Recently my mother and I had to decide whether our 16-year-old dog required surgery. The need was clear, without going into too much detail he had a cancerous growth that had to be removed otherwise his quality of life would be severely impinged. Fairly straightforward right? Unfortunately these things rarely are. As a result of his age, he has kidney problems, a heart murmur and was unlikely to survive the surgery. Which therefore led us to the next consideration, if he was unlikely to make it, could we afford the cost, which was substantial and if we couldn’t what’s next?

Luckily it all ended well, however, hearing last week that the Victorian government continues to push forward with legalising euthanasia begat some reflection on how much longer it will be before I start making the same decisions about my mother.

“Woah!” I hear you cry, “Comparing your mother to a dog is a bit rough, this euthanasia stuff is within strict bounds, only to be used in the most severe cases”. Which sounds reasonable enough, few could not be moved by some of the stories of never ending anguish. If you could somehow guarantee that these were the only cases put forward then I can see an argument (although I would remain unconvinced). As the old proverb goes, “the road to hell is paved with good intentions”.

A parallel with the current debate can be found with that of abortion. We all remember the justifications used for legalising abortion, women who were impregnated out of wedlock, or dumped by the father, impoverished or in the most horrific cases impregnated through rape. These were legitimate problems facing women and causing some to take awful risks. Most could understand the hardships and the need for a safe alternative to the law. However after the laws were enacted changes began to occur and before anyone realised or at least commented upon, abortion became so common (83,000 performed in 2005) that it moulded into another form of birth control. Whether you agree with it or not, the point is, what started with noble intentions changed into a force much larger then was first proposed.

The same tread can be found with euthanasia. In 2001 the Dutch legalised euthanasia, with the law stating it was reserved for those with “unbearable and hopeless suffering”. However the law allowed this to be extended to psychological pain. In 2012 doctors helped a 35-year old woman with clinical depression kill herself. The same pattern is seen in other nations, the number of cases in Belgium is rising quickly, from 1,432 in 2012, to 1,816 in 2013 with a staggering 15 per cent of cases involving under-60s.

In 2014 a 44-year-old transsexual was helped to die as a result of a ruined sex change operation. In one of the more disturbing cases, it was reported that doctors in Belgium were contemplating killing a 24-year old girl because she had “suicidal thoughts”, there was a documentary and everything. Did anyone ponder how she could gain the zest for life to film a documentary but couldn’t get up for the mundane effort of living? Regardless, just before she was due for the injection she changed her mind. If this is not the start of a coming tide, I am not sure what is.

However, Victoria could be different but by looking at the preliminary wording for the justifications of euthanasia it’s easy to see it falling down the same cliff. The report given to the Victorian government, which was the primary driver of this renewed push for its legalisation, states “it is essential that the patient must be experiencing enduring and unbearable suffering that cannot be relieved in a manner which they deem tolerable”.

Firstly, please define “enduring and unbearable pain” remembering that pain cannot be measured or identified accurately or even objectively. Doctors still employ pain measurement scales, which have cartoon pictures that require subjective interpretation. This is not to degrade the medical profession but if we are using such a liberal device to just measure pain, how are we possibly going to know when patients are experiencing “enduring and unbearable suffering” enough to kill them?

The reply would be quickly summated, as “it’s obvious”, however as we all have different pain thresholds it might not be as obvious as we would like to think. One of the principle arguments against a death sentence is, what if you get it wrong? It’s a hefty price. The same could be employed here; what if the pain is exaggerated or temporary when does “unbearable” become “unbearable”?

I am not sure when Doctors became Gods, but I am much more comfortable with them trying to rip life from death then contemplating between the two. A second point is found in the words “which they deem tolerable” so which is it, the patient or the doctor who decides the end? When I used to hurt myself playing football the coach would tell me to run it off. What if I deemed this to be an intolerable way for my pain relief? Should I find another coach that will bandage my leg or ice it, or let me sit down for half an hour, which I would have preferred?

“But that is a trivial example we are talking of excruciating and never ending pain”. If a rule does not apply for the most trivial example it will not work for one as infinitely as complex as life and death. The report goes on to state that “this is a fundamental to patient-centred care, and is a subjective measure judged by the patients themselves”. Well that makes it clear! If that’s the case why involve the doctor at all, we could just buy a pill over the counter at a pharmacy. It begs the question when does suicide stop and euthanasia begin? When the patient decides.

The UK Parliament has rejected these assisted dying laws; in fact the rejection of the right to die has increased from 72 per cent in 1997 to 74 per cent in 2015. In the UK, the campaign revolves around the notion stated by Dr Peter Saunders that “the current law exists to protect those who are sick, elderly, depressed or disabled from feeling under pressure to end their lives”. How much longer will it be after these laws are enacted until I’m standing around with my siblings contemplating whether we can afford a surgery to save my mother. “She’s had a decent go at it” one would say, quickly re-joined by another “she probably wouldn’t get through the surgery any way”, finally “five grand is a lot and she never bought health insurance… so really…”. All of a sudden you find yourself justifying doing nothing in the face of death. “I would never do that” you may retort, but you only contemplate such things when they become an option and once they do justifications of all sorts can be made and implemented.

This is how the trickle turns into a flood. I was speaking to a woman about my dog, she was in a similar situation, her dog was old and becoming enfeebled. She said that it’s hard to know when to put them down, too early and its unfair on them, robbing them of extra years of life, but too late and you don’t want them to suffer. I agreed, but in the next sentence she said at least with animals we get to choose.

This struck me, many people have the tendency to show great and caring compassion to all animals and especially those furry creatures we call pets, but if it is a hard decision to put a dog down, then I can only imagine what it would be like to sign off on killing a human, let alone my mother. This is the crux of the matter, in the end who decides, if three out of four siblings want the death, does democracy prevail? What happens if the doctor doesn’t agree or my mother is semi-conscious, strong enough to be cognisant but too weak to fight?

Now you may say “this would never be, didn’t you read the outline above, the patient must decide” and to that I would reply for how long will that inalienable right be secure? I would imagine until another set of amendments, perhaps outlining the ability of the children to override the wishes of their parents in cases of semi-consciousness. Which brings another point, at what stage is a person conscious or semi-conscious, do you include dementia in a state of semi-consciousness? Can a person suffering from dementia make an informed decision or should someone else make that decision for them?

These are merely the questions that bubble to the surface when faced with the concept of euthanasia. I cannot fathom the intricacy involved in applying these broad questions to pragmatic medical situations. The pro-euthanasia camp proclaims that it’s all so simple you can see pain, suffering, the desire for the release of death, “It’s compassionate”. However, other countries that have lead the way down the rabbit hole have shown that when you take away the line, people no longer have to stay within the boundary, they will go where they please. As a perfectly abled body 24 year old showed us.

We live in a society that looks at its ageing population as a burden as if their living was somehow their fault. You cannot tell me that no one will think that an extra two years of life for a $20,000 cancer treatment is really worth it? If one person is subjected to that kind of pressure then we begin to loose ourselves. We live in a state of moral subjectivity where we are encouraged to live by our own standards, if we no longer value life in all of its forms what’s left?

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