Euthanasia in Tasmania - Assisted suicide in Tasmania - Dying with Dignity in Tasmania

     
Community viewpoints
Viewpoints from eminent Tasmanians...
Legal viewpoints

Advocates speak out on the risks to the vulnerable in our community; the rise of elder abuse; and messaging to persons with disabilities

Written article
Christopher Newell

Medical killing and people with disability

Dr Christopher Newell AM

Associate Professor and Lecturer in Medical Ethics, UTAS

In an incisive piece published in the Australian Disability Review, Dr Christopher Newell observes that the current euthanasia debate has largely ignored many issues for people on the margins, including people with disability and warns that such people cannot be adequately protected in a regime where medical killing is decriminalised. This article was submitted to the Joint Standing Committee on Community Development on the Dying with Dignity Bill in 2009...

 

 

Key Reasons why Euthanasia should never be legalised:

 

Key Points:

  • The debate with regard to medical killing revolves around contested notions of "rights", "human rights" and "human dignity".
  • The use of a human rights approach, upon which values rest many of our community oriented moral and legal norms, stresses the inalienable dignity of people.
  • Medical killing violates that notion of inalienable dignity rather than enabling it.
  • Regarding  "autonomy” - this is an issue for people in community, rather than just an issue of individuals doing what they want.
  • The legalisation of medical killing provides challenges for providing for people on the margins.
  • Medical killing cannot be legalised in such a way to ensure that human rights are preserved and protected. This is particularly borne out by the situation of all those not able forcefully to put their views, especially those regarded by society as "incompetent".
  • Once we introduce a "right to die" we also open a way not only for well motivated people to request euthanasia for such people, but also those with abhorrent motivations. The considerations might range from malice to everyday resources allocation issues for administrators.
  • It would also be possible to argue that someone's "right to die" is being curtailed by virtue of their being unconscious or incompetent. According to such an argument, it would either be discrimination or a violation of a claimed “right” not to do this.
  • Claims to a “right to die” have been shown to lack substance, and to rest upon simplistic notions of rights. Such a claim is in direct conflict with our right to live.
  • It is hard not to believe that the provision of the “technical fix” of medical killing will not have implications for the value we place on human life, people on the margins, and the role of death as a part of life.
  • We cannot pretend that palliative and personal care will provide an adequate fix for suffering, but I would contend that suffering is an important and inseparable part of life.
  • If we are to grant euthanasia based upon the mistaken claim to autonomy, we must do it for all people at all times, not just based upon proximity to death or disability.
  • It is hard not to see calls for euthanasia at times being based upon narrow notions of health which deny disability, aging and death as an important part of life.
  • We should seize this opportunity to call for the injection of the same effort into allocating resources and effort to support people, rather than killing the person. Any other solution is impracticable and a denial of human rights in their fullest sense.

 

 

 

 

Medical Killing and People with Disability: A Critique


Christopher Newell


The debate with regard to medical killing has largely ignored many issues for people on the margins, including people with disability. In exploring these, claims to a "right to die" are critically examined, shown to be wanting, and held to rest upon simplistic and consequentialist notions of rights. It is also proposed that such a claim is in conflict with our right to live. This is also clearly an issue for people in community, rather than just an issue of individuals doing what they want. Communitarian values, and particularly those articulated by the United Nations Declaration of Human Rights, are shown to uphold the rights of less powerful people on the margins, including people with disability. Such people cannot be adequately protected in a regime where medical killing is legalised or decriminalised.


The debate in Australian society, and indeed the Western world with regard to the nebulous concept of "euthanasia" presents particular issues for people with disabilities. These have not adequately been covered in the needlessly polarised media debate. This debate has used the euphemism of "euthanasia" for what is commonly being proposed, which is the killing of people by medical practitioners.


This article will show that whatever one's personal opinion, there are significant issues for those on the margins of society, including people with disabilities, which mean that so-called euthanasia cannot safely be legalised or even decriminalised. Indeed, such measures could actually increase the oppression experienced by people with disabilities.


Of course calls for medical killing occur in a variety of forms and are hardly black and white. This is an issue where personal experiences are used to evaluate our stories and arguments regarding the ending of life. There have certainly been incidences I have known where my silent prayer has been "let this person pass quickly". Indeed, I have a personal fear of dying in indignity and pain, which is common to our human condition. Yet the policy question I shall ask is whether we can adequately protect the rights of people on the margins? In doing this I shall examine critically and refute claims to a "right to die" and individuality which are used by proponents of "euthanasia” .


