Death with dignity. Harder than crossing the boarder at San Ysidro, California
Death is an intersection of powerful forces. A legal void where there are no clear guidelines. Political ducking and weaving from anything that could ‘damage careers’ including standing on religious toes. An immensely wealthy and high-tech health system that gets paid only in a fragmented system of rewards for each test and treatment, not for it’s overall success in making it’s customers happy or comfortable. And an aging and often uninformed population who were brought up to trust authority figures like doctors.
Australians are increasingly dying in in hospitals, in pain, semi-naked, surrounded by noisy machines and enduring unnecessary medical treatments. Doctors and nurses often have to watch sights that would upset the general public. Elderly frail people being routinely given distressing medical treatments, for little or no outcomes. Now Doctors are speaking out.
Their voices are not always welcome. Dying is not a popular subject. It’s not sexy. You can’t make big money out of it. And no, there isn’t ‘an app for that’. But dying is something we will all have to face. Having a good death, in your bed, pain-free and surrounded by your loved ones is something we all have a right to receive. But it’s not something that will happen unless Australians take control of their old age.
Three Australian doctors discuss their experiences with the dying, the law, political indecision and the health industry.
Philip Nitschke is an author of the book Dammed if I Do and founder of the pro euthanasia group Exit International. He campaigned successfully to have the legal euthanasia law passed in the Northern Territory before it was overturned by the Conservative Federal Government. In 2014 his Medical License was suspended. In 2009 Philip Nitschke stated:
“It seems we demand humans to live with indignity, pain and anguish whereas we are kinder to our pets when their suffering becomes too much. It simply is not logical or mature. Trouble is, we have had too many centuries of religious claptrap.”
He is now working on a stand-up comedy for the Edinburgh Fringe Festival in August 2015. He has teamed up with a UK comedian Mel Moon. Their show is to be titled ‘Dying Laughing’.
Ken Hillman is the author of the book Vital Signs and Professor of Intensive Care at the University of New South Wales. He describes his role as being ‘a doctor in a society where euthanasia is illegal’. He described being caught by his patient’s personal wishes and legal and hospital regulations. His book Vital Signs describes elderly frail patients ending up in noisy, artificially light Intensive Care Units, surrounded by complete strangers and enduring painful procedures.
Charlie Cork is an Associate Professor of Intensive Care at Geelong hospital. He has publicly raised the issue of elderly frail patients ending up in Intensive Care Units with little hope of recovery while suffering painful treatments. He featured in an ABC documentary called In The End, by Compass.
From America, Dr Atul Gawande discusses the fact that ageing and dying can’t be ‘fixed’. He described how doctors can be afraid of talking to patients about end of life issues. And he honestly discusses his own father’s experience with terminal cancer. Dr. Atul Gawande says that we may be inflicting therapies on people that shorten their lives and extend their suffering.
Australian’s only way to gain control over their end of life care, is to complete legal documents before they become unwell, clearly stating their wishes are about aggressive medical treatments. They can also give medical power attorney to a loved one, granting them the power to make decisions on their behalf. It is essential that people over seventy consider end-of-life issues seriously. Leaving end of life care ‘up to the doctor’ places medical teams in a legal bind. And without the political will to introduce in broad-ranging changes, dying without firm legal documentation can lead to a painful hospital death.
Wikihospitals February 2015
Doctor challenges euthanasia law that calls mercy a crime. The Sydney Morning Herald. 28th April 2014. Julia Medew.
US Surgeon Dr Atul Gawande questions modern medicine’s treatment of dying patient. ABC. 13th November 2014. Eleanor Hall and Sarah Sedghi.
The Right to Die Reality. The Age. 13th November 2014. Konrad Marshall.
Palliative Care Australia
A good death. Australians need support to die at home. The Conversation. 29th September 2014. Hal Swerissen.
How the care conveyer belt tortures people back to life. The Conversation. 16th September 2013. Kenneth Hillman.
The Business of Dying. The Washington Post. 2014.