24 November 2020
Article from October 2020 edition of INPractice
You could say Andrew Denton has a death wish
The former television star, who came so very close himself to making a rather large dent in the national obituary pages just a few years back, wants to bring about a humane end to the suffering of the terminally ill - human beings so desperate to end their torment they are driven to often horrific suicides.
Such as the 90-year-old man who, racked with cancer. killed himself by repeatedly firing a nail gun into his head and chest.
The case rocked Victorian Coroner John Olle, and his subsequent haunting testimony rocked a parliamentary committee into end-of-life choices. The upshot was that in 2017 Victoria became the first Australian state to legalise voluntary assisted dying (the law taking effect in 2019).
In South Australia, a voluntary euthanasia bill, the 15th of its kind introduced in this state, was shot down by a single deciding vote in 2016 ... much to the profound disappointment of Denton and indeed the ANMF (SA Branch).
For years the irreverent face of Aussie telly, Denton has a new calling in life as an ambassador for the voluntary assisted dying cause, having successfully championed law reform in both Victoria and WA (the latter expected to come into effect in 2021).
"I was very heavily involved in that South Australian debate and I had the opportunity to speak to many of the politicians sitting in the Parliament, even a lot who opposed it, ultimately didn't vote for it," he recalls.
"And I came away thinking that most of the people I spoke to did diligently engage In the debate. They really tried to understand what the issues were.
"There was a strong, clearly religious campaign against it, leaders of the Church standing up in their pulpits and getting their constituents to write to MPs, attacking the laws. And that had some influence. Certainly, if you're an MP and you think that conservative Christian preferences might go against you, then that's part of your calculus as to 'am I going to be reelected?'.
"So that has an influence, but there's a much more powerful influence, which is not as easily visible and that is that the Church has the most powerful surrogates in this argument, who are doctors and some nurses, but mostly doctors, and in particular palliative care doctors who are representing religious institutions and a religious view of end-of-life care, but who do not represent themselves as that. They represent themselves as senior doctors, giving a purely medical point of view, and they tell politicians some very significant things.
"One is that if more resources were just given to palliative care. then all this suffering need never happen, which is not true. But they tell politicians that specifically.
"And I can tell you for a fact that the then Attorney General of South Australia, John Rau, who was going to support the law, voted against it at the last minute. He crossed the floor at the last minute, which tied the vote, which gave the casting vote to the speaker (conservative Christian Michael Atkinson, who voted against it).
"And he (Rau) gave as his 1eason that he'd been persuaded by palliative care that this law wasn't necessary because they could deal with all suffering.
"So they tell politicians that, and it's a very significant piece of misinformation. And they in some ways try to minimise or make disappear those stories of suffering, they explain it away as system errors or things
we could do better next time," Denton says.
"But, of course, for the person who's just died painfully, and the family that had to witness it, there is no 'next time'."
Denton, famed for his rapier wit and effusive energy, shot to fame in 1988 as the quip-a-minute host of ABC comedy series Blah, Blah, Blah, going on to front sports show
Live and Sweaty, acclaimed social issues show
The Money or the Gun, which often ventured into terrain considered taboo by mainstream networks, and revealed himself as an interviewer extraordinaire with his one-on-one chat series Enough Rope with Andrew Denton. He also hosted his own self-titled variety show and another interview series. called simply
Interview, both on Channel 7.
But it was the death of his beloved father, author Kit Denton, of heart failure in 1997, which helped change the trajectory of his life. "Watching my father, Kit, die remains the most profoundly shocking experience of my life," Denton told the ANMF (SA Branch) Annual Professional Conference in 2016.
Ever-increasing doses of sedatives were not enough to ease his father's pain, prompting Andrew to question why good people are left to die such bad deaths in this country.
Years later he would embark on an overseas odyssey to observe how euthanasia is successfully practised in countries such as the USA. Belgium and Holland where, he says, a raft of safeguards have protected against potential abuse of the system (for example, by negating the ability of greedy kin to coerce an affluent granny to kindly shuffle off her mortal coil).
Denton, now 60, says his television days are behind him, with his new advocacy role prompting him to produce a series of podcasts,
Better off Dead, investigating why people are allowed to suffer needlessly (one interviewee, the late former PM Bob Hawke, called for the introduction of assisted dying laws); a book The Damage Done, a powerful collection of harrowing testimonies from the dying and close family members to the trauma and excruciating pain inflicted on everyday Australians through lack of assisted dying laws; and Go Gentle Australia, an organisation dedicated to bringing about a better conversation around death and more compassionate end-of-hie choices for the terminally ill.
