Talking Point: Liberty, autonomy important sources of dignity

The first duty of a doctor is the preservation of life, but very close behind this is the relief of suffering, writes Alan R. Scott

Doctors should not be seen as authority figures, but as trusted guides, who don’t always have the perfect answer.

I WRITE as a doctor in support of the Voluntary Assisted Dying Bill presented to the Tasmanian parliament by MLC Michael Gaffney.

Of course the first duty of a doctor is the preservation of life, but very close behind this is the relief of suffering. There may come a point in an incurable disease, when death is inevitable, and when an individual wishes to exercise some autonomy over the process.

For many, but not all, the motivation to exercise autonomy will be to avoid intolerable pain. For others, it could be such factors as an inability to enjoy their life and the loss of dignity in having to rely totally on carers for all their daily needs.

Liberty and autonomy are important sources of human dignity.

It is important to stress that by passing this Bill into legislation; there is no compulsion for anyone to go down this path; and that this is a decision entirely related to an individuals wish for self determination.

Most people, if asked, would prefer to die at home in familiar surroundings, and not in a hospice; where they are often under heavy sedation – yet deaths at home are now in the minority.

The AMA, as an organisation, opposes this Bill; but it is not obvious to me as to how many of their members in fact oppose the bill. Many probably don’t. Also, it needs to be said that a large number of Australian doctors are not AMA members. I was interested to learn that when the British Medical Association polled its members the majority thought that the BMA should drop its opposition.

Opponents of the Bill will constantly talk about “the slippery slope”, where assisted dying will be foisted on vulnerable patients by grasping relatives etc. Experience in places such as Oregon, which has had the law since 1997, suggests the reverse. Those choosing this path are well educated and receiving palliative care.

Doctors should not be seen as authority figures, but as trusted guides, who don’t always have the perfect answer. There is no evidence, that in jurisdictions where voluntary assisted dying is permitted, that there is any weakening of belief in the medical profession.

If this option becomes available, many will consider it, but not use it; but will have been glad that the option was available.

I would appeal to our elected representatives to respect the wishes of their constituents and the overwhelming community view.

Poll after poll, not just in Australia, but throughout the world, have shown that a significant majority of the populations are in favour of this measure. Perhaps we all need to reflect on the opinion of the late Stephen Hawking who said that, “To keep someone alive against their wishes is the ultimate indignity”.

Those who would ultimately decide to go down the path of voluntary assisted dying are motivated not only by the desire to avoid intolerable pain or total lack of mobility; but by a desire to preserve their own dignity, autonomy and pleasure in life.

What right have we as doctors to deprive them of these basic human rights?

Hobart surgeon Alan R. Scott is a member of Doctors for Assisted Dying Choice (Tasmania). He has volunteered as a surgeon in Papua New Guinea and the South Pacific and with Medecins Sans Frontieres in Africa and Pakistan. Since retiring from clinical practice, he has taught young surgeons around Australia.