About us - Example letters

These are real letters that have been sent in the past and are representative of the type of content and respectful tone taken by this group.

 


 Doctors for Assisted Dying Choice

 

 

 24A Renown Av

 Tranmere SA 5073

 

  08 8431 9134

 

 

  24 July 2015  

 

  

 Lilian Topic

 Secretary

 Legal & Social Issues Committee Parliament House

 Spring Street, Melbourne VIC  3002

 

 Dear Ms Topic

Re: Submission – Inquiry into End of Life Choices


In Australia the ability of a person to exercise a preference in end of life choices is constrained by factors not freely or easily controlled by that person, such as location of the person’s domicile, type of illness, medical practitioner attitude, legal inconsistencies  and religious pressure.

 

Location

Location plays a major role in limiting access to specialist palliative care for the optimal management of end of life care.  Palliative care services and practitioners are concentrated in major cities and less well represented in distant townships and country areas.  The provision of on-line consultation allows some alleviation of this divide but is not a completely satisfactory alternative to that provided by face-to-face, experienced carers.  Choice of institutional care options is likely to be similarly reduced.

 

Restrictions on provision of terminal medical care 

It is acknowledged that even with optimal palliative care availability, 5-10 % of patients continue to experience inadequate relief of their suffering.  Current medical practice fails these people.  This is the group who will receive relief of their suffering only by death; but it is this group whose achievement of the desired relief is somewhat of a lottery and dependent on the medical practice of their care givers.

 The Palliative Care Council makes the statement that voluntary euthanasia and assisted death are not part of palliative care.  This claim is rational; if voluntary euthanasia or assisted death were practiced openly as part of palliative care, palliative care givers would be acting illegally.

 The appropriate use of drugs for symptom control is an established and effective part of palliative care.  When large doses of sedatives are used in the presence of refractory symptoms, the practice becomes terminal sedation: the end point is death of the patient.  The essential difference between the administration of drugs to achieve euthanasia or to undertake terminal sedation is the intent of the doctor responsible for the procedure.  Even when requested by the patient, intending to end a life by terminal sedation is illegal: administering drugs sufficient to control symptoms, which may result in the death of the patient, is not illegal.  The end point of each procedure is the same: the legality or not is based on the intent of the medical practitioner which can be known only to each practitioner at the time.

It is recognized that a few medical practitioners do agree with a patient’s rational request to end suffering by administering drugs in sufficient concentration to control symptoms by the ending of the patient’s life.  This practice requires both subterfuge and personal courage on behalf of the practitioner: it persists in the face of its illegality because it has ethical impetus, a feature to which current laws are blind. 

 

Type of illness

A person’s ability to achieve assistance in obtaining relief of intolerable suffering may depend on his or her type of illness.  The consensual withdrawal or removal of life sustaining treatment from a patient is legal, even if this action results in the patient’s death. The consensual administration of drugs to a patient not dependent on life support, is illegal.  The inconsistency of the legal illogicality is obvious and discriminatory.

 

Continued Religious Influence

Within the community there exists a small, vocal and strong opposition to assisted death and voluntary euthanasia on the basis that human life is sacred and divinely given.  In general these groups are well supported by various religious bodies, which allow them to exert political influence disproportionate to their numbers and to maintain the limitations on assisted death as a choice at the end of life: a choice which is favoured by more than 75% of the Australian community in general. A similar number of people professing a religion see voluntary euthanasia as consistent with their faith.   Australia has become a secular society, but a society in which the freedom to practice personal and religious beliefs is retained and respected.  The maintenance of law based on the beliefs of a selected, but disproportionally influential few, significantly reduces choice in end of life care for the majority and is implicitly undemocratic.

 

Increase in end of life choices

Currently many Australians die in unsatisfactory circumstances and with unrelieved suffering.  We have outlined areas which limit the provision of optimal choice of care at the end of life.  Some are location dependent and difficult to solve but the salient restriction which can be addressed and which is desired by most of the Australian community, is the removal of the undemocratic legislation prohibiting voluntary euthanasia and assisted death as a choice in end of life care.  The essential element in any liberalisation of the law is that of personal choice.

 

 Yours sincerely

 

Associate Professor Arnold Gillespie

and 97 members

 


 

3 May 2014

 

The Editor 

Sydney Morning Herald

 

 Frustrated at the failure of parliamentarians of all States to enact legislation to allow voluntary euthanasia in defined circumstances, Dr Rodney Syme has courageously elected to make public his role in the death of Steve Guest, in 2005 (SMH 28 April 2014).  Dr Syme has taken this brave course to force police action, which is likely to result in judicial activity, in the hope that a Court decision might facilitate parliamentary action.  The undersigned members of Doctors for Assisted Dying Choice applaud the action of Dr Syme and strongly advocate the modification of the law in all States to permit voluntary euthanasia and physician assisted dying in legally defined circumstances.

