News

Euthanasia Goes Against All We Stand For - Young Doctor

Catholic Communications, Sydney Archdiocese,
16 Dec 2011

Samuel Birch

If euthanasia is legalised in Australia either by individual states or the Federal government itself it would be against the bedrock of everything it means to be a doctor, says University of Notre Dame's honours graduate Samuel Birch.

"The primary goal of those with a terminal illness is to be relieved of their suffering. But if a person is in pain, eliminating the person who suffers rather than the suffering itself is against everything a doctor stands for," he says.

At 23, Samuel along with 102 others will make history on 20 December when they are awarded their Bachelor of Medicine and Surgery degrees and become the first-ever medical students to graduate from Sydney's newest medical school.  They are also graduating at a time when the legalisation of voluntary euthanasia is once more being debated, with the Greens and various independent MP's in state parliaments lobbying for a change to current laws to permit mercy killing.

"A doctor wears the white coat of healing and under Hippocratic Oath promises to 'do no harm.' But if a doctor is to become the one that not only wears the white coat of life but also the black cloak of death, I believe this would not only vastly change the medical profession itself but the way people view the medical profession," Samuel says.

Like many others in the medical profession, including the AMA and the South Australian Law Society,  Samuel believes if legalised homicide is allowed in one small area, then it will be all too easy for society to decide that the original circumstance should also apply to other similar circumstances.

"I believe once we let people determine whether their life is or isn't worth living, from complying with requests for voluntary euthanasia, the medical profession will be asked to start making judgements about Alzheimer's and dementia patients and pretty soon this will include babies with birth defects and on it will go," he says and cites the Remmelink Reports on euthanasia practices in the Netherlands where physician assisted suicide was approved by Parliament in 1984 under strict guidelines, although it wasn't until 2000 that a law was passed to protect physicians from criminal prosecution.

Doctors wear the white coat of healing
and vow to do no harm

The Remmelink Reports collected data from more than 5000 for each of its studies, the first of which was carried out into euthanasia practices 1991, which was followed by a second comprehensive study in 1995 with a third completed and published in 2001. (click here to read references and a summary of the reports).

"What the Reports found was that initially in the Netherlands the patients who underwent euthanasia were only those who specifically requested it. But the later studies showed doctors were killing many patients who didn't express consent for euthanasia, or were unable to express their consent or even more troubling, were able to express their consent but never got that chance because they are not even asked," Samuel says.

He also cites instances uncovered in the studies which showed many elderly felt it was their duty to consider voluntary euthanasia not because of suffering but for fear of being a burden on their loved ones.

"The right to die for many has become a duty to die," he says and is convinced legalisation of intentional homicide in any form would remove the bedrock on which the practice of medicine and law in Australia are based.

"Some surveys claim to have found 85% of Australians in favour of euthanasia. But the questions asked in the survey have suspect wording and do not go into any depth about the issue or the consequences," Samuel says and firmly believes that "deep down in their heart of hearts, no one wants to be euthanised."

"I am certain that even those who say they support mercy killing would prefer to keep living if there was a way to relieve their suffering," he insists.

Palliative care offers comfort
and relief rom pain

With palliative care now considered an important area of medicine, together with the development of effective medications to combat both pain and depression, common to many at the end of their lives, suffering can be alleviated. But more important than any medication Samuel believes is the capacity to hope and to look forward to a future, no matter how brief that may be.

"Hope is key," Samuel says and recalls first two patients he had to deal with on his clinical rotations as a student. "One was a man who had an incurable auto immune disease. He had already gone blind in both eyes and his prognosis was pretty bleak. But he was one of the happiest men I have ever met. He told me his ex wife had moved back in to help him, and they had got back together again. He saw his illness as a positive for reuniting him with his wife. Telling me he didn't need to see to run his business, he insisted what was happening to him was not the end of the world. He said everything in life had a purpose and what he was now facing, also had a purpose."

Samuel was inspired by this man and the power of hope. But the other patient he saw in those early first days of clinical rotation was the complete opposite.

"He was about the same age and had MS which had left him with no feeling in his legs. By the time I saw him he had tried to commit suicide twice and was severely depressed. He had no hope at all and saw no reason to keep living."

From both men, Samuel says he realised that it was not so much the circumstances of one's life that affected how you felt, but it was your attitude and how you viewed the world that made the real difference.

"It all comes down to whether you have hope or not," he says, admitting although he had been aware of this at an intellectual level, it was only after meeting these two patients that this fact was brought home to him on an emotional level.

Hope and the capacity to still see a future was essential when it came to helping a 10-year-old Samuel and his family deal with the devastating loss of Samuel's younger brother to leukaemia.

"My brother was 18 months younger than me and was so brave; far braver than I could ever have been. Losing him is something my family will never get over. But over time it is something we've learned to deal with," he says describing the huge impact on his parents and had a dramatic effect on the entire family.

"If we hadn't had hope and weren't able to look ahead to a future, we would have collapsed into a heap."

Not only did this early tragedy reveal the fragility of life to Samuel, but it introduced him to the difficult decisions that may have to be made when the best efforts of doctors can no longer be called on to save a life.

"I remember my parents talking to me about the decision they had to make after doctors told them there was only a small chance he would survive. That's when they had to decide on whether to continue with strong treatments and life-saving measures or instead to make him as comfortable as possible through palliative care."

Life must be valued in both the young
and the very old

During Samuel's medical rotations he spent time in the palliative care wards. "As a fresh young medical student every death seems to be the worst thing ever. The first time I saw a patient certified dead just a few moments after he died, I was so overcome I wanted to cry. As a trainee doctor you tell yourself to put the patient first but don't let emotions get in the way. But I believe it is important to feel. Rapport, empathy and making a connection with your patient help make a good doctor. You need to be able to connect with your patient, not just from an organ perspective but to the whole person. Patients don't just want to be fixed, they want to be healed."

But Samuel warns it is important a doctor not get lost in his grief or empathy for his patient's situation. "I see the way a doctor should be as similar to the incarnation of Jesus who became human but was still God, and able to identify with us without losing who he was. That's not to say physicians should have a God-complex but rather to show the need for them to become like their patients, and identify with them but not lose who they are in the process."

As with the other students graduating from Sydney's four-year-old UNDA's Medical School next week, for Samuel medicine is a vocation, not merely a career.

For the next two years he will be a resident at Bankstown and Campbelltown hospitals and eventually hopes to specialise in cardiology or neurology as well as further his training in bioethics, a field in which he is particularly interested.

But wherever his medical career eventually leads, he will continue fighting against any moves to legalise euthanasia. As he points out, survival is innate in all human beings and our first instinct.

"If we see a young person standing on the edge of a bridge, we are horrified and want to stop him or her taking their life. But if someone is elderly and has lived their life, somehow we think that it less important and less worrisome. But their lives are just as valuable and important. We should be as troubled by their wish to commit suicide as we are by a young person's attempt to take their own life."