Interview - Dr Trevor Mudge, Chairman, AMA Ethics Committee, with Howard Sattler, Radio 2SM

MUDGE: Good Howard thanks.

SATTLER: Thanks for joining us on the program. Do you think doctors should do the will of the people just like politicians?

MUDGE: (laughter). Do you think doctors should kill people Howard?

SATTLER: They kill them everyday. And in fact I'll put it to you that today around Australia in hospitals with terminally ill patients, doctors will prematurely end these people's suffering by upping the doses of morphine, which will close down their muscles, including their heart muscles, and they will die prematurely. You and I know that that happens, and I've had first hand experience of it.

MUDGE: That's one of the myths and mistruths that surrounds this whole emotional debate of course, and one of the biggest ones. In fact that is not the case at all. What doctors are doing is what the second motion that was passed at National Conference yesterday says, doctors are using medication to relieve pain and suffering and sometimes - -

SATTLER: To knock people out.

MUDGE: Sometimes that hastens people's death. In fact the evidence shows that it more often prolongs life than shortens it. And one of the things that is missing in this debate is evidence in fact. There's an awful lot of emotion but not a lot of evidence.

SATTLER: You'd expect there to be emotion - -

MUDGE: Of course, it's a very emotionally charged area.

SATTLER: You can't criticise there being a lot of emotion involved because - -

MUDGE: Yes, I think I can if it excludes fact. I mean good fact informs good ethics and good ethics informs good law.

SATTLER: You just said sometimes increasing the doses of morphine hastens people's deaths. That's what you just said.

MUDGE: Yes sometimes it does but more often - -

SATTLER: Well, why isn't that murder?

MUDGE: Will you let me finish? More often it actually prolongs life. But whether it shortens it or prolongs it, it's not only good medical practice to relieve pain and suffering, it's really an ethical and a legal obligation to do so. And what's important is that doctors and patients understand that if they are using medication to relieve pain and suffering, then they are not transgressing the law and they are not acting unethically.

SATTLER: All right. So if you assist people by giving them a massive dose or a dose of barbiturates or whatever Nancy Crick took, what's the difference?

MUDGE: There's a vast difference in ethics, a vast difference, and this is another of the myths that surrounds the debate. The proponents say well there's no difference at all between withdrawing treatment and giving somebody a lethal injection.

There is a very big risk to society in licensing the right to kill.

SATTLER: OK. But if the patient has set out in what I call a "living will", the circumstances under which they want their life ended and their suffering ended, and a doctor went along with that, how would that be contrary to the patients wishes?

MUDGE: It wouldn't necessarily be contrary to the patient's wishes. Patients have a right to kill themselves. There is now no law against suicide in almost every country in the world. Although in the past there have been laws against suicide. Nobody would disagree that a patient has the right take their own life or to have life saving treatment refused or withdrawn.

But what they don't have the right is to ask another member of society, be it a doctor or a lawyer or a radio presenter - a radio journalist to kill them with a lethal injection.

SATTLER: I wouldn't know how to do it, but you would.

MUDGE: It's very easy to do, I could teach you in two seconds. After all in capital punishment which is given by lethal injection in the US, doctors are not involved. You don't have to license doctors to do it.

SATTLER: We know that you know or hope that you know how to deal with the human body. Now, in shutting down the human body you know how to deal with that too. So why not leave it to doctors on the basis that the patient has clearly set it out in writing, the circumstances under which they would want you to help.

MUDGE: You do trust the medical profession by and large, would you still trust them if they killed people?

SATTLER: Of course I would if the people set it out in writing that they wanted to go and this is what they had to be suffering before their life was ended, of course I would.

MUDGE: So there would never be any subtle pressure brought to bear on people. You see the whole crux of the debate is that personal autonomy and individualism says that people should be able to decide the time, the place of their own death. That is the question that you get 90% of the population agreeing with.

Ask them if they think that doctors should kill people and you will get 90% the other way. It's all in how you ask the question. Society has to balance the undoubted need to absolutely respect individual patient autonomy versus the risk to society and the trust that society places in the medical profession of licensing doctors to kill people.

SATTLER: So it doesn't matter to you that the overwhelming majority of the community would like to see voluntary euthanasia legislation introduced? That doesn't matter, you're going to continue to rail against that?

MUDGE: No, we're going to continue to advocate for the position that we take that euthanasia, licensing people to kill others, is too big a risk for society to take - -

SATTLER: Even though that's clearly the minority opinion.

MUDGE: Look, you of all people would know that you can manipulate opinion polls very easily, it's called push polling. And it's a very common technique. As I said it depends on how you pose the question. Should people decide when and how they want to die? Yes. Should doctors kill people? No. It depends on how you ask it.

What we have here is a very complex argument. And I think one of the failures both of us and I have to say perhaps of the media, is that we don't put the arguments on both sides clearly enough. The pro euthanasia argument is easy. It relies on emotion in what is a very emotion fraught and charged area.

The other case is much more cerebral and much more difficult to put, but equally, if not more compelling.

SATTLER: Thank you for your time. And I think you'll agree we've heard your side of the argument.

MUDGE: Thank you Howard, you have.

SATTLER: Dr Trevor Mudge, from the AMA, Deputy President by the way and heads up their ethics group and as you heard he continues to oppose it.

Ends