One of the 72 testimonies in The Damage Done is the story of 90 year old South Australian Eileen Dawe. As she was dying of cancer in 2015, Eileen kept a diary.
Despite her stated wish to die and attempts to starve herself, she was forced to endure 17 painful weeks until death finally released her. In her diary she wrote "My country's laws decree 'Death by a thousand cuts for me"'.
Go Gentle Australia notes that voluntary assisted dying is not in fact suicide. that the distinction between suicide and a rational decision to end suffering was clearly understood by New York's chief medical examiner, Charles Hirsch, who investigated the deaths of office workers who Jumped from the Twin Towers on 9/11. Faced with a terrible choice - a slow, agonising death by fire, or a quick death by jumping - many chose to jump. Seeing this as a rational choice to avoid needless suffering. Hirsch refused to classify their deaths as 'suicides'. The same can be said for voluntary assisted dying.
"I've always found this kind of astonishing, that it's ethically okay in Australia for somebody to die slowly and psychologically painfully, like Eileen Dawe, but it's ethically not OK for that same person who is terminally ill and dying to be helped to die quickly and painlessly in a manner they would choose," Denton says.
"There is no social issue on which there is a more sustained and greater public support than this.
"When I first engaged with this issue about five years ago, looking back over polling for the previous decade, and this is many different polls, the average (percentage of public support) was about 70%. That has since moved to over 80% and in some cases towards 90%, and again, I'm not talking one or two polls, I'm talking multiple polls made by multiple, reputable companies asking multiple questions, from the very specific to the very general.
"What is beyond question is Australians support the basic concept that a terminally ill person who is suffering and who can't be helped by medicine in any meaningful way should be offered a choice about whether they want to continue suffering. Australians support that, and they do so in enormous numbers.
And so it really is only, it's probably about a committed 10% of hard-line Christian thinkers who have influenced this debate sufficiently to make politicians hesitate to support it."
This campaign of "fear mongering and disinformation particularly comes from the Catholic Church and their surrogates in the medical profession", Denton says.
"And the most powerful lie is that palliative care can deal with everyone's pain. This is a deliberate fudge because the issue is not pain, it's suffering, which is many things. Palliative Care Australia themselves say they can't ease all suffering, but doctors will still make this representation to MPs.
"They did in South Australia. They went to your MPs and said, 'No, we can deal with everything'.
"Well, they can't, and that's the biggest lie, and that's the lie that makes me most upset. And most of your readers, nurses, will know that is a lie. And to me it is walking away from their obligation to patients. It's a deeply unethical lie.
And, unfortunately, it's a powerful and persuasive lie."
Denton is at pains to stress he has "incredible respect" for palliative care.
"We have brilliant palliative care in this country. The failure to be able to help a certain percentage of people is not about a failure in their system. It's about the reality of people living longer than ever before in history and that chronic illnesses are what many of us die of now. So, it's not a criticism of palliative care.
These things happen despite our great palliative care."
As for Denton himself. he had his own brush with death in 2017 ... in the form of quintuple bypass surgery for heart disease.
"It's a pretty audible knock on the door of mortality. And so: that's the thing, if you nearly have a car accident then suddenly the air smells a bit sweeter, every1hing seems a bit better. I mean, I've always had a pretty healthy appetite for life, but I dodged the bullet. I could so easily have had a major heart attack and just dropped dead." he says.
"I've always been a fan of being alive and not such a big fan of being dead. I'm really not that interested in dying.
"Going into the hospital system reminded me of two things: how good our hospital system is, and how horrible it is to be in hospital."
His first trip to hospital, a two-month inpatient stint at age 17 to fix a badly broken leg caused by a car accident, sparked his ever-deepening respect for nurses.
"I got a chance to look at what nurses do at length. And I've had an undying admiration for nurses ever since, not just for what they have LO do, but for the emotional pressure they carry, which doctors don't necessarily have to carry. And, so, I'm an unabashed fan of nurses."
He's also an unabashed fan for the way the ANMF in SA and Victoria rallied behind the assisted dying cause (Denton's sister Jo is a training officer with the ANMF in Victoria).
