Select Committee on Euthanasia Submission No.1112 Tonti-Pilippini N
Tabled Paper 1622
Tabled Papers for 7th Assembly 1994 - 1997; Tabled papers; ParliamentNT
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6 community founded upon respect for the worth and dignity of each. The promotion of euthanasia is in itself negative in that respect. Dignity is reductively, and hence falsefy, equated with autonomy. Human, dignity includes respect for autonomy but much more. There is little dignity, for instance, in voluntarily selling oneself into slaver^ or prostitution, or in voluntarily fabricating research results, or deceiving investors and defrauding them of their funds. I Reduc ionism is even more evident in the sort of reasoning which seeks to identify those elements of being a human being that make them \)aluable - the sort of logic that looks to sentience, self- consciousness, capacity to reason and the like, as the determining characteristic of being valued. To say that a human being is self- conscious or sentient captures merely one element of a complex. It Is not one single element that makes us one in community with others of our kind. Rather it is the complex interplay of aspects of the Individual and the many relationships both distant and intimate, passive and active that endow that being with significance for all of us. Odious discrimination on the basis of the comparative capacity to function of members of our community, using grounds such as those listed above, harms not just the individual so excluded, but everyone of us. I The reductionism involved devalues who each of us is as a whole |by seizing upon just one or two aspects of who we are. Thus, from the severely brain damaged neonate or foetus to the persistently comatose dying patient, all have meaning and significance as members of our community. That membership is a matter of who they afe, rather than what they do or contribute or which capacities they have. Like all moral decisions, medical treatment decisions have a significance not just for the individuals directly involved, the patient and the practitioner, but for the entire community. This is no more evident than in the care of the dying. The quality of the care given, :not the so-called quality of life, is what is central. In my experience as a hospital ethlcist, "quality of life" is usually a third person, judgement made in order to justify discriminating against the patient; and providing less than adequate care. At the Jsame time it is important to stress that adequate care does not necessarily involve doing all that can technologically be done. Essential to adequate care is at least basic care3 which in itself is necessary to express support for the patient as an individual and a member of the community, and in that way asserting respect for his or her human dignity and enacting the dignity of the caregivers. 2. It is a matter of great concern that health care funding is now being directed more to doing procedures than to providing care. Thus hospital culture Is being changed so that hospitals no longer care fo;r the sick. They just do procedures. The sick are either neglected or they are cared for at home, usually by women, isolated, unpaid j and under-resourced. For elaboration on this point see Nicholas Tonti-Filippini "Casemix: A Disaster for the Disadvantaged" Journa l o f Hospital and Health Care> February 1995 or Blame Casemix, Not Just the Budget Cuts" Quadrant May 1995 (Forthcoming)