Dr Trevor Mudge, AMA Vice President, with Neil Mitchell, Radio 3AW

Now, it clearly does happen. I've seen it happen. I've talked to many doctors who practice it - not regularly - not every day, and only with great reluctance, but they do it. And this survey says more than one-fifth of the nation's surgeons do it. On the line is the Vice-President of the Australian Medical Association, the Ethics Committee Chairman, Trevor Mudge. Good morning.

MUDGE: Good morning, Neil.

MITCHELL: You don't trust the findings. Why not?

MUDGE: I think it's very hard to extrapolate from findings -survey findings about attitudes, especially retrospective one, and I guess the election taught us that, didn't it?

MITCHELL: Well, would you doubt that more than one-fifth of the surgeons are involved in euthanasia?

MUDGE: It's not euthanasia. What the surgeons are saying in response to the questionnaire is that there have been times when they have given treatment to relieve pain or improve the quality of remaining life in a terminally ill patient, and that that treatment has had the effect of shortening the patient's life.

MITCHELL: And why is that not euthanasia?

MUDGE: It's a matter of the primary intent. It's exactly the same difference as between murder and manslaughter.

MITCHELL: But…

MUDGE: If the intent is to improve the quality of life, then that's what doctors do and that's what they should be about. If the intent is to take another human life, that's not what the medical profession's about.

MITCHELL: But would you…

MUDGE: And we shouldn't be licensing people to do it.

MITCHELL: But that is really semantic, isn't it? I mean, would you really doubt that there are regular occurrences of doctors prescribing, whether it be pain-killers - I suppose it is usually pain-killers - prescribing pain-killers to a level they know - they know - will hasten death?

MUDGE: No, I wouldn't deny that for a minute, that…

MITCHELL: Okay, well, this is the point of it. People have been denying it.

MUDGE: That's right and proper, because no, what they're doing is improving the quality of that patient's life knowing that it will shorten the time-course of it. And that's good medical treatment.

MITCHELL: But that … to shorten from days to minutes. I mean, that happens, doesn't it?

MUDGE: No, I don't think it does at all. I don't think…

MITCHELL: You really don't?

MUDGE: No, no, I don't. I absolutely don't.

MITCHELL: I'm astounded.

MUDGE: It's not…

MITCHELL: I don't see why we keep avoiding this.

MUDGE: To deliberately take a life in the context of medicine or elsewhere is not ethical, it's not moral, and it's not legal.

MITCHELL: I understand it's not ethical. I'd argue about the morality, and I understand it's not legal. But the point is, I can't see why we keep avoiding the reality that it happens. Now, maybe we're not talking about reducing a life by six months, maybe we're only talking about reducing the length of that life by hours. But that is the same principle, is it not?

MUDGE: The principle is one of improving quality of life, and not taking it. And I think that if, in improving the quality of life, we shorten it, then that's a secondary effect. It's not a primary intention. And look, semantics is very important in this terribly fraught, very emotionally charged area, in which all of us, as patients, relatives, and for those of us who are doctors, find these decisions very difficult.

MITCHELL: Have you ever prescribed or administered such a drug yourself, where you believe life was shortened?

MUDGE: I don't think that's the issue. I'm a gynaecologist. I don't deal much with death. Perhaps, fortunately, most of my work is at the other end of the spectrum, for which I can give thanks.

MITCHELL: See, I think it is an issue because I believe it is one of the great undiscussed issues of this world, but particularly Australia at the moment. And I believe … I can't believe the number of doctors I speak to privately who admit to me that it regularly goes on, and they'll tell me of examples where they've done it. But nobody will actually stand up and admit it publicly. Or very, very few.

MUDGE: They are talking to you of examples where treatment they have given has shortened life. No question. But they're not…

MITCHELL: Deliberately.

MUDGE: …talking about…

MITCHELL: Deliberately. They see somebody suffering, they know, 'If I give them this extra morphine'. They may well already be comatose. 'I give them extra morphine, they'll be dead quicker. And that's fairer on their relatives and it's fairer on them.'

MUDGE: Their suffering will be reduced.

MITCHELL: What, by dying earlier?

MUDGE: No, by the treatment given.

MITCHELL: But if a patient's already comatose, are they suffering?

MUDGE: No. In those circumstances they won't be given it.

MITCHELL: I've seen it happen.

MUDGE: Have you? Well, the law provides a remedy against it.

MITCHELL: Is the law right?

MUDGE: The law's a damned sight righter than allowing it into your relatives' and your patients' death room, and letting the courts decide such things. Such decisions should be made by patients' relatives and their doctors.

MITCHELL: Of course. Of course they should. I'm not arguing about that. But I'm saying it does happen, and it happens … and I've seen it happen, as I said, through consultation.

MUDGE: Not with the primary intent.

MITCHELL: Well, I disagree, and I think a lot of people would have seen it happen and would disagree. And I repeat, we're not talking about weeks, we're talking about hours. Shortening a life by hours. You know, ..... criminal offence.

MITCHELL: Do we need to address it, or do you really think it's satisfactory as it goes at the moment?

MUDGE: Oh, look, I think the debate is very important, and I think people, like yourself, should be making sure that the debate takes place. But I think one of the things that … apart from the fact that it is a difficult emotional area, one of the things is that we have very high expectations of medicine, now. We think that because medicine can improve the quality of our lives so often that it's going to give us a comfortable and easy death. Well, apart from taxes, death is the only certainty in life and it isn't always going to be easy or pleasant, either for the patient or for the family.

MITCHELL: No, which is exactly why I think we need to consider euthanasia as a method of treatment, if you like. The other concerning thing in this survey - and I'd be interested if you believe this - is that in many of the cases the death is hastened without consultation with patient or relatives.

MUDGE: I find that hard to believe also.

MITCHELL: Mmm. Okay, thank you very much for speaking to us.

Ends