Advertisement

How to have a good death: What palliative care can and can’t do

The mental toll of euthanising what are often healthy animals weighs heavy on veterinarians. <i>Photo: Getty</i>

The mental toll of euthanising what are often healthy animals weighs heavy on veterinarians. Photo: Getty Photo: Getty

Victoria’s current debate about voluntary assisted dying has heard harrowing stories about so-called “bad deaths”, but those working in palliative care say those stories are not the norm.

Professor Margaret O’Connor, former president of Palliative Care Australia, said she had been surprised by the horror stories.

“Really there’s no excuse for a poor death in Australia,” she said.
“When I listen to some people’s stories about bad deaths, I’m very concerned that we have proper education about palliative care.

“We need to make sure that our clinicians are educated in the skill of palliative care across the board, because people die in all sorts of settings.”

Victoria assisted dying bill passes

Victorian Premier Daniel Andrews (right) embraces health minister Jill Hennessy after the Victoria assisted dying bill passed.

Professor O’Connor is a member of the Ministerial Advisory Panel that drafted the framework for the Voluntary Assisted Dying Bill, which Victorian Upper House MPs will continue to debate next week.

She said Australia ranked second in the world after Britain in the global Quality of Death Index just two years ago.

How does palliative care work?

Palliative care is not necessarily about a person’s final days or weeks of life.

It’s about quality of life, not end of life, said the director of palliative medicine at Cabrini Health, Associate Professor Natasha Michael.

Drugs for a good death

Victoria’s bill does not seek to legalise the use of Nembutal, the drug considered to induce the best death for suffering patients.

“Good palliative care fundamentally remembers that we care for the whole person,” she said.

“We don’t just look at the physical needs of the person, we look at the psychosocial, spiritual, emotional, existential needs.”

