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The Exit Internationalist

September 24, 2016

Should Age be Relevant to the Right to Die?

Fiona Stewart, Sydney Morning Herald

Twenty years ago this week Darwin man Bob Dent became the first person in the world to receive a legal, lethal voluntary injection under the Northern Territory’s Rights of the Terminally Ill Act.

The act was a carefully drafted piece of legislation that allowed a terminally ill person, of sound mind, to ask a doctor for help to die.

As the first law of its kind, it had no benchmarks to go by. Could children ask for euthanasia? The question was not even on the radar.

The Belgians have reasoned that suffering is suffering, regardless of what year you were born.

In the Territory back in 1996, you had to be older than 18 years of age and assessed by a psychiatrist as having appropriate mental capacity before you could qualify for help.

Fast-forward two decades and the assisted dying debate is almost unrecognisable.

The Rights of the Terminally Ill Act lasted only nine months before Kevin Andrews inspired the federal Parliament to use the loophole of s122 of the Australian constitution to strip the territory of its ability to legislate. This stopped the law in its tracks.

Meanwhile, four states in the US, and three countries in the European Union (plus Switzerland) now provide aid in dying.

What all but one place does not allow, is euthanasia for kids, irrespective of age. The Netherlands allows euthanasia for children over 12.

In 2014, Belgium abandoned reference to age requirements. The Belgians reasoned that suffering is suffering, regardless of what year you were born.

It has taken almost two years for the first young person to make use of this legislative amendment. The Belgians always said the law would be sparingly used and they were right.

The Belgium Federal Euthanasia Commission has reported that a terminally ill 17-year-old requested (and received) euthanasia because they were in “unbearable physical pain”.

What is there to argue about? The teenager was terminally ill. They did not have a long life ahead of them. And it seems their pain was such that palliative care offered no solutions.

Should we – as a society – insist this young person suffer on simply because they are under 18 years of age?

When it comes to children and euthanasia, the largesse of Belgium’s (and Holland’s) laws cannot be underestimated. This is the pointy end of the right to die debate.

This week Exit International will mark the 20th anniversary of the Rights of the Terminally Ill Act with a conference in Melbourne.

Speaking at this meeting is controversial Belgium psychiatrist Dr Lieve Thienpont.

Dr Thienpont’s practice in Flanders concerns approving requests to die by those who are psychiatrically ill, young and older people who are “tired of life”. Belgian law provides for assistance for these three groups.

While pro-lifers argue that euthanasia in countries like Belgium and Holland is out of control, this is not true.

For Dr Thienpont and her colleagues, suffering is suffering regardless of age and irrespective of whether one’s untreatable illness is physical or mental.

If treatment, let alone cure, is no longer possible then why should such people be forced to live on if they want out?

Dr Thienpont’s work is radical because it involves the complex matter of establishing mental (and thereby) legal capacity of those requesting help to die.

This is not a slippery slope, nor is it eugenics.

It is an extremely pragmatic approach to universal questions surrounding human pain and suffering, individual assessments of quality of life and our intensely personal decisions about when and how to die.

With debate about the need for law reform in Australia well established, it is only a matter of time until new legislation is passed by a parliament of our nation.

The next step in the process will be for the politicians to decide the type of law that will best suit Australians .

Belgium’s approach should have resonance given our own pragmatism.