Safe assisted dying laws are possible, so let’s make them

Paying attention to the interests of the elderly and disabled people ensures we use appropriate eligibility criteria in euthanasia legislation. SalFalko/Flickr

A report we recently prepared with independent think tank Australia21 calls for state governments to institute laws allowing and regulating voluntary euthanasia and assisted suicide – in defined and limited circumstances. In the report, we confront the idea that such laws pose risks to vulnerable people, such as the elderly and people with disabilities. We argue that safeguards can ensure the law is only used by those it’s intended for.

Safeguards have been a prominent issue in both the voluntary euthanasia debate and in efforts to implement related laws. Some politicians think it’s not possible to design laws that protect vulnerable groups. This position is also linked to “in principle” objections to voluntary euthanasia.

Even politicians open to a change in the law may feel concerned about how risks are addressed. They would presumably be prepared to consider models of reform that focus on protecting people with disabilities and the elderly.

In the 1990s, a number of parliamentary committees considering voluntary euthanasia and assisted suicide laws found that developing adequate safeguards was problematic. In 1994, the UK’s House of Lords Select Committee on Medical Ethics concluded that it would be “virtually impossible to ensure that all acts of euthanasia were truly voluntary and that any liberalisation of the law … could not be abused”. A Tasmanian parliamentary committee reached a similar view in 1998.

But a body of international experience with assisted dying regimes has emerged since, including legislation in Oregon (1997) and the Netherlands and Belgium (2002). Although there have been critiques of these regimes and how they operate, there’s now a body of reputable empirical evidence that concludes they’re generally operating as designed and within the scope of relevant laws.

So concerns about widespread abuse of voluntary euthanasia and assisted suicide laws appear to be unfounded.

There are now also a number of reports from parliaments around the world concluding that safe reform is possible. This was the view of the Quebec Select Committee on Dying with Dignity in 2012 and the position taken in Tasmania by the premier, Lara Giddings, and leader of the Greens, Nick McKim, in their 2013 consultation paper.

So we now have evidence that legislative safeguards can be drafted to ensure only patients who are “eligible” can receive legal assistance to die.

Depending on the design of the legislative framework, this could mean voluntary euthanasia or assisted suicide is available only to competent terminally ill adults who can make a voluntary and informed request for assistance to die. These criteria can be enforced through processes such as the provision of information, obtaining a second medical opinion and cooling-off periods. The effective operation of a regime can also be overseen by an independent monitoring body.

None of this should be taken as saying that concern for vulnerable people is not an important consideration. It is. And it is especially so when drafting voluntary euthanasia and assisted suicide legislation. Paying attention to the interests of the elderly and disabled people actually ensures we use appropriate eligibility criteria in the legislation. And that those criteria are supported by robust procedural safeguards as well as effective and independent oversight mechanisms.

It’s possible to have the best of both worlds – a regulated voluntary euthanasia and assisted suicide law that protects the interests of vulnerable groups. We can draft legislation that permits choice for those whose suffering we cannot help as well as valuing and safeguarding vulnerable people in our community.