Speaker 1: Well, this is a bit of a strange moment for
Speaker 1: me and probably for you as well. I have to
Speaker 1: tell you something. There's something I have to share that
Speaker 1: has been going on in my life and that I
Speaker 1: now have to tell you about because I'm not going
Speaker 1: to be here for a few months. I've got to
Speaker 1: go off and deal with something. And the thing I've
Speaker 1: got to go off and deal with is cancer. I've
Speaker 1: got a cancer.
Speaker 2: And from his diagnosis with aesophageal cancer in twenty twenty
Speaker 2: four to openly wrestling with end of life decisions, beloved
Speaker 2: ABC broadcaster and longtime voice of Sydney Afternoons, James Valentine
Speaker 2: took his listeners along with him as he stared down
Speaker 2: his own death.
Speaker 3: I'm James Valentine, and this season we're talking about death
Speaker 3: or on this episode, why we don't talk about it enough?
Speaker 4: Now?
Speaker 2: After his passing, that openness continues with James's decision to
Speaker 2: share the fact that he ended his life through voluntary
Speaker 2: assisted dying or VAD.
Speaker 4: He was able to do the VAD, which was really
Speaker 4: important to him, so we were all able to be
Speaker 4: together and just you know, yeah, it was really beautiful.
Speaker 4: In his final moments, he was still concerned about making
Speaker 4: a difference and that was something that was so important
Speaker 4: to him that we mentioned that.
Speaker 2: I'm Nicole Johnston and you're listening to seven AM today.
Speaker 2: Go Gentle Australia founder Andrew Denton on James's decision and
Speaker 2: why some Australians still have trouble accessing VAD despite it
Speaker 2: being legal in all but one Australian territory. It's Wednesday,
Speaker 2: April twenty nine. Andrew, you knew James Valentine and had
Speaker 2: spoken to him about voluntary assisted dying. How did that
Speaker 2: converse sation go? And could you tell us about how
Speaker 2: open he was while facing death.
Speaker 5: About a year before James died, I did a remarkable
Speaker 5: podcast conversation with him and a clinical psychologist, doctor Kerry Noonan, which,
Speaker 5: in James's inimitable style, he titled Let's talk about Death, Baby,
Speaker 5: and we spoke very openly about the difficulty of confronting death,
Speaker 5: the way conversations shut down around it, about how to
Speaker 5: have those conversations, and about what happens after people dian
Speaker 5: how to have those conversations, and it was remarkably raw
Speaker 5: because of James's situation, he was in between his first
Speaker 5: cancer treatment and he had gone into remission. But at
Speaker 5: the end of the conversation, and I remember very clearly,
Speaker 5: I could see James getting emotional and I asked him,
Speaker 5: I said, what are you feeling right now, James?
Speaker 3: Well, if we have a funny connection over many decades
Speaker 3: and to observe you go through, to see you transformed
Speaker 3: doing that, it's been quite extraordinary. And I'll probably just
Speaker 3: contemplated my own death and exactly.
Speaker 4: Right, jameson.
Speaker 5: I think it says a lot about his courage and
Speaker 5: his skill as a communicator that he was prepared to
Speaker 5: be so open about something about which many of us
Speaker 5: ever closed.
Speaker 2: Now, James had decided that he wanted his family to
Speaker 2: share with the public how he died. Why do you
Speaker 2: think that he wanted them to know? And what type
Speaker 2: of impact do you think that kind of conversation and
Speaker 2: sharing will have on the community.
Speaker 5: Look, it shouldn't be courageous, but unfortunately there's a great
Speaker 5: deal of stigma that sits around for untry sister dying.
Speaker 5: It's a stigma that was in many ways created and
Speaker 5: forced and amplified by its opponents, most particularly the Catholic Church,
Speaker 5: who still refer to it as some form of suicide,
Speaker 5: even though leading suicide prevention organizations in Australia sare is
Speaker 5: something distinctly different choice between two forms of death. I
Speaker 5: think they wanted to talk about it because they for
Speaker 5: the same reason that James wanted to talk about his
Speaker 5: illness and his diagnosis and his treatment, that he wanted
Speaker 5: to demystify and model a good way to approach end
Speaker 5: of life.
