Assisted dying is not suicide

This article was first published in The Kansas City Star on 4 August 2018 as "Medical aid in dying is not the same thing as suicide".

 

Dr David R Grube of Compassion & Choices Oregon
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The untimely deaths of Anthony Bourdain and Kate Spade have shone a spotlight on the suicide crisis our country faces. However, it is important to differentiate the act of committing suicide from medical aid in dying.

Suicide is a tragic result of untreated, reversible diseases such as depression or addiction. Suicidal patients want to end their lives as a result of impaired cognition and deficiencies of impulse control. They are most often alone and may use violent means.

By contrast, patients seeking medical aid in dying do not want to die, but they are dying of an irreversible and untreatable disease or condition. Their goal is to end, rather than prolong, their suffering. They are rational and their cognition is intact. They are connected to family and hospice.

Medical aid in dying is a medical practice that gives mentally capable, terminally ill individuals with a prognosis of six months or less to live the option to request, obtain and self-ingest medication to die peacefully in their sleep if their suffering becomes unbearable. It is a well-established, palliative end-of-life care option with clinical criteria and guidelines that meet the highest standard of care.

I am a retired family physician in Oregon with more than 35 years of experience caring for patients in all stages of life through death, including those who have requested and utilized medical aid in dying. When patients are dying from terminal illness and there is no alternative but suffering in their final days, it is crucial that they are presented with options that will enable them the freedom to face their passage from this life in a manner of their own choosing.

There is absolutely no evidence that in states where medical aid in dying is authorized suicide rates have gone up. National and state level data from the Centers for Disease Control and Prevention’s National Vital Statistics System suggest that suicide rates have varied slightly, but overall have gone down in Oregon since its Death with Dignity Act went into effect in 1997. And in the year and a half since California’s End of Life Option Act has been in effect, the state’s suicide rates have also gone down.

Oregon has 20 years of experience with medical aid in dying, with a tremendous amount of data that assures us of the safety and value of this option. We have seen this same trend in five other states with 40 years of combined experience with medical aid in dying: Washington, Montana, Vermont, California and Colorado.

As the data shows, many terminally ill patients get tremendous solace from knowing they have the option of a peaceful death. With the best possible end-of-life care, most patients will not find the need to use medical aid in dying. Yet we all benefit from the option to end terminal suffering should the need arise because these laws spur conversations between patients, their doctor and their loved ones about all end-of-life care options. As a result, we see better use of hospice, palliative care and pain control.

The debate over whether state legislatures should allow people to manage their passages from this life in the face of terminal illness is an important one. It deserves an honest dialogue that doesn’t falsely equate a violent, disruptive act like suicide with a proven medical practice that allows people in the final days of their lives to die a peaceful death.In Oregon, since our medical aid-in-dying law was passed, more people have not died. But fewer people have suffered.

David R. Grube is national medical director for the nonprofit Compassion & Choices Oregon.


E-Petition for Queensland

 VoicesforChangeVAD.JPGA passionate group of Queenslanders, united under the name Voices for Change Voluntary Assisted Dying, recently launched a Parliamentary E-Petition on End of life choices and voluntary assisted dying.

The minister must respond to a petition within 30 days. The more signatures, the more powerful the message. The goal is to collect 10,000 signatures.

The aim of the petition is "to ask the House to start in inquiry by the Health Committee into better end of life choices and voluntary assisted dying, no later than October 2018 to allow debate and submissions and tabling of a bill within this term of government. 80-85% of Queenslanders want greater choice when it comes to managing their end of life choices which include better palliative care and voluntary assisted dying. "

Please note:

  • you must be a Queensland resident to be able to sign the petition;

  • closing date is 20 August 2018.

Note: this is an E-Petition which is signed electronically only (no paper involved).

 

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August 2018 Newsletter

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The big news of the month is Senator David Leyonhjelm's deal with the government to put the Restoring Territory Rights (Assisted Suicide Legislation) Bill on the agenda. It will be debated in the Senate from the 14th to 16th of August. If you'd like to follow the debate, you can do so online via the website of the Parliament of Australia.

