Dear Brothers and Sisters,
The Queensland Parliament is currently conducting an “Inquiry into Aged Care, End-of-Life and Palliative Care and Voluntary Assisted Dying”. In spite of the broad title of the inquiry the concentration has been on Euthanasia and the Chair of the Committee conducting the inquiry is on record as being in favor of voluntary assisted dying: the inquiry is therefore likely to lead to legislation for euthanasia being put before the Parliament. The Anglican and Catholic Archbishops of Brisbane have been asked to appear before the inquiry on the morning of 23rd August and I have been asked to join Archbishops Phillip Aspinall and Mark Coleridge. We will be putting forward the view that that much more needs to be done for aged care and palliative care in Queensland rather than legislating for euthanasia.
The discussion below about euthanasia is unpleasant and will consider issues such as suicide and terminal illness. Those who are suffering from mental distress are advised to contact Lifeline on 131114 or seek support from their minister or counselor.
Euthanasia comes from the Greek for “good death” (eu + thanatos): however, the word itself is somewhat controversial as it was used by Nazi Germany to describe their programme of killing handicapped persons in the period 1939 to 1941: this programme was the forerunner of later programmes of mass murder. Therefore a number of other words are used in the current debate. Many of these words are pejorative: either equating euthanasia with murder or alternatively using words which obfuscate the fact that either suicide or killing is taking place. In general proponents tend to go for the term Voluntary Assisted Death.
Voluntary Assisted Death can occur in at least two ways. The first is to give a person the means of ending their own life such as through giving them medications. The second is for a health care worker or another person to administer the means of death directly.
Thanks to cultural changes and advances in medical technology the way in which humans die has changed. A century ago people usually died at home, surrounded by their extended family. Possible medical interventions were limited, and death was usually not greatly prolonged. Morphine for pain relief was available from the 19th Century and used as it is today: for pain relief even if such pain relief shortens life.
However today most people in a western nation die in a hospital or a palliative care facility attached to a hospital. Death is far more likely to be prolonged: all of us will have stories about the prolonged and unpleasant death of someone we love. While pain is still effectively relieved by morphine there are many other complications of a prolonged dying process that can distress both the person dying and their loved ones: dementia, incontinence, blindness and so on. It is this change in the pattern of death which is one of the factors leading to increased demand in the western world for euthanasia.
The term “euthanasia” covers both a person being assisted to kill themselves, or another person administering the means of death (usually a medical or nursing practitioner). Proponents of euthanasia often refer to it as “Dying with dignity” or with the more neutral term of “Voluntary Assisted Death” (VAD).
Only one state so far has passed legislation to allow euthanasia: the Voluntary Assisted Dying Act 2017 recently came into force in Victoria. It is fairly conservative in its approach: it allows a person who is not cognitively impaired and who is terminally ill and has less than six months to live (twelve months if suffering a neurological degenerative condition) to access euthanasia. There is one reported case so far of euthanasia under this legislation but a reported expectation that 150 persons will avail themselves of euthanasia each year in Victoria. https://www.theguardian.com/australia-news/2019/aug/04/cancer-patient-is-first-to-die-under-victoria-euthanasia-law
There are now proposals for euthanasia legislation in Queensland. A draft bill prepared by academics from the Queensland University of Technology has been circulated and it is a little more liberal than the Victorian legislation although it does allow for conscientious objection for both individuals and for entities such as hospitals and aged care facilities.
Why now? Cultural Issues
Twenty years ago moves towards legalising euthanasia were soundly defeated and it was seen as the limited interest of the left wing of politics. So why now? The advance in medical technology which can prolong lives but with an uncertain quality of life is certainly one factor. But perhaps the new political factor is the rise of Libertarianism – the idea that you can do whatever you want as long as it does not harm others. In this ideology the individual and their right to choose is more important than community. This has increasingly become the ideology that motivates the right of politics and has prominent supporters in Australia. Thus a centre-left concept of human rights has been joined to a right wing concept of libertarianism to produce the grounds under which euthanasia is now being revisited.
In general terms Christianity derives from Judaism a very high view of the value of human life. Humans are created in the image of God and murder is clearly condemned as sinful in both Old and New Testament: for example Exodus 20.13, Matthew 15.19, John 8.1-11.
The position on suicide is not quite as clear and arguably suicide was not clearly condemned until the writings of St Augustine of Hippo in The City of God in the early 5th Century. Since then it has been considered as being self-murder and hence contrary to the ban on murder; more recently it has been seen as a matter of mental illness rather than moral choice but is still considered by most Christian scholars as something that is bad and not to be encouraged.
Having said all that, it is also recognised that our life here on earth is not of infinite duration: we are not called upon to prolong life needlessly. A person who is dying is not required to take every measure to extend their life but can be allowed to die; and as mentioned earlier pain relief which hastens the end of life is not of itself wrongful. The line is between “letting die” and “killing”: the latter crosses a moral line by actively inviting people to either kill another person or by inviting them to help someone kill themselves.