"It was fantastic. what the nurses did then to go around and talk to MPs," he says.
"Because you can give MPs an argument, and that is useful. But what is really effective is to give them understanding. And when a nurse walks in and says "This is what we see. and this is what we can do. And this is what we can't', that's very different. Once you understand an issue. then you can begin to properly assess the arguments.
"I'm trying to write a book, which explains what I've seen and how these laws get blocked, but also to tell a story of how Victoria's law came to pass, because it was historic. When it passed the Upper House it made news around the world.
"Historically these are very difficult laws to get through a parliament and it required incredible heroics and courage from a number of people in Victoria: politicians, doctors. nurses. people who were dying and suffering, and families who had witnessed such suffering.
"We often disparage politicians and politics, but in some ways I'm trying to write a love letter to parliamentary democracy (via the new book). because what I saw in Victoria was an entire system, not just the parliament. but a civil service and the nurses' union and others working together to overcome what was viewed to be an impossible task.
"There've been more than 50 attempts to pass a law like that through a state parliament. And every one of them had failed. And then this one got through, there are many reasons for that, and that's what I'm hoping to explain, which is how these laws get blocked, despite enormous public support for them. and the kind of lies that have been told to make politicians hesitant to vote for them.
"I sat in the Victorian Parliament through those debates, which went for a total of 160 hours, all through the night and sitting with me were terminally ill people, wanting those MPs to do the right thing. These were seriously ill people who sat up all night 10 have their presence understood and felt by those MPs.
"And that will give you a sense of the level of need - and I think anger - out there, that this thing which is so necessary, and so right, has been so remorselessly and resourcefully blocked by a very committed and clever group of, largely, conservative Christians."
Suggest that the passing of assisted dying laws in South Australia is only a matter of time and you'll be met with a gentle rebuke.
"I think the first thing is not to assume it's inevitable," Denton says.
"This may be the hardest law for a parliament to pass because of the entrenched opposition, and because it is wrapped in our most primal emotion: Fear. Fear of death.
"But every year that the law doesn't exist. the kinds of deaths described in The Damage Done will continue. There's no doubt about that.
"We printed that book to be handed personally to MPs, and whenever I handed it to them, that's what I'd say to them: 'You need to understand that if you oppose this law, you're allowing these things to continue every week of every month of every year until such a law passes'.
"So don't assume it's inevitable. The forces against are still very, very focused and very effective. And the best thing you c;,n do is first of all talk to your local MP, and by talk I mean make a phone call, or make a visit or write to them. These actions still have real impact.
"So contact your local MP and, also, speak to your doctor. And if your doctor is supportive, ask them to speak up because the voice of the medical community in this debate is, not surprisingly, very, very important."
One such doctor who has been an active assisted dying campaigner for decades, locally, nationally and internationally. is Adelaide palliative care doctor Roger Hunt. one of the guest speakers at this month's ANMF (SA Branch) Annual Professional Conference. "Roger is one of the true heroes of this debate," Denton says, "He goes right back to Darwin".
In 1996, the Northern Territory became the first jurisdiction in the world to explicitly legalise euthanasia, before the Howard Government quickly overturned the ruling and quashed the NT's right to make
such laws.
"Roger was one of the very, very few palliative care doctors prepared to speak the truth, which is 'we really can't help everyone and there are people that need this law' and he copped a lot of censure and pressure within his own profession for doing that. And I really respect someone like that, who's prepared to put other people's interests ahead of his own.
So I have great admiration for him.
As for the role of nurses in this debate? Their testimony. as was the case in Victoria, can be crucial.
"They're the ones getting the requests (from the terminally ill), they're the ones that have been asked, 'please help, do something, do something. And that's very hard for nurses." Denton says.
"You know, in Victoria the vote only passed by four votes in the Upper House. And there were some key votes, which we weren't sure how they were going to go until the very end.
"And one was an independent MP called James Purcell. And he explained in his speech saying he was going to vote for it, that. to help him make up his mind, he wanted to hear from his electorate.
"And he said what ultimately made up his mind was there wasn't a single nurse that he spoke to that didn't say to him, 'please vote for this law'."
"The Damage Done"
can be downloaded as a free e-book from the Go Gentle Australia website: www.gogentleaustralia.org.au/ the_damage_done
Click
here to read the October 2020 edition of INPractice.