If passed, this bill will allow the parliaments of the ACT and the NT to consider legislation for Voluntary Assisted Dying, a right they currently do not have. As you may be aware, the NT was the first area in Australia to implement legislation in 1997, which was subsequently revoked by the Commonwealth. If you haven't done so already, please contact your Federal Senator to let them you you want them to support this bill. 

It's easy to do: All you need is your address to look up your Senators, write your message and press SEND. It will only take a minute and it's really important as they have already been bombarded with letters from the opposition. We need your voice!

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Several State Dying with Dignity groups have also mounted campaigns, click on your relevant state name to be taken to that page:

DWD NSW DWD Victoria   DWD Tasmania  DWD WA

If the bill passes the Senate, it may go to the House straight away. In that case, we will call on you to contact your local State MPs as well, so please stand by!

Marshall PerronOn the eve of the debate, former Chief Minister of the NT Marshall Perron will address the National Press Club in Canberra on Wednesday 8 August at 12.00 pm. 

A keen advocate of individual rights, Marshall created world history when his private member’s bill, The Rights of the Terminally Ill Act, passed through the Territory Parliament in May 1995. Although the legislation was subsequently overturned by the Federal Parliament, four terminally ill Australians chose to end their suffering using the provisions in the Act while it was in force.

If you are in the area, please join us on the day. Tickets include lunch and are available directly from the NPC website

VoicesforChangeVAD.JPGIn Queensland support for Voluntary Assisted Dying continues to grow. On the 25th of June a public forum was held by the Clem Jones Trust and Dying with Dignity QLD which was well attended.

Soon after a passionate group of Queenslanders, united under the name Voices for Change Voluntary Assisted Dying, launched a Parliamentary E-Petition on End of life choices and voluntary assisted dying. The minister must respond to a petition within 30 days.The goal is to collect 10,000 signatures. Please note that you must be a Queensland resident to be able to sign the petition, which lives here.

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Last but not least, we would like to say a big THANK YOU everyone who supported our End of Financial Year appeal which came to $28,400! These funds will be put to good use. Behind the scenes, a lot of work has been done on several projects. We are close to publishing a new e-book - watch this space. 

We need your support to continue our work. There are two ways to help:

1. Consider a monthly donation. Our opponents are fully resourced and staffed. We cannot hope to match them by volunteers alone. 

Sign Up
2. Encourage one new person to join our campaign. Then ask them to do the same.

Donate Now

 

The law only changed in Victoria because many thousands of people stepped forward. But compassionate end of life choices shouldn’t stop at the Victorian border. We need you now more than ever.

Thank you for your support!

Kiki Paul
CEO

 


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Go Gentle Australia is a registered charity. All donations over $2 are tax deductible.


Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015

In just a few weeks the Senate will debate a bill to restore the rights of the Northern Territory and the ACT to make their own laws on assisted dying.

Starting 14 August 2018, the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015 will be debated in the Senate.

If passed, this bill will allow the parliaments of the ACT and the NT to consider legislation for Voluntary Assisted Dying, a right they currently do not have. As you may be aware, the NT was the first area in Australia to implement legislation in 1997, which was subsequently revoked by the Commonwealth.

 

We NEED your support! Please let ALL the Federal Senators in your State know that you would like them to support this legislation.

We want Senators to know that

  • Their voters feel strongly about voluntary assisted dying laws;
  • They feel just as strongly that Territory citizens should have the democratic right to decide these laws and not be second class citizens in their own country; 
  • They should be able to make their own decisions about health care at the end of life. 
  • We want them to support the Bill restoring Territories Rights.

It's easy to do: All you need is your address to look up your Senators, write your message and press SEND. It will only take a minute.

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Please share this campaign with your friends and networks and ask them to take action. Together we can right this wrong and help write these laws.

Thank you for your support!


