Andrew Denton investigates the stories, moral arguments and individuals woven into discussions about why good people are dying bad deaths in Australia – because there is no law to help them.
For a deeper dive into each episode, follow the link to the episode page for photos, transcripts and more.
My name is Andrew Denton. I’m a writer and broadcaster who lives in Sydney, Australia.
In October 2015, I delivered a public address arguing for an assisted dying law in my country. This podcast is the end result of that process. In it, you will hear the voices of those who I spoke to for my research and learn the reasons that led me to argue for a new, and merciful, law.
Liz is a dynamic 48 year-old businesswoman who’s dying of cancer. She wants to have a choice about how she dies because she’s been through palliative care. In her words: ‘They can’t control your pain, let me tell you. I’ve been there.’.
According to Canadian anti-euthanasia campaigner Alex Schadenberg, Melbourne doctor Rodney Syme is a threat to society: a ‘cowboy’ and ‘the worst of the worst’. Why? Because for over a decade now, Syme has been publicly assisting terminally and chronically ill patients to die – despite the threat of jail for doing so. How did a respectable 80-year-old urologist come to be a law-breaking cowboy?
Opponents of assisted dying in Australia want to leave things as they are, because of the worrying things they claim might happen if we did have a law.
But what about the worrying things that actually are happening because we don’t have one?
The Netherlands’ euthanasia laws are the longest-running in Europe.
Surprisingly, the drive to create them didn’t come from politicians; it came from doctors. Recognising that, like doctors in many countries (including our own), they were already assisting people to die, they pushed for a law that would bring the practice into the light – protecting both them and their patients.
For those who hold out the Netherlands as a textbook case of a ‘slippery slope’, they see a law originally designed to help the terminally ill – but that has now ‘slipped’ to include those who aren’t. But the Dutch law wasn’t written to deal only with certain diseases; guided by doctors themselves, it was deliberately created for people whose suffering is ‘unbearable and untreatable’.
This might include, for example, people with long-term, corrosive illnesses such as multiple sclerosis or motor neurone disease. In some circumstances, it may even include people with Alzheimer’s.
But if the basis of your law is that only a mentally competent adult can request euthanasia, how do you deal with cases where that competence is unclear?
If there is an epicentre for anti-euthanasia sentiment, it’s Belgium – home to what are often described as the most liberal euthanasia laws in the world. Here, people of any age – even, in some circumstances, children – can be euthanised.
Allegations are made of a euthanasia culture that has become so uncaring that the elderly are regularly despatched without their consent. The word ‘murder’ is sometimes used.
Shortly after arriving in Belgium, I learned of ‘Laura’ – a 24-year-old woman who had sought the right to be euthanised after years of unrelieved mental suffering.
Immediately, I heard alarm bells.
My gut reaction?
If you’d asked me to tell you the point where it began to feel uncomfortable, this was it.
The success of Oregon’s Death with Dignity Act – at 18 years, the world’s longest-running law of this kind – puts two things into sharp relief. Firstly, the increasingly desperate attempts of opponents to discredit it. Secondly, the truth they don’t want you to see – that this law works, and exactly as intended.
How that law came to pass in such a religiously conservative country stands as a masterclass in public policy, and one that set the template other US states have since followed.
Speaking with doctors in Belgium, the Netherlands and Oregon, I’d learnt that in those places, palliative care and assisted dying are seen as things that go together – and assisting a patient to die may sometimes be the ultimate offer of help for those beyond the skills of even the most dedicated palliative care experts.
Back home in Australia, the law forbids assisted dying. Without a law to protect or guide doctors and nurses, I wondered: how does palliative care here deal with those same kinds of patients?
Associate Professor Richard Chye is the director of the Sacred Heart palliative care unit at St Vincent’s Hospital in Sydney. A gifted physician and teacher, he is also a hugely influential figure in palliative care in Australia. Apart from being a member of various state and national committees, he’s a board member of Palliative Care Australia – the peak national organisation.
Responding to my request, Richard invited me to spend a week with his team to see what they do – and to discuss the subject of assisted dying.
Assisted dying has no more committed opponent than the Catholic Church. They have thrown resources, and the full weight of their political influence, against it wherever it has been proposed.
That’s why the words of Sydney’s Archbishop Anthony Fisher – one of Australia’s most senior Catholic clerics, and a man who commands the ear of many politicians – are worth listening to.
The repeated call by opponents of assisted dying is that the elderly and the vulnerable must be protected from coercion. In this, they are right – and there are many safeguards built into existing laws overseas which do exactly that.
But what of the elderly described in this episode by two of Australia’s coroners: rational men and women from loving families – who, faced with an irreversible and painful decline into death, are deciding to kill themselves violently instead?
Of all the arguments against assisted dying, the most heartless I’ve heard is this:
"Suicide is legal. Why do you need assistance to do something that you can do yourself?"
Every time I hear that thought expressed (and I’ve heard it more than once while making this podcast), I’m astonished at the ease with which the people saying it manage to completely overlook the suffering of the people they’re talking about.
My search for the truth about assisted dying began when I was invited to attend the HOPE International Symposium in Adelaide, featuring anti-euthanasia speakers from around the world.* There, I heard dire warnings about what was happening in Belgium, the Netherlands and Oregon – where laws to help people die already exist.
20 years ago, four dying people were able to access the Northern Territory’s world-first law to help them die more mercifully, before the law itself was extinguished.
By the end of 2016, over 100 million people on three continents will be able to access such laws – the most recent places to adopt them being America’s most populous state, California, and Canada.
Since that Northern Territory law was overturned in 1997, nearly 30 attempts to create a new one here in Australia have failed. But as the tide of history turns in favour of assisted dying, how much longer can our politicians continue to ignore the call for change?