Consequences, Intentions and the Value of Human Life
Predominantly in society we have proscriptions against the killing of another human being. We might say this because human life is regarded as either important, or indeed sacred, or because it is high in a hierarchy of values we hold, (Kaye, 1990). Alternatively we might also argue this because a world where killing was allowed with no restrictions would mean that none of us would feel safe or happy. Common sense ethical reflection also suggests that intent is an important part of whether or not we see an action as moral.


For example, we may be sitting with a loved one who is terminally ill and in apparent agony, with no hope of saving them. We are holding a syringe of pain killer and have the opportunity to put that person out of his/her misery, and the skill to do this. How would we respond to them begging us to do this? Would we seek to kill them or intend merely to relieve their pain, knowing that we may hasten their death with such a measure? Is there an important distinction for us between relieving pain and intending to kill? Consequentialist thinkers (See for example Kuhse & Singer, 1985; Kuhse, 1994) would suggest that it is the end that is important- the death- but is that so? For many of us there is a difference between an honourable intent and one where, for example, we wish Auntie Jane to die quickly such that we will have a greater inheritance.


A Right to Die?
Certainly, the arguments of proponents of euthanasia have predominantly been formulated to rest upon certain basic claims. The first of these is the claim to a "right to die", which might more accurately be called a claimed "right for another to kill us" where another person is involved. This is based upon a prior right to autonomy or self-rule, which is examined later.


Yet, the claim to a right to die also prompts me to ask a logically prior question – whether or not we have a "right to live" and whether or not that is adequately recognised in law? In Australia and around the world, there are already many human rights violations. While we have the UN Declaration of Human Rights, and anti-discrimination laws, we certainly don't  have an adequately articulated "right to live", which is consistently followed in law, policy and everyday practice. Certainly, as a person with disability I routinely encounter many basic violations of my right to live in society. In short the right to live that I might claim is imperfectly articulated and realised in Australian law and practice, and does not adequately protect Australians with disability and others on the margins.


However, we could argue that we have a right to choose to die, since we have a right to choose- or think- many things. The practical question, however, is whether or not we have a right to enact that choice, and to compel or request others to do it as our agent? In addition, will this curtail the rights of others?


Human Rights
Taking a human rights approach, as spelt out in the UN Declaration of Human Rights, people's rights are held to be inalienable - they cannot be taken away from them. (See for example Fleming, 1995, p.13) For example, I might claim that it is my right to sell myself into slavery. Provided I am single and have no other attachments, at an individual level, this might seem quite reasonable. Yet, the institution of slavery is regarded by many in society as barbaric. In exercising my claim to autonomy or liberty I would also be curtailing that liberty. In this way, the notion of the inviolability of my human rights would be contradicted.


In the same way, I refute that we have a right to die- to violate our inherent human dignity- but would agree that we do have an inherent right to ensure that our persons are not violated, for example by treatment we have refused. We also need to be assured that those rights are protected in law and practice, but I remain to be convinced that we actually have a "right to die". Indeed, which takes precedence for proponents of such a right- the right to live or die? At times they would be in conflict.


Death and Autonomy
Exercising a claimed "right to die" could also lead to an interesting situation. Proponents of euthanasia seem to presume that death is a more desirable state than living with the illness or disability described in either the case studies or other circumstances that they describe. Yet, how can we know this? There would appear to be either a presumption that the state of death is a state of nothingness (presumably for the atheist) or that it is a positive state.


Yet how can we know what life will be like when we are dead? It might well be that it is horrendous. It could be a state of indescribable pain or suffering, or some form of intermittent variation on this. We really don't know. Yet, in most other instances when we claim a right to autonomy, or self-rule, we would also claim the right to be able to rectify a situation where we have made a mistake. For example, even with permanent medical procedures, there is still either a presumption of ongoing autonomy or a desire for this to occur. We can change our mind. Death would appear to be a rather different state about which it is difficult to change our mind. Hence, we face the logical contradiction of constraining autonomy in the name of pursuing it.


