October 29, 2023

Memo from Switzerland by Sean Davison

Exit’s new Swiss Assistance Programs have been going exceptionally well for our members who prefer the option of an assisted peaceful death in Switzerland.

It is a requirement of Swiss law that a person receiving a Voluntary Assisted Death (VAD) in Switzerland, have their identity confirmed by a witness (or a dental X-ray).

For various reasons, some people do not have a family member or friend to act as their witness. These people seek out the services of Exit International to provide such a person.

The most common reason for requesting a witness is that they don’t want anyone to know their plans, because they fear they will try to stop them.

In addition to assisting numerous people with their applications to Switzerland (Application Assistance Program), I have been the identification witness for 12 Exit members so far this year (Identification Assistance Program).

My first trip to Switzerland as a witness was for Angela Leonard, a 78-year-old woman from Wales.

Before she died, Angela gave me permission to share her story.

Sean & Angela at dinner, the night before she died

I couldn’t have had a better introduction to being an identification witness than to share this experience with Angela Leonard, a delightfully witty and charming woman from the south of Wales.

She wanted to go to her death because her husband had cheated on her – but not in the conventional sense.

She and her husband had applied for a couples VAD in Switzerland because of his rapidly deteriorating health; she wanted to end her life with him, rather than live her remaining years in the void of his loss.

However, before they could enact their plan he had a fatal heart attack – Angela felt cheated! But she was not deterred and proceeded with the VAD plan on her own, in the hope of joining her husband on the other side.

I spent two days sharing Angela’s company, and it was a wonderful introduction to the world of VADs.

We often talked about her upcoming death, and how she had no fear whatsoever about it, and couldn’t wait for her VAD appointment to come.

The night before her death we had a celebratory dinner – celebrating her life and being granted a VAD the next day.

The following morning when we met at breakfast at the hotel, her excitement at going to her death had not waned.

Even when I gently tested her determination, by asking how she felt about sipping her last cup of coffee, she raised her cup in the air and spouted “I’ll drink to that!”

When we arrived at the clinic, she followed all the formalities of completing the final paperwork.

At this point a person would normally go to the designated room, lie on the bed, and have an intravenous cannula prepared to administer the Nembutal.

But Angela Leonard wasn’t ready for that just yet.

She had previously chosen a song she wanted played at her death, but changed her mind and decided she wanted it now so she could have a final dance.

The tune ‘Don’t stop me now’, by Queen, her favourite group (which also happened to be mine!).

She dragged me on to the clinic’s ‘dance floor’ and we had an impromptu rock & roll dance as the tune pounded out!

What a wonderful way to go, full of joy, and hope for what she thought awaited her on the other side.

My first VAD trip to Switzerland is ingrained in my memory forever – and a marker for how grand it can be for others.

October 14, 2023

Report from Ireland

On Tuesday 10 October, Exit Directors Tom Curran and Philip Nitschke were invited to speak to the Joint Committee on Assisted Dying at the Irish Parliament (the Oireachtas).

While Tom’s session went ahead, Philip’s session was rescheduled due to it being budget day. (Philip will now present on 29 November).

In reality, budget day had been reported back in June 2023, so it remains unclear why a Committee would schedule hearings on this day only to cancel them a few days before (and once Philip was already in the country).

Be that as it may, Tom was one of four witnesses on the day. The others were:

• Elma Walsh – whose son died of cancer at home with palliative care, aged 16
• John Wall – a friend of Vicky Phelan’s but who himself has prostate cancer
• Garret Ahern – whose Belgian wife, Vicky Janssens, got an assisted death in Belgium

From the start you could see the session was going to be hard-going.

Not so much for the heart-felt personal stories of the witnesses but for the rather elementary level of the debate and questioning.

Ireland is seemingly still in its infancy in discussing a good death (euthanasia).

This despite it being 10 years since Tom’s partner, Marie Fleming, took her case of discrimination to Ireland’s High Court and Constitutional Court.

Philip & Tom, Oireachtas, Dublin 10 October 2023

This is why the session was disappointing.

The first witness was the mother of a 16 year old who died of cancer. To those unfamiliar with the case, it seems that once Donal got terminal cancer, he became a passionate advocate against suicide.

His mother, therefore, spent her time discussing the ills of suicide and the fact that Donal had the best death at home and that legalising assisted dying would amount to nothing more than a slippery slope as it would undo all the good in Donal’s anti-suicide work.

Go figure that one.

Of interest is the fact that even if Ireland had a law, almost all laws exclude the under 18s. Even if Donal had wanted choice at the end, he would never have qualified. Too young by two years.

The second witness was John Wall who took an extraordinarily hardline position.

Terminally ill with < 6 months to live was the only criteria he would countenance.

Speaking with John afterwards about his stance, he seemed to have little understanding (and certainly no answer) for anyone who falls outside of this tiny exclusive club of the most seriously terminally ill: people with neurological conditions and/ or unbearable suffering like Marie Fleming.

Tom Curran spoke of course about Marie and he spoke also about the Swiss model as the only legal regime that could help people like Marie.

