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Medical ethicist believes Australian debate over the legalisation of euthanasia has been far too narrow

TONY EASTLEY: A visiting Canadian medical ethicist says the Australian debate over legalising euthanasia has been far too narrow, looking only at personal rights and not the impact of such laws on the whole society. Dr Margaret Somerville, Director of the McGill Centre for Medicine, Ethics and Law, says the proposed Bills currently before Australian Parliaments are internationally unprecedented. She claims the laws, if enacted, would damage the very basis of our social institutions. Dr Somerville insists her objections are not religious but says that at the heart of the debate are competing views of what it means to be human. This morning, Michael Carey asked her if it wasn't appropriate that most people view the issue in terms of their own right to choose.

MARGARET SOMERVILLE: Yes, and that's correct, but you can't do only that. You have to - if you want to have a community and you want to have a society and you want to .. actually, the interesting thing is there's a paradox in this because in order to be fully humanly individual, you actually have to have a community in which to be that individual. We're not simply isolated atoms or units, and what we have to think about is what would that do to our society? We have to think, as well, what would it do to some of our most important professions? Let's just look at medicine. No matter how you phrase it, no matter how you describe it, you are still authorising doctors to take life, and that's fundamentally contrary to the principles of medical ethics for thousands of years. I mean, we're not talking about changing something that was instituted even 50 years ago. We're talking about thousands of years of cultural response and tradition.

MICHAEL CAREY: And yet, of course, the proponents of euthanasia law would frame it in terms of relieving pain and relieving suffering and say that that's been fundamental to the role of doctors and the medical profession for the same length of time.

MARGARET SOMERVILLE: Yes. But if you think about the conditions that give rise to the calls for euthanasia, you've got someone usually who is terminally ill although some of your legislation isn't restricted to terminal illness. Secondly, they've got unrelievable pain and suffering; and thirdly, they want to die and they're consenting to it and they know what they're consenting to - although again, your Canberra legislation would go further than that. And fourthly, you've got somebody who is able to kill them. Now, if you think about those conditions, none of them are new. As long as we humans have been around, we all inevitably die. Often we have suffering before we do so. Our pain relief is now infinitely better than it's ever been in the past and ....

MICHAEL CAREY: But is it at such a stage that we can say that palliative care relieves suffering to the degree where nobody need remain alive in a painful condition, an excessively painful condition, what they believe is an unbearably painful condition?

MARGARET SOMERVILLE: In the vast majority of cases, good palliative care can relieve pain. There's a lot of education that needs to be done especially outside the palliative care context for other health care professionals. I personally have a total campaign about pain relief treatment. I mean, I believe that doctors should be prosecuted who do not relieve pain. I also believe that giving pain relief treatment, even that which could shorten life, is not euthanasia.

MICHAEL CAREY: You've been in Australia for a week and you're obviously very aware of the enthusiasm with which the euthanasia debate has been taken up in some quarters. Is that the international trend? Is there a sort of one-way movement towards this sort of legislation around the world?

MARGARET SOMERVILLE: There are groups in the communities that are similar to Australia - post-modern, secular, Western democracies that are raising the issue. I find that the Australian position seems to be far in advance - and that's a funny word to use because I think it's actually a retrograde step - but it's far beyond what we're seeing in other jurisdictions. I mean, there's a very - even the people who are pro-euthanasia argue for a much more limited approach than what you would see under current proposals for legislation in Australia.

I have another theory about what's happening, here. I believe that the euthanasia debate is what I call a surrogate debate, that the real issue that we're debating is: Whose vision of the society of the future is going to form what we call the paradigm of the society, the story which informs the society and on which it's based? And I think there's one group of people in this society who have what I would call the logical, cognitive, rational biological model, that we humans are these immensely impressive biological sort of 'machines', and that when we're finished and there isn't anything more we can do in that sense, then we ought to be able to just simply opt out of the race.

MICHAEL CAREY: And how is the state to reconcile that with those who demand a moral vision within the legislative framework?

MARGARET SOMERVILLE: Well, the two views are irreconcilable and they're in conflict. I mean, the other view says: Sure, we're biological machines, but that's only part of us; that there is, as well, what I would call a fourth door, a third dimension or a fourth dimension, because I find the biological model - I would say - two-dimensional. And that other dimension is that there's a mystery about human life, that there's a search for meaning in human life, and that in respecting that and respecting what I would call the natural sacred, because my position doesn't come from a religious base. We can't afford euthanasia. There's something that we have to respect. Even if it's what you would call the mystery of the unknown.

MICHAEL CAREY: But couldn't proponents of the rationalist and humanist school that you referred to, in the first instance, accuse you of trying you to impose your mystery upon their bodies?

MARGARET SOMERVILLE: It's not a matter of me imposing my mystery on their bodies. The issue is that we can only have one of those views that informs the society.

MICHAEL CAREY: So we can only have one tone in a pluralist society?

MARGARET SOMERVILLE: You can only have one fundamental ethic and legal tone about something that is as fundamental as whether you can kill each other. You can't both kill each other and not kill each other. You have to choose.

TONY EASTLEY: Dr Margaret Somerville, Director of the McGill Centre for Medicine, Ethics and Law, in Canada.