Speaker 6: We knew it was.
Speaker 4: Coming, we knew there was sort of no way out
Speaker 4: of this, but to be able to sort of do
Speaker 4: it on his own terms was really important to him,
Speaker 4: and to sort of get that choice as much as
Speaker 4: he could in this time, and he really wanted to know,
Speaker 4: like he wanted it to be something that people knew
Speaker 4: that he did that if there's ever you know, he
Speaker 4: could lend his voice to the argument of why this
Speaker 4: is such a necessary thing for so many people.
Speaker 5: The fact that his kids have now gone on air
Speaker 5: and talked about what those last days were like for James,
Speaker 5: the level of control and love it enabled.
Speaker 6: Everyone's bringing a heavy heart to it and it's a
Speaker 6: big loss, but he was so full of joy still
Speaker 6: and we're full of joy and we're laughing along to
Speaker 6: all we clips in the saxophone, and.
Speaker 5: James had a big living wake where he was farewell
Speaker 5: by three hundred of his friends and the people who
Speaker 5: loved him. So it leaves, and I'm sure it's left
Speaker 5: James's family and friends with beautiful memories of James. And
Speaker 5: I understand he played the sacks, which of course was
Speaker 5: part of his essential persona. And you still grieve. Death
Speaker 5: is still the loss it will always be, but at
Speaker 5: least you know that that person has died in as
Speaker 5: merciful of fashion as as possible, and that you've been
Speaker 5: part of that, and you have helped them with their
Speaker 5: final wishes. So I think all that informed James's choice
Speaker 5: and the family's willingness to be so public about it.
Speaker 2: And as you said, his family they've spoken about how
Speaker 2: special the time was leading up to his death because
Speaker 2: they knew it was coming. Is that a common feeling
Speaker 2: for families in this sort of situation.
Speaker 5: We often hear this about people to choose vad that
Speaker 5: even if they were unsure about the process or unsure
Speaker 5: about the original choice of the person going through it,
Speaker 5: they deeply value the fact that they were able to
Speaker 5: have that time without the levels of distress and collapse
Speaker 5: that I was describing before. I've learned there's a scarier
Speaker 5: sea word than cancer, Nicoleon, that's cascade. And sometimes at
Speaker 5: the end of life, your medical condition can really accelerate
Speaker 5: out of control. And the great value of VAD the
Speaker 5: choice of that is it gives you the offer of
Speaker 5: control even if things accelerate very quickly. If you have
Speaker 5: that medication, they're with you, or if you have access to
Speaker 5: that medication, you can still make things happen in a
Speaker 5: way that you want them to be. I'm just thinking
Speaker 5: of a young man whose local palady care service and
Speaker 5: nurses did an extraordinary job. They facilitated him dying on
Speaker 5: the beach, which is where he wanted to die grown
Speaker 5: up near the beach. You know, I think for myself, Gee,
Speaker 5: wouldn't I like to go with a perhaps a decent
Speaker 5: p cocktail and a nice sunset and beautiful music and
Speaker 5: my football team having won the premiership. That might be
Speaker 5: a bit hard, but that's isn't that what we want?
Speaker 5: We want to die as who we are, not as
Speaker 5: a shell of who we are.
Speaker 4: Coming up.
Speaker 2: The barrier is still standing in the way of voluntary
Speaker 2: assisted dying. Andrew voluntary assisted dying is now legal in
Speaker 2: every state except the Northern Territory, but it still doesn't
Speaker 2: feel like something that Australians are really comfortable talking about.
Speaker 2: Why is that, do you think and what examples have
Speaker 2: you seen of that kind of taboo playing out in
Speaker 2: our healthcare systems and in age care.
