Tasmanian Euthanasia Submission 1998

Submission to the House of Assembly Community Development Committee’s Inquiry into the Need for Legislation on Voluntary Euthanasia in Tasmania 1998

(1) Introduction

Many people think that we need euthanasia to end the pain and suffering of the terminally ill. While this argument might have been appropriate thirty years ago when it was more common for people to die in pain, today it is true only in a minority of cases. Even supporters of euthanasia agree that because of advances in pain control and the growth of palliative care, in 90 to 95% of cases, with proper palliative care, terminally ill people do not need to suffer painful deaths. The rest are usually kept sedated.

Paradoxically, as the need for euthanasia to end the terminally ill’s suffering has decreased, the demand for euthanasia has increased. A lot of people seem to base their support for euthanasia on situation which most likely no longer happen, namely, the memory of a dying relative’s suffering years earlier, whereas in 90 to 95% of cases that person would not have died in the same painful manner today.

Moderate euthanasia supporter argue that the only need for euthanasia is the remaining 5 to 10% of cases where their physical suffering cannot be relieved by palliative care and pain control. These remaining cases do not mean that euthanasia is the answer. Killing people should not be an acceptable solution to any problem. After all, one could logically argue that killing people is an efficient and efficient way of solving many social problems. We could solve the problems of unemployment and Aboriginal issues by simply killing all the unemployed and Aboriginals. The problems would be gone completely; more quickly and cheaply than our current efforts to deal with them. We could even justify this killing with many of the arguments used by euthanasia supporters – they are suffering, unwanted, an economic burden and have a poor quality of life. Of course, we would all reject this reasoning as absurd and unthinkable for the unemployed and Aboriginals, but killing is taken seriously as a solution to the suffering of the terminally ill, along with the elderly and the disabled.

The fact, that a minority of terminally ill patients cannot have all their suffering alleviated by modern palliative care and have to be sedated, does not mean that there is a legitimate need for euthanasia any more than the suffering of the unemployed or Aboriginals justifies killing them or assisting them to commit suicide. As a caring and humanitarian society, we must search for better medical and social solutions which ease their suffering and do not cross the line and condone killing and assisted suicide.

This submission is opposed to the introduction of voluntary euthanasia legislation. There is no need for it. It will examine the prejudices underlying support for euthanasia, the slippery slope argument, some political issues related to euthanasia and will suggest some alternative avenues of legislation.

(2) Euthanasia and Prejudice

Although its supporters like to portray euthanasia as an act of compassion, many of the arguments for it appear to be based on prejudice which is directed against people because of their physical condition.

(a) Being a Burden

Euthanasia supporters agree that the reasons for requesting euthanasia are not always of a medical nature. Marshall Perron has said that a major reason for requesting it is “total dependence syndrome” which is the lack of control and independence, and having to depend on others [1].  He has written, “Even if the perfect palliative care was available to everyone, it would never satisfy those who find the concept of total dependency so unacceptable that they would rather be dead.” [2] Thus, many people apparently support euthanasia not out of fear of dying in pain, but because they do not want to be a burden and have to depend on others. We are being asked to accept euthanasia not for objective medical reasons, i.e. physical symptoms which cannot be alleviated, but for subjective reasons which vary from person to person. Not everyone thinks that having to depend on others is so bad they would rather be dead. The terminally ill are not the only ones susceptible to “total dependence syndrome”. Many people with disabilities are totally dependent on others for their whole lives. They cannot eat, wash, get dressed or go to the toilet without help. By saying that being a burden and having to depend on others is so bad that your life is not worth living and you would be better off dead, euthanasia supporters are also attacking the value of the lives of people with disabilities. They are probably not openly prejudiced against the disabled (no more than anyone else is), rather they simply have not thought through the implications of what they are saying. I am not saying there is always virtue in suffering or that “total dependence syndrome” is not horrible and humiliating, but surely, these people are suffering enough and have enough worries and fears without hearing that if other people had to be dependent like they do, they would rather die. What is need is not euthanasia, but a more compassionate society which is tolerant of and does not condemn and devalue people for needing the help of others.