Tom told the story of how Marie’s neurologist always said that it was impossible to know how long Marie had to go: it could be 2 months, 2 years or 20 years he had always said.

Tom asked the committee to name any future bill after Marie, and for it to be known as ‘Marie’s Law’. He will now be starting a new campaign asking ‘Would Marie have qualified?’

The answer thus far in the process is clearly NO.

The final witness of the day was Garret Ahern whose wife had had to organise her own assisted death in Belgium in April this year.

After a failed suicide attempt in Ireland in February, and next to no support from Garret in terms of taking things into her own hands and dying in Ireland, Vicky realised her only choice was to go ‘home’ to Belgium to die.

Garret accompanied Vicky but spoke of how he was not involved in ‘helping’ her. Garret’s point was that the Irish should be able to avoid the ‘stress and trauma’ that comes with travelling to Belgium to get help to die.

Philip & Tom with other witnesses & Gino Kenny (2nd from right)

Gino is a Teachta Dála (TD) for People before Profit in the Oireachtas

It was a strange day and a rather odd selection of witnesses.

Despite this, People before Profit’s Gino Kenny, commented that it was one of the better days of the hearings: other days he explained had been intensely hostile to the concept of a bill on assisted dying.

Despite Ireland moving forward on other social issues (eg. gay marriage and abortion), it is clear that any law that is introduced in this country about end of life choices will be the most conservative and narrow imaginable.

Despite all the rhetoric about learning from the mistakes in other jurisdictions, the Irish are setting out to repeat those exact same mistakes.

This will amount to a lost opportunity.

Adopting a narrow medical model is not the way to go, it never was.

New thinking is needed, instead of blind adherence to the old adage of ‘doctor knows best’.

It beggars belief that the Committee has not yet invited anyone from the world’s largest right to die organisation, the NVVE in the Netherlands, to present to the Committee.

The biggest source of legislative experience in end of life is at Ireland’s doorstep.

Come on Gino, Exit calls on you to use your position on this Committee to open the window and let the sun shine in … just a bit!

It’s never too late!

September 10, 2023

Why I am voting YES says Exit Founder

It is not often that I stray into mainstream politics, but the forthcoming Australian Referendum on a Voice to Parliament is one issue that I cannot stay silent about.

I am voting YES because Aboriginal people have received a raw deal from us white Australians for over 200 years (to put it mildly).

Genocide and dispossession are more accurate descriptors?

It is not good enough for the ‘white man’ to continue to think that they know best for black Australia.

The Voice to Parliament is a very small step:

• An advisory body to be consulted on policy matters
• An advisory body whose advice the government is under no obligation to accept, only to hear

It doesn’t seem like much does it.

Of course, the Voice should be the first step along the road to Aboriginal Australians being formally recognised in our country’s Constitution – itself correcting an embarrassingly racist, colonial wrong.

Treaty and reparations can and must follow.

But for now, let us concentrate on a Voice.

To those nay-sayers who argue the Referendum is a political grab for power, I don’t actually care which side of politics works to bring about this change, as long as one side does.

This is history in the making.

I despair that the conservative side of Australian politics have been, and are doing their utmost to create confusion and doubt and to bring the Referendum down.

Australia is racist to its core as a country.

This is not the reason that I left, but it provides absolutely no incentive to ever return.

I treasure my years when I worked as a scribe for Vincent Lingiari out at Wave Hill in the early 1970s.

Following my pacifist action against the Vietnam War when I was at university, it was Aboriginal land rights that took me to the Northern Territory all those years ago.

Even I got a taste of white racism back then, as I was harassed by the powers of the day: those who saw me as traitor to my race, those who believed the Gurindgi should remain in servitude to their white pastoral masters.

Lord Vestey was in outback Australia for one reason: to make money. Free black labour was his stock and trade.

Fast-forward 50 years and it should be a no-brainer to vote yes in the Voice Referendum: to help black Australia reclaim its pride, its dignity and its self-determination.

If now is not the time to begin to right the wrongs of the past, then when?

August 13, 2023

VAD Law must be More Ethical than Recent Police Tactics

Online Opinion, by Dr David Swanton

Although suicide is legal and the ACT Government is working to legislate for voluntary assisted dying (VAD), recent insensitive actions of police in Canberra suggest that police think suicide is illegal.

Welfare checks

What happened? In recent months, police have conducted so-called welfare checks on elderly Canberrans.

This sounds innocuous, and commendable, if the checks were of ill people contemplating irrational suicides. However, these checks were devious.

They were tactically designed to unsettle vulnerable people and were carried out late at night.

In the cases of which I am aware, up to three police officers awakened people in their 70s and 80s late at night, after 11 pm.

The victims of these ‘welfare checks’ were startled and disconcerted when police interrupted their sleep.

The police knew their ages and must have suspected that they would be asleep at that late hour. People normally fear the worst when police contact them late at night and continue to ring door buzzers.

The police also interviewed neighbours, raising privacy issues. In such instances, dispatching three police officers is intimidatory.