Speaker 5: It's an enforced taboot still. I mentioned earlier the people
Speaker 5: who opposed this law that it's always been their line
Speaker 5: to describe this as suicide, which has a very different
Speaker 5: meaning in society. The most senior Catholic in this country,
Speaker 5: the Archbishop of Sydney, Reverend Anthony Fisher, at the end
Speaker 5: of last year, described doctors going into hospitals to legally
Speaker 5: assist people to die as quote unquote kill teams. You
Speaker 5: can't get much more aggressive or stigmatic than that, and
Speaker 5: it astonishes me that a man of Christian faith, who
Speaker 5: much is under the banner of mercy would use such
Speaker 5: aggressive and ugly language about medical professionals helping people at
Speaker 5: the end of their life. There's a lot of other
Speaker 5: problems too, you know. We did a survey of most
Speaker 5: of Australia's age care providers in each state and nationally
Speaker 5: to see what kind of information they provide about VAD,
Speaker 5: and only five percent full providers provide full information about VAD,
Speaker 5: so there's an institutional reluctance to talk about this. Doctors
Speaker 5: are often dismissive or sometimes openly hostile towards people make
Speaker 5: requests because of their personal beliefs, and even in the
Speaker 5: Age Care Act, which was rewritten and relegislated last year,
Speaker 5: despite repeated it is from ourselves and others within the
Speaker 5: definition of end of life care, there's no mention of that.
Speaker 5: So this flows down and the kind of behavior we
Speaker 5: see sometimes is inexcusable.
Speaker 2: And yet despite all those problems and the debate and
Speaker 2: the taboo, we've seen the applications for voluntary assisted dying
Speaker 2: rise by more than forty percent in the last year
Speaker 2: or so, but still almost half of patients who start
Speaker 2: the process don't actually finish it. Why do you think
Speaker 2: that is.
Speaker 5: Well, there's a number of reasons. First of all, the
Speaker 5: law itself, the process is not meant to be easy
Speaker 5: to get through. It's meant to be careful and deliberative,
Speaker 5: and that's as it should be. And not everyone chooses
Speaker 5: to proceed. It's a choice, and some people choose palliative care.
Speaker 5: Some people feel just having that control was sufficient for them,
Speaker 5: so they don't choose to proceed. But there's also the
Speaker 5: other factors, as I was mentioning before, hostility and obfuscation
Speaker 5: from doctors when asked. You know, there's a fine line
Speaker 5: between conscientious objection, which the law allows as it should,
Speaker 5: and conscientious obstruction. I spoke to a man in Sydney
Speaker 5: last year who died of cancer, who had been told
Speaker 5: by his doctors he had between three and six months
Speaker 5: to live, which has legally made him eligible for VAD,
Speaker 5: But when he asked them to support his application, they
Speaker 5: just stonebaarded it and they stonewalled him for months, and
Speaker 5: he got to a point where in tears he said
Speaker 5: to his oncologist, I'm dying, Please, I need this information.
Speaker 5: And at the end they gave him the information and
Speaker 5: he immediately switched to somebody that would support his case.
Speaker 5: And when you consider the fact that the Catholic Church
Speaker 5: still provides a lot of Australian health care and is
Speaker 5: deeply opposed to VOD, they describe it as intrinsically evil.
Speaker 5: They are concerned with that are center support VAD that
Speaker 5: will affect their career prospects, and when you have, as
Speaker 5: I said Archbishop Anthony Fisher describing VAD doctors as kill teams,
Speaker 5: you get a sense of how that pressure might flow
Speaker 5: through to people that may support VAD within the Catholic
Speaker 5: health system. We're afraid to say.
Speaker 2: So, Andrew, your organization go gentle. Australia is campaigning for
Speaker 2: telehealth to be an option for patients who want to
Speaker 2: go through this process. Why do you think that's so important.
Speaker 5: Well, it's a matter of equity. Really, Not all sick
Speaker 5: people live near a doctor. Not all sick people live
Speaker 5: near a hospital. The problem with telehealth it's a strange
Speaker 5: one really because it refers to a think of the
Speaker 5: Commonwealth Criminal Code and it's an amendment that was written
Speaker 5: in two thousand and five, long before our VAD laws existed,
Speaker 5: saying that it's illegal to use a carriage service to
Speaker 5: encourage or assist in suicide. But as I mentioned before,
Speaker 5: state's law and leading suicide preventional organizations do not see
Speaker 5: VAD as suicide. They have different things. However, this law
Speaker 5: has been interpreted in different states to mean that doctor
Speaker 5: can't use telehealth or zoom or email or even a
Speaker 5: text to discuss or advise at parts of the VAT process.
