Voluntary assisted dying advocate and former President of Dying with Dignity Victoria, Dr Rodney Syme has been awarded an AM, a Member of the Order of Australia, in the Queen’s Birthday Honours list.
In October last year Dying with Dignity NSW was one of a number of organisations asked to respond to Rodney’s nomination. Our President, Penny Hackett, made the following submission.
Dying with Dignity NSW – Dr Rodney Syme
I have consulted with members of the Board of Dying with Dignity New South Wales and others associated with our cause and we are firmly and unanimously of the view that Dr Syme is a deserving recipient for such an honour.
We are delighted to have the opportunity to highlight the achievements of this remarkable man who has distinguished himself as a physician, educator, mentor, author and advocate. In both his personal and professional lives, he is defined by his honesty, courage and compassion.
As a physician and counsellor
Dr Syme’s medical career alone would make him worthy of an Order of Australia award. He is still practicing medicine at over 80 years of age, after a career of over 50 years as a surgeon and physician. While he could have limited himself to treating physical conditions, his conscience and compassion have led him to examine the needs and concerns of patients at the end of their lives.
He has helped thousands of patients as a doctor and also as a counsellor for those facing death, to help them deal with the understandable fear of both physical and existential suffering. He has provided this assistance directly to his own patients and to numerous others who have sought his help. This has often been delivered by telephone to people in rural and remote areas who cannot access expert services or their own doctors lack the professional resources or willingness to have these difficult discussions.
Through this work Dr Syme recognised that giving people knowledge and control over their death has profound palliative benefits and allows people to live out their remaining days without fear of what is ahead of them.
Patient-centred care is supposed to be at the heart of modern medicine. This is often stated, but unfortunately not always practiced. However, it has been the essence of Dr Syme’s philosophy and his medical practice. The compassionate care which he gives to his patients is something all physicians should aspire to provide.
Dr Syme’s professional experience of palliative care and the clear evidence that modern medicine and drugs cannot always alleviate the suffering and distress of dying patients has forced Dr Syme to confront what he describes as his “self-evident truths”:
Firstly, “that giving people control over the end of their lives is one of the most valuable palliative tools we have at our disposal”.
Secondly, “that intolerable and unrelievable suffering is common in terminally ill persons, and often escalates as death approaches”.
Thirdly, ”that some suffering is only relieved by death”.
Fourthly, “that a doctor has a duty to relieve suffering”.
Fifthly, “that a doctor has a duty to respect his patient’s autonomy”.
As a consequence, Dr Syme has been led by his conscience to assist a number of his patients to end their suffering with medication which has hastened their deaths. This is something which frequently but secretly occurs in medical practice all over the world. Dr Syme has bravely spoken openly about his actions to draw attention to the need for an alternative to traditional palliative care and to highlight the unspoken reality that many doctors help their patients to die.
Raising public awareness of death and dying and the importance of end of life care
At a time when modern medicine was making amazing advances in curing illness and keeping people alive, there was little interest or focus on the process of dying and ensuring that patients do not suffer in their last days. The provision of medical care to those who cannot be fixed or cured has not been something which attracted prestige for medical practitioners or funding for research. Ironically, medical advances have often led to the dying process being prolonged and patients subjected to invasive, often futile treatments as they near the end of their lives.
Over the last decades this has begun to change with the development of palliative medicine as a recognised specialty, the ageing population and the breaking down of taboos about discussing death and dying within the community.
Dr Syme has been at the forefront of raising public awareness of the importance of end of life medical care, the need for open and frank discussions about death and dying, advance care planning and the rights of patients to control their care and to refuse treatment.
As Dr Syme says “How we die is important – it is at the core of how our loved ones remember us”.
He has drawn attention to the limitations of palliative care and campaigned fearlessly on the need for a regime where patients have the right to choose how they die. This has forced debate about these issues at a time of increasing concern in the community about having a “bad death” and challenged the medical profession to confront long held views and misconceptions about end of life medical care, ethical guidelines and the individual rights of patients.
Dr Syme’s books, A Time to Die (2017) and A Good Death (2008) have comprehensively addressed the issues surrounding death and dying and end of life care and articulated a powerful case for voluntary assisted dying laws. He has also given numerous speeches and media appearances including on Australian Story in March 2016.
Dr Rodney Syme (middle) with Jan Edwards and Andrew Denton at ‘The Truth About End of Life Choices’ forum in 2018.
As an advocate and campaigner for law reform
For over 25 years, Dr Syme has persistently and patiently advocated for safe and legal voluntary assisted dying laws to enable patients to have to control over the end of their lives. Having this choice is, of itself, a powerful palliative tool and enables patients to live what remains of their lives without fear or anxiety about what lies ahead of them.
He was a pioneer in the right to die movement in Australia. Dr Syme was President of Dying with Dignity Victoria from 1996-2006 and has been its Vice President ever since.
Dying with Dignity NSW (and its counterparts in all Australian states and territories) is an advocacy group seeking law reform to enable people with a terminal illness or irremediable medical condition who face intolerable suffering to seek the assistance of a medical professional to end their lives quickly and painlessly. Such laws have very high levels of public support, with recent Australian polls showing over 80% in favour. Voluntary assisted dying laws have been in place for extended periods in jurisdictions overseas. The evidence is clear that they can be safely and effectively implemented and also enhance doctor-patient communications and delivery of end of life care.