(b) Economic Burdens

Most euthanasia supporters find the blatant economic arguments for euthanasia abhorrent, but not all of them. Bill Hayden has said, referring to euthanasia for the elderly in nursing homes, “… there is a point when the succeeding generations deserve to be disencumbered – to coin a clumsy word – of some unproductive burdens.” [3] One wonders how the elderly are supposed to feel about their value as human beings when they hear such comments from our then Head of State who is supposed to represent all Australians. These “unproductive burdens” would have worked for over 40 years, raised burdensome children, helped to build this country and paid 40 years of taxes to support others, including Bill Hayden. When they become too old or too sick to keep working and paying taxes, some think they are not entitles to, in turn, be cared for in their last years. They have become burdens and consequently, lost their right to life, like closing an unprofitable business when costs get too high. Some might say this is economic rationalism gone mad.

The economic arguments for euthanasia are obvious. The terminally ill, the elderly and the disabled are an economic burden. It is cheaper to kill them than to treat them. If euthanasia became legal in this age of economic rationalism and reducing government costs, there will be the temptation to see it as a way of reducing health care costs. A lethal injection costs about $20. A year of palliative care for a patient costs over $20,000. It is easy to imagine euthanasia leading to reductions in palliative care funding if a much cheaper alternative is available. The proof of this argument is in Holland where euthanasia is practised and palliative care is virtually non-existent. Since the terminally ill are already thought to be a burden by some, they could be covertly pressured into euthanasia rather than selfishly wasting taxpayers’ money by asking for palliative care.

(c) Dying with Dignity

Considering Australia’s high suicide rate, it is grossly irresponsible to describe any form of suicide as “dying with dignity” even in the context of euthanasia. It can only send the wrong message. Euthanasia supporters clearly associate dignity with one’s physical condition, i.e., if you are in pain, have a terminal illness or  a disability, you do not have dignity and it looks like the only way you can regain your dignity is through euthanasia. They doo not seem to believe that it is possible to die with dignity if you die naturally. This understanding of dignity is not in any dictionary. “Dignity” means the value or worth of a person and the “dying with dignity” argument implies that some people do not have dignity because of their physical condition. This example of how society values people according to their physical condition is not much different from the mindset which leads to eating disorders in women. Both believe a person’s value is dependent on their physical condition.

(d) The Right to Die

In spite of their rhetoric about the “right to die”, euthanasia supporters do not believe that everyone is entitled to this right. Other rights are universal, such as freedom of speech and the right to vote, but only those, who in their eyes do not have a life worth living are entitled to this “special treatment” of the right to die. Many euthanasia supporters are no doubt upset by high youth suicide rates or Aboriginal deaths in custody. If young unemployed males want to end their lives, this is bad and they should be talked out of it and protected from their suicidal wishes, regardless of their supposed right to die. But if someone, who is terminally ill, elderly or has a disability, wants to commit suicide, their wishes are taken seriously. They have the right to die. Some euthanasia advocates argue that there is such a thing as “rational suicide” which is good[4], however rational suicide only appears to be possible if the person is in poor physical condition. Only the most extreme euthanasia advocates would suggest that regardless of how bad his circumstances were, an unemployed but healthy male could commit rational suicide. On the other hand, few euthanasia supporters would dismiss a terminally ill person’s request for euthanasia because it was not rational. By saying that only some people have the right to die, rather than the right to protection from suicide, euthanasia supporters are denying their dignity and the value of their lives. They are saying that they are not worth living. If they believe that the right to die really exists, then everybody should be entitled to it.

(e) A Cry for Help

Often, suicide is, in fact, a cry for help. When a terminally ill person says he wants to die, this could also be a cry for help rather than a genuine request for euthanasia. Their request might mean that they really want to be told by their relatives that they are still loved and they do not want them to die. Instead, in the name of compassion, their requests are taken literally and their fears, that they are unloved and unwanted, are confirmed.