Campaign Update

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My name is Kass (with Sir Elmo Pug) – I’m living with cancer. As a Victorian – from June 2019, once the Voluntary Assisted Dying law is implemented, I’ll have a choice. But my fellow Australians in other states and territories don’t have this choice. Please help change this - click here to support our campaign.

~*~*~

Our campaign is rapidly approaching the halfway mark and we're at just over $14,000.

Thanks to everyone who already donated. You are among the majority of Australians who believe in sensible, humane laws that can reduce the suffering of terminally ill people and their families. It was people like you who helped pass the law in Victoria.

While this is great news, we're still a little bit away from the $25,000 target. 

Please help me reach our target by doing at least one of the below:

1.   Donate now here: https://chuffed.org/project/GGA-EOFY18

We've added some options so now you can use also Apple Pay, a credit card stored in your browser or Paypal.

2.   Phone a friend and ask them to donate.

Tell them this is an important cause that is close to your heart and you'd really appreciate their support. Then ask them to phone their friends! Copy and paste this link into a message: https://chuffed.org/project/GGA-EOFY18 so you can forward it to your friends.

3.   Share, share, share - on Facebook and Twitter via the buttons on our Chuffed campaign page.

Another easy way to share is simply forwarding this email to all your contacts.  Or copy and paste this link:
https://chuffed.org/project/GGA-EOFY18 
and send it to your friends via text, iMessage, Whatsapp, Messenger, carrier pigeon or even "snail mail".

Even if you've done it already, please do it again. Sometimes you need to ask friends a few times.

If you (or your friends) prefer to donate via a friendly human, please call me on 0468 464 360.

Have a great week and thanks for your support. Together we can right this wrong and help write these laws.

Best wishes

 

Kiki Paul
CEO


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Go Gentle Australia is a registered charity. All donations over $2 are tax deductible.


Fundraising campaign

My name is Kass – I’m a teacher, an artist, I’m nearly a lawyer. I’m a wife, a daughter, a sister, and since I was a child I’ve been living with cancer. I’ve been living my life and fighting this disease for a long time, and I will continue fight with everything I’ve got.

But one of the great comforts to me, in not knowing what the future holds, is that if all the fighting is done and the end is inevitable - I’ll have a choice.

I don’t want to die, but if it comes to it, I don’t want to die in intolerable pain and suffering. As a Victorian – from June 2019, once the Voluntary Assisted Dying law is implemented, I’ll have a choice. But my fellow Australians in other states and territories don’t have this choice. Please help change this - click here to support our campaign.

~*~*~

Last year’s campaign in Victoria was a great success. Go Gentle Australia contributed to the passing of the first Voluntary Assisted Dying Bill for a state. But we would like all Australians to have access to this law.

Despite public opinion sitting consistently on over 80% support, believe it or not, there is well funded and determined opposition to this compassionate law – and they spread fake news – relying heavily on fear, uncertainty and doubt. We’re here to discredit their case by presenting the facts. We collect evidence and heart breaking real stories that help educate our MPs about why Voluntary Assisted Dying laws are important. We use every last dollar from our donations from the public to make that possible.

Let me be blunt: we need money to keep the organisation running. That’s why we’re running an end of tax year appeal.

We can’t defend the gains, like the Victorian laws, nor get ready for the next fight, like the coming campaign in WA, without your support. The more people who get involved in this campaign, the more we can do to influence politicians, replace fear and untruth with the facts, and give more people the choice and rights they should have. We’ve achieved so much already, but to really win, we need more good people onside and more support.

Please help GGA keep up the momentum by donating to our end of financial year appeal now. Here’s the link to the Chuffed campaign page: 

https://chuffed.org/project/GGA-EOFY18

And please, take your impact even further by sharing the campaign as widely as possible.

Together we can right this wrong and help write these laws, and help end the suffering of terminally ill people.

Thanks so much for your help.

Best wishes

 

Kiki Paul
CEO


May 2018 Newsletter

News Update

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As Andrew Denton mentioned in our last newsletter, there is movement across the continent towards legislation with inquiries underway in WA and the ACT, and a campaign in QLD to start one. The above map gives a quick overview.

