A REFLECTION: EUTHANASIA, AGED CARED & SOCIAL WORK.
THE DEBATE surrounding euthanasia has long attracted attention in both our public and political discourse - particularly in regards to voluntary euthanasia.
A concerns grow, regarding increasing rates of dementia, rising costs of health care, an ageing population, and a dramatic shift from paternalized medicine to patient autonomy, there has been a shift in focus on end-of-life-care both internationally and domestically. Lately there has been significant progress with the state of Victoria passing the Voluntary Assisted Dying Act 2017, and with committees on the issue now established in a number of other states, there is reason to predict a major shift in the political climate and willingness to grapple with Voluntary Euthanasia. One-by-one, states and territories in Australia are granting patients with more agency in their end of life care through specific legislative actions.
Euthanasia, however, will always be a contested and multidimensional issue to dismantle and address. For the purpose of this blog, human rights and regulatory frameworks will be discussed in an effort to further conceptualise the complexity of this social issue.
As of current, Australia is committed towards up-keeping seven key human right treaties when discussing euthanasia. The most pertinent duties can be found in the International Covenant on Civil and Political Rights (ICCPR, 2005).
When developing framework and practice of Euthanasia it is integral that the following are acutely engaged with; Right to Life; Freedom from cruel, inhumane or degrading treatment; Right to Privacy; Rights of People with Disabilities; and Freedom of thought, conscience and religion (ICCPR, 2005).
The Right to Life ensures that by protection of the law, no one will be capriciously deprived of their life (ICCPR, 2005). Debate from the UN Human Rights Committee have suggested that laws allowing for voluntary euthanasia and the State responsibility to protect the ‘Right to Life’ are not mutually incompatible or exclusive. Furthermore, the UN Human Rights Committee have stressed significant emphasis on how laws that allow for euthanasia must coexist with efficient safeguards against procedural abuse (UN Human Rights Committee, 2011).
Freedom from cruel inhuman or degrading treatment ensures that the dignity and physical or mental integrity of the individual is protected. This article consequently enforces affirmative obligation on States protection of persons from ill-treatment (ICCPR, 2005).
The Right to Privacy ensures that no person shall be subjected to illegal or arbitrary interference of their family, privacy, or home, no to illegal attacks on their reputation or honour. The case of being refused allowance to euthanasia despite expressed wishes of patient, therefore, would represent interference to the Right to Privacy (ICCPR, 2005).
The Rights of People with Disabilities safeguards that those living with a disability, equally those without, have an inherent right to have their physical or mental integrity and privacy respected and protected. Furthermore, Article 25 of the Disability Convention on the Rights of Persons with Disability obligates States to ‘provide care of the same quality to persons with disabilities as to others, including on the basis of free and informed consent’ (Convention on the Rights of Persons with Disabilities, 2008).
Finally, Freedom of thought, conscience and religion ensures the inherent dignity, autonomy and freedom to exercise agency in one’s own choice independently (ICCPR, 2005). Ultimately, this safeguards the belief of sanctity to life, personal autonomy, or right to choose a ‘good death’.
Whilst Human rights are integral to the development of effective and just frameworks in euthanasia, there is no one identifiable right that requires legislative action toward euthanasia, nor is there a specific right that prevents its legalisation (Christie, 2001).
From a human rights perspective, however, in order to establish an effective framework that supports the legislation of euthanasia practices, sufficient safeguards are necessary to prevent discriminatory or arbitrary deprivations of life. In this regard, there are a number of safeguards that are integral to the fair practice of euthanasia in Australia, including; a person’s condition, assessment of competence, assessment decision-making processes, facilitation of voluntary and informed choice, and oversight of decisions (Australian Human Rights Commission, 2016).
Having established a sound foundation of human rights frameworks, I have come to recognise that the legislation of euthanasia is a necessary movement to the quality of life of our ageing population. As a social worker, a large premise of my work is based upon advocating for human rights and lobbying for increased agency, autonomy and independence in the necessary decisions needed for end of life care. Throughout this research process I have acquired a deepened understanding of the role of social work in developing frameworks and facilitating this practice (Callahan, 1994). A notable shift in my mentality towards euthanasia, however, has been from a focus of the individual, to connection with the client’s family. Social workers in nursing homes, hospice, assisted-living, or hospital settings can support the individual and family, in a holistic and appropriate manner by engaging in skills such as emotional assessment, goal setting, advocacy, active listening and strength-based crisis intervention. In this way, social workers are able to foster a meaningful relationship with patients and families navigating end of life care (Chong & Fok, 2009).
It is clear that our responsibility as social workers is to embrace a human rights framework to lobby and guide future endeavours to legislate and practice euthanasia on Australian shores. Whilst with cautious optimism, I believe that with effective frameworks and appropriate safeguards to monitor and regulate policy and practice legislation of euthanasia in Australia is achievable in all states and territories.
References
Australian Human Rights Commission. (2016). Euthanasia human rights and the law. Retrieved from https://www.humanrights.gov.au/our-work/age-discrimination/publications/euthanasia-human-rights-and-la
Callahan, J. (1994). The Ethics of Assisted Suicide. Health and Social Work, 19(4), 237-244.
Christie, E. (2001) Voluntary euthanasia: Social work attitudes towards moral and policy issues, Practice, 13(1), 51-64, DOI: 10.1080/09503150108415471
Chong, A. & Fok, S. (2009). Attitudes Toward Euthanasia: Implications for Social Work Practice, Social Work in Health Care, 48(2), 119-133, DOI: 10.1080/00981380802533298
UN Covenant on Civil and Political Rights: CCPR Commentary. (2005). (NP Engel, 2nd rev. ed, 2005) 412.
UN Convention on the Rights of Persons with Disabilities (2008) opened for signature 13 December 2006, 2515 UNTS 3 (entered into force 3 May 2008).
UN Human Rights Committee. (2011). Consideration of Reports Submitted by States Parties under Article 40 of the Covenant: Concluding Observations Of The Human Rights Committee – Netherlands, Human Rights Committee, 72 sess, UN Doc CCPR/CO/72/NET (27 August 2001).