 

 We also challenge the ill-informed view that all doctors are opposed to voluntary euthanasia. Currently it is illegal for a doctor to even sit with a terminally ill person with intolerable symptoms who has decided to terminate his or her life.  We believe that assisting people with intolerable symptoms, who have made an informed decision to die, is the ultimate compassionate, palliative care action. 

 

Sincerely

Doctors for Assisted Dying Choice

 

 

 ---------------------------------------------------------------------------------------------------------------------------------------------------------------------

 

2 May 2014

 

The Editor, The Age

Dear Sir/Madam,

 

The undersigned doctors write in support of Dr Rodney Syme who has admitted his part in the death of Steve Guest in 2005.  Steve Guest died by his own hand, using a drug supplied by Dr Syme.  The Police decided that no action was required but now are likely to investigate, given further information supplied by Dr Syme.  Given the failure of legislatures to enact permissive legislation, Dr Syme has concluded that a favourable judicial conclusion may influence the Parliament to take action.

 We write also to contradict the ill-informed belief that doctors are opposed to liberalisation of the law.   We strongly support the modification of the law to permit voluntary euthanasia and physician assisted dying in legally defined circumstances.  We favour a legal framework in which decisions to end life are entirely patient-centred and not reliant on the views of a doctor.  We are appalled that currently it is illegal for doctors to even sit with a terminally-ill person with intolerable symptoms, who has decided to take his or her own life.  End-of-life assistance in whatever form should be a final, compassionate act of palliative care and should be legal. 

Yours sincerely

 Doctors for Assisted Dying Choice

 

 

 

Letters to South Australian parliamentarians

 

 Doctors for Assisted Dying Choice

 

 

25 October 2013

 

Hon «FirstName» «LastName» MLC

Parliament House

Adelaide SA 5000

 

  

Dear «Title» «LastName»

 

As a national medical group we aim to provide our elected representatives with updates of worldwide developments in end-of-life thinking. Accordingly, from time to time we will send you quotations from respected medical journals, with the references, so that the full articles may be obtained.

 

Quote No. 6:

  

“There is evidence of advancement of palliative care in countries with legalised euthanasia, also after the legalisation of euthanasia and/or assisted suicide. The idea that legalisation of euthanasia and/or assisted suicide might obstruct or halt palliative care development thus seems unwarranted and is only expressed in commentaries rather than demonstrated by empirical evidence.”

 

Legalisation of assisted dying does not harm palliative care, study concludes.

 

Dyer C. British Medical Journal 2011; 343: d6779  

Commenting on: Palliative Care Development in Countries with a Euthanasia Law. Report for the European Association for Palliative Care; October 4, 2011. 

 http://www.commissiononassisteddying.co.uk/wp-content/uploads/2011/10/EAPC-Briefing-Paper-Palliative-Care-in-Countries-with-a-Euthanasia-Law.pdf

 

We, the South Australian members of Doctors for Assisted Dying Choice, continue to urge you to respect the views of the majority of your electorate in support of the Ending Life with Dignity Bill 2013.

 

Yours sincerely,

(Signed by South Australian Members)

 

 

Doctors for Assisted Dying Choice 

 

 

17 October2013

 

 

Hon «FirstName» «LastName» MLC

Parliament House

Adelaide SA 5000

 

 

 

Dear «Title» «LastName»

As a national medical group we aim to provide our elected representatives with updates of worldwide developments in end-of-life thinking. Accordingly, from time to time we will send you quotations, with the references, so that the full articles may be obtained.

 

Quote No. 5:

 

“Making someone die in a way that others approve, but he believes a horrifying contradiction of his life, is a devastating, odious form of tyranny.”

 

 

Ronald Dworkin, QC

 

Emeritus Professor, University College London

Previously – Chair of Jurisprudence, Oxford University. Fellow of University College Oxford.

Professor of Jurisprudence, University College, London. Professor of Law, New York University.

 

 

Dworkin died of leukaemia in London on February 14, 2013 at age 81.

 

Faculty of Law News (Oxford) http://www.law.ox.ac.uk/newsitem=537

 

Orbituary The Guardian 14 February 2013. http://www.theguardian.com/law/2013/feb/14/ronald-dworkin

 

Obituary NY Times 15 February 2013. http://www.nytimes.com/2013/02/15/us/ronald-dworkin-legal-philosopher-dies-at-81.html?_r=0

  

 

We, the South Australian members of Doctors for Assisted Dying Choice, continue to urge you to respect the views of the majority of your electorate in support of the Ending Life with Dignity Bill 2013.

