Health Report first broadcast by ABC (Australian Broadcasting Corporation) on 25 June 1990 Click here to listen

 

 

1990
IVF and Feminist Ethics. Paper presented at the First National Foundation for Australian Women conference, University of Canberra.


The first occasion on which I began to take an interest in the variety of conflicting issues raised by the development of in-vitro fertilization (IVF) technology was when I attended the ‘Liberation or Loss? Women act on the new reproductive technologies’ conference held at the Australian National University in Canberra in May 1986. One of the most vivid memories it left me with was the almost palpable hostility and distress I felt amongst the audience at a plenary session when one of the two IVF clients to address us asserted, ‘I was born with the right to have a baby and nobody will take that right away from me, if there is another way, including women’s groups’.


Click here to download full paper



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27 October 1992
Letter to Consumers Health Forum


Ms Deborah Matrice
Consumers’ Health Forum
PO Box 52
LYONS ACT 2606



Dear Deborah

Thank you for asking me for a response to the draft guidelines for the management of terminally ill patients, provided by AHEC [Australian Health Ethics Committee].

My being away on holiday when your correspondence arrived has meant that I could not give this exercise as much time as it deserved, and still meet your deadline of 30 October.


I support the first of the 3 points raised in AHEC’s letter to you.  That is, I think there is a need for the NHMRC to develop guidelines on this issue, and not leave it to individual institutions.


My reasons for this belief include the following:

  1. There seems to be a substantial and growing interest by health care consumers in this matter, judging by media reports, membership of groups such as Euthanasia Societies…

  2. It is ethically desirable that Australians, wherever they live, should be treated in the same way, and not at the discretion and judgment of individual hospital managers and care providers as is the current situation.

  3. There is evidence that the management of terminally ill patients is extremely costly, and if unnecessary and unwanted care is being offered because of a misjudged belief that such care is ethically required, then such costs could be saved for other more desirable ends.

 

In arguing for the NHMRC to develop national guidelines, I would hope that they might offer CHF or a group of similar consumer-oriented organisations a consultancy to conduct adequate consultations to prepare such guidelines.  Through the time allowed for such consultations, there should be the possibility of workshops to discuss what I felt was the most contentious issue in the RPA guidelines, the principle of the Sanctity of Life (specifically, preserving life) which heads its list.

At this stage I can speak only for myself when I say that this principle should no longer hold primacy for the efforts of hospitals and their staff.  In a planet which is suffering from human overpopulation, such a principle goes against the goal of ecological sustainability which I think should be the prime public policy goal.  I know that there are at least some of my colleagues in the Women’s Health Network, the Public Health Association of Australia and the Voluntary Euthanasia Society of NSW/ACT who would share this view.  While I accept that this position might be a minority one, I think it an ethically defensible one which should be given some “space” in any public debate on such ethical guidelines.  I would welcome participating in such a debate in the future.

To turn to other matters about which I spoke briefly to Kate this morning:

I have arranged with Sue Andrews to produce a short report on the PHA Annual Conference for Health Forum by the end of November.

I heard this morning that CHF has been asked to provide a representative to NHMRC’s Health Care Committee’s new Working Group on Assisted Conception.  This is a matter I have been lobbying them for since the end of 1989, and so have a continuing interest in getting some strong women onto this group.  Kate told me that she had passed the task on to you, and that you would be away for the rest of the week.  I would like you to give strong consideration to nominating Sue Andrews on to this group on behalf of CHF.  Her science background, her early involvement in the ACT Women’s Health Network Reproductive Technology Working Group, her continued commitment to women’s health through the Canberra Women’s Health Centre, and her good practice in democratically reporting to her constituency would all point to her being an excellent candidate for the task.  I spoke to her this morning about the possibility, and she has agreed that I can pass her name on to you.

I’d appreciate hearing from you about this when you get back.  Do you have time for us to get together for lunch again, perhaps at the Dilly Bag once more?  Now that the PHA conference is over, I have time to be human on Mondays and Tuesdays!


With best wishes,

Romaine Rutnam


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12 February 1993
Letter to Michael Moore MLA

Mr Michael Moore MLA
ACT Legislative Assembly
CANBERRA  ACT  2600


Dear Mr Moore


I am writing to thank you for your work to bring in a bill to permit voluntary euthanasia in the ACT.  I would appreciate being sent a copy of your bill when it is available.


I wonder if you have seen a note in Bioethics News January 1993 (p.7) which mentions the 1992 law in Denmark which includes a provision for a “life testament” by which a person can register in a computerised file her or his wish regarding treatment when no longer competent to make the decision.  Doctors are then required to check this file to find out whether the patient has registered such a testament regarding treatment or non-treatment.  Maybe you could consider including some such clause, for a file to be maintained perhaps by the Community Advocate’s office.

From what I have read in the press, it appears that your stand will be more conservative than the position I hold.  I believe that it is your intention that you will make it lawful for doctors or others to assist a suicide only in the case of persons who have suffered from a terminal illness for some time.

My own views have been influenced by what I consider to be the admirable example of a retired Sydney judge and his wife who, at the age of 71 and when in excellent health, being thankful for their happy and healthy lives, chose to say goodbye to their families at that time, and committed suicide with their doctor’s assistance in prescribing drugs adequate for their purpose.

It seems to me that if humans are to do what they can to make life on this planet ecologically sustainable, then we will have to confront the problems created by extending longevity, especially by those of us living in the rich countries.  I consider it a sensible social goal for our society to foster a learning to be satisfied with the excellent health status the vast majority of Australians enjoy, without wanting continually to extend the length of the average human life.  This would help us to redirect our health care resources in an equitable as well as ecologically sustainable manner, so that we can assist Aboriginals and poor people in our communities, as well as those in the Western Pacific region, to enjoy a healthy life to the age of 70, without pouring money into postponing our inevitable deaths for years beyond that.

I do accept, though, that you will have a hard enough time of winning support for your proposed stand, and would not expect you to go beyond it at this stage.  I am writing to other members of the Assembly to tell them of my views.