Regulation
Of course we could also ask whether medical killing just involves doing what the person requests and is therefore a victimless crime? On these grounds we might, for example, suggest enabling the practice, as is the case in the Netherlands within certain circumstances. Yet, as Pollard suggests, there has been a significant incidence of unrequested medical killing of aged people and younger people with disability in such an environment. (Pollard, 1994)


There is also no doubt that law can have an educative effect. Indeed, we have learnt well when much of our debate these days regarding social policy uses legal language and concepts. There are clear distinctions between decriminalising a practice and permitting, regulating or requiring it. One of the reasons we have not seen much support for just decriminalising euthanasia in Australia, I suspect, is that many would see it as requiring regulation for all sorts of practical reasons, including the concerns regarding abuse highlighted in studies about the incidence of non-requested medical killing in the Netherlands. In legalising and regulating a practice we teach, and introduce, a powerful message, especially in a social context where a dominant belief seems to be, "if it is not forbidden, it is OK". Such an individualistic perspective runs contrary to the communitarian values which have tended to protect those of us who are most vulnerable in society.


Some have also argued that suicide is not a criminal offence, and that therefore means that the law tacitly recognises a right to die. Parsons (1996) Yet is this really the case? Australian law allows for someone physically to restrain another if they are trying to commit suicide, yet prohibits us assisting them. For example, many people with psychiatric conditions, including clinical depression, may attempt suicide in a particular state, and yet when they are over the episode they are experiencing may be glad that they were restrained. In fact many would claim that they were not in their "right" mind and that a curtailing of their autonomy was actually a good thing. In this case we may make the presumption that someone may, on considered reflection, wish to have their autonomy restrained and have their actions constrained. Often in such emergency situations we have not entered into dialogue with people and cannot know the reasoning behind their action·and/or their situation. It is of course both heartless and pointless to have a law which makes suicide a criminal offence, when if the suicide is successful there is no-one to prosecute and if the suicide is not successful, no person with an humane bone in their body would wish to prosecute someone in such circumstances.


In other words, the fact that the law does not forbid something does not necessarily mean that it is recognising a right to die. In this preceding argument I have also demonstrated that various people may be in such a state whereby they are not able to exercise a rational decision and the presumption is that they would wish to. Likewise, the clear presumption in medical law and ethics is that an unconscious person would prefer you to sustain their life in an emergency situation such as that requiring resuscitation, so that they may exercise their autonomy later on. This presumes, of course, that they have not specifically proscribed this or that the treatment is not disproportionately burdensome. It can also be observed that there is evidence to suggest that there is a high incidence of depression present in those people who request medical killing (Hendin & Klerman, 1993, pp., 143- 145)


A Risk to the Vulnerable
Yet is there a case for arguing that legalising medical killing could put the lives of some who are powerless or vulnerable at risk? It certainly may be argued that the proponents of these arguments need to demonstrate their validity, in that it involves the legal curtailment of human freedoms and therefore requires some form of argument to justify it, (Hwang, 1995)


Yet, because the law currently proscribes euthanasia, except in the Northern Territory, the onus should be on the proposers of medical killing to show that it will not disadvantage others. Likewise, for legislators, before they change the status quo there should not only be evidence to support the change, but also there should be some form of "social impact statement" whereby the impact upon all sections of the community is mapped, and it is demonstrated that either there will be no risk (an ideal situation which is very difficult to achieve) or that the risk will be minimal and will not further disadvantage various members of society.


Of course, treating this just as a philosophical argument, I would agree that there needs to be some form of argument for a curtailing of people's actions. This may be found in those arguments which point to the experience on the margins, including people with disabilities in the Nazi regime. These may be used to examine whether or not euthanasia laws could bring about direct or indirect harm to people with disabilities. Certainly, the WORK OF VARIOUS DISABILITY ADVOCATES IN Australia supports such a proposition. (See for example Alister, 1994; Fitzgerald 1994 & 1996; Galbally, 1995; Hume, 1995; Leipoldt, 1996)  Likewise the work of Robert J. Lifton (1985) regarding the medical killing which occurred in the Nazi years also supports such an argument. There would certainly seem to be some similarities to the Nazi regime, although the discrimination which occurs in today’s society is much more insidious.


Certainly discrimination against people with disabilities may not have been totally based upon hatred of people with disabilities (although this could be said for the Jewish race) Rather, those were designated by Nazi ideology as “life unworthy of life” were either blamed for society's misfortunes or seen to exist to the detriment of both themselves and society. This is in accordance with the social Darwinist principles that we see today, found in the notion that we should ensure that only the fittest survive, and those notions of fitness and goodness are defined very narrowly.


