Should prisoners be allowed to access assisted dying?
A victim's right to justice vs a person's right to healthcare
This time last year I was working as a pharmacist in the newly established South Australian Voluntary Assisted Dying Pharmacy Service. As part of this role I supplied medication to people who were deemed eligible to access Voluntary Assisted Dying (VAD) and helped them understand how to self-administer it to result in death, should they decide to do so.
The service was established earlier that year. It had been a steep learning curve, exposing me to a new frontier of practice that was equal parts rewarding and challenging. One of the main challenges was learning to manage the way in which the work followed me home. I would hold people in my thoughts well after our interaction had passed. And, on occasion, I would have my peaceful morning coffee rudely interrupted by a news story run by the weekend newspaper.
One of the more difficult stories to deal with was when the news broke about a convicted paedophile prisoner being given access to VAD. Not surprisingly, his victims were greatly distressed by this and called on the government to override the decision. The story even made the national news, with a prominent TV presenter sharing a public tirade about how unjust this was.
I had situations of my work being in the news before, but I’d never been in a situation where I felt so judged for merely doing my job. A job, that I might say, was pretty bloody difficult at times.
Up until this point in my career, I had been pretty brazen in sharing my philosophical views about the ethical responsibilities health practitioners have in providing person centred care. I used to give a lecture to the pharmacy students called What I Learned About Empathy From Christopher Hitchens based on his writings from Mortality. The premise was, that even if you thought someone was an asshole with a conflicting ideological view from your own, part of being professional is to provide them with the same level of care as anyone else. My tagline was even “Who knows, one day you might be caring for a peadophile”.
Turns out, when you’re faced with the prospect of having to do this in reality, it’s not easy. But just because it’s not easy, doesn’t mean you don’t do it. Because if you believe, as I do, that healthcare is a universal human right, you have no choice. Prisoners have a right to access the same level of care as anyone else does. Paedophiles do too.
I left the VAD pharmacy service around six months ago. But last weekend, once again, I had my peaceful morning coffee interrupted by a news story. This time accompanied by an editorial Accused’s dying wish can never happen again in relation to a story about the alleged ‘Bicycle Bandit’ being given access to VAD.
The editorial called on the state government to block prisoners from being able to access VAD, casting blame on the “bureaucrats making literal life-and-death decisions”. It claimed all issues relating to the victims understandable distress could have been avoided “had SA Health looked beyond its “strict criteria” for VAD and asked more questions of…individual personal and legal circumstances”.
I understand for most people that would be a fairly throw away line. But I’ve worked with the people that were copping that criticism. I know how much they care about serving the public. And I know how thankless their job can be. So let’s pause for a moment and dig into the argument of the editorial a bit more.
One of the key points to establish is that within South Australia VAD is considered a healthcare service, and it must be provided in a way that complies with the rights-based principles and safeguards enshrined in legislation. Individuals are free to have a conscientious objection and refuse to participate in any part of the process. But a healthcare service cannot block someone’s access to VAD.
One of the safeguards employed in South Australia is a bureaucratic compliance review to grant someone a permit to access VAD. It’s critical that the ‘bureaucrats’ doing this job are pedantic about the “strict criteria” of VAD. It’s critical that they are ethical in their conduct, remaining fair and impartial. Asking them to consider an applicant’s “personal and legal circumstances” is asking them to make a values-based assessment which would undermine the integrity of the entire VAD scheme. Doing so could threaten the ongoing availability of this health service for the many people who, unfortunately, need it.
Yes, allowing prisoners access to VAD creates an undeniable tension between a victim’s right for justice and an individual’s right to healthcare. And that feels really wrong. But casting criticism toward the people who are working hard doing a difficult job is not the right thing to do. Asking people to ‘bend the rules’ of legislation is not the right thing to do. Denying someone their human rights is not the right thing to do. And if you feel this is something that you truly can’t accept, well, go and talk to your local member of parliament about amending the legislation. That’s the right way to try stopping this from happening again.