In 1996 The examiner printed an article about a 30 year old quadriplegic who had to live in a nursing home for elderly dementia patients. She was not terminally ill but she wanted euthanasia[5]. Quite frankly, if I had to spend the rest of my life in those conditions, I would probably want to die too. Naturally, no newspaper would run a story about how depressed unemployed males have the right to die. It is a pity they did not print an article about how care for the disabled is so bad that they want to kill themselves. People, who request euthanasia, are often not only victims of their illnesses or disabilities. They are also victims of a society which does not merely abandon them  and shut them out of sight and out of mind. It denies their value as human beings and regards them as “burdens”, as almost offensive. Then, when their miserable plight is publicised, we only add to the injustice committed against them by suggesting that, partly because of how society has treated them, they would be better off dead.

If our society were truly compassionate about the terminally ill, the elderly and the disabled, this would be reflected in the greater priority given to their funding and better quality care and services. If they were cared for in supportive environments without the stigma of being a burden, they would still have their illnesses and disabilities, but much of their emotional pain and suffering would be alleviated, so their desire to end their lives would not be so strong. Furthermore, the pro-euthanasia arguments about burdens and dignity would be rejected as the obscenity that they are. It is a condemnation of the kind of society we are becoming that such thinking is actually taken seriously.

(3) The Slippery Slope of Euthanasia

(a) Euthanasia and Society

A common argument against euthanasia is called “the slippery slope” which says that if voluntary euthanasia for the terminally ill became legal, it would not stop there but would lead to euthanasia for others, like the elderly and disabled, and ultimately to involuntary euthanasia. Opponents of euthanasia cite the example of Nazi Germany, which, contrary to what many think, was the first government to legalize euthanasia in 1939, not the Northern Territory. Many German medical personnel, who participated in the gassing of the disabled, were later transferred to extermination camps in Poland where they gassed Jews.

That does not mean all voluntary euthanasia supporters are closet Nazis. They are usually motivated by misguided compassion, like those responsible for the stolen generation of Aboriginal children. The danger is that if voluntary euthanasia were legalized, it will be easier for more extreme views to become accepted. According to Dr Leo Alexander, who worked with the German euthanasia doctors at their post-war trails;

“Whatever proportions these crimes finally assumed, it became evident to all who investigated them that they had started from small beginnings. The beginnings at first were merely a subtle shift in emphasis in the basic attitude of physicians.

It started with the acceptance of the attitude, basic in the euthanasia movement, that there is such a thing as a life not worthy to be lived.

This attitude in its early stages concerned itself merely with the severely and chronically sick. Gradually the sphere of those to be included in this category was enlarged to encompass the socially unproductive, the ideologically unwanted, and finally all non-Germans. But it is important to realise that the infinitely small wedged-in lever from which this entire trend of mind received its impetus was the attitude toward the nonrehabitable sick.”[6]

If voluntary euthanasia is legalized, it will change the way our society views killing, from one in which killing is only justified in cases of war or self-defence (excluding the abortion issue) to one in which killing is justified if others decide that the person does not have a life worth living. Like the German intellectuals of the 1920s had no idea that their proposals for euthanasia would, combined with anti-Semitism, lead to the extermination of 6 million Jews within 20 years, today’s euthanasia supporters do not know what the long term consequences of voluntary euthanasia will be.

(b) The Proof of the Slippery Slope

The slippery slope argument can be seen in issues of morality, music, art, pornography and violence in movies. Values and tastes change and they are often not changes for the better. Once a belief gets its foot in the door, so to speak, the door gradually opens and more extreme and offensive views become acceptable, built on or evolving from the original concept. If there had been no Elvis Presley or The Beatles, there would be no punk rock or death metal. The slippery slope is an easily observable historical trend.