Over the coming months we will be working hard on developing myth busting materials to help counter the FUD (Fear, Uncertainty and Doubt) that opponents bring up again and again, despite The Facts telling a different story. Similar to what's happened in SA and Victoria, the same discredited arguments are put forward in WA. 

We are your voice in this debate - using facts, first person testimonies, and powerful advocacy from doctors, nurses and palliative care experts to counter the conservative and religious voices, that seek to stop this legislation every time it is proposed. Opponents to this law have significant resources. To counter them and their arguments effectively we need your support.

Meanwhile, last month Hawaii became the 6th American state where Voluntary Assisted Dying laws are now in place - watch the video: 

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Go Gentle Australia is not just about Voluntary Assisted Dying. We are also about a better conversation around death, dying and End of Life Choices.  From 16-23 April Australia had its National Advance Care Planning week. If you follow us on Facebook, you may have seen our daily posts, which we kicked off with this cartoon.

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Have you thought about what's important to you? Chances are, you have. But have you talked about it with loved ones? Or have you put pen to paper to ensure your wishes are made clear, even if you're not in a position to communicate them? Chances are, you haven't. 

If you'd like to know more about the laws that apply to Advance Care Directives, visit the QUT End of Life Law website for a handy state-based summary. In our Resource Centre you will find further tools and and organisations that can help start the conversation.

It's never too early to start, you're only ever at risk of not starting early enough. 

We are also working on some other exciting projects, that are still in the very early stages and not quite ready to share. 

We need your support to continue our work. There are two ways to help:

1. Consider a monthly donation. Our opponents are fully resourced and staffed. We cannot hope to match them by volunteers alone. Even $10-$20 a month goes a long way.

Sign Up
2. Encourage one new person to join our campaign. Then ask them to do the same.

Donate Now

 

The law only changed in Victoria because many thousands of people stepped forward. But compassionate end of life choices shouldn’t stop at the Victorian border. We need you now more than ever.


Hawaii's governor signs the Bill

This January, the House took up four separate Death with Dignity bills, choosing to advance HB 2739, Our Care Our Choice Act, sponsored by Hawaiʻi State Representatives Della Au Belatti (D-Makiki), Mark Hashem (D-Hahaione), Nicole Lowen (D-Kailua-Kona), Sylvia Luke (D-Makiki), Dee Morikawa (D-Niihau), Scott Nishimoto (D-Kapahulu), Scott Saiki (D-McCully), Gregg Takayama (D-Pearl City), and Chris Todd (D-Hilo).

This time around, the legislative outlook for supporters was positive. Would 2018 be Hawaii’s year?

On February 28, the House Health and Human Services and Judiciary Committees passed the bill 4-1 and 7-1, respectively, paving the way for the landslide 39-12 vote in the full House of Representatives on March 6.

The Our Care Our Choice Act received a major boost when Hawai‘i Governor David Ige said he would be “proud and honored” to sign the bill.

The Senate worked quickly to move the bill through committees. The Senate Committee on Commerce, Consumer Protection, and Health on March 16, 2018 passed the bill unanimously. The Senate Committee on Judiciary passed the bill 4 to 1 on March 23, 2018.

When the full Senate approved the bill on March 29, 2018 by a vote of 23 to 2, it became clear that Hawaii was on the verge of making history. Sixteen long years after the movement’s near-win, Death with Dignity advocates were one signature away from the Aloha State becoming the nation’s seventh jurisdiction with an assisted-dying statute.

Today, Governor David Ige signed the Our Care, Our Choice Act into law. Starting January 1, 2019, Hawaii’s citizens will have the same compassionate end-of-life option that residents of Oregon, Washington, Vermont, California, Colorado, and Washington, D.C. enjoy.

Reflecting on the legislative victory, Death with Dignity Executive Director Peg Sandeen expressed gratitude for the lawmakers and advocates who over many years worked to make policy reform in Hawaii a reality.

