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23 Nov 2017

Transcript:  AMA President, Dr Michael Gannon, with Fran Kelly, Radio National, Breakfast, Thursday, 23 November 2017

Topics:  Victorian Assisted Dying Legislation,health of asylum seekers.


FRAN KELLY:   Michael Gannon is the President of the Australian Medical Association. Michael Gannon, welcome back to Breakfast.

MICHAEL GANNON:   Good morning, Fran.

FRAN KELLY:   You heard the Premier, doctors are assisting people in ending their lives every single day to help terminally ill patients end their suffering. Why not make it legal and put some regulatory processes around this?

MICHAEL GANNON:   I wake up in Melbourne this morning to a beautiful, sunny day. I'm not convinced it's a better or safer day for Victorians. I wasn't expecting to hear that sound grab at all. That's even more disappointing than what I was expecting to hear. To me, that suggests the Premier still possibly doesn't understand the very clear ethical differences between what used to be called- the old terminology is passive euthanasia, and active euthanasia. Withdrawal of care is not unethical. Not initiating or not continuing futile care is not the same as euthanasia. The law that is very close to being passed in Victoria now is euthanasia, it's physician-assisted suicide, it's at odds with established medical ethics and our concerns about it remain.

FRAN KELLY:   We've had a lot of texts on this from our listeners. Let me just read you a couple. Philippa says: I'm sorry, I can't agree with that statement - the statement we just heard there from the Premier - I've been a nurse for 48 years in palliative care and medical area, et cetera, I've never seen a doctor ramp up the morphine to that level that would kill them. She also adds, I'm glad the bill got through. But, would you agree with that observation from Philippa?

MICHAEL GANNON:   Well it's just an absolute myth that this is happening every day. One very clear premise of medical ethics - it's hundreds of years old - is the doctrine of double effect. If you've got someone who is so ill that the dose of drugs that you use have the secondary effect of ending their life, well then that should not be regarded as the same as giving someone a pharmacological agent whose primary intention is ending someone's life. Now, I have to commend in many ways the Victorian upper house End of Life Choices report and I'd also commend the seriousness with which parliamentarians on both sides of the discussion conducted themselves. But, I must admit, I'm very surprised to hear the Premier, at the end of all this discussion, still trotting out old myths that every day in hospitals, in clinics, in nursing homes, doctors are ending people's lives - it's just a falsehood.

FRAN KELLY:   Well, let's talk another response here we got from a listener. I'm a doctor, the AMA doesn't speak for all of us. This bill will hopefully get us some certainty. You must have heard that from some of your members that they would like some more direction, if you like, around this end of life stage and how a doctor manages the pain and suffering of their patients.

MICHAEL GANNON:   There's no question about that. Our statement very clearly lays out the fact it's parliamentarians’ job to make laws on behalf of their citizens and between our membership we have a significant minority of doctors who support euthanasia physician-assisted suicide. Indeed, there's a great number of doctors that would state that one of the reasons they are not members of the AMA is because of our position on euthanasia, assisted suicide. So there are more important points to make. We think that in the 49 recommendations of the Victorian upper house End of Life Choices report there was the opportunity to codify and clarify end of life decisions. We've constantly said that in recommendations 1-to-48, like improved palliative care, like better codification of double effect, there is an opportunity to deliver better end of life care without delivering on recommendation 49 - euthanasia, assisted suicide.

FRAN KELLY:   Alright. This bill, that looks like it will pass the lower house of the Victorian Parliament next week, makes assisted dying only available to Victorians over 18 years of age and capable of making decisions, and they must be suffering from an incurable illness which causes intolerable suffering and be expected to live for less then six months or 12 months if they suffer from neurodegenerative diseases. The Premier has called it the most conservative assisted dying legislation in the world and, under this bill, a doctor is not allowed to initiate discussion or suggest voluntary assisted dying to a patient. Patients will have to make two formal requests as well as a written statement and the doctor will then prescribe the substance. That seems to be a fair range of safeguards and gateways for people to get through. Why are you still worried about this if people are having to have such a personal role in directing their doctor? Aren't people allowed to direct their doctors in their care?

MICHAEL GANNON:   Well again, one thing that I would like to make very clear is I don't doubt for one moment the motivations of the Premier, those who support this bill on both sides of politics, or any people who advocate on behalf of this. I have no doubt at all that underlying their motivations are compassion for themselves, their families, their fellow citizens; I don't doubt that for a moment. I'll also accept the contention that there are numerous safeguards in this bill. One of the things that is near certain is that- well, we know for example that there's a parliamentary process underway in Western Australia. We know that on 50 or 60 occasions there's been attempts by other jurisdictions to introduce euthanasia, assisted suicide laws, so it won't be the last time we're discussing it. And it won't be the last time it's discussed in Victoria. We know that some of the most high profile euthanasia advocates in the country think that the Victorian bill should have gone a whole lot further. We know that many people see this as the first step.

We remain determined to see that there's no fiddling with this legislation so that it is expanded beyond the narrow scope that started. But be under no illusion, the Victorian Parliament has crossed the Rubicon here. They've changed one of the fundamentals of medical ethics and we're concerned about where it might lead.

FRAN KELLY:   Okay. And can I just ask you finally and briefly; a group of health professionals, former Australians of the Year, including Professor Patrick McGorry; have released an open letter today calling on the Federal Government to allow the AMA access to the Manus Detention Centre. The letter says it's inevitable people become sick and even die through the lack of basic sanitation, food, water and medical care. How concerned are you about the health conditions of these men on Manus Island, and do you seek permission to send representatives there?

MICHAEL GANNON:   Yeah, we are very concerned about what's going on on Manus Island. And the AMA is uniquely placed to put together a team of doctors who have the expertise to independently verify the quality of the health care. Professor McGorry and I are meeting later today. We plan to work together to address, to the extent we can, the serious mental health and physical health emergency that's unravelling in Manus.

FRAN KELLY:   Michael Gannon, thank you very much for joining us.

MICHAEL GANNON:   Pleasure, Fran.

FRAN KELLY:   Michael Gannon is the President of the AMA.


23 November 2017

CONTACT:        John Flannery           02 6270 5477 / 0419 494 761

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Published: 23 Nov 2017