Euthanasia supporters refuse to acknowledge the historical reality of the slippery slope and the potential dangers of what they are promoting. Nevertheless, the surest proof of the slippery slope argument comes from the mouths of euthanasia supporters themselves. Although many do only want voluntary euthanasia for the terminally ill, others have more extreme agendas and see the current debate as the first step to extending euthanasia beyond the terminally ill.

(c) The Elderly

Bill Hayden is not the only one who believes euthanasia should include the elderly. Sir Mark Oliphant has expressed more radical sentiments about euthanasia for the burdensome elderly[7].  Two recent letters to The Mercury in June 1997 called for euthanasia for the elderly[8].  In 1995 a four page feature on euthanasia in The Examiner included an article about a suicidal elderly woman who was not terminally ill[9]. This article was clearly intended to encourage support for euthanasia.

If voluntary euthanasia were extended to the elderly, it would no doubt result in some degree of pressure to die. If some elderly people chose to die because they do not want to be a burden, others would probably fell guilty for staying alive and consuming precious financial resources. It is utterly unrealistic to claim that voluntary euthanasia can be a private act with no consequences for others. The greater danger is not overt involuntary euthanasia but more subtle, coercive euthanasia where people feel pressured by others’ opinions to end their supposedly worthless, burdensome lives.

(d) People with Disabilities

The pro-euthanasia arguments about dying with dignity, poor quality of life and being a burden are just as applicable to people with disabilities as they are to the terminally ill. Beatrice Faust has argued that having to use a colostomy bag is a reason for euthanasia[10]. It is hardly dignified, but many people with disabilities and former cancer sufferers also use them. If euthanasia for the terminally ill were legalized for these reasons, sooner or later there will be a call to give the disabled the right to die for the same reasons.

Two of Australia’s leading euthanasia advocates, Peter Singer and Helga Kuhse, have argued in their book Should the Baby Live? That some infants with disabilities should be killed.

The AIDS Council of NSW (ACON) has prepared a draft euthanasia bill which, along with the terminally ill, also allows for euthanasia for a person “who has a serious physical condition or serious physical illness which causes her or him unacceptable pain or distress.”[11] This can include people with disabilities and probably any illness which causes someone unacceptable distress. ACON did not consult any organizations representing the disabled when they drafted this bill[12]. Instead of the disabled wanting euthanasia to end their suffering, this looks like a case of others deciding their lives are not worth living. ACON is part of a euthanasia coalition with the Voluntary Euthanasia Society and others. Although this bill would greatly extend the availability of euthanasia, voluntary euthanasia supporters keep dogmatically insisting that there is no such thing as the slippery slope.

Most euthanasia supporters believe that a request from someone with an intellectual disability or clinical depression should not be acted upon, yet these people get terminal illnesses like the rest of us. In order to protect them from their irresponsible requests, they would presumably have to be left to suffer whereas others with the same illnesses would have the right to die. This would probably be a violation of the Disability Discrimination Act since it denies equal rights to those with intellectual disabilities.  Alternatively, if an advocate or doctor made the decision for them, then we would have crossed the line to involuntary euthanasia and would be following in Hitler’s footsteps.

(e)  Legal Interpretation

If the Rights of the Terminally Ill Act (RTIA) had not been overturned, it is possible that people, who were not strictly terminally ill, would have been eligible for euthanasia through a literal interpretation of its definition of  a terminal illness which reads, “in relation to a patient, means an illness which, in reasonable medical judgment will, in the normal course, without the application of extraordinary measures or of treatment unacceptable to the patient, result in the death of the patient.” [13]

The Hobart Community Legal Service’s draft euthanasia bill contains the same definition.

In contrast, the Australian Medical association (AMA) defines a terminal illness as;

“An illness which is inevitably progressive, the effects of which cannot be reversed by treatment although treatment may be successful in relieving symptoms temporarily) and which will inevitably result in death within a few months at most.”[14]

Whereas the AMA says a terminal illness cannot be reversed by treatment, the RTIA’s definition includes illnesses which could be treated, but if the patient refuses, he will die. The RTIA also avoided the question of how long a terminally ill person was still expected to live. This Act could probably be applied to many people with disabilities[15] or even someone with diabetes[16] since if they do not receive regular medical treatment, they will die, yet no doctor would think of them as terminally ill.