 

 

Yours sincerely,

(Signed by South Australian Members)

 

 

Doctors for Assisted Dying Choice

 

1 October 2013

 

 Dear…appropriate addressee

 

 

As a national medical group we aim to provide our elected representatives with updates of worldwide developments in end-of-life thinking. Accordingly, from time to time we will send you quotations from respected medical journals, with the references, so that the full articles may be obtained.

 

Quote No. 4:

 

 

“Despite the huge progress made in palliative medicine in terms of symptom control, many are intractable (refractory symptoms), either because the treatment is ineffective or because the treatment itself is intolerable”

 

 

 

Palliative Sedation in End-of-Life Care and Survival: A Systematic Review

 

M Maltoni, E Scarpi, M Rosati, S Derni, L Fabbri, F Martini, D Amadori, and O Nanni.

 

Journal of Clinical Oncology, 2012; 30:1378-83.

 

 

We, the South Australian members of Doctors for Assisted Dying Choice, continue to urge you to respect the views of the majority of your electorate in support of the Ending Life with Dignity Bill 2013.

 

Yours sincerely,

 

(Signed by South Australian Members)

 

 

 

Doctors for Assisted Dying Choice

 

29 September 2013

 

Dear...appropriate addressee

 

As a national medical group we aim to provide our elected representatives with updates of worldwide developments in end-of-life thinking. Accordingly, from time to time we will send you quotations from respected medical journals, with the references, so that the full articles may be obtained.

 

Quote No. 3:

 

"... our Death with Dignity program has been well accepted by patients and clinicians….

…..[it] allows patients with cancer who wish to consider this option to do so within the context of their ongoing care and accommodates variation in clinicians' willingness to participate”

 

Implementing a Death with Dignity program at a comprehensive cancer center.

Loggers ET, Starks H, Shannon-Dudley M, Back AL, Appelbaum FR, Stewart FM.

N Engl J Med. 2013; 368(15):1417-24. doi: 10.1056/NEJMsa1213398.

 

We, the South Australian members of Doctors for Assisted Dying Choice, continue to urge you to respect the views of the majority of your electorate in support of the Ending Life with Dignity Bill 2013.

 

Yours sincerely,

(Signed by South Australian Members)

 

 

Doctors for Assisted Dying Choice

 

 

 

16 September 2013

 

  

Dear...appropriate addressee

 

As a national medical group we aim to provide our elected representatives with updates of worldwide developments in end-of-life thinking. Accordingly, from time to time we will send you quotations from respected medical journals, with the references, so that the full articles may be obtained.

 

Quote No. 2:

 

“That there is a moral right, grounded in autonomy, for competent and informed individuals who have decided after careful consideration of the relevant facts, that their continuing life is not worth living, to non-interference with requests for assistance with suicide or voluntary euthanasia.”

 

Quotation from: Section 8, Conclusions. End-of-Life Decision-Making in Canada: The Report by the Royal Society of Canada Expert Panel on End-of-Life Decision-Making 

Bioethics. 2011 November; 25(Suppl 1): 1–4.doi: 10.1111/j.1467-8519.2011.01939.x

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3265521/

 

We, the South Australian members of Doctors for Assisted Dying Choice, continue to urge you to respect the views of the majority of your electorate in support of the Ending Life with Dignity Bill 2013.

 

 

 

Yours sincerely,

(Signed by South Australian Members)

 

 

 

Doctors for Assisted Dying Choice

 

 

 

9 September 2013

 

Dear...appropriate addressee

 

As a national medical group we aim to provide our elected representatives with updates of worldwide developments in end-of-life thinking. Accordingly, from time to time we will send you quotations from respected medical journals, with the references, so that the full articles may be obtained.

 

Quote No. 1:

 

“The consistency of international views indicates a mandate for legislative and medical systems worldwide to listen and understand this.”

 

Quotation from: Why do we want the right to die? A systematic review of the international literature on the views of patients, carers and the public on assisted dying.  

Hendry M, Pasterfield D, Lewis R, Carter B, Hodgson D, Wilkinson C. Palliat Med. 2013;27:13-26. doi: 10.1177/0269216312463623

 

We, the South Australian members of Doctors for Assisted Dying Choice, continue to urge you to respect the views of the majority of your electorate in support of the Ending Life with Dignity Bill 2013.

