Assisted Dying

An Argument for Assisted Dying in Australia: Andrew Denton’s Di Gribble Argument in full

A wild topic appears.

Andrew Denton, if you don't know him, and you might not if you aren't Australian, is no longer one of the bright young fellows of Austrralian TV. He has done many shows now and his name is known widely for comedy, interviews, and assorted humanistic tv shows. He's been out of sight for the last three years but popped up recently to start talking about assisted dying. The speech he gave recently is worth reading, and probably the podcasts he'll eventually put out (called Better Off Dead) will be good too.

The short version is Australia, and probably most places, is not good at managing the end of lives. Now that people do live a lot and often grow old and infirm without being taken too early does mean they reach a point where, maybe, enough's enough. A point where suffering has grown too intense and remediation too weak. And this would hold for other kinds of people too, even younger ones who've acquired some deathly thing that has taken enough of their physical capacity that after a while they will be dead but not before misery has wrung enough from them.

I think within a generation Australia will have these kinds of laws, but not any time sooner than that. There's a great blind eye everyone there wants to turn on this kind of experience, but enough of the population there is old that they won't for too many years more be able to unsee. I have an old parent, of course, but her time's not near, nor is she suffering, so the question's not pressing. But it does seem important. And to make it China-centric, they getting old here too.

Population Aging in China: A Mixed Blessing

China is rapidly getting older. Three decades ago, only 5 percent of the population was over 65; today, 123 million people, or 9 percent of the population, are over this age. A report released by a government think tank forecasts that China will become the world’s most aged society in 2030. Further, by 2050 China’s older population will likely swell to 330 million, or a quarter of its total population.

China's actually a really good place to have the assisted dying discussion. All the horrible, threatening furphies will emerge: state sponsored age limits, bureaucratic murder of the mentally ill, family pressure pushing the elderly into lethal injections....

First a funny lesson on the subject, then an object lesson on your question, Calach. The funny: Back in the late 70's when I was a freshman  at a (prestigious) US Catholic university, Freshmen had to take a class in Christian Ethics and I'll never forget the teacher-who later became the President of the uni when it's most famous President retired. In class one day he posed the issue to us of: "What about Euthanasia?" He didn't write the word on the board, nor did he use a PPT or handout. I heard it as,what about Youth-in-Asia" and at the time, late 70's, the U.S. was going through the convulsions of winding down the Vietnam War and also moving to winding down the Draft to a Draft Lottery which was a big deal to us young college students. So I raised my hand and said, "I think we need to stop sending our youth to Asia."

Puzzled looks from everyone in the classroom, and the good father said, "we're not talking about Vietnam." Was left more puzzled. It was a couple foyers later when I saw the word Euthanasia written, and looked it up that I realised what a boob I had been.

As to the issue itself, currently, in China-it came two weeks ago in one of my classes. I currently teach three classes of Chinese professors/assoc. profs/researchers who have been selected for further study/research abroad. We prepare them for that task-to be able to function living/studying/researching abroad. They are mostly in the non-language teaching fields (STEM, Medicine, etc.) In one of my lessons, designed to build their confidence in using English, I put them in groups and have them create a survey of three questions. For this group, I let them choose their own topic based on their field. After they create the survey (the first 45 minutes of the lesson), I spring on them that they will go out on the campus and survey strangers In English. Real english for Real Purposes. We're on a college campus and most everyone walking on the road here can communicate in English.  The following class, each group has to prepare and present their results which kills another class with lots of discussion of opinions on results. It's amazing! So there's your lesson plan if you want to use it.

But back to the point, one of the groups last week asked the Euthanasia question.Their group leader is a hospital doctor. She presented the issue and results. Most people they surveyed felt Euthanasia was a personal. family decision that shouldn't be regulated by the government. interestingly most also felt it shouldn't be an individuals decision.

Asked the doctor about the specific situation of her as a doctor in a Chinese hospital, and offered her the chance to avoid answering the question directly. 