Yours sincerely

Romaine Rutnam



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13 August 1993

Submission to Select Committee on Euthanasia

Mr Ron Owens
Committee Secretary
Select Committee on Euthanasia
ACT Legislative Assembly
CANBERRA  ACT  2600

Dear Mr Owens


I am writing to provide the Select Committee with my views on the Voluntary and Natural Death Bill 1993.  I hope that the Committee will be able to take my views into account, despite the fact that the closing date for written submissions was apparently last Friday.

In this connection, I wish to express my dissatisfaction at the early closing date decided upon, given that the Committee has until March 1994 to report.  I will be informing Mr Moore’s office that I was not pleased to learn, purely by chance of hearing Kate Carnell on 2CC last Friday, about this closing date.  His letter of 18 June 1993, which enclosed a copy of the bill for my attention, merely mentioned the March 1994 date and so I did not think consideration of this bill was an urgent priority.  I also thus misinformed several members of the ACT Women’s Health Network who had gathered to discuss their views on the proposed bills on both surrogacy and euthanasia, and we are unlikely to be able to get a considered collective view on this matter for a few weeks yet.  I regret that I have not had time enough to give this Bill a closer analysis.

Before detailing my specific comments on clauses of the Bill, I wish to make a statement about my personal views and background that are relevant to the debate about voluntary euthanasia.  I am Sri Lankan born and have lived in Australia since 1969.  My background contributes to my perspective that Australians are unfortunately too afraid and denying of death as a part of life, and are too willing to countenance what I see as a waste of human and financial resources in prolonging their dying.  My academic training is in philosophy and politics.  My PhD thesis was on the history of the research and development of in vitro fertilisation in Australia, and focused on the ethics of the research process, as well as on the ethics of resource allocation directed to this technology for assisting conception as against other health services.

I have been a member of the Voluntary Euthanasia Society of NSW for some years.  I carry in my wallet a signed card, provided by VES, which states “Should my brain or body be so badly damaged as to make my life intolerable, PLEASE LET ME DIE”.  I know that this card has no legal status.  I therefore strongly support the intention of this legislation, to make my wishes binding on health professionals finding me in such a state.

However, my personal wish is also to have legal assistance with my suicide, even if I am not “terminally ill”, but at a time when I consider I have had a fruitful life and don’t wish to take the risk of future lingering illness.  I understand that this Bill would not help me, and that probably what I would require would be a change to the Crimes Act to drop the offence of assisting suicide.  I would welcome the Select Committee considering, in its deliberations, such an amendment to that Act at the same time that it facilitates this important community debate on the issue of euthanasia for terminally ill patients.


In regard to the VNDB’93:


p2.            I would like to see the definition of “extraordinary measures” to include “constant nursing care or” after “means”.

            It is unclear why “health professionals” are defined (I could not find future reference to them) and why they are restricted to doctors, nurses and physiotherapists.  I would imagine that at least pharmacists, veterinarians and dentists might have access to the means by which a painless and voluntary death could be induced.


p2.            It seems to me that the terms “imminent” and “natural death” may also merit interpretation or definition in this section.  “Imminent death” is apparently defined in a new Danish law passed in May 1992, as mentioned in the Centre for Human Bioethics’ Bioethics News 1993, 12(2):7.


p3.            I would like to see added to clause 5 a new sub-section which requires that the written direction be deposited in some central computerised registry (see the provisions in the Danish law mentioned above), and that it be obligatory for the health professional (rather than just medical practitioner?) in clause 10 to check the computerised file for the existence of such a direction.  Such a registry could be maintained at little extra cost, I imagine, by the Registrar’s Office and perhaps the Guardianship Board should also be required to check that file on registering any new powers of attorney or guardianship appointments.


pp4-5            I wonder about the appropriateness of penalties as low as $5000 and $1000, when the point is to try to ensure professional behaviour that respects the patients’ wishes and directions.


p5.            Clause 10(1) should be reworded to make it clear that the agreement of the other practitioner is required purely to confirm the diagnosis and prognosis, not to imply discretion to comply with the patient’s direction.


p9.            I had real problems with understanding the intention of clauses 22 to 24.  The way I read them, it seems to me that the doctors are not allowed to rely on a person’s directions as a defence (22 contrary to 29?), or are being asked to ignore them (23), and that 24.1.a seems to make the situation in 24.1.d, where it specifies “after”, an unlikely eventuality.  I would like the Committee to consider whether these clauses couldn’t be worded more clearly.


p10.            In respect of clause 26, I would like the Committee to consider whether there is a possibility, either through this bill or another such as the Power of Attorney Act, to require prospective patients to think about the issues and either sign or not sign such a direction on entry.  If I were given the opportunity of an oral submission to the Committee I would be able to expand on my personal situation where I have power of attorney of my sister who has been a resident of a nursing home in Canberra since 1989, due to multiple sclerosis, which doesn’t meet this bill’s definition of “terminal illness”.


p11.            Clause 28 might perhaps be tightened up, to allay any fears about a looseness of interpretation by a doctor as to what “good faith and without negligence” might mean, in order to include checking with the register as in the Danish system, and consultation with an appropriate panel or ethics committee as in the USA in the case of oral directions.


p12.            I am horrified by Clause 30(b)!  In no way would I countenance using a dead pregnant woman’s body as a means of preserving the life of the foetus.  I hope the Committee will think through the implications of this section further and delete it from the next version of the Bill.


As mentioned above, I would welcome the opportunity to meet the Select Committee at a public hearing.  I would also urge the Committee to extend the time available for written submissions by at least another month, so that my colleagues in the ACT Women’s Health Network, and women who might attend the Health and Wellbeing stream of CAPOW!s regional forum on 21 August, may be given the time to finalise their views on this important legislation.