The passage of the Victorian Voluntary Assisted Dying Bill in late 2017 was a watershed moment and it is expected that, over time, other Australian jurisdictions will adopt similar laws. A Western Australian parliamentary inquiry into end of life issues has just recommended adoption of assisted dying laws. A similar
inquiry is underway in the ACT and the Queensland Premier has recently announced plans for a parliamentary inquiry in that state.
It is not possible to overstate Dr Syme’s contribution to these events. Through his tireless advocacy and courageous actions in assisting patients to have control over the way they die, Dr Syme has challenged politicians and law-makers to consider the rights of the terminally ill and establish a regime for patients to request a medically assisted death with appropriate processes and safeguards.
He has been a touchstone for those of us associated with the dying with dignity movement in Australia and around the world.
As an educator and professional mentor
End of life care has not been part of formal medical training. It is unfortunate that many doctors are reluctant to have conversations about death and dying with their patients or lack the professional resources and knowledge to alleviate suffering for people for whom modern medicine has no more answers.
Dr Syme quotes palliative care specialist Dr Diane Meier in saying “a peaceful death must be acknowledged as a legitimate goal of medicine and as an integral part of the physician’s responsibilities’.
Dr Syme has provided invaluable guidance and support to many in the medical profession, particularly GPs, who deal with terminally and chronically ill patients in their daily practice. He has given both professional and personal assistance to numerous doctors dealing with the medical and emotional issues confronting patients (and their families). He has also acted as a mentor and counsellor for doctors in managing their ethical dilemmas and responsibilities and coping with the personal and psychological impacts which practicing in this area of medicine can have on medical professionals.
Among other things, Dr Syme conducted the first Australian GP Accredited Professional Development Workshop on ‘Talking with Patients about End if Life’ in Port Macquarie in 2016.
He is regarded by many in the medical profession as a role model for his professional excellence and academic rigour and for his amazing courage and compassion in dealing with his patients.
I hope this overview of Dr Syme’s many achievements and his contribution to the Australian community will be sufficient to demonstrate that he meets the criteria for an Order of Australia Award. By way of further support I have attached some quotes from others involved in the Dying with Dignity movement.
We understand that the awards are to recognise an individual’s service to the community and, by any measure, the contribution made by Dr Syme to the people of this country has been both profound and outstanding.
President, Dying with Dignity NSW
Dr Syme has the utmost respect and admiration of many doctors. He has been a source of professional wisdom and counsel for many. In my case, he has provided a model for the compassionate assessment and management of dying patients who seek an alternative to Palliative Care. Dr Syme has been a mentor for myself and my Group in person and over the telephone for many years.
His courage and fearless forward-thinking approach exemplifies the very best attributes of the modern physician.
The obvious method of assessing his contributions to the community come from the legions of patients and their carers who, seeking his help when all else had failed, were met with clear compassion and competence at potential cost to himself.
Dr David Leaf
B Med FRACGP FACRRM EMD (ACEM)
Dr Rodney Syme has selflessly given his time and expertise over decades to death literacy for patients and the medical profession throughout Australia.
He was Key Panellist in the first Australian Q&A on Medically Assisted Dying in Port Macquarie, NSW in 2015. He ran the first Australian GP Accredited Professional Development Workshop on ‘Talking with Patients about End if Life’ in Port Macquarie in 2016 at a time when this subject was not part of any medical training.
Dr Rodney Syme has telephoned counselled many end of life patients from rural and regional areas when their own doctors did/do not have the professional capacity to do so.
He is a true Australian hero, totally deserving of Australia’s highest honour.
Convenor, Dying with Dignity NSW Mid North Coast Group
Rodney Syme’s compassion is exceeded only by his absence of fear. I have watched as he has worked courageously for decades in support of the right for people who are suffering and terminally ill to be able to choose a voluntary assisted death. People who most need dying with dignity legislation reform are people who can’t get out and march down main Street…they are too sick. Rodney has been a key representative and voice for them. The successful passing of Voluntary Assisted Dying legislation in the Victorian State Parliament, in no small part, is attributable to the persistence and leadership of Rodney (in combination with Andrew Denton and Marshall Perron). Could one ask more in a candidate for the Order of Australia?
Dr Max Sutherland
Rodney Syme has been a tireless advocate for law reform to permit voluntary assisted dying, that is, legislation that would allow terminally-ill people to choose to ask a doctor to help them die quickly and painlessly.
I believe his achievements deserve national recognition for several reasons.
First, the issue itself is one of national importance. It affects everyone, and 80% of Australians support the concept.
Second, Rodney has worked with considerable success in the interests of Australians without hope or expectation of reward. In this he is unlike some recipients of national awards, who are, though doubtless worthy, simply doing their job at a level of professional excellence.
And third, Rodney exemplifies three personal virtues that resonate particularly with Australians. They are compassion, courage and honesty.
He is driven by a keen desire to reduce unnecessary suffering.
He has made public the fact that he has helped terminally-ill people to die, thus challenging the law and risking prosecution and imprisonment.
And he has participated in the debate about assisted dying in a respectful and intellectually honest way, in stark contrast to some opponents who have deliberately denied or misrepresented the extensive evidence of the successful operation of assisted dying legislation overseas. He has never proffered “alternative facts” to cloak a personal belief system.
I consider him to be very worthy of an award in the Order of Australia.
Former President Dying with Dignity NSW