She answered, "it's illegal in China. As A doctor who has experienced these situations, I can understand it. I can support it. But I do not have the power to approve or disapprove. And it's not legal anyway.

Yeah, as with the findings in Australia, assisted dying is going on, whether we (as bystanders) approve or not. And Chinese civilization has surely seen a lot of people die. But I wonder if people know what they're talking about if they say it should be a family decision. If, as suggested in the speech, a morally defensible entry point for assisted dying is suffering that is both unbearable and untreatable, then we're talking about conditions that no family can ascertain. Only competent, informed doctors know if a condition (or collection of conditions) is no longer treatable and only the sufferer knows what remains bearable.

As it is in Australia, it seems like doctors are the key. In Australia, the doctors, or at least the doctors' associations, don't want to talk about it. In China, with the guanxi culture and the parlous state of doctor professionalism, how can doctors, in fact and in perception, be relied on? I don't know what palliative care doctors are like in China, but health care is all set to boom here, and end-of-life care should tag along with it.

I'm pretty shocked, to be honest, at the state of these things in Australia. I'm appalled that the one option formally available to people who want to die in palliative care is starvation. You can't formally be administered drugs that will end your life, but you no longer wish to take food and water, the docs and nurses will let you. Or you could choose whatever violence you can manage to do to yourself.

It seems to me we all sort of know that bad deaths are waiting for us.

This discussion takes me back over 50years to when I was Nursing. I was on duty in the Children's ward and I had spent the whole shift looking after a baby that required constant resuscitation. At the end of my shift, the Doctor came and observed the baby, checked my records and then he gently pushed me back. I had to watch the life leave this child's body and I will never forget it. I know that it was the only decision, but I really didn't have much life experience then, so it was hard. My heart specialist has told me that I can have a stroke, so this is a subject which is important to me. I do not want to end up a "vegetable" or a burden to my family. The only chance I have, is to end my own life by overdosing on something like sleeping pills. When the time comes, I probably won't have any warning and I don't want to end my life prematurely, so it's a bit of a worry. Believe me, I am working on a solution where I can die in my own Country and where my son will not have to take the blame.

I vaguely have the idea that I won't be waiting around at the end too. But I'm way too young to be thinking in anything other than idealistic terms. When the time comes, practical matters and probably a grave unwillingness to give up will complicate the situation.

I think at least being able to talk about how and when is vital. That seems to be the thrust of Denton's collection of claims. Currently in Australia, dying is nearly a taboo topic, and making choices about dying seems to scare people. That, I think, is why Denton and people like him are speaking up in public, so that speaking about death can be normalized, and for instance, the actual experience of doctors and nurses can become better known, and in that way people can be better prepared. Plus, if there were a law, that'd be good. But the talking needs to happen first so that the nation makes the right choices.

I don't know that Australians can get it right right now. Oz is a fairly life affirming nation. That alone means Australia has a shadow too, the things we don't talk about. It seems sort of obvious that to truly affirm life, you must recognise death... but I may be talking out of my idealism again.


/rambling

I always assumed that all you would need to do Down Under is take the soon-to-be dearly departed on a walk around a crocodile infested salt marsh and wait for the crocs to notice that one member of the group is walking a lot slower and lagging behind the others.  Sort of the equivalent of Inuit taking grandpa out to see the polar bears.

That would constitute too much assistance.

Quoth the article:

Coroner Olle went out of his way to stress that these were people without a history of mental illness, faced with the slow, ‘irreversible decline’ of chronic disease.

Speaking of those left behind, he said:

"What seems to be a common thread through the family is this absolute sense of respect for someone they love [and] this absolute sense of helplessness. They know this person is screaming for help, but no-one is going to answer the call, not in this society. So they have to die alone."

Coroner Olle estimates the number of elderly Victorians dying in this way at one a week.

I contacted the National Coronial Inquiry Service to see if they could give me a sense of the national picture. Their estimate: that two people over the age of 80 are taking their lives in Australia every week.

The most common method used? Hanging.