The slide down the slippery slope could have begun with the RTIA’s vague and medically unsound definition of a terminal illness and this could occur under legislation which merely copied the RTIA and all its faults as some have proposed.

(f) Ineffective safeguards

Although euthanasia supporters argue for safeguards to prevent abuses and the slippery slope, it is doubtful if they would be fully enforced and violators would be prosecuted and convicted. In recent years, there have been several cases of people not being convicted or receiving nominal sentences for the mercy killing of relatives. Often, these were sufferers of Alzheimer’s’ Disease, which is not a terminal illness, yet both the media and euthanasia advocates regard these as contributing to the euthanasia debate. They obviously believe euthanasia should not be limited to the terminally ill. Many will probably be disappointed when they learn that Alzheimer’s is not a terminal illness even though it is often mentioned in the euthanasia debate.

Since juries, who apparently already believe that some lives are not worth living so killing them is not really a crime, have already shown that they are unwilling to convict someone for mercy killing, it is unrealistic to expect them to convict a doctor who abuses the safeguards and kills someone who was not strictly eligible, but who in their eyes  did not have a life worth living, i.e. they had Alzheimer’s’, a chronic illness, a terminal illness and clinical depression or were just too old and feeble. After all, if it legal to kill some people because of their poor physical condition, it is difficult to argue that it should still be a crime to kill others because of other poor physical conditions. A sympathetic court decision could start the side down the slippery slope.

(4) Euthanasia and Political Issues

(a) Euthanasia and the Death Penalty

There is an interesting double standard on euthanasia and the death penalty. Many conservatives oppose euthanasia and support the death penalty, while progressives tend to support euthanasia and oppose the death penalty. While both groups support some form of state-sanctioned killing, I am opposed to both euthanasia d the death penalty because I do not believe the legitimate roll of government includes killing its citizens.

Opponents of the death penalty say it is cruel and barbaric. Their arguments often contain graphic descriptions of how prisoners suffer agonising deaths, yet the lethal injection technology, which is used to kill criminals in the Unites States, is not much different from the lethal injection technology which was used to kill people in the Northern Territory. (In an interesting twist on the slippery slope to genocidal gas chambers argument, the American lethal injection patent is held by Fred Leuchter who claims to have proved there were no gas chambers in Auschwitz.) I wonder if the terminally ill, who were killed by lethal injection in the Northern Territory, experienced similar violent thrashing, suffocating death throes as prisoners executed by lethal injection in the United States. It seems bizarre that many of those who think this technology is too cruel and horrible to use on murderers, believe that killing the terminally ill, and possibly also the elderly and the disabled, by the same means is a progressive and compassionate act. They want to do to vulnerable terminally ill people what they would not dream of doing to someone like Martin Bryant.

(b) State Rights and Federal Intervention

There was never any doubt that the Commonwealth could overturn the RTIA under section 122 of the Constitution. Although the Northern Territory is not a state and has a different relationship with the Federal Government, many conservatives saw the Andrews’ Bill as a States’ rights issue. Although I am a supporter of Federalism, I do not believe it means the States can do anything they want, including kill their citizens. Like when a criminal loses many of his rights, a government, which goes too far, also loses its rights and should be brought back into line. The intrinsic value of all human beings and their right to life must have priority over the right to legislate of any government. It is disturbing that some conservatives thought there was a dilemma here or believed that State or Territory rights were more important. When any government believes its rights and authority are greater than the rights and value of its citizens. That is the foundation of human rights abuses and authoritarianism.