“We thank the members of the Legislature who recognized that the will of voters could no longer be ignored and brought the bill forward to successful votes in the House and Senate.

“As we celebrate the Governor’s signing this legislation into law, we cannot help but think of and thank the many citizens of Hawaii who worked for passage of this law, but never saw it come to pass. We thank them for the courage to speak out and begin this conversation.

“Hawaii residents can feel comfort knowing that the laws in other states, particularly Oregon where it has been in effect for more than 20 years, have proven flawless in their implementation, protecting the rights of patients, family members and health care professionals as they work through this process. Be assured that the safeguards your legislators have enacted into this law will ensure that patients are in control of this process and make their own decisions at every step of the way—as is their right.”

 


ASSISTED DYING – A SIMPLE CHOICE

Everald Compton is Chairman of the LONGEVITY INNOVATION HUB, which is a not for profit entity implementing the Blueprint for an Ageing Australia. He was a Founding Director of National Seniors Australia. Everald served on its Board of Directors for 35 years and was Chairman for 25 years, retiring in 2010 when he took up a new role as Chairman of the Australian Government’s Advisory Panel on Positive Ageing for three years. The below article was published on www.everaldcompton.com on 31 January 2018.

 

I am grateful for the gift of life that has been mine and I hope that I have managed to make a good contribution to the society in which I live.

This being so, I don’t want to live if a time arises when I have no quality of life. At this point, I want out immediately, and if there are no laws authorising Voluntary Euthanasia in Queensland where I live, then I fully intend to do everything I can to bring on a good heart attack.

I do not want to lie in bed like a vegetable and cause my family to make endless visits to my bedside to see someone who is simply not me, just an object of pity.

I want them to remember me as an active and happy achiever who enjoyed their company. Their last sight of me must not be awful.

And I want to save the nursing home fees so the money can be used to give my grandkids a great start in life.

Clearly, the best outcome is for the Queensland Government to make it legal for me to voluntarily take a tablet.

Typically and sadly, Queensland is the only Australian State never to debate Voluntary Euthanasia legislation. Every other State has tried, some several times, and finally Victoria won the battle last year, making a huge breakthrough about which I rejoiced. For some reason, Queensland tries to hang on to the past and fear the future, something our earliest pioneers definitely did not do. It’s out of character.

Let us for a moment review the case for voluntary euthanasia.

We will all die one day. It is inevitable. So, why go to extremes in perpetuating life when there can be not enjoyment of it. What are a few months in the whole fabric of our existence.

I believe that I am entitled to a life choice and I have left a health directive where I declare that I want all the plugs pulled when my life has no quality. If that doesn’t work, I want a tablet or a needle or I will keep holding my breath for a long time.

Opponents say that some children will use voluntary euthanasia to get their parents money as early as possible, but safeguards are in place in Victoria to stop this happening. It causes no problems for me, as I love and trust my family and have spoken to each one of them about my attitude to dying. They know and accept the circumstances when I want to go.

Others say that palliative care is so good that people can be kept painless for months while they await death. This is quite simply a nonsense. Underneath the sedatives, the patient is under great mental stress as they struggle with the pointlessness of it all and its utter indignity.

Others say that assisting someone to die is an offence before God. That is simply an attempt to put all the blame on God for everything. As a practising Christian, I do not believe that God decides who lives or dies. Jesus himself deliberately chose the time of his death. He had a number of options to avoid the crucifixion, but he chose to go to the cross. We all have the same choice.

So, its time to stop making excuses and get rid of our fear of death. As death is part of life it must be rejoiced as if it is a birth.

If I am fortunate enough to get some notice of my death, I intend to stage a lively party with my friends and family where we share a drink and remember happy days. I will kiss them all goodbye and close my eyes. If nothing happens, I will ask them to keep giving me full glasses of whisky until my old heart can take no more.

I hope that the Queensland Government will legislate to take my death out of their hands and place it in mine. Democracy is totally about freedom of choice.

Some MP’s fear losing their seats over this issue. They won’t. Politicians only lose when they sit on fences and forget about doing their job.