Yours sincerely

 

Romaine Rutnam



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Ockhams Razor first broadcast by ABC (Australian Broadcasting Corporation) on 19 December 1993 Click here to listen


 

14 April 1994
Letter to Lisa

18 Cornish Place
HOLDER ACT 2611


My dear Lisa


It’s 3.30 pm on the first of my two free days this week, and I’ve just drunk a cup of camomile tea to calm me down!  Last Saturday after Tony left for a week overseas and interstate (including Kuala Lumpur for a World bank workshop on HIV/AIDS in Asia) I started to make sense of my crowded study and order my unfinished tasks, and I set aside today to “be with” you again.  In preparation I decided I would make use of my free evenings finally to get through Janice Raymond’s A Passion for Friends.

 

This morning I woke up to a blissful sunny day, after three or four days of unseasonal and bitterly cold, wet, windy weather.  Autumn is such a glorious time in Canberra.  I got myself my breakfast of fresh orange juice and caffe latte, and settled down in bed to enjoy the view of the crimson rosellas, king parrots and peewits having their breakfast at the feeding table I made for them outside our bedroom, and also to finish the last chapter of the book.  It took me till about 11.30 to come to the end, because each page seemed to set my mind racing on a whole lot of tangents.

 

Can you remember any of the detail of the book?  One of the things that particularly struck me this morning was her writing about passion needing time and timing. If I’d replied to your last letter of 31 October any time before now, my reply couldn’t have been as special as it will be today.  I suspect this is going to be one very long letter, and I’m glad I’ve got several hours of solitude ahead of me.

 

Before today I was really struggling with the book.  I can’t even remember how long ago I started it.  Even a week ago I would have said to you that the only value I got out of it was the richness of “hearing” you thinking through the book because of your notes, and learning about the Chinese marriage registers, which was fascinating.  I think, perhaps what was troubling me was that so much of her writing seemed to exclude men.  (I’ve found a paragraph on page 42 against which you’ve written “only women or men too?” so perhaps you felt it too.  I imagine you might because you seem content in your companionship with Mark, as I am with Tony.)  I also felt irritated by what I thought was too much wordiness and repetition.

 

But last night I went to a meeting of the ACT branch of the Public Health Association.  I may have mentioned to you how valuable I have found my active membership of two NGOs: this one and the ACT Women’s Health Network [WHN].  Before the meeting started, I was chatting with several of the academic women whom I really admire, who were talking about their exhaustion from working full-time and also for a variety of voluntary organisations.  I said to them that I had found the only way to avoid that, and to have time to tend my many friendships, was to limit my paid work to three days as I have managed to do since 1986.  We reflected on how hard that was for most people to achieve and left it at that…

 

I’ll tell you about some of my ideas, sparked off by this morning’s reading of Raymond’s last chapter.  It’s headed “A Vision of Female Friendship: Two Sights-seeing”.  Her first major section, Dual Vision: Its Forms, which gives her wonderful development of the need for “vision” in both senses, of seeing ordinary reality and also looking beyond it, made me remember the notion I developed but couldn’t really incorporate into my thesis: the need for “a bi-focal gaze or vision”, which “attempts to focus (almost) at the same time on the level of particular individuals and their ethical responsibilities for their decision-making, as well as that of the wider social/institutional contexts which structure those decisions”.  I got excited by the thought that, while Raymond (and several other feminists whom I cited in my thesis) had all offered similar images of the need for near- and far-sightedness, perhaps my perspective was still developing it further.

 

A sub-section, headed “optimism and pessimism” set me off thinking about my conversation at an impromptu lunch with my colleague Manoa Renwick yesterday at work.  She is the convenor of the WHN and we met to chat, and also to talk about the agenda for our next meeting due on 4 May.  (I had previously agreed to facilitate this, on the topic of “Global issues in women’s health”, beginning with a brilliant video of India’s family planning program, but after last month’s AGM we decided to continue discussion on the Network’s future role.)  Manoa is one of the three members of the Reproductive Technology Working Group (I’m enclosing FYI my report for the RTWG to the AGM) with whom I ran the session in October ’91 at which I gave the talk which was finally broadcast on 19 December last.  She is a woman of 61 now, has been a single parent of 4 children for decades, and has become a good friend and colleague.  She is ending her working life, appropriately, in our Department’s Women’s Health section, developing criteria for a longitudinal study of women’s health which was promised at the last election, and which should be advertised for tender before long.

 

She mentioned that she thought she and I were both optimists, and I said I found her judgment of me interesting, because I have always considered myself a pessimist!  She said I couldn’t be, because I wanted to change the world.  I reflected on that conversation as I read what Raymond wrote:

Having viewed many of the obstacles to female friendship, we see that a vision of Gyn/affection certainly raises the optimism-pessimism tension…hope expresses the correct tension between the two.  Tension is not always a neat dialectical movement between two opposites in which a third reality proceeds from a preceding two (thesis-antithesis-synthesis)…

This paragraph, and more particularly the next sub-section on theory and practice, then led me to think about the years when I was studying Marxism and, after that, when I became an active member of the Communist Party of Australia.  The 1977 essay for my MA in Philosophy and Politics that I was proudest of was titled “Antonio Gramsci (1891-1937): aspects of his practice and theory”.  He was the founder of the PCI (Italian CP), murdered by Mussolini.  I began that essay with a quotation from his writing which reverberated strongly for me when I first read it: To live means to take sides.  It was only some years later, when I was being a practical communist by working (more than) full-time for the CPA in Wollongong in about 1982, that I came to understand the full meaning of a more famous (within communist circles) quote from Gramsci: Pessimism of the intellect, optimism of the will, which nicely illustrates Raymond’s tension.

 

I then drifted off into thinking about the things I’d written at that time, and how surprised and pleased I was at the originality of some of my ideas when I re-read, about four years later, the last piece I ever wrote as a communist, for the “Broad Left Conference” which I helped to organise in 1986.  It hinted at several ideas which I only developed more fully after I really began to appreciate feminist theory through my work for the PhD (post-1988) and reading about ecology (post-1991).

 

Then I came to the next major section titled “The Conditions of Female Friendship”, with its sub-sections on thoughtfulness (with your superb – and “so timely” for me – note against Raymond’s paragraph on intercourse with oneself, “why I like writing letters”!), passion, worldliness and happiness.  By this time I was so excited, and looking forward to writing to you – one of my many good friends – I was almost beside myself.

