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Delivering death down under

Lynda Cracknell

Lynda Cracknell is the president of Australia's Northern Territory Voluntary Euthanasia Society, which hopes to see the world's first euthanasia law come into effect from July 1st 1996.

A snapshot as of 10 June

In the Northern Territory of Australia, those of us who have been closely involved in supporting our voluntary euthanasia legislation are anxiously pacing the floor like expectant parents awaiting the birth of a child.

However, there are those even closer to the issue than ourselves - the terminally ill people waiting and hoping for a lawful and merciful death when their suffering becomes too great to bear. What these final weeks of waiting and hoping must be like for them we can only imagine.

Two months ago, and after other earlier dates had been given and changed, the NT Government announced a commencement date of 1 July. This time it sounded for real - no ifs, buts or maybes - a firm commencement date. This acted as a catalyst for some of the more hardline opponents to increase the tempo of their campaign. An opposition MP vehemently opposed to the legislation introduced a long foreshadowed repeal bill into Parliament; attempts to have it pass through all stages in the same sitting, however, failed. The repeal Bill has been adjourned and is not expected to be debated until September, at least two months after the Act is scheduled to come into operation.

...actual injection of the death inducing substances... with computer software called Deliverance

But will the Act become operational on 1 July as announced? Perhaps by the time you read this, we will know the answer. We think it will, despite the biggest threat of all now hanging over us - the threat of a legal injunction against the Act. Within the last week, media speculation has been building that the Coalition Against Euthanasia (a group including the Australian Medical Association, the Catholic, Anglican and Uniting churches, and the various Right to Life Associations) is backing action through the courts. This has since been confirmed by the local Catholic Bishop, and a press conference is being held on Tuesday June 18 to announce the details.

These rapid changes make it extremely difficult to write a current account of the legislation, because the only thing we can be sure of is that the ground shifts under our feet almost daily.

A brief history

In February of 1995, Marshall Perron, the then Chief Minister of the Northern Territory, foreshadowed the introduction of a Private Members Bill to allow voluntary euthanasia in controlled circumstances.

The Bill, called The Rights of the Terminally Ill Bill, was introduced into parliament later the same month, and the media went wild. Some politicians immediately announced how they would vote on the Bill, but some kept their own counsel and it was impossible to anticipate how the vote would go. This didn't stop various reporters predicting different outcomes - seemingly aligned with their personal views on the matter and giving an impression of "wish-fulfilment" rather than unbiased reporting.

There was no right-to-die organisation in the Territory at that time, but by late February a small community group had established itself, with the aim of circulating a petition to determine the extent of community support. The group called itself Operation TIAP for "Terminally Ill Act Petition", although it soon expanded in scope to include many other related activities.

The opponents ran a similar campaign, enjoying the advantage of extensive funding through their powerful backers.

Prior to the parliamentary debate on 24 May 1995, Marshall Perron announced his resignation from Parliament - timed to ensure that no-one could suggest that his position as Chief Minister would influence the conscience vote to be exercised by members of his party. In the early hours of 25 May 1995, after a marathon debate, the legislation was passed by a vote of 15 to 10.

No-one was more stunned than this writer, who sat through the debate in the public gallery with other members of Operation TIAP. As we went down the staircase towards the waiting media, I said to a friend "Thank goodness that's over". She looked at me wisely, slowly shook her head, and said "Lynda, this is just the beginning".

How right she was. Since then we have had many months of work to hold the hard won ground. The government established a working party to develop regulations and guidelines for the operation of the Act, and Operation TIAP became the Northern Territory Voluntary Euthanasia Society (NTVES) - with Marshall Perron as its Patron. Along with a number of other community organisations, the NTVES provided extensive input and feedback to the government working party. During this period the wording of the psychiatric qualification was questioned, resulting in an Amendment Bill being introduced in November. The Amendment Bill was subsequently passed in February 1996 - despite extensive efforts by some of the opponents to use the Amendment Bill as an opportunity to abort the Act.

There are no residency requirements, although doctors may be less inclined to assist patients they do not know. Overseas people may face difficulties obtaining visas.

During this time too, we saw our first sad suicides by people who could not wait for legal assistance. One desperate cancer victim, Marta Alfonso-Bowes, came to the NT after hearing that the Act had been passed, not realising that it was not yet operational. Marta attended the inaugural meeting of the NTVES in September and suicided alone in a hotel room the following day. Her memory lives on in a memorial award currently being administered by the NTVES for a poem/essay on voluntary euthanasia.

A key campaigner throughout the last 15 months has been Dr Philip Nitschke. An articulate medical practitioner (who also has a PhD in Nuclear Physics) with a strong social conscience, Dr Nitschke took up the baton on behalf of supporting doctors. As a result, a group of 22 doctors, calling themselves Doctors for Change, advertised their names and their support in Northern Territory newspapers. More recently, Dr Nitschke has received widespread attention for his development of a computer driven device which would enable a patient to have control over the actual injection of the death inducing substances. Dubbed the death machine by the media, it is activated after confirmation by the patient in a dialogue with computer software called Deliverance.

The Act

The following is a lay-person's overview of the Act and its proposed operation and no responsibility can be taken for errors or omissions. It is provided as a guide only. Interested persons should obtain a copy of the Act, and/or the explanatory brochure published by the Northern Territory Health Services Department.

Very briefly, the act allows for terminally ill persons, at least 18 years of age who are not suffering from treatable clinical depression, and who are experiencing pain or suffering, to receive medical assistance in terminating their life. A second doctor with prescribed qualifications in the illness must confirm the diagnosis and prognosis.

The assistance may be direct, such as a lethal injection given by the medical practitioner, or may be indirect - such as the medical practitioner prescribing the substances to be used. In either case, the doctor must be present during the delivery of the assistance and must remain until death occurs and for a reasonable period afterwards with family/friends. Family and friends can be present if the patient wishes.

The patient must be advised of palliative care options, but as with any treatment has the right to refuse palliative care. Doctors or other health care workers are not obliged to assist, and no reason need be given. There are no residency requirements, although doctors may be less inclined to assist patients they do not know. Overseas people may face difficulties obtaining visas.

Where to from here?

As highlighted in the first section, the legislation is once again threatened by those who would cruelly impose their own values and beliefs on the rest of us. But as Marshall Perron, in a message to NTVES members, after noting the conditions under which world history has been made by this overdue social reform, said:

"These same circumstances were no doubt applicable when, as part of the fledgling self governing colonies, the tiny colony of South Australia [which then included the Northern Territory] passed ground breaking legislation to give women the right to vote and stand for parliament for the first time anywhere in the world. Detractors predicted disaster and chaos would flow from such irresponsible legislation. What actually happened was that the whole western world followed suit!"

We hope detractors of this legislation will suffer a similar fate, and that in a 100 years time we will find it hard to comprehend a society which did not allow a compassionate dignified choice in the manner of our death. When that day comes it will be inconceivable that the right be taken away.