Many MP’s also fear the clout of Churches whom they feel will be aggressively upset about this matter. Some will, but the reality is that few people now take any notice of Churches, sad though this is. As a long term Elder of my Church, I have to bear a heavy responsibility for this tragedy.

I am not a fearsome character, but I want all my parliamentary friends to know that I am in their relentless pursuit in the cause of Assisted Dying. I will do it nicely, but ceaselessly.

May grace and peace be with you all.

Yours at Large

Everald Compton


Victoria becomes the first State to legalise VAD

This article was first published on the ABC on 29 November 2017 as "Euthanasia: Victoria becomes the first Australian State to legalise voluntary assisted dying." By Jean Edwards

 

Martin Pakula, Jill Hennessy and Daniel Andrews address the media outside Parliament.
PHOTO: Daniel Andrews (right) Jill Hennessy (centre), and Victorian Attorney-General Martin Pakula (left) congratulated MPs after hours of debate. (AAP: Joe Castro)

Victoria has become the first state in the country to legalise assisted dying for the terminally ill, with MPs voting to give patients the right to request a lethal drug to end their lives from mid-2019.

After more than 100 hours of debate across both houses of Parliament and two demanding all-night sittings, Lower House MPs ratified the Andrews Government's amended bill.The bill will now go to the Governor for royal assent.

Premier Daniel Andrews, who came to support euthanasia after the death of his father last year, said it was an historic day.

"This is a day of reform, a day of compassion, a day of giving control to those who are terminally ill," he said. "I'm proud today that we have put compassion right at the centre of our parliamentary and our political process."

The landmark legislation passed the Upper House 22 votes to 18 last week, but the changes had to be approved by the Lower House for voluntary euthanasia to be enshrined in law.

Lower House MPs voted 47 to 37 in favour of the original bill last month.

Victorian Health Minister Jill Hennessy said the lengthy debate had given the Parliament the opportunity consider what constitutes a "good death".

"It's one of those things in life — we talk a lot about the start in life, but we don't talk a lot about the end of life," she said.

"We've had some frustrating moments, but ultimately we have landed in a place where Victorians who are confronted terminal illnesses, that are enduring unbearable pains, will have a safe and compassionate option around assisted dying."

Ms Hennessy said experts would immediately start work finalising the scheme, including the type of lethal drug to be prescribed to patients.

"I know this is a disappointment to some people who have terminal illnesses, but the bill does require an 18-month implementation period," she said.

"We have been very dedicated to the task of developing this bill and we're going to be as equally dedicated to the task of getting a safe, sensible and robust system in place."

The changes needed to pass the bill included halving the timeframe for eligible patients to access the scheme from 12 months to six months to live.

There will be exemptions for sufferers of conditions such as motor neurone disease and multiple sclerosis who have a life expectancy of 12 months.

The Andrews Government also pledged to spend $62 million over five years on end of life and palliative care.

New criminal offences to protect the vulnerable

Opponents of the legislation made a last-minute bid to block the legislation by proposing to defer debate indefinitely on Tuesday, but the motion was lost 46 votes to 37.

Government minister Natalie Hutchins missed the vote because she was attending her husband's funeral in New South Wales and was not granted a pair.

Under the legislation, Victorians with a terminal illness will be able to obtain a lethal drug within 10 days of asking to die, after completing a three-step process involving two independent medical assessments.

They must be over the age of 18, of sound mind, have lived in Victoria for at least 12 months and be suffering in a way that "cannot be relieved in a manner the person deems tolerable".

Victorian Premier Daniel Andrews embraces Health Minister Jill Hennessy in Victoria's Parliament.
PHOTO: Daniel Andrews embraced Jill Hennessy after the bill first passed the Lower House last month. (AAP: Julian Smith)

The patient must administer the drug themselves, but a doctor can deliver the lethal dose in rare cases where someone was physically unable to end their own life.

The legislation includes 68 safeguards, including new criminal offences to protect vulnerable people from abuse and coercion, and a special board to review all cases.

 


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