Deathly silence

This week, Philip Nitschke agreed to stop giving advice on assisted dying. As part of an arduous list of terms set out by the Medical Board of Australia, he will not discuss any form of voluntary euthanasia with patients, even after they have initiated such a conversation. He will not address workshops on assisted dying, or practise medicine outside the Northern Territory. He will no longer engage in any of the advocacy work for which he is known. His name will be removed from the book he co-authored, The Peaceful Pill Handbook.

In exchange, the Medical Board of Australia will halt proceedings for a tribunal hearing into Nitschke’s professional conduct. He says he does not have the million dollars that would have been necessary to defend it. He had already spent $250,000 in the NT Supreme Court to prove the board’s suspension of his registration last year had been unlawful. Having been silenced after decades of advocacy, he apparently intends to focus on refining a comedy show he took to the Edinburgh Fringe in August. This could be a joke, if it were funny.

“The role of the Medical Board of Australia is to protect the public and manage risk to patients…” the MBA said in a statement. “The Board will be making no further comment on this issue.”

This is not a medical issue. It is a free speech issue. Patients are not to be protected from proscriptions in these orders; they are to be protected from ideas. Great length and expense have been gone to in defence of the status quo.

In Melbourne this week, the day after the board made public its tawdry deal, Andrew Denton delivered the Di Gribble Argument. His subject was the case for voluntary assisted dying. It is an argument with which the majority of Australians agree. But it was put with a force of eloquence that reminded why this issue must be discussed – even if the Medical Board, and the Australian Medical Association and the various palliative care bodies would rather it was not.

It must be discussed because until we have laws in place that allow doctors to support patients who choose to die we will have a system of care that is forced to live in the shadows. That criminalises compassion. That enshrines suffering.

Denton’s research had taken him through systems in Oregon and the Netherlands and elsewhere. Nowhere did he find laws abused. If anything, officials were surprised by how infrequently they were used. In the end, people do not want to die.

But they should have the right to die, and a regulatory system that makes safe that right. The alternatives are imprecise and brutal: prolonged opiate deaths, with and without pain, or lonely and makeshift suicides.

And yet because we do not talk about this, politicians are unmoved by overwhelming support for it. The elderly continue to improvise their deaths, their agony preferred to the shred of leadership necessary to change this system.

Nitschke’s forced silence is the silence of political cowardice. It is a cowardice that will not lift until the public asks loudly for its end. And so we must.

This article was first published in the print edition of The Saturday Paper on October 31, 2015 as "Deathly silence".

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