Canberra seems to like overturning Tasmania’s laws and if Tasmania legalized euthanasia, Canberra would surely seek to overturn it like they did to the northern Territory. Several submissions to the Senate Legal and Constitutional Legislation Committee suggested that State euthanasia laws could be overturned using the external affairs power and Article 6 (1) of the International Covenant on Civil and Political Rights (ICCPR) which reads, “Every person has the inherent right to life. This right shall be protected by law. No one shall be arbitrary deprived of his life.” This was not intended to apply to euthanasia and there is no consensus  as to whether it would work[17]. Nevertheless, I believe a case could be made that euthanasia laws contravene Australia’s obligations under the ICCPR since they undermine the value of some people’s lives because of their physical condition, and suggest that the do not have the same right to life and protection from suicide as others and they could lead to people being coerced or pressured into euthanasia because they believe society thinks they are burdens who should be dead. Euthanasia laws are discriminatory and only grant the right to die to those who lives are considered inferior.

Alternatively, since euthanasia laws discriminate against people with intellectual disabilities, perhaps any future legislation could be overturned because it violates the Disability Discrimination Act.

(c) Personal Autonomy

Euthanasia supporters often accuse their opponents of imposing their beliefs on others denying them their personal autonomy and their right to choose. They like to quote the libertarian philosopher John Stuart Mill who argued that laws restricting freedom can only be justified if they prevent people from harming others. I only wish progressives would apply such principles more consistently, not just when they can be twisted to suit their political agenda.

However, in spite of what its supporters claim, euthanasia is not a private act with no consequences for anyone else. As already mentioned, it attacks the value of people’s lives because of their physical condition and would probably result in some people feeling pressured or obligated to die because they do not want to be a selfish burden. Furthermore, Mill’s philosophy cannot be used to justify euthanasia because no true libertarian would believe that the government should be able to decide which people have lives which are not worth living and would be better off dead.

Those, who object to churches lobbying governments to oppose euthanasia, seem to want to deny Christians the same political rights as others. There are hundreds, if not thousands, of pressure groups which lobby politicians to try to persuade them to impose their agendas on others. This is what our political system is becoming. If everyone else tries to do this, surely the Churches have the right to do it too.

Personal autonomy advocates should keep in mind that euthanasia is an act which takes away one’s autonomy and ability to choose forever, like exercising your personal freedom by selling yourself into slavery. Furthermore, there is some evidence that relatives of those involved in euthanasia experience guilt afterwards[18]. Regardless of the nice, progressive slogans, part of them still thinks that they have helped to kill a family member. This is another problem which euthanasia supporters ignore.

(5) The real Need for Legislation

(a) The Rights of the Terminally Ill

Many seem to think  that the terminally ill are artificially kept alive by machines against their will when they should be dead. This might happen in soap operas and hospital dramas but the reality is that terminally ill people are usually not even put on life support in the first place[19] and that doctors withdraw or withhold futile medical treatment from terminally ill patients who are going to die anyway. Although this is sometimes called passive euthanasia, many opponents of active euthanasia support it since the patients die naturally from their diseases, rather than being killed. Patients also have the common law right to refuse any medical treatment even if they may die as a result. If a doctor continued to treat a patient against his wishes, he would technically be committing assault[20]. The terminally ill already have the right to die, but not the right to be killed.  Much of the popular support for euthanasia is probably based on ignorance of these facts.

Withdrawing futile medical treatment is still a legal grey area in Tasmania. I have heard doctors disagree on its legality. The authors of the Parliamentary Labor Party’s options paper Reforming Tasmania’s Laws for the 21st Century seem even more confused. They appear to think palliative care is illegal and a form of active euthanasia[21].

Instead of potentially dangerous active euthanasia legislation, there is a genuine need for legislation which will affirm the legality of withdrawing and withholding futile medical treatment from terminally ill patients and the right of patients to refuse any medical treatment. This type of legislation already exists in some states and is allowed for under the Euthanasia Laws Act 1997. This legislation would not be the first step down the slippery slope of euthanasia. It would be more like  a safety valve relieving much of the pressure for euthanasia. It would be a legal confirmation of existing responsible medical practice and would educate the public about their existing rights.