Speaker 5: In some states they have to use snail mail to
Speaker 5: send a prescription, so it's a very anormalous law which
Speaker 5: should have nothing to do with VAD and everybody from
Speaker 5: the state's attorney's generals to health ministers to the AMA
Speaker 5: has petitioned the Federal Attorney General, Michelle Roland to fix
Speaker 5: this law. It's a pretty easy fix, you just remove
Speaker 5: VAD from the definition of suicide and the law. But
Speaker 5: complete silence. I find it hard to understand. The Prime
Speaker 5: Minister has always been supportive of this law. He came
Speaker 5: to the launcher go Gentle at the National Press Club
Speaker 5: a decade ago. It's caused unnecessary harmon and it's difficult
Speaker 5: to understand why the government won't act on what is
Speaker 5: a relatively easy fix.
Speaker 2: Andrew, you've been campaigning for this for so long now
Speaker 2: and you've achieved so much, But what is really the
Speaker 2: ultimate goal and where do you want Australia to be
Speaker 2: on this issue over the next five to ten years.
Speaker 5: Well, I would like to see first of all, just
Speaker 5: VAD normalized as a compassionate person centered part of end
Speaker 5: of life care. I would like it to be thought
Speaker 5: of in exactly the same breath as palliative care. You know,
Speaker 5: it's interesting that eighty percent of the people choose bad
Speaker 5: are also in palliative care. These things are all part
Speaker 5: of the same discussion. And I do have a real
Speaker 5: question about taxpayer funded health care facilities which obviously have
Speaker 5: a faith basis, denying legal care to taxpayers in their care.
Speaker 5: I think that's a real issue, and I think we
Speaker 5: need to look at the laws of the governess. You know,
Speaker 5: currently VAD doctors they have no peak organization, there's no
Speaker 5: government support for their needs, for instance, remuneration. So I'd
Speaker 5: like to see them support it. And you know, I
Speaker 5: think that John lennonsong, whatever gets you through the night,
Speaker 5: whether it's VAD or palliative care, or your faith or
Speaker 5: none of the above, these should be all uncontested its paces.
Speaker 5: They should be supported. If your faith tells you that
Speaker 5: that is not something you want to be involved in,
Speaker 5: I completely support you right not to be involved. But
Speaker 5: our laws should recognize that this is legal and that
Speaker 5: people should not be allowed to stand in the way
Speaker 5: of it. Newsflash, We're all going to die, and we
Speaker 5: all want to be taken care of as best we can.
Speaker 5: When we die. And that's my dream that this is
Speaker 5: an uncontested thing for all Australians wherever they live, no
Speaker 5: matter their faith, no matter their beliefs.
Speaker 2: Andrew, it's an important topic and thank you so much
Speaker 2: for speaking with this about it.
Speaker 5: Thanks, Nicole, really appreciate it.
Speaker 2: Also in the news, the federal governments release draft laws
Speaker 2: aimed at forcing e tech companies to pay for Australian
Speaker 2: news published on their platforms. Under the proposed news Bargaining incentive,
Speaker 2: platforms like Meta, Google and TikTok would face attacks of
Speaker 2: two point twenty five percent of their Australian revenue if
Speaker 2: they don't strike commercial deals with news publishers. The government
Speaker 2: says the law is designed to fix gaps in the
Speaker 2: existing bargaining code after platforms were able to avoid payments
Speaker 2: by pulling back from news, and is expected to raise
Speaker 2: up to two hundred and fifty million dollars a year,
Speaker 2: and a UK parliamentary inquiry has cast out on the
Speaker 2: country's ability to develop and deliver nuclear submarines promised as
Speaker 2: part of the Orcist Defence packed. The deal, estimated to
Speaker 2: cost up to three hundred and sixty eight billion dollars,
Speaker 2: is meant to deliver Australia its first US built submarines
Speaker 2: by the early twenty thirties, before delivering British designed submarines
Speaker 2: within the same decade, but the House of Commons Defense
Speaker 2: Committee says decades of underfunding, workforce shortages and low submarine
Speaker 2: availability in Britain could derail the plan. I'm Nicole Johnston
Speaker 2: and this is seven a m. Thanks for listening.