IT is a problem for democracy that strident minorities are able to achieve undue notice in some controversial matters.
In relation to end-of-life issues and political judgement, this was highlighted by Stephen Sedley, a former UK Lord Justice of Appeal, who in an essay titled “The right to die” wrote: “Why are MPs so out of kilter with public opinion? Part of the answer, familiar to US politicians, may be fear for their seats. Any votes to be won by support for assisted dying are eclipsed by the damage that can be done by hate campaigns”.
Professional advocacy can suffer a similar fate. Earlier this year, an invitation to Dr Rodney Syme to speak at the Royal Australasian College of Physicians (RACP) annual congress in a session on end-of-life issues was withdrawn. Dr Syme is a well known advocate for legislation to allow medically assisted suicide.
In a statement made to the conference, the College said it had “received feedback from Members shocked that Dr Syme was on the program in the first place and similarly we received feedback from some Members of the College, concerned that he had been uninvited”.
When I was informed that Dr Syme’s invitation had been withdrawn, I wrote to the RACP asking that it respect differences of opinion and maintain an open approach when engaging speakers on matters of controversy and concern. We need to recognise divided judgements and ensure that none are arbitrarily silenced.
The incoming RACP president Dr Catherine Yelland, in an email reply to me, noted the action had followed “a substantial number of College members” expressing “significant and repeated disquiet over several months”. Because of this, she suggested that the College had “acted appropriately in the interest of our collective membership”.
The same letter affirmed that “end-of-life care is a topic of great importance, and one that the College feels warrants a national conversation”.
Yet the plan for such a conversation was stifled by what appears to have been a determined collective effort by opponents of medically assisted suicide, which, at the time, was not matched by contrary opinion.
The issue was on the national agenda again earlier this month when the ABC’s Q&A program “Facing death” reignited the conversation in the community. Well-moderated, there was passionate and civilised debate from panel and audience members with diverse views. An underlying theme was the value of dialogue between advocates of palliative care and assisted dying.
One important component of opposition to assisted suicide stems from concepts of life as God-given and holy. Death is less often regarded so, yet it could be seen as equally God-given and holy.
In the words of St. Francis: “And thou most kind and gentle death, waiting to hush our latest breath, O praise him, Alleluia”.
I think I have support for my request to the RACP from another Francis from the same camp — the current Pope.
In his address to Congress recently, Pope Francis affirmed the need for dialogue, saying, in part: “We know that no religion is immune from forms of individual delusion or ideological extremism. This means that we must be especially attentive to every type of fundamentalism, whether religious or of any other kind.”
He also said: “The complexity, the gravity and the urgency of these challenges demand that we pool our resources and talents, and resolve to support one another, with respect for our differences and our convictions of conscience”.
There must be room for different opinions to be aired within our professional bodies, with the aim that common ground will be sought and respect for difference affirmed.
It would be appropriate for the RACP, and other medical associations, to state an intention and to frame policies that support relevant expressions of “differences and convictions of conscience”.
Emeritus Professor Ian Maddocks is an eminent palliative care specialist, recognised internationally for his work in palliative care, tropical and preventive medicine. He was Senior Australian of the Year in 2013.