(b) The Need for Palliative Care Funding

It is not enough to simply vote against euthanasia. Parliament must provide funding to ensure that all terminally people can have access to palliative care which can alleviate as much of their physical and mental suffering as is medically possible. Palliative care should not the privilege of only the wealthy in capital cities. If budgets do not provide for proper palliative care for all who need it, they will be, in effect, creating an unnecessary need for euthanasia, i.e. terminally ill patients with treatable symptoms do not have access to proper palliative care so they want to end their unnecessary suffering by euthanasia. This appears to have already happened in the Northern Territory which has Australia’s worst palliative care. Marshall Perron did not know what palliative care was before the present debate[22]. One cancer patient was not given prescribed morphine by a Northern Territory hospital for her pain[23]. Margaret O’Connor, Chairperson of the Victorian Association for Hospice and Palliative Care has said that Bob Dent’s suffering, which he described in his final statement, could have been alleviated with proper palliative care [24]. One wonders if he would have still requested euthanasia if the Northern Territory ad better palliative care.

One would think that an Act called The Rights of the Terminally Ill Act would be a bill of rights for the terminally ill, but it turns out the only right they have is the right to euthanasia, not even the right to palliative care.

If politicians do not provide adequate palliative care funding and people unnecessarily die in pain, thereby stimulating the demand for euthanasia, they will virtually be killing people to save money.

Conclusion

I do not believe a good politician is necessarily someone who is intelligent or honest, but someone who can understand the implications and consequences of legislation. As the committee makes its recommendations on this issue, I hope that you see behind the slogans and rhetoric and consider the potential dangers of euthanasia for society. Instead of euthanasia, I hope that you will recommend the more humanitarian alternatives.

 

 

 

[1] Senate Legal and Constitutional Legislation Committee, Euthanasia Laws Bill, 1996, Submission No. 3117, Attachment, p 2

[2] Ibid., p 7

[3] Simon Chapman and Stephen Leeder, The Last Right?, Mandarin, Melbourne, 1995, 69

[4] Derek Humphrey, Dying with Dignity, Carol Publishing, New York, 1992, p 79-86

[5] The Examiner, November 6, 1996, p 5

[6] C Everett Koop, To Live or Die?, Word Publishing, England, 1987, p 12-13

[7] The Last Right?, op cit., p 117

[8] The Mercury, June 16, 1997, p 19

[9] The Examiner, June 2, 1995, p 16

[10] The Weekend Australian, June 10-11, 1996, p 26

[11] ADIS Council of NSW, Voluntary Euthanasia Bill 3 (b) (I), p 3

[12] Senate Legal and Constitutional Legislation Committee, Euthanasia Laws Bill, 1996, Submission No. 3503, p 5

[13] Rights of the Terminally Ill Act, 1995, Section 3

[14] Senate, op cit., Submission No. 3229, p 4

[15] Senate, op cit., Submission No. 3146, p 2

[16] Senate, op cit., p Submission No. 10483-10488

[17] Senate Legal and Constitutional Legislation Committee, Consideration of Legislation Referred to the Committee Euthanasia Laws Bill 1996, Canberra, 1997, p 23

[18] Rita Marker, Deadly Compassion, Harper Collins, London, 1994, p 72-74

[19] Brian Pollard, The Challenge of Euthanasia, Little Hills Press, NSW, 1994, p 27

[20] Margaret Otlowski, Active Voluntary Euthanasia, A Timely Reappraisal, University of Tasmania Law School, Occasional Paper No. 1, 1992, p 9

[21] Parliamentary Labor Party, Reforming Tasmania’s Laws for the 21st Century, An Options Paper, 1995, p 38-39

[22] Senate Legal and Constitutional Legislation Committee, Hansard, January 24, 1997, p 29

[23] Senate, op cit., Submission No. 3237, Document 2

[24] The Weekend Australian, October 26-27, 1996, p 1