 

 

Yours sincerely,

(Signed by South Australian Members)

 


 

11th August 2010

Dear [Politician Name],

Re: Recent findings in Voluntary Euthanasia

This letter addresses a frequent concern that legislators express in regard to VE, known as the "slippery slope". This is the idea that an act to legalise VE which in itself may not be ethically repugnant or illegal on a small scale, will lead to an unacceptable increase in the use of VE and even the ending of a person's life against their wish.

We draw your attention to information we have taken from the website of the Department of Human Services, Government of Oregon reporting the experience of legalised VE in Oregon, USA.

Last year there were 19.3 physician-assisted deaths per 10,000 total deaths (0.19%). This is the rate after 12 years of legalized physician-assisted suicide, and represents a total of 59 deaths out of 30,000 deaths in 2009. As in previous years, more individuals were legally prescribed lethal drugs than actually took them (see figure in appendix).

Thus, the incidence of VE remains very low, the overall increase is slight, consistent with gradual acceptance by a society that physician-assisted dying legislation is compassionate, and the un-used prescriptions point to patients not being pressured, or forced, to take that option.

This is an excellent example of evidence refuting the idea of a 'slippery slope' of run-away euthanasia. We are happy to respond to any questions you may have.

Yours sincerely

John Willoughby—for the group

 

Appendix: The Oregon voluntary euthanasia experience from 1998 to 2009.

 

The Oregon voluntary euthanasia experience from 1998 to 2009

 


Letter to Editor of the Adelaide Advertiser

10th September 2011

With the introduction of the legislation proposed by Hon Ms Steph Key and The Hon Dr Duncan McFetridge we are at a critical point in our society's approach to end-of-life matters. The effect of the proposed legislation will be that un-relievably distressed adults may request medical assistance that would shorten their lives. At present, a doctor acting on such a request could be charged with murder: this proposed Bill seeks to provide medical carers with a defence against such a criminal charge.

The two of us are members of a national group of 127 doctors and specialists. We write on their behalf to both support and to criticize the Bill. We support it for the diminished threat of compassionate medical carers being charged when they respond to a request for assistance at the end of life. We criticize the Bill because patients who make a decision to have assistance to end their life, deserve to have their decision supported by law and we still seek to achieve this. We cannot conceive a rational basis for opposing such assistance and we are perplexed by minority groups who do oppose it.

In the meantime, the Key/McFetridge Bill has our support. Medical carers regularly deal with difficult life and death decisions in which the patient's opinion is pre-eminent. The Key/McFetridge Bill will, for the first time in SA, enable effective open communication at what is a very sad time for all involved and provide one more option for suffering individuals.

With best wishes

Dr Rosemary A Jones         Emeritus Professor John Willoughby

Writers for members of Doctors for Assisted Dying Choice

 

Letter to SA Parliamentarian, Dr Bob Such

Dr Bob Such

Member for Fisher

Parliament House

Adelaide SA 5000

Dear Dr Such

We are doctors from all Australian states who have recently joined forces in the cause to legalise voluntary euthanasia.  Our website can be found at drs4assisteddyingchoice.org

We strongly support your stance on this cause, which we all recognise is supported by the most powerful of ethical arguments.  We do feel, however, that aspects of your Bill will preclude several groups of patients whose medical indications for requesting an assisted death are equally as strong ethically as patients who are the focus of your Bill. 

While those with advanced cancer, who are in pain and in the terminal phase of terminal illness, would benefit from the passage of your Bill, individuals who are suffering unbearably from permanent deprivation of their vital functions deserve the right to request a peaceful end-of-life; these functions would include the capacities of secure breathing, eating, drinking, and self-care.   You, yourself, have indicated in the SA Parliament that the provisions of your Bill will be utilised no more than rarely. We have the view that the exclusion of unbearably distressed individuals who have fixed, non-fatal or slowly destructive illnesses, will be seen to be arbitrary compared to the compassionate options your Bill will provide for those with end-stage cancer.

We will, of-course, provide a supportive medical campaign for your currently proposed Bill, as exclusionary as it is.  However, we would make the strongest of public efforts to achieve reform that gives choice to patients on the basis of even-handedness in the face of equivalent medical need.

As representatives of Doctors for VE Choice, Drs Rosemary Jones, Arnold Gillespie and John Willoughby would appreciate the opportunity to meet with you to discuss these matters.  Would you kindly advise us if you are receptive to discussion, and if so, suggest a time for meeting?

Yours sincerely

[This was signed by over forty doctors from Doctors for Assisted Dying Choice]

 

 


 

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