 

The ideas kept tumbling around in my head.  “Timeliness” made me think first about a proposal to put to the next meetings of the WHN and Women’s Electoral Lobby (I don’t usually go to the latter, but had decided when I got their last minutes on Monday that I would get to the next, while Tony is away in Geneva.)  I thought that we should use the opportunity of having a brand new Minister for Health – Dr Carmen Lawrence, a brilliant woman, the first Labor Premier of a State, who came into Fed Parliament a couple of weeks ago and went straight into Cabinet to take over from Ros Kelly who was finally forced to resign in March over her stupidity in handing out grants – to get a delegation to see her soon to ask for three things:

  • that she take over responsibility for women’s health from a(nother) stupid woman who is a junior minister;
  • that she fund a major women’s conference in 1995 (she also represents women’s affairs in Cabinet) on how to change (particularly the exhausting Parliamentary/bureaucratic) culture and enhance health in all our working lives by going for (broke) – a well-paid 25 hour week with 15 hours community service and/or study for all;  and
  • that she fund a major qualitative and quantitative research project into the long-term health and well-being of women participants and their families in the IVF program.

 

The latter idea came from what I learned just last Friday, that Judith L and her Melbourne colleagues from the PHA’s Women’s Health Special Interest Group (which I used in 1991 to lobby the NHMRC to do something on the topic, and which eventually ended in Judith’s chairing the NHMRC working group I told you about) has got full funding from the Council to do a matching of the names of the Monash and Royal Women’s patients against the Victorian Cancer registry to check if there might be excess rates of ovarian and breast cancer.  I was truly staggered to learn that the study they began last year includes 12,000 women who’ve been on just the Monash program between 1979 and 1992.  The Royal’s numbers are probably not much less, if not higher.  I shudder to think of the compensation payout our Department will face if they do find excess rates.  One can only hope that they won’t.

 

Raymond’s section on worldliness, and her excellent term inside outsider, expressed so well for me the life I have chosen since deciding to go back into the bureaucracy, but on a permanent part-time basis.  I spoke passionately about this way of living at the session on “challenging male models of work and family” at the pre-Beijing national women’s conference in Canberra last November, and got lots of other women excited about that possibility too.  (I’ve only just made time to skim through the special conference bulletin from CAPOW! – isn’t that a marvellous acronym, for Coalition of Australian Participating Organisations of Women – and found their report on this session translated into the following strategy for Beijing: “promote community education about alternative patterns of occupation to the five day week central model – alternative patterns are not inferior patterns – better balance of work-family-leisure is better for everyone and for health”.  I suspect we need more than just education…)

 

By this stage I was beginning to dare to think that, maybe, I did have something worthwhile to offer in a book.  I told you and Laura last May, didn’t I, that I had more or less given up on turning my research into a book after reading Judy Wajcman’s Feminism confronts technology and Lorraine Hepburn’s Ova-dose?  I decided more firmly against it after Tony and I began planning in July to build our solar passive house, telling myself that it would be a more ecologically useful thing for me to leave the planet than just another book.  Since then I’ve had occasional flashes of regret about not being able to share with others the detailed documentation of the making of a new medical technique which I put together in 1988 and then discarded for the narrower-focused thesis.  I told myself that maybe I might do something if I finally succeeded in getting the long-term follow-up for women.  Timing!

 

I went back to the title I chose in 1990 and though about a new sub-title: IVF and Power: Reflections on the Birth of a Medical Technique.  I decided I would put my original empirical research into a first part, and have a second part on my reflections on power and ethics and medical research policy.  I felt dissatisfied with the “male dualism” implicit in these two parts, and wanted a third (the old Hegelian/Marxist thesis-antithesis-synthesis again).  It suddenly occurred to me that this could be a transcript of a collective discussion coming out of a group of some of the key participants in my IVF story, who would have been given copies of my first two parts in advance.  It could be a testing of the method I had proposed for the NHMRC to resolve “ill-structured problems”.  It would also be a nice move from the individual to the social and participative vision.

 

I then got out of bed to look through the list of acknowledgments in my thesis and came up with more than 30 names!  I immediately rang my friend Judy W who was one of the readers of my first draft of the thesis, and who is also a skilled group facilitator.  (More timing: she had just walked in the door.)  After discussion (she said she could hear me squeaking with excitement!) she thought the idea might work if we had three groups of no more than twelve people, perhaps meeting all together first over breakfast, and finally meeting in a plenary.  I remembered what another friend had said to me, that three is a sacred and significant number.

 

Over lunch I divided my list into three groups of eleven, one of which would be for women only.  The latter would include you and Laura and me (I have grand plans for getting funding for your and others’ fares, and the holding of the workshop!) as well as Robyn and Renate.  I would want it to be facilitated by the most skilful and caring feminist I know, Dorothy B, because I also deliberately want it to include some of the key but “difficult” women participants to generate creative tension, like Rebecca A, Ramona K, Charlotte P and Terri J.

 

Yet more timing: I will be meeting Robyn and Renate in Adelaide next week at the Bioethics Conference.  I intend to ask Renate whether she thinks her Spinifex Press might be interested in publishing it.  I am hopeful she will, particularly when she learns of the impetus for the book given by A Passion, since she was the last person mentioned in Raymond’s acknowledgments.

 

By this time it was about 1 pm and I felt I should wait for the mail before writing to you.  I was right; timing again.  I got two letters, both of which relate to what we have shared.  One was from Robyn’s Centre for Women’s Studies, a copy of their submission to the NHMRC’s review of their IVF/ET guidelines.  By some coincidence I was at home working on my own submission at the end of January, when I turned on Radio National for a break over lunch, and heard Robyn debating John F on IVF etc on their national talkback program.  I got onto it, criticising John and supporting Robyn with further evidence from what I’d just been writing. (I could have done better than I did; I wish I could think faster “on my feet”.)