These elderly people were stressed by these visits and had difficulty getting back to sleep. In short, these welfare checks were counterproductive.

So why did the police visit these people?

These people were suspected of having ordered lethal end-of-life substances. The alleged substances are legal. I suspect that, in the absence of effective Australian VAD regulatory regimes, thousands of elderly Australians have had such deliveries.

For many people, suicide is a better alternative to suffering and dementia. Hence the need for effective VAD legislation that meets the needs of all people who are suffering.

Late night welfare checks of elderly Canberrans are not an efficient use of police resources. Police officers play an important role and are rightly highly respected in the Canberra community.

Their jobs are not easy.

But if the welfare of these elderly Canberrans was a legitimate concern, a meeting with a social worker could have been arranged at a mutually convenient time.

I have alerted ACT Attorney General Shane Rattenbury, a strong supporter of VAD, to the inappropriateness of these late-night police welfare checks.

Survey

That elderly Canberrans choose to acquire lethal substances is understandable, and not a reason for police investigation.

In my comprehensive worldwide 2021 Ethical Rights VAD Survey of VAD advocates and supporters, 85% of respondents indicated that they would have an improved quality of life if they had ready access to a lethal end-of-life substance.

This included 24% whose well-being would be improved even if the substance were illegal. The percentage of respondents wanting to access these substances increased with age after 40.

That gives them comfort and peace of mind in those circumstances where they might be suffering and where VAD regulatory regimes are inadequate.

VAD legislation should not discriminate

Will Canberrans still need to obtain these legal lethal drugs when the ACT has VAD legislation?

No, not if the ACT enacts an effective, compassionate, and non-discriminatory VAD legislative system based on a VAD human rights model that empowers each person to determine what is right for their own body. Otherwise, they will.

There is some hope, given that the ACT Government has been at the vanguard in ensuring equality and outlawing discrimination based on attributes such as Indigenous heritage, sexual orientation, gender identity, race, and religion.

We should expect that the government would publicly condemn any discrimination, including in VAD legislation.

Australian medical model for VAD

In contrast to this desirable non-discriminatory approach, the ACT Government has stated that it ‘will be pursuing a model consistent with Australian states’ for its VAD legislation. Australian states’ legislative schemes are, however, based on a VAD medical model (as described in the British Medical Journal) that discriminates on the degree and type of suffering.

Moreover, doctors can overrule people wanting VAD if they do not consider they are sick enough. Doctors should not be the judges of whether a person’s life is worth living; every individual is responsible for their own lives.

According to the ACT Government (and all Australian states), the principle of individual rights applies to LGBTIQA+ relationships and women seeking abortions, but apparently not to VAD.
Advertisement

Additionally, Australian state medical models discriminate on life expectancy (perversely, people who could suffer more, must suffer more) and age and residency (children and non-residents must suffer when adults and residents need not).

Suffering does not begin when there is less than 6 months to live with a terminal illness, when you enter adulthood, or when you cross the ACT border.

As all people can suffer, all people should have the human right to access voluntary assisted dying. However, if the ACT Government implements aspects of this unethical discriminating Australian medical model, it will be marking some people as intrinsically ineligible for VAD and forced to suffer.

Age discrimination in the ACT

So, does anyone know where the ACT Government stands on discrimination?

Consider discrimination based on age.

The ACT Government has decided to reject the views of the states and increase the minimum age of criminal responsibility to 14 years.

That would reduce the suffering of some children who would otherwise be tried as adults. It would be inconsistent to develop policy concerned with the welfare of children in the criminal justice system while being indifferent to the plight of all terminally ill children who are suffering unbearably.

All people, including suffering children and infants (with parents and guardians acting on the advice of doctors), should have the right to access VAD.

It is not just young children that are the problem for ACT policymakers.

Dementia is the leading cause of death for women aged 75 and over and for Australians 85 and over. Advance care directives, which are legal now, should be extended in scope to allow the option of VAD for people who want to avoid being ravaged by dementia.

It can be done and has been done overseas.

Without VAD advance care directives, people might choose to acquire legal lethal substances. Without advance care directives, they realise that if they are to use their substances, that ‘it’s always too early to act until it’s too late to act’.

ACT Government must not discriminate

The responsible ACT minister, Tara Cheyne, has been a strong advocate of legalised VAD, like Michael Moore and Caroline Le Couteur in previous legislative assemblies.

We are hopeful that the ACT can enact compassionate, ethical, and non-discriminatory VAD legislation.

Its VAD legislation must be consistent with its VAD policy objective, but given it is seemingly developing discriminatory policy, it doesn’t seem to have an objective.

Without a policy objective, the ACT Government won’t know what it is doing.

If the ACT’s VAD legislation does discriminate on the degree or type of suffering, life expectancy, age or residency and places doctors as arbiters of what is right for individuals, then the ACT Government will have to accept that people will continue to acquire legal lethal drugs.

The police must then appreciate that being in the possession of legal lethal substances does not require welfare checks. It’s just a reflection that VAD legislation is not meeting the needs of Canberrans.