Choice must be honoured if assisted dying is to be voluntary

Editorial by Jim Birch, AM – Chair, Calvary Health Care

Published 4 May 2021 in The Adelaide Advertiser

Support for Voluntary Assisted Dying is strong. Plenty of polls will testify to this. Ask most people if they should have control of their lives and deaths and they will say of course we should.

If asked whether better care of the aged, frail and dying should take immediate national priority, the answer will also certainly be yes – it is a fundamental human right to be provided with safe, quality and compassionate care free of coercion and abuse.

Royal Commissions into Aged Care Quality and Safety and Violence, Abuse, Neglect and Exploitation of People with Disability have shown us all too clearly far too many examples of the abhorrent treatment of vulnerable people for us to think these crimes no longer occur.

But we tend not to question too deeply the unintended consequences that legislating medical assisted suicide will have on vulnerable people. In particular for people who suffer from pain – physical and existential and spiritual and psycho-social and the many other forms deep hurt and despair can take.

At Calvary we know suffering because we see it in our services every day. We accompany people who suffer and work to address pain and suffering in whatever form it takes.

Our approach to care for people who are dying is holistic palliative and end of life care which is centred on the needs and desires of the individual. The holistic care we provide helps people negotiate their dying and so often gives them more time to live—and critically—to live with purpose.

The difference this makes to a person and their loved ones can be profound.

Dying is not a futile act. A dying person is often able to do something which needs to be done, achieve reconciliation with others and with self, discover new and often unexpected purpose, and die with a sense of hope and peace. Pain will often render itself an acceptable burden to carry in exchange for the value and meaning to be discovered and explored in the final weeks and days.

For the surviving loved ones, because their experience of the dying and death is transformative, there are life changing experiences on offer which would have been lost had the person taken the VAD substance at an earlier stage in the journey.

The same can also be said for the experience of witnessing a bad death, often unsupported by the appropriate care but equally transformative as it emphasises the need for us to do our dying better.

But better care of the dying person is the answer, not abandonment. This is why Calvary cannot and will not participate in Voluntary Assisted Dying.

We do not believe assisting a suffering person to end their own life actually addresses and responds to their suffering. Rather, it ignores and fails to address the complex physical, psycho-social and spiritual causes of a person’s suffering at end of life.

If Voluntary Assisted Dying is to be voluntary for the public, then any VAD scheme should be voluntary for clinical staff and medical officers and for the organisations that they work for. This expectation is grounded in the Bill’s title–voluntary–and the expectation must be honoured.

Not every hospital or health service offers, or is required to offer, every conceivable service. Not every hospital can offer specialist oncology services or undertake heart transplants. Why then should every health provider be forced to offer a medically assisted suicide?

Calvary has served the South Australian community for over 120 years. We have been able to serve our most vulnerable citizens with compassionate dedication because Calvary in itself is a community of practice.

The mission, vision, by-laws, policies and procedures attract and bind every person called to practice in this community. Many people choose Calvary and other faith-based services precisely because there is a clear identifiable focus of purpose. There is an articulated code of practice, a strong and clear ethical and values-based proposition, a sense of continuity of care which is grounded in mission.

Our services are valued by the people in our care, as well as those who choose to practice as part of the Calvary community because of this commitment.

If the South Australian Parliament attempts to impose VAD on our services, it would violate the consciences of most of the individuals involved together with the institutional commitment to promoting and upholding critical ethical and other values.

The current Bill does not provide for organisational conscientious objection and this needs to be addressed. If not provided, Parliament risks choice being valued only when individual autonomy aligns with that of the State.

We are all strengthened when we nurture communities (including faith-based communities) where people can maintain a sense of personal integrity while making their contributions to the common good of all.

Choice must be honoured if assisted dying is to be voluntary.

Jim Birch, AM is the Chair of Little Company of Mary Health Care Ltd. (Calvary Health Care)