In current Australian society the social Darwinism which informed Nazi doctrine lives on in a much more subtle form. It is found in the ideologies which support the screening and termination of those with genetic disease, which was actually one of the corner stones of the social Darwinist movement in the early 1900’s, not only in Germany, but in all Western societies. Such thinking locates problems within the individual as opposed to the narrow norms provided by society. It uses narrow notions of health to suggest that some of us are less fit, or would be less desirous of life if we only had a right perception. It also justifies the termination of many foetuses that are deemed to have a risk of particular disabling conditions, and the sterilisation of people with disabilities.


Stereotypes which Disable
Such stereotypes which dominate negative conceptions of people with disability are the knowledge utilised by many of us, including medical practitioners, to decide upon the quality of life of a person and whether they should actually live. Predominantly, the dominant medical literature does not recognise the social nature of disability, as opposed to those of us with disability being seen as defective collections of body parts with inherent limitations. (Newell, 1994)


The use of these stereotypes for decision making by health care practitioners and other care givers is perhaps one of the strongest practical arguments for allowing regulated and controlled medical killing. In this way, the argument may be formulated, practices which are undertaken away from public scrutiny may be properly reviewed. For example, medical practitioners believing that a particular state is unbearable may decide to terminate the life of either a neonate with spina bifida or an adult with a physical or intellectual disability.


It may certainly be claimed that there should be increased scrutiny of health care settings and practitioners, a point which could be taken up in law reform so as to make sure that actions taken with regard to all people are not discriminatory. However, we have not then addressed the oppressive nature of the knowledge used to make decisions about such people. (Abberley, 1987) Likewise we have not addressed the underlying reasons for people either seeking to die, or requesting that others be killed.


Choice
Proponents of medical killing also use the argument that it is a person's choice. This has certainly included a few people with disability. (See for example, Hwang, 1995). Yet, if social policy were to recognise such an unfettered right to autonomy why should we constrain that choice to a medical practitioner?" Current formal medical training does not cover how to kill someone, although certainly that could easily be rectified. In other areas of life, we allow important decisions and rituals to be administered by officials that have some standing in life. For example, nurses, and the types of people who can witness signatures or invigilate examinations: not just medical practitioners, but ministers of religion, school teachers and the like. It would be cheaper and easier and perfectly feasible to have tablets or injections freely available, if that is to be deemed someone's right. Alternatively, specially trained people could be provided and at a lower cost to the community or individuals than a GP. Indeed, why should that claimed right be constrained by judgments about disability or a likely time before we die?


In addition, the involvement of the medical profession in administering death according to some form of bureaucracy may be a barrier to the "good death" that we all seek. Such an issue is highlighted by those who speak of the development of suicide pacts with the active assistance of medical practitioners. The regulatory hoops provided by the Northern Territory (1995) legislation, as amended, which requires certification by three medical practitioners who meet various criteria, can hardly be seen as conducive to the "good death" we all seek. It is also pertinent to consider that one of the aims of the disability rights movement in Australia has been to remove ourselves from needless "medical dominance", yet the bureaucratic regulation of death could actually be far from liberating in effect.


The Northern Territory situation also suggests that rights have not been well protected by a process which saw parliamentary debate and proposal many amendments continuing until the early hours of the morning, and great uncertainty for some days as to the exact nature of the legislation that had been passed. As many commentators also noted the Act was unworkable and needed to be amended due to poor research as to the current qualifications of psychiatrists. (Manne, 1995)


Further, such regulation as offered by the Northern Territory (as amended this year) also allows and requires medical practitioners to make decisions as to who they or their colleagues will kill. It relies upon the judgments of professionals who are unlikely to have direct experience of having serious disability or terminal illness. In such circumstances it seems an unwarranted form of paternalism for doctors to decide who merits euthanasia and who doesn't.