The prohibition on murder is found in all cultures and is one of those constants in all human systems of morality. It is another question as to whether or not euthanasia is murder: we can all think of horrible cases of slow and prolonged dying where we wish that death had occurred earlier. Likewise, we can think of people we love who have died more quickly and see that as a mercy from God. Clearly in these cases the use of euthanasia is not necessarily the same as a brutal murder and there are many shades of grey. However the law deals not in grey but in black and white: the important thing here is to recognise that the intentional taking of life is a significant line across all cultures. To cross that line requires strong justification. It puts the emphasis on those who want to cross that line to show why: why should an exception to the intentional taking of life be made?
The evidence from jurisdictions where euthanasia is permitted is mixed. In the Netherlands there has been a clear slippery slope from aged competent patients with terminal illnesses to children and non-competent adults with incurable diseases (including mental illnesses such as depression). In 2018 just over 6,000 people availed themselves of euthanasia (out of a population of 17 million people), with over 5,800 of those cases being administered by health care professionals. In contrast in more conservative jurisdictions (such as Oregon State in the US) where euthanasia is only allowed to competent adults who are terminally ill and are considered to be in the last year or six months of life, the rates of death are somewhat lower.
The view being put to the Inquiry is that voluntary assisted dying or euthanasia crosses a line where we should not cross and if permitted must be permitted in the most conservative way possible. I am also personally concerned as I look at the list of those giving evidence to the Inquiry that there appears to have been no consultation made with Aboriginal or Torres Strait Islander groups. Given the impact that euthanasia will have on the broader community this seems to me to be a significant oversight.
If voluntary assisted dying is legislated for then we want robust conscientious objection provisions. These should not be tied to religious criteria but available for all health care workers. Likewise, no health care facility should be obliged to take part in voluntary assisted dying. I have consulted with the leadership of the aged care facilities for which we are responsible and they have indicated to me that they do not wish to be involved in voluntary assisted dying.
In the sense of the original Greek, we wish euthanasia – a good death – for all people. Everyone in our society should die with dignity. However, dignity is something conferred by the broader society: it is we as a community who make death dignified or otherwise. If a dying person is receiving the best possible palliative care and if our aged care allows for older Australians to live in dignity and to be truly valued then much of the impetus for voluntary assisted dying is removed. This is what we as a society should be doing: putting our physical and human resources into looking after the aged and in providing the best possible palliative care, especially in the regions.
It is a common complaint of Aboriginal people that they are not allowed to die on country; and in general, most people want to live and die at home and not in a health care facility in a capital city or a large regional center. So the viewpoint I will be putting most strongly to the Inquiry is this: if we want people to die with dignity legislating for voluntary assisted dying is not the answer. Rather we should be putting our resources into good palliative care and good aged care available to all Queenslanders regardless of where we live.
Please pray for all taking part in the Inquiry and especially for our elected representatives as they consider these important matters.
Moves and Ministries
The Reverend Robyn Boyd is retiring from Rector of Atherton from 9th September 2019 and will be retiring to Melbourne.
The Reverend Canon Dway Goon Chew is resigning as Rector of Ayr from 6th October 2019 in order to take up a new ministry as Rector of Tweed Heads in the Diocese of Grafton.
I am very sorry to see Robyn and Dway depart and we wish both Robyn and Dway every blessing as they prepare for their moves south.
The Reverend Pawel Hrynczyszyn has been appointed locum for West Cairns and the Reverend Frances Maltby is to leave the Church of the Ascension Heatley to take up a new role at St Peter’s West End.
Mr Lindsay Murgha of Yarrabah has been nominated by the Anglican Church of Australia as the Australian Steward at the Lambeth Conference which is to be held in twelve months’ time.
The Discernment Panel under the leadership of the Reverend Dr Kenneth Lay is holding its first meeting this Saturday morning 24th August. More information about its procedures and policies will be made available in the next Bishop’s Bulletin.
We give thanks for the life of Dr Ian Chapple, formerly of Kerrisdale Gardens and the Parish of St Charles, Mackay, who died on 9 July 2019. Ian was a distinguished medical practitioner both as an anaesthetist and general practitioner. He also served on Diocesan Council during the episcopate of +John Lewis. Please pray for his widow Beth and their children Jenny and Greg.
We also give thanks for the life of Mrs Maud Way, older sister of Bishop George Tun Yep: Maud was a devoted and much loved member of the congregation at St John’s Cairns. Maud passed into the closer presence of God on 1st August 2019. Her funeral will be at St John’s on 23rd August 2019.
Mr David Williams, brother of the late Fr Tom Williams of St Margaret’s West Cairns has also recently died. The new west door at St Margaret’s is in memory of both men.
The Right Reverend Dr Keith Joseph
Bishop of North Queensland
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