A LEADING bioethicist has claimed that many people who request euthanasia do so not because of pain – but because they fear being a burden to others.
Professor of Bioethics at University of Notre Dame Australia, Margaret Somerville, has cited the situation in Quebec, Canada, where terminal sedation is allowed as a form of euthanasia, which can be consented to by a surrogate decision-maker.
When people request euthanasia, it is often because they fear being a “burden” on others, Prof Somerville told a recent webinar on bioethics, palliative care and assisted dying, conducted by the independent Catholic news site The Tablet.
She noted that very often pro-euthanasia cases were promoted on the grounds of people being in terrible pain, but for those requesting euthanasia, pain was not cited as a major reason.
The main reasons were a fear of loss of independence, a feeling of loss of dignity, and very often a feeling that they are a burden on other people.
“I have just been consulted on a case in Canada, where two people in the family are very upset because they found out after their mother had been euthanised that she had told her carer that she wanted it because she didn’t want to be a burden on other people, particularly her children,” Prof Somerville said.
Professor Somerville’s claim is supported by academic research conducted in 2017 into the cost of medical assistance in dying (euthanasia) in Canada, one year after it was legalised.
“As the elderly population enlarges and health-care social support costs increase, the elderly and vulnerable are commonly considered a burden to their families and society,” Prof Somerville wrote in a research paper in 2018.
“They may feel pressured to request PAS-E [(euthanasia), which has been suggested as a means to decrease health-care costs; the right to die is leading to a duty to die.
“In fact, a study found that the legalisation of medical assistance in dying could reduce annual health care spending across Canada by up to $138.8 million exceeding the maximum $14.8 million in direct costs associated with its implementation.”
In Australia, laws allowing voluntary assisted dying (VAD) have been passed in five of Australia’s six states.
Victoria’s and Western Australia’s VAD laws have already started operating.
VAD will commence in Tasmania on October 23 this year, South Australia in early 2023, and Queensland on January 1, 2023.
During the webinar, British Professor David A Jones, Professor in Bioethics at St Mary’s University in London, acknowledged there could be ambiguities for medical professionals faced with hard decisions as to when relieving pain becomes assisted dying.
“But I think that it would be a mistake to think that those ambiguities will change if you change the law,” he said.
“What will happen is that they will shift, and a new set of ambiguities will arise.”
Britain is still grappling with the euthanasia issue. The House of Lords last month rejected an attempt to legalise euthanasia in England and Wales.
Further to the question of legal ambiguities, Prof Somerville cited the situation in Quebec, Canada which allows for voluntary assisted dying and terminal sedation as a form of euthanasia.
“What I think is appalling about it is that it is the only form of euthanasia that can be consented to by a surrogate decision-maker,” she said.
“So, you could have somebody who is incompetent to give informed consent to euthanasia and the surrogate decision-maker could consent to terminal sedation, which is often called, in practice, slow euthanasia.”
She also noted concerns raised by the Dutch Medical Society about the fact that a high rate of mental illness and post-traumatic stress disorder has been observed among doctors carrying out a substantial number of cases of euthanasia.
This has led to an increase in the use of terminal sedation as it is perceived to take less of a toll on doctors.
Prof Somerville stressed that nobody should be left in terrible pain and that palliative sedation needed to be distinguished from terminal sedation.
