[Right_to_die] Doctors have conspiracy of silence on euthanasia -- says doctor

[World right-to-die news (nonprofit)]

Doctor pushes for voluntary euthanasia to be legalised

[This is the print version of story 
http://www.abc.net.au/pm/content/2008/s2236158.htm]


PETER CAVE: The man described as Victoria's Dr Death is hoping to start 
a new dialogue on physician-assisted dying by publishing his own 
experiences.

Dr Rodney Syme has practised medicine for 45 years and in the past few 
years he's been actively campaigning for a change in the law to make 
voluntary euthanasia legal.

He is also campaigning for a private member’s bill on physician-assisted 
death that is set to go before the Victorian Parliament later this year.

Dr Syme spoke to Edmond Roy and admitted that he was being deliberately 
provocative in an attempt to change the law.

RODNEY SYME: Yes, that is one aspect of it although I originally decided 
to write the book in order to try and educate the public about the 
context in which decisions are made by a doctor to help patients to die.

Although there was very strong public support for this concept I didn't 
think the public really had very good understanding of the issues 
involved, so I set out to write a book that described the context of 
these issues.

And that's why there are a number of patients stories in the book but as 
I went further and further I realised that the law was unclear, opaque, 
that it wasn't being prosecuted and where you've got a bad law sometimes 
the only way to change it is by being provocative.

EDMOND ROY: So who is your view, is the law protecting?

RODNEY SYME: Well the law is protecting both doctors and patients, 
because if you think about it, if a doctor is prosecuted for providing 
humane and sympathetic treatment to a patient at the end of their life, 
it would knock the guts out of all palliative care, decent palliative 
care, because all decent palliative care has an intrinsic risk of 
hastening death.

EDMOND ROY: But as you put it in your book, there is an unofficial 
conspiracy of silence within the medical profession, how does that tally 
with what you're doing?

RODNEY SYME: Yes, well doctors are very, very loath to talk about this. 
One of the unusual things about this book is that it gives two people a 
voice.

It gives patients a voice because throughout the book I've been able to 
use letters and comments from patients who are faced with these terrible 
predicaments and it's also probably almost a unique book in being a book 
written by a doctor about his experiences in this area.

Doctors are very, very loath to talk about the things they do. I'm very, 
very far from being the only doctor whose helped patients at the end of 
their life by hastening their death but doctors naturally because of the 
opaque nature of the law are very, very loath to talk about these things.

As such, the medical profession doesn't talk about it, the prosecutorial 
authorities don't talk about it, the police don't look for doctors to 
charge, and so it all goes on under the table, under the carpet and who 
knows what things are happening there that are not being exposed to the 
light of day.

It would be far, far, far better if doctors had some guidelines, some 
regulations it was out in the open and we would have far better 
practice, far safer medical practice than we have at the present time.

EDMOND ROY: You talk in your book about the idea of a natural death, 
dead so to speak. Is that true? I mean, have we reached a point in 2008 
where you cannot die naturally?

RODNEY SYME: Well, people do die naturally if they have sudden death. 
They might be having a shower and die of a heart attack or some people 
do die in their sleep but most people who are dying have a death in 
which there is considerable medical influence.

Very few people who do die do so without some administration of drugs. 
Drugs which inevitably are going to have some influence on how that 
person dies. Natural death would be one in which there is no medical 
intervention at all and that's actually very, very uncommon unless it's 
a very acute death.

EDMOND ROY: How do you as a doctor make the decision about who should or 
shouldn't get advice on how to organise their death?

RODNEY SYME: I don't make the decision, the patient makes that decision. 
All I do, I'm a facilitator, I like to think that I conduct a dialogue 
with the patient and that dialogue is involved in finding out exactly 
what it is that they are concerned about, what suffering they have, 
addressing the question of is there any way in which that suffering can 
be relieved.

My aim is to get people to go as far with their life as they possibly 
can. I'm concerned to make sure that they are suffering from any mental 
illness which would be impacting on their decision.

I'm concerned to see that nobody is putting duress on them to make their 
decision but if after that dialogue it is absolutely clear that the 
well-informed patient is making a rational and clear and persistent 
decision that they do want to bring their life to an end - in order to 
end their suffering, in order for them to end their suffering - then I'm 
prepared to assist them. And that assistance is in the form of 
medication which they then control.

This is the nature of the legislation which has been put before the 
Victorian Parliament in a private member’s bill which will empower 
patients, it won't empower doctors. Patients are empowered by them 
having control of their medication.

They will decide when they when they need to use it or if they need to 
use it, and that is the best possible control you can have against any 
possibility of abuse.

PETER CAVE: Dr Rodney Syme speaking to Edmond Roy. His book,"A Good 
Death: An Argument for Voluntary Euthanasia" is out this week.