Distress and Suffering as Grounds?
Another related argument which may be put in support of medical killing is the claim based upon suffering and distress, which certainly medical practitioners are called upon to assess under the Northern Territory legislation. Indeed, the importance of listening to a person's request to die cannot be over-stated. In my experience often that request to die is an initial cry for help and/or an opening up of a dialogue. It is a very human cry of despair and one which I have experienced myself in requesting death at the hand of a health care professional. Yet are distress or suffering adequate grounds for someone to administer death? People are greatly distressed by a variety of things including relationships breaking up, the death of a loved one, and so on, but quite clearly it would be ridiculous to many notions of common sense ethics for us to suggest that this is grounds for death.


Further, as Brendan Nelson pointed out as President of the Australian Medical Association (Anon, 1995, poll), how do you actually regulate against ill will or abuse in administering death? There could also be instances of the situation of people which give rise to great sympathy in a doctor who may decide to hasten a decision to administer a terminal injection or the like. At times this may be a medical practitioner putting them out of his/her suffering! I am also reminded of instances of relatives talking in corridors, impatient about the death of a family member who is dying, already dividing the spoils. These are situations that are very difficult to guard against. The motivation and intent behind someone's request to die, or the request for another in the case of an advocate, is particularly important.


Communitarian Concerns
This also brings us to the problem with the approach predominantly fostered by proponents of euthanasia when claiming the rights of an individual. For we are discussing not just individual wishes, but the interests of the community at large. The community is comprised of a variety of people, many of whom do not have the influence and control of resources necessary to highlight concerns regarding those most vulnerable in the community. The libertarian arguments proposed by such as Charlesworth (1993) conveniently ignore such matters as power relations, and the social construction of reality in accordance with ableist and ageist values, in putting their arguments.


This factor becomes crucial in examining the creation by statute of a category of people who may die. The moment that we actually suggest that it is allowable for certain categories of people to die, and understandable, then we set them apart and value them differently. Such people are predominantly less powerful, and certainly subject to dominant ageist and ableist notions in the community. This has major implications for the provision of personal care and support for people with disabilities, aged people, and the provision of palliative care for those who are dying. There is a fundamental risk of people also being put under pressure to request a quick death, which would be much more resource effective than a slower death, compared with expensive personal/palliative care, which is under their own control.


The fact that the debate in Australia regarding so-called voluntary euthanasia so far has mostly avoided the issue of what to do for those labelled as "incompetent" is in itself a lesson. This is particularly found in examining the situation of people with intellectual disability, a reality that the Northern Territory legislation did not even consider. This was no more apparent than in recent interviews of various Australians by Ian Parsons and I for our recent book (1996). One of the case studies we used to focus the thought of interviewees was that of "Abdul", a young man with intellectual disability and progressive cancer who has no speech but who would appear able to covey his emotions. This is hardly an atypical situation. Those interviewed who advocated euthanasia suggested that they were not sure what to do. Marshall Perron, the architect of the Northern Territory legislation, even admitted that these situations were avoided "like the plague" (Parsons & Newell, 1996, p.94).


The avoidance of consideration of the situation of people who are in such a marginalised situation certainly seems discriminatory and suggests that the members of the Northern Territory legislature who voted for the legislation valued the situation of people like Abdul less than others.
What are we to do for the Abdul's of this world? We certainly cannot just avoid them "like the plague". Indeed, once we legalise medical killing for people we cannot ignore any category of person. It is even possible to conceive of a situation where, once a "right to die" is established, anyone could claim that not allowing for people like Abdul to be killed would be an act of discrimination. Could the Disability Discrimination Act 1992 be used in a way contrary to the values of the Human Rights instruments that inform the anti-discrimination legislation in this country? The failure of parliaments to consider such issues in legalising so-called "voluntary euthanasia" will merely leave it to the courts and covert practices, furthering the oppression of people on the margins, such as people with disability. This example also shows how so-called voluntary and involuntary euthanasia are inextricably linked.


Here again we also see the importance of considering the legalisation of medical killing as an issue for the community, as opposed to individuals whose actions have no ramifications upon others. There are few situations where a decision we take may not have a wider impact. For example, a smoker may claim that the decision to smoke is theirs alone. Yet the decision to smoke in various situations may adversely impact upon the health of others.


Conclusion
In the end, the debate with regard to medical killing revolves around contested notions of "rights", "human rights" and "human dignity". Yet the use of a human rights approach, upon which values rest many of our community oriented moral and legal norms, stresses the inalienable dignity of people. Medical killing violates that notion of inalienable dignity rather than enabling it. The different interpretation of "autonomy" is of course the reason for such differing opinions in this debate. Further, this is clearly an issue for people in community, rather than just an issue of individuals doing what they want.


