all been argued elsewhere in detail, and they are not the point of this article.
Each of the newspaper articles focus on the plight of the individual patient and individual choice, as highlighted by the title of the Joint Select Committee Report, My Life, My Choice.
But there is so much more than individual choice.
There are consequences for Medicine and Society, affecting the world in which we live.
Twenty years ago, in 1998, I was stimulated to write a piece on “The Passion of Medicine” in response to a national competition. I managed to whittle the entry down from 150 words to the 50 words required, as below. It occurred to me that the final argument, the final plea to be heard by MPs and the informed public, is the cost to the future of Medicine and Society. Hence my thoughts as below, based on The Passion of Medicine.
Which was it? the thrill of the chase of the elusive diagnosis? the triumph of solving the puzzle? the entrée into people’s lives? the adventure of saving life? the awe, excitement and responsibility of the birth? the presence during the last illness?
The passion was the privilege of being there…*
“… the presence during the last illness”
To ease the way…
… medically as a part of good palliative medicine; physically; in honourable care minimising loss of dignity by honouring dignity; enabling appreciations; facilitating healing of relationships including through forgiveness; letting go – in itself a finishing – of unfinished business and aspirations; to enable peace with oneself; and as much as possible with others, including God.
…including God – sometimes just a final submission, a final “letting go” of any defiance or self-sufficiency, an acquiescence, a surrender
To ease the way… with good medical care to relieve distress till the final breath
To ease the way, but never to intentionally kill.
To comfort always, but never intentionally (for that purpose) kill.
Doctors are never to be perceived as being killers.
Killing must never be endorsed as “good medicine”.
Killing must never be a part of Good Medical Practice.
For doctors to be killers is the death of Medicine (with a capital M) as we know it.
Yes, pharmacists or nurses may be involved in that final step – or even lawyers – with the right of conscientious refusal, or other “trusted” people, but never doctors.
Medicine would be the poorer. (Why do you think the Declaration of Geneva with its strong respect for human life was formed in 1948?)
Society would be the poorer.
And, yes, there are other consequences too – enormous and significant, but paling into insignificance in light of the above catastrophic shift.
“The (undeclared) Battle for Medicine”
“Coercion of Doctors: What is happening to modern medicine?”
in response to the 2008 Victorian Abortion Legislation
*The Passion of Medicine: introduction
Was it the thrill of the chase of the elusive diagnosis?
Was it the triumph of solving the puzzle?
Or was it the ability to facilitate healing and restoration when the diagnosis is made?
Was it the privileged entrée into people’s lives?
Or was it the satisfaction after that entrée was given of being able to influence for good — medically, psychologically, socially, spiritually?
Was it the privilege of having entrée that over a period of thirty years?
Was it the adventure of saving life, particularly in the high drama of the emergency?
Or was it the awe, excitement and responsibility of the delivery room and the incredible feeling of handing over that healthy newborn baby to the emotional parents?
Was it the privilege of presence during the last illness and the dying breath?
Or was it the facilitation of recovery and welcoming of the future for those who were left behind?
The passion was the privilege of being there…
9 May 1998