"Just over 150,000 Australians will die this year, about half in hospital. The average age for men will be 79 and women 85. The leading cause of death will be heart disease followed by dementia, stroke and lung cancer. Some will drift off peacefully in the easy embrace of opioids, many will pass quickly and quietly, more than a few in the stubborn end stages of dementia and some poor souls in dire pain and discomfort. None of this is surprising; it’s the reality that hums in the background of our everyday lives, which is where most of us are happy to leave it.

"In a world that expects you to have an opinion on every issue, the bills to be debated shortly in Victoria and NSW will force us to face something most of us have been happy to avoid or leave to others.

"High-profile advocates for change have deemed it a campaign to achieve ‘‘dying with dignity’’. In politics everyone loves a catchy slogan and the advocates for change have got a beauty. How could anyone oppose dignity in death? Of course what we should be asking is what the slogan means and how will it be put into practice. Simplifying complex, multilayered and important matters to three word slogans has not served us well in recent years.

"While clearly many Australians are committed to reform, there are also large numbers who are wary about the debate and worry about the possible outcomes. Many resent the proselytisers on both sides; the clear-eyed ones, those blessed with unshakeable certainty.

"While many of us search for answers and second-guess our judgments about such difficult moral issues, they are able to see the matter with absolute clarity. How they find such surety in an issue as mysterious as how life should end is confounding.

"There are legitimate concerns over assisted suicide proposals before our parliaments. One is for the health care professionals who will be drawn into a regime of regulated assisted suicide.

"Until now a medical practitioner’s essential duty has been to protect life and do no harm. That will change if the law is reformed. The concerns voiced by doctors’ groups representing those who will administer the regime are legitimate. It would inevitably drive divisions in the profession.

"Others who work in our aged care sector legitimately worry about those who are lonely and depressed and who may take the momentous decision to seek an assisted death out of their heartache or loneliness or because they feel a burden to their carers or children.

"There are too many examples of elder abuse and inheritance impatience before our guardianship tribunals to comfortably ignore this risk. But we should especially worry for the powerless and voiceless; those with dementia or severe disability and wonder how they will be protected in the long-term. There are already calls to expand any assisted suicide regime so that it avoids ‘‘discrimination’’ against those with advanced dementia who have gone beyond the point of being able to approve of their own death by allowing it though the decisions of guardians or supported decision makers. It is justifiable to worry if the primacy of an individual to decide will become secondary to the judgment of their guardian or supported decision maker however well-motivated they are.

"There is concern that the push for a regime of assisted suicide, that will only ever be used by a small minority, will further frustrate the needs of the many for intelligent, well-resourced, universal and compassionate palliative care. But for many in the community the greatest worry remains what assisted suicide will do to our notion of the value of human life. Most would agree that it is overwhelmingly a good thing that there are still absolutes regarding life and death; that our society still holds life to be precious and worth defending. That view holds that in a world where there is so much violence and so little regard for any human life that it’s not a bad thing to maintain the ancient prohibition against the taking of life even by humanely motivated assisted suicide.

"For most of us the end of life remains a mystery. It is challenging to think that at some point our precious, unique lives so rich and layered will come to an end and that life will go on without us, our existence the merest note in the history of the world. For some the ultimate right of the individual is to control when and how that happens.

"But many don’t want the right to choose when life ends. Generations of humanity have felt this way and most societies and legal systems have recognised this position.

"All this may be about to change in Australia. If it does, the reformers will be jubilant but there will be many others who will feel that something precious about the dignity of human life has been lost in the cause of reform.

"John Watkins is the Chair of Little Company of Mary Health Care and a former NSW deputy premier.

"There are legitimate concerns over assisted suicide proposals before our parliaments."