Overwhelmingly the focus in deliberations regarding medical killing has been acute illness, such as that occasioned by AIDS, rather than pertaining to chronic disability. Likewise, in general the focus of those arguing for euthanasia has been on achieving the end desired, rather than addressing some of the issues pertaining to disability, and especially intellectual and psychiatric disability. Yet this article has sought to show that the legalisation of medical killing provides little realised challenges for providing for people on the margins. Clearly medical killing cannot be legalised in such a way as will provide adequately for all people, ensuring that human rights are preserved and protected. This is particularly borne out by the situation of all those not able forcefully to put their views, especially those regarded by society as "incompetent". Once we introduce a "right to die" we also open a. way not only for well motivated people to request euthanasia for such people, but also those with abhorrent motivations. The considerations might range from malice to everyday resources allocation issues for administrators. I have shown that it would also be possible to argue that someone's "right to die" is being curtailed by virtue of their being unconscious or incompetent, and that such a claimed right means that they should have their rights exercised for them – be killed. According to such an argument, it would either be discrimination or a violation of a claimed “right” not to do this.


Further, claims to a “right to die” have been shown to lack substance, and to rest upon simplistic notions of rights. It is also proposed that such a claim is in direct conflict with our right to live.


It is hard not to believe that the provision of the “technical fix” of medical killing will not have implications for the value we place on human life, people on the margins, and the role of death as a part of life. We cannot pretend that palliative and personal care will provide an adequate fix for suffering, but I would contend that suffering is an important and inseparable part of life. Indeed, if we are to grant euthanasia based upon the mistaken claim to autonomy, we must do it for all people at all times, not just based upon proximity to death or disability.


In addition, it is hard not to see calls for euthanasia at times being based upon narrow notions of health which deny disability, aging and death as an important part of life. We should seize this opportunity to call for the injection of the same sort of effort into allocating resources and effort to support people, rather than killing the person. Any other solution is impracticable and a denial of human rights in their fullest sense.


Notes
For an exploration of the concept of "oppression” see Abberley (1987).
For an accessible exposition of this, with particular regard for people with disability, see Parsons (1966).
This is recognised both in common law and the Parliament of Victoria Medical Treatment (Enduring Power of Attorney) Act 1989.
Wolfensberger (1994) provides a useful commentary on such values.
See For example the story of "Charles" in Parsons & Newell (1996).
For a minimalist argument with regard to the role of the state and a libertarian approach to euthanasia in the Australian literature, see for example Charlesworth (1989) & (1993).


References
Abberley, P. (1987). The Concept of Oppression and the Development of a Social Theory of Disability,  Disability, Handicap & Society, 2(1) pp. 5-20.
Alister, J. (1994). Values in end-of-life decision-making: some implications for people with disability, Australian Disability Review, 4. pp. 45-53.
Anon. (1995). Mercy killing could be abused: Nelson, Mercury. (27 February), p.11.
Charlesworth, M. (1989). Life. Death, Genes and Ethics, Crows Nest: ABC Enterprises.
Fitzgerald, J. (March, 1995). When 'Quality of Life' Becomes 'Quality or Life', It's time to challenge the concept, Health Issues 42:19-22.
Fitzgerald, J. (1996) Challenges to the Lives of People with Disability. Queensland Advocacy Incorporated Newsletter: 20-28.
Fleming, J. (2 June, 1995). Compassion would rob us of rights, The Australian: p.13.
Galbally, R. (19 October, 1995). Killing the disabled, Herald Sun: p.13.
Hendin, H., &. Klerman, G. (1993). Physician-Assisted Suicide: The Dangers of Legalization, American Journal of Psychiatry, 150 (1) 143-145.
Hume, J. (1995). Putting us out of your misery: Euthanasia: Why I am against it, Quad Wrangle, (Spring), pp. 2-5.
Hwang, K. (1995). For Our Own Good, New Mobility, 6 (25): 10-12.
Kaye, B. (1990). The Value of Human Life and Ethical Practice in Medicine, St Mark’s Review, (142): 26-33.
Kuhse, H. (1994). (ed). Willing to listen – Wanting to Die, Ringwood: Penguin Books.

Viewpoints

Viewpoints on euthanasia and assisted suicide from eminent Tasmanians