 

I got in touch with Robyn after that and sent her a copy of my submission.  During a long telephone catch-up chat, she told me that Renate had been to the Bangladesh pre-Cairo conference in December, organised by FINRRAGE member Farida Akhter whom I heard at AIDAB’s pre-Cairo conference last November.  This was just a few weeks before the two-day PHA workshop for NGOs on Population and ESD which I had originally organised for December 1993, and, when we had to put it off, for which I put in a grant application to Ros Kelly’s Environment Dept.  (This must have been one of her last discretionary grants, for which I am very grateful!).  The workshop was attended by about 50 people, representing 11 or so NGOs, about 6 Government Departments and some ANU academics, and it was more successful than I feared it would be, particularly after the first day.  Renate and a friend of hers provided a lot of creative tension there too, and I think the workshop outcomes were much better than they otherwise would have been.  This was particularly the case in the decision of a working group over dinner the first night to call for an integrated national policy on sustainability and not population as earlier small groups had decided.  (I’m sorry I forgot to send you a copy of my FPA discussion paper last year.  I’ve put it together with copies of my NHMRC and CJD submissions – the latter was a sneaky way of getting some of my censored research into potentially important hands – in a pile on the floor to include this time.)

 

Talking of CJD, the other letter was from the inquiry head Professor Allars acknowledging receipt of a copy of my NHMRC submission.  She wrote that she was following up the question of the HPHP’s compliance with the NHMRC’s Statement on Human Experimentation, and wanted copies of my IRAGE article and one of the papers I gave to the Bioethics Association conference in Nov ’91, “Australia’s guidelines for clinical research: an ethical evaluation”.  More timing again: at last night’s PHA dinner I learned from a former Departmental colleague that he was to appear before her inquiry today.  So I rang her office in Sydney and learned that she would be staying at a hotel near me tonight but would leave first thing tomorrow.

 

On flicking through a copy of the conference paper I printed out to take to her hotel I re-read what I had written about the method I had proposed for the NHMRC to take in reviewing its Statement.  (My memory is so appalling, I had completely forgotten the details.)  It made me realise that we could strengthen the workshop idea for my book by using the conscious clash of paradigms, backgrounds and genders of the participants to solve the “ill-structured problem” of revising these guidelines.  Given some of my proposed participants and the make-up of the new Council and its committees, I am feeling fairly confident of getting the NHMRC to fund the workshop, and if so I would like to see if I could grant copyright to them as a gesture towards the collectivism of knowledge and intellectual property, another thing I am (mildly!) passionate about.

 

By the way, the CJD inquiry is not due to report till 30 June (they are frantically working towards meeting the new Minister’s deadline of a draft by 15/6).  The Assisted Conception working group did not meets its deadline of last year, and according to Marcia O’s report to the Consumers’ Health Forum which I received this week, the group’s report may not be available till about June too.   I’ll certainly send you copies of them when they are out.

 

Before I finish, I want to comment on some of the things you wrote about in your last letter.  I am so pleased you and Mark had such a wonderful time in Europe.  It’s funny that while I can imagine the richness of what you experienced, I really have no desire to go overseas at all, or even anywhere out of Canberra except Lizard Island!  I definitely don’t want to go either to Cairo or Beijing.  I would find the crush of people much too overwhelming – Melbourne was bad enough last week.  I am toying with the idea, though, of staying on in Adelaide after the PHA conference in September, for the early October conference on “Women, Power and Politics” being organised to mark the centenary of votes for women in South Australia.  Tony and I can then spend some time in between conferences with his mother who for the first time, at the age of nearly 86, has been feeling so poorly that she couldn’t spend Easter with us as usual.

 

Your delight at meeting your nephews in Germany made me wonder if that made you feel at all “clucky”.  (Did you come across that Australian expression while you were here? – wanting to have a baby?)  Do please, both of you, at least think about whether you would be devastated if you found out you couldn’t have kids of your own a few years down the track.  My job this year is offering me the rare opportunity of reading the contents pages of the major health and medical journals as they come into the library each week, and I’ve collected yet more evidence about increasing infertility and troubles with childbearing for women after 30.  I also skimmed an interesting article on radical feminism and IVF in Sociology of Health and Illness yesterday.  I thought then that it wasn’t worth my copying it; after today I think it might be more valuable to me.

 

You asked about response to my Ockham’s Razor talk; fairly disappointing overall.  (Robyn Williams evaded my question about listnership, which I believe is only about 1%, by saying it was the station’s 3rd highest rated program and was now broadcast to 20 million people over Radio Australia.)  I was only given a few days’ notice of the date of the broadcast so I couldn’t tell many people about it.  I had immediate surprised but largely favourable phone calls from a Sri Lankan friend of my parents in Sydney; from Tony’s mother; and from my brother who told me he found it quite moving, but that if my father hadn’t died when I was 16 he (my brother, then 23) would probably have killed himself.  I received congratulations from only 2 colleagues at work, and three letters requesting copies of the transcript, including a lovely one from the Professor of Social Work and Social Policy at Sydney Uni, Lindsey N’s “boss”.

 

I’ve since had congratulations from Marcia and three members of the WHN, one of whom told me that mention of it was made in the media clippings done for the Office of Status of Women, which pleased me, although nothing tangible has come of that.  (By the way, it turns out that Marcia was featured on a brilliant 4 Corners program on IVF, “A Difficult Birth”, which I used to lead off a great meeting of the WHN last October.)  And Tony told me that at the Health Ministers’ Conference in Perth last month a colleague of ours (one of the most senior femocrats in the Dept) said to him that she had been meaning to congratulate me on my “brilliant ideas” and that more use should be made of me.  Knowing her I haven’t been waiting with bated breath.  She is unfortunately one of the many brilliant women I’ve met in Canberra who seem comfortable playing the male power game.

 

I loved your characterisation of MC as an “arrogant close-minded fool”!  I saw him in person for the first time at a wonderful conference I attended in Melbourne on Thursday and Friday last week, called Researching Health Care: Methods, Ethics and Responsibility.  I was very apprehensive about meeting him, considering the strong criticisms I’d made of reports he’d co-written on Surrogacy and Access to ReproTechs for the NBCC.  Anyway he chose to ignore me and I reciprocated.  I suspect he was the (single) reviewer who recommended to Cambridge UP that they not publish the book from my thesis.  Cambridge did tell me then that they would be interested to look at the more general book I’d mooted, so perhaps I’ll try them if Spinifex can’t do it.

