A terror management strategy for dementia


The following article was written in response to Dr Philip Nitschke’s latest round of public meetings.

When the headline act in the Nitschke travelling road show’s visit to Bendigo is titled, Voluntary euthanasia: Making choices in the context of Alzheimer’s and dementia, we need to ask some serious questions about what the real agenda might be and who gets hurt.

Why Alzheimer’s and why dementia? Simply because these particular conditions are among those that we who are “past our prime” as they say, fear the most. Don’t think for a minute that Nitschke has a particular heartfelt desire to help Alzheimer’s and dementia sufferers. He is a salesman and what he does is simply marketing. Focusing on our natural fears is about demographics: pitching to an audience who are most likely to buy what he has to sell.

Professor Johnstone from the Deakin University School of Nursing and Midwifery calls the promotion of euthanasia to Alzheimer’s and dementia sufferers a “terror management strategy”. She adds, “Especially when faced by the terrifying knowledge of their own inevitable future death and ‘lack of control’. That euthanasia achieves none of these things is not seen through the illusion.” Nitschke tries to increase the terror factor, but it is an illusion.

The euthanasia bill being debated in South Australia is full of such illusions. There are no real checks and balances here and a doctor need only claim after the fact (note: patient killed already) that he or she thought the patient to be of sound mind and that his or her action, to kill the patient, was reasonable in the circumstances. When is it reasonable for a doctor to give a patient a lethal injection? A doctor could collude with a relative; a doctor could act alone and without consent. No witnesses required. Did the patient consent? No one will ever know.

Why does he limit the lower age for attendance to 50-year-olds? Good corporate citizenship perhaps? Not likely. This is the same person, after all, who was comfortable promoting his Peaceful Pill for troubled teens, who called the death of a young Australian man who had followed his advice on how to kill himself “collateral damage”. I believe that the only reason you “young folks” under 50 aren’t allowed is that there would be a public outrage if teenagers turned up to his meetings. Nitschke would be run out of town like the snake oil salesmen of Wild West fame!

And what of our youth? What do we think happens in the minds of troubled teenagers when they hear the message that rings loud and clear in Nitschke’s sales pitch that some people are “better off dead”? In Oregon following the introduction of doctor-assisted suicide, suicide by other methods went up and not down as predicted. This is consistent with suicide contagion or clusters.

Think about it: if euthanasia and assisted suicide are legal do you really think that the excellent, but often expensive and sometimes time-consuming, treatments that are now available to us will stand as a genuine option if there’s a cheaper, easier solution? Sure, perhaps no one you know would be as callous to suggest to an ailing relative that they’d be better off dead, but subtly in those circumstances people may well come to feel it their duty to die. That was certainly the opinion of the UK’s Baroness Warnock when, a few years ago, she had the audacity to tell an assembly of elderly dementia sufferers that they were an unacceptable expense on the public purse and they had a “duty to die”. Euthanasia and assisted suicide limit choice, not Alzheimer’s or dementia.

Our elderly, frail and disabled deserve to know that they will always be cared for, not killed.

Paul Russell is director of Hope, a national network working against euthanasia and assisted suicide. This article originally appeared in the Bendigo Advertiser and has been republished with permission. 


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