22 mo opppoclinicalreview ‘P-qo’ h‘Name at end of quote’ here 1 ju2011 MEDICAL WHEN Don Flounders and his wife, Iris, entered a Mexican pharmacy in 2008, it was Val- entine’s Day and they considered their purchase of Nembutal just another act of love in their 60 years together. On the evening of 28 April this year, Don, 81, terminally ill with mesothelioma, and Iris, 88, took the Nembutal. They were found dead the next day, holding hands. A video, later posted at their request on YouTube, captured their last thoughts as they spoke oftheir decision to end their lives. Originally from London, the Flounders and their two children had made the Victorian town ofWarragul their home. In 2007 Don was diagnosed with mesothelioma, and the fol- lowing year, with the help ofeuthanasia advocate Dr Philip Nitschke, he and his wife travelled to Mexico to purchase the barbit- urate commonly used to euthanise animals. “When we got the drugs, I thought I might not want to live on without Don. Three years on, my thinking is the same. We decided this together,” Iris, who had no reported terminal illness, told the camera. “I knew that I would want to have the choice at the end as to how and when I die,” said Don. “I have reached the point where my quality of life is dread- ful. I am dependent on Iris and my worl d has shrunk to this small bedroom. This is no life.” The couple also said they resent the fact they had to t ravel halfway round the world to have the choice of a peaceful death. They hoped their video would help force a change in Australian laws, preventing prosecution ofthose who attend or assist such a suicide. Recent court cases have high- lighted the very real threat of pros- ecution and, with public support for voluntary euthanasia poll- ing at 75% to 85% and attempts by state Greens to legalise it, the euthanasia debate is again in the political and media spotlight. In May, a NSW Supreme Court judge ruled in a retr ial of a woman sentenced to manslaughter for assisted suicide that she would serve no further jail time. Shirley Justins, 62, had already served a 22-month periodic deten- tion sentence after she had placed an open bottle of Nembutal within the reach of her late part- ner, Graeme Wylie, 71, who had Alzheimer’s disease. The manslaughter charge was quashed last November and she pleaded guilty to aiding and abet- ting a suicide in the retrial. On leaving the court, her only comment to the waiting media was: “It is a relief.” For the medical profession, the euthanasia question sits within a wider debate about end-of-life care. Last year a survey of 500 doc- tors by Exit International found that 60–70% of GPs in Victoria, SA, NSW and WA were in favour of euthanasia laws. AMA president Dr Steve Hambleton says the organisation recognises the divergent views about euthanasia among the med- ical community and even within its own ranks, but it does not sup- port the push to legalise it. “We believe that medical prac- titioners should not be involved in interventions that have their pri- mary intention of ending the per- son’s life.” With technology allowing doctors to keep people alive for longer, the question of choice raised by the euthanasia debate should focus more on the unneces- sary prolongation of life, he says. “We have to give people back the ability to make that decision, but we don’t want to do it at five to midnight; we want to do it much earlier,” he says. “It may be that we’re pushing people into desperate places.” Dr Hambleton acknowledges that even with greater control some patients will find themselves in that desperate place where euthanasia is seen as the answer. “We do hear about the extremes but the reality is that the majority are not uPdate Managing abnormal Pap smears 25 real caeunravelling diagnostic dilemmas 30 tetintetinA new era in identifying microbes 34 exual ealinGiving the news of a positive HIV test 33 fcun diabeteAge concerns with bariatric srgery 38 page 24i S t o c k p h o t o . c o m eut ana ia: the medical divide The political debate is heating up, but is the medical profession in favour of legalised euthanasia? Jane Lyonsreports. s
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8/3/2019 Euthanasia: the medical divide - Medical Observer
wife, Iris, entered a Mexicanpharmacy in 2008, it was Val-entine’s Day and they considered
their purchase of Nembutal justanother act of love in their 60years together.
On the evening of 28 April thisyear, Don, 81, terminally ill withmesothelioma, and Iris, 88, took
the Nembutal. They were founddead the next day, holding hands.
A video, later posted at their
request on YouTube, captured
their last thoughts as they spoke of
their decision to end their lives.Originally from London, the
Flounders and their two childrenhad made the Victorian town of
Warragul their home.In 2007 Don was diagnosed
with mesothelioma, and the fol-lowing year, with the help of euthanasia advocate Dr PhilipNitschke, he and his wife travelled
to Mexico to purchase the barbit-urate commonly used to euthanise
animals.
“When we got the drugs, Ithought I might not want to live
on without Don. Three yearson, my thinking is the same. Wedecided this together,” Iris, who
had no reported terminal illness,told the camera.
“I knew that I would want tohave the choice at the end as tohow and when I die,” said Don.
“I have reached the pointwhere my quality of life is dread-ful. I am dependent on Iris andmy world has shrunk to this small
bedroom. This is no life.”The couple also said they resent
the fact they had to travel halfway
round the world to have the choice
of a peaceful death.They hoped their video would
help force a change in Australianlaws, preventing prosecution of
those who attend or assist sucha suicide.
Recent court cases have high-lighted the very real threat of pros-
ecution and, with public support
for voluntary euthanasia poll-ing at 75% to 85% and attemptsby state Greens to legalise it, the
euthanasia debate is again in thepolitical and media spotlight.
In May, a NSW Supreme Court
judge ruled in a retrial of a woman
sentenced to manslaughter forassisted suicide that she would
serve no further jail time.Shirley Justins, 62, had already
served a 22-month periodic deten-tion sentence after she had placedan open bottle of Nembutalwithin the reach of her late part-ner, Graeme Wylie, 71, who had
Alzheimer’s disease.The manslaughter charge was
quashed last November and shepleaded guilty to aiding and abet-ting a suicide in the retrial.
On leaving the court, her only
comment to the waiting mediawas: “It is a relief.”
For the medical profession, the
euthanasia question sits within awider debate about end-of-lifecare.
Last year a survey of 500 doc-tors by Exit International foundthat 60–70% of GPs in Victoria,
SA, NSW and WA were in favourof euthanasia laws.
AMA president Dr Steve
Hambleton says the organisationrecognises the divergent viewsabout euthanasia among the med-
ical community and even withinits own ranks, but it does not sup-
port the push to legalise it.“We believe that medical prac-
titioners should not be involved in
interventions that have their pri-
mary intention of ending the per-son’s life.”
With technology allowingdoctors to keep people alive for
longer, the question of choiceraised by the euthanasia debateshould focus more on the unneces-
sary prolongation of life, he says.“We have to give people back
the ability to make that decision,
but we don’t want to do it at fiveto midnight; we want to do itmuch earlier,” he says.
“It may be that we’re pushingpeople into desperate places.”
Dr Hambleton acknowledges
that even with greater controlsome patients will find themselves
in that desperate place where
euthanasia is seen as the answer.“We do hear about the
extremes but the reality is thatthe majority are not
uPdate
Managing abnormal
Pap smears 25
real cae
unravelling diagnostic
dilemmas 30
tetin tetin
A new era in identifyingmicrobes 34
exual ealin
Giving the news of a
positive HIV test 33
fcu n diabete
Age concerns with
bariatric srgery 38
page 24 i S t o c k p h o t o . c
o m
eutanaia:
the medical divideThe political debate is heating up, but is the medical
profession in favour of legalised euthanasia? Jane Lyons reports.
s
8/3/2019 Euthanasia: the medical divide - Medical Observer