 

Two of the three of last week’s conference organisers were people I first met through my IVF research: Jeanne D and Evan W of La Trobe’s Health Sociology Research Group.  They will, I hope, want to be participants in my proposed workshop, and I’ve decided to sound them out as to whether the conference venue they used, at St Vincent’s brand new Centre for the Study of Clinical Practice, would be suitable.  I think it would be appropriate for the workshop to be held in Melbourne, and at this stage (it is now just past midnight!) I’m toying with the idea of inviting everyone to a dinner party to celebrate Australia Day on Thursday 26 January 1995 – that’ll be about one week short of my arrival in Australia 26 years previously! – and then work through most of Friday.  Can you be there?!

 

I’m hoping to have 4 of my prospective Canberra participants to dinner next week, to thrash out the feasibility of this idea, and also to celebrate the pouring of the concrete slab for our new house.  If they think it’s an idea worth pursuing, I’ll start work over the next few weeks checking out the willingness of my preferred participants to join in.  I wonder what chance I’ll have of getting Carl Wood and Alex Lopata to come along…

 

It was great to read that you were putting in motion steps towards a PhD.  Perhaps this letter will come at the right time to spark some useful ideas for you too.  By the way, I’ve been in touch with Laura quite a lot since she finally wrote, sending me a fascinating package of extracts from Canada’s Royal Commission on New Reproductive Technologies.  The package arrived just before Christmas, so I found time to read them while relaxing for two weeks at Tony’s son’s paradise property on the north coast of NSW.  When I got back to work I gained access through our VAX system to the Internet, and Laura and I have been happily e-mailing each other since.  It seems she’s hooked on the technology, and that seems to be the only way I can get her to write letters.  I sent her an e-mail on her 30th birthday, 22 March, and in her reply (in which she thanked me for my “electronic hug”!) she told me that she hadn’t met her self-imposed deadline of having her PhD submitted by then.  (What day in May is your birthday and how old will you be?  I turned 47 on 2 January.)

 

Laura faxed me the entire RCNRT chapters on IVF and Surrogacy, both of which were most timely (again!) for my personal submission to the NHMRC review, and the collective WHN RTWG submission to the ACT Attorney-General in response to his discussion paper on Surrogacy Arrangements in the ACT.  The writer of that paper, Meg W, is also a member of our working group, a nurse turned lawyer, and it’s a wonderful paper and draft legislation.  I think we may have been persuasive too with the Liberal leader of the opposition, to convince her that Victoria’s Liberal position of supporting “altruistic surrogacy” is inadvisable, to say the least.

 

Meg’s Minister has, as of yesterday, also become ACT Health Minister, and another thought that occurred to me today about political timing was that it may be useful to seek a delegation from the WHN to argue for legislation to regulate IVF here.  Another topic for the WHN meeting in May!

 

I think I must go to bed now (it’s 12.45) because tiredness has overtaken my excitement.  I’ll finish later with some details about the house…

 

It’s now 8.40 am on Friday 15th, and I’ve hung out two loads of washing.  I’m afraid I have to confess that the house won’t be as “ideologically (and ecologically) sound” as I would have liked.  This was largely due to cost, but also because I decided to give in to hankerings for some luxuries which would make Tony’s and my great relationship even more exciting.  This includes a two-person spa bath in an enormous ensuite overlooking a private fernery, and a wall of mirror against our bed.  I discovered by accident in 1977, when I moved into my first sexual relationship after I left my husband, the stunning enhancement of love-making a mirror offers.  (I didn’t understand or appreciate Raymond’s quote from Virginia Woolf, that “mirrors are essential to all violent and heroic action”!)  I incorporated a mirrored wardrobe in my house in Wollongong and that (along with my queen-sized bed for which there was no room here in Tony’s townhouse) was something I missed on moving here.

 

Anyway, we have got sun-attracting north-facing windows to most of the rooms (living, Tony’s music room, the kitchen, our bedroom, my study and the lovely guest room).  The first two and the last of these will have ceramic tiled floors to absorb the heat in winter (the polished granite tiles were the first of my luxuries to go).  We’ll use gas instead of electricity for space heating, hot water and the cook top, so that means we should save enormously on our greenhouse gas emissions and huge electricity bills in this inefficiently heated house.  We are hoping to be able to afford landscaping for the (quite large) garden, and have given specifications to two designers, seeking deciduous trees to the north, no lawn and mostly native plants, to limit water use and also to attract birds to the “bird garden” I’ve designed into the courtyard between our bedroom and the living room.

 

The whole process has been great fun so far, with only one major disappointment when we learned as late as January this year that our designer/builder had not incorporated our specification for brick internal walls.  I was seriously upset by that, because I thought I had worked so hard to avoid misunderstandings.  But we probably couldn’t have afforded the extra cost that would have entailed, and I’ve resigned myself to a standard Aussie brick-veneer house instead of the more energy-efficient reverse brick-veneer.

 

Otherwise the builder, Terry and his co-director Rachael are terrific.  We picked them because they were highly organised and efficient, and also because I sensed he treated his much younger partner with great respect and equality.  I like him even more since learning that he is a very caring single parent of three kids.  We took the wise advice of friends who said the most important thing about choosing a builder was to pick someone you thought you could bear to talk to every day for six months!  I “dismissed” one of the solar-passive expert architects we interviewed because of his self-importance, and Tony dismissed the other because he was a disorganised wimp who had inefficient heating in his office!

 

The contract specifies a 22 week construction schedule, which means – if we don’t have too much rain or injuries which have already led to about two lost weeks – moving in sometime in August.  Tony says we should be setting our expectations on being in the house by Christmas!  Anyway, it should certainly be ready by the end of January ’95, so you are welcome to visit if my plans for the book and workshop go ahead.

 

I must stop now, as I have a lot more things scheduled to do today.  Please say Hi to Mark.  I hope he and you have been able to find work situations that don’t involve so much commuting for him and aggravation for you.  I also hope that you are able to reply to this much sooner than I was.

 

With much love,

 

Romaine

 


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1995
Opening session speech: Changing patterns of working and living.
Third National Women’s Health Conference, 17-19 November 1995.


Opening session speech: Changing patterns of working and living. Third National Women’s Health Conference, 17-19 November 1995. One of the ways in which I differ from the other speakers in this session is that I was not born in Australia. I emigrated from Sri Lanka at the age of 22, after I’d finished an Arts degree and just got married to a teenage sweetheart, with whom I fell in love because he wrote me wonderful poems. The year was 1969, which meant that my nerve-racking search for fulltime paid work only lasted two weeks. It was a search that was by then socially acceptable.


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9 December 1996

Submission to Senate Committee

The Secretary
Senate Legal and Constitutional
Legislation Committee
Parliament House
CANBERRA  ACT  2600


I write to put my views on the Euthanasia Law Bill 1996 before this Senate Committee, and am willing to testify personally before the Committee if it wishes me to do so.

There are three basic grounds on which I object to the passage of this Bill into law.

First, I have been in favour of legally assisted suicide ever since 1986 or so when the issue was brought to my mind by a front page article in the Sydney Morning Herald.  It reported the planned suicide of a former Reserve Bank governor and his wife at the age of 71.  They had previously won the support of their children and their family doctor for their action, and left letters saying they were satisfied with the rich lives they had been privileged to live.  Their doctor, of course, then risked criminal prosecution for his assistance in prescribing drugs adequate for their purpose, and doctors volunteering to take similar compassionate action still do so all around Australia, except in the Northern Territory since the passage of its landmark Rights of the Terminally Ill Act and regulations earlier this year.

My brother and I read that story at the bedside of my sister who was by then into her second year of incapacitation by multiple sclerosis, aged 43.  The importance of legally assisted suicide (or active voluntary euthanasia as it is more often termed in Australia, but confusingly so, I believe) has been stressed more for me since I had to assume primary responsibility and the power of attorney for my sister after she moved to a nursing home in Canberra in 1989.  By then she was incapable of asking for euthanasia even though she had spoken of it before.  Her friends and family are deeply distressed by her lost ability to enjoy all the things in life she had previously loved doing, by her slow and inevitable dying over these past seven years.

This is one of the reasons why I became a member of the Voluntary Euthanasia Society of New South Wales, and have been active over the past five years or so in advocating law reform in the ACT and the Northern Territory to decriminalise assistance voluntarily given by sympathetic health professionals to adults who have carefully and responsibly, and after full discussion with their family and friends, chosen to end their own lives.

My second major reason for opposing this Bill is that I consider it an affront to the citizens residing in all the Territories of Australia, that the Federal Parliament should deny them the right to make laws on particular matters, only because a clause in our badly outdated Constitution allows them to do so in respect of Territories but not the States.

I do in fact agree with those Federal Parliamentarians who argue that the matter of assisted suicide is of national importance, and one which should ideally be settled consistently across jurisdictions.  But I believe that should be the case with all social policies which provide the prerequisites of universal and responsible citizenship in this country, and that means everything to do with public health, education, the environment, economic policy, family services, housing and transport.

I think it ridiculous for the Federal Parliament to argue that it can and should intervene in the Territories’ rights to legislate on this matter, but not on other public health matters or the environment or family services as it is presently trying to do through the Council of Australian Governments process.  I also think it offensive that the Federal Parliament should ignore – as most State and Territory politicians too have done so far – the clear wishes of the majority of Australians surveyed in poll after poll, that laws be changed to support voluntary assisted suicide.

My last ground for opposing this Bill is that, according to several leading lawyers in both the States and Territories, it is bad law.  By failing to provide definitions of “euthanasia”, “medical or surgical measures”, “intentional killing”, and “palliative care” this law, if passed, would throw into question the ACT’s Medical Treatment Act 1994 and any similar legislation providing protection to health professionals withdrawing or withholding treatment from terminally ill patients in the other Territories – but not, of course, the States which have had similar legislation in place for longer than the ACT has.

I urge the Senate – and the House of Representatives – to strike down this Bill.

My preferred alternative would be for all the Parliaments of Australia to fund a national discussion based on an issues paper which puts forward the social, ethical and environmental advantages and disadvantages of decriminalising assisted suicide, and then hold a referendum on the matter which will bind all jurisdictions.


Yours sincerely

Romaine Rutnam

 

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January 2, 2002

Letter to The Australian

Your editorial (31/12/2001) asking us to “imagine our nation after an excess of horror” suggests that Australia needs to forge a new economic and social policy consensus that can unite the mainstream behind fresh ideas.

Any sustainable consensus can only be based on commonly held values. Yet your paper has, over the past few years, documented brilliantly the fact that the predominant values which determine both public and private policies have assumed the inevitability of economic and social inequalities both nationally and globally.

At the beginning of 2002, and at the beginning of a new part of my life as a (fairly reluctant) early retiree from the Australian public service, I offer the following brief alternative as a guide to personal behaviour.

They are based on my personal journey over thirty years, away from a deeply devout Judaeo-Christian upbringing to a very recent articulation of a secular philosophy based on the science of ecology as well as the ancient Chinese and Hindu understandings of universal energy, chi and the seven chakras. I have formulated them in the hope that they are readily understandable by and acceptable to people of any educational, cultural, religious or philosophical background. I believe they encapsulate a much-needed bridge between individualism and the social good.

• I recognise the power that comes from understanding that all living and lifeless things are one and the same energy source. With that understanding, I acknowledge and build on what I have inherited from my family and those people and things that inhabit my environment.

• In that knowledge, I honour and respect my relationships with all beings and things, and practise strengthening my relational powers in my daily activities.

• After learning to honour relationships, I recognise the importance of learning to honour myself as the source of unique talents, and strengthen my personal power by sharing those gifts and contributions with my world.

• I nourish my emotional powers by practising love and forgiveness, and creating harmony in my environment.

• I understand that since I am only one part of a whole environment which I cannot control, I am most powerful when I surrender my personal will and remain open to every opportunity that comes my way.

• I develop my mental powers by seeking only the truth.

• By living in the present moment, I gain spiritual power.


I would welcome responses from readers of The Australian if this were accepted for publication.

Romaine Rutnam
NCEPH, Bldg 62
ANU ACT 0200

 


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Paid Maternity Leave Submission
Sex Discrimination Unit
Human Rights and Equal Opportunity Commission

GPO Box 5218
SYDNEY NSW 1042

 

 

Notes to add to the points I made at the public forum organised in Canberra on 8 July 2002 by YWCA Canberra and WEL ACT:

 

I am attaching the reference and relevant page of Nancy Folbre’s publication that I mentioned, as well as the full text of a review article covering that and 2 other relevant publications, both of which I think answer q 26, and should be of great value to the Commission’s amplification of the May 2002 options paper.  An additional Australian publication which I think would add value to a strengthening of the argument in Chapter 9 is Zubrick SR, Williams AA, Silburn SR and Vimpani G, Indicators of Social and Family Functioning, Canberra: Dept of Family & Community Services, 2000.  This documents the 5 domains of resources that support children as income, time, human capital, psychological capital and social capital. Time is crucially important if we are to strengthen all Australian families, particularly in the early years.  Parental leave along the lines suggested by Folbre on p.227 should be considered as a crucial public investment in Australia’s future, not a cost to particular employers.

 

Please get in touch with me if you require further clarification of the points made above, or at the forum.

 

Yours sincerely

 

Dr Romaine Rutnam

Visiting Fellow

National Centre for Epidemiology and Population Health [NCEPH]

Bldg 62, Australian National University ACT 0200

 


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October 2, 2002

Contemplating Motherhood

I always expected I would be a mother. It was the accepted future for females in my Asian country of birth, where I was brought up in a large extended family assisted by many servants. Even after I was told by my Muslim classmate R about her being woken up by the screams of her older sister on the latter’s wedding night, and the struggle and distress R witnessed as she spied on them through a window, I assumed that however distasteful the conception and birth of babies might be, it would be my Christian duty to endure.

On the other hand, I remember also thinking that if I couldn’t have children of my own, that adoption would be the right thing to do. Both my medical (paternal) grandmother and my mother were very involved in the Family Planning movement, and I grew up believing that there were already too many children being born in this world.

I was 16 when my father died and 17 when I met the young poet whom I married just after my 22nd birthday, the same age my mother was when she married – an age then considered quite old for a first marriage in that country. I was later relieved that my widowed mother refused to let me marry him until I had graduated from university.

We migrated to Australia a month after our marriage, and I began to dream about the two children I would have – Daniel and Christiane – once we saved enough to own our first home. Unfortunately, soon after we moved in (about 18 months after arrival) I discovered that my husband had responded to what he described as my ‘frigidity’ by embarking on an affair with a vivacious work colleague. I tried to leave him, going so far as packing a suitcase and walking to the door, but was paralysed by fear and shame.

We continued living together but in separate bedrooms for another six years, until halfway through my Masters degree by which time I had made enough Australian friends at university, and learned enough from the many mature age (and separated) women students I hung around with, to have the courage to leave my marriage. They had been a hard six years, fielding regular questions from my mother, in-laws and aunts about when we’d start a family. Being a devout Christian and not wanting to tell a lie, I resorted to saying “We can’t have children” which was technically true since we hadn’t had sexual intercourse all those years.

I was 30 when I moved into a group home and began a sexual relationship with a university friend, G, who was five years younger than I. (That seemed to be the norm for many of our couple friends at this time of the so-called ‘second wave of feminism’.) Two years later I moved cities for work, but G and I spent every second weekend and our holidays together.

At the end of 1979, just before my 33rd birthday, I woke up to the news that the USSR had invaded Afghanistan, and my immediate thought was “There’ll be a world war and I’ll have died without being anything but a public servant”. So I planned, in my usual methodical way, that I would have a child with G, take my 12 months maternity leave, and consider my options after that. I started reading current books about planning for childbirth, organised for myself a rubella shot, and told G my plans when we met to fly to New Zealand for our Christmas holiday with friends. I was taken aback when he said he didn’t want to go along with my plans, since he thought he was too young to be a father. But he also mentioned a university research job that he’d been asked to find someone for, and it sounded to me exactly what I wanted to do. As soon as we returned, I applied for the job and was told I’d got it the day after my interview. To the amazement of several colleagues, I resigned from the public service just short of 10 years’ service, and skipped off to another city and a new life. All thoughts of a child had disappeared.

My new life was full of excitement and adventure. I found a wonderful house near the beach which I bought together with G; we made many friends; and lived and breathed our shared political activism. When I turned 35 I stopped using the contraceptive pill on medical advice and shortly after, found that the ‘Billings’ method had failed me. My caring partner said he would support any decision I made, and since I was having so much fun in my new job, we went together to have my pregnancy terminated. It is a decision I have never regretted.

By 39, after my relationship with G had ended, I was certain that I wanted to live a childfree life and chose to have a tubal ligation. I was 41 when I met my present partner, with whom I have shared the most wonderful past 14 years of my life. I do recall, at a film we were watching soon after we met, looking at him as he laughed uproariously at one point, and thinking how I wished I’d met him earlier as he’d have been a wonderful father of any child we might have had. However, when we met he had two fine adult sons whom I could cope with very well, and I had felt for a long time that I was not patient enough with small children who need such constant attention, care and responsibility. (Before my mother died in 1985 and when I was living with G, I answered her question as to why I didn’t have children by saying “Well, I can’t have servants here the way you had, and I don’t think it worth doing all that work.”)

I remember writing to a younger American friend who was contemplating motherhood in her mid-30s, that I think one needs to be an optimist about the future in order to plan to have one or more children, and that since I grew up with a pessimistic orientation, I was right, and very privileged, to have and use the technological means to avoid unplanned pregnancies. I would love to see a world where every baby born is one who is truly wanted.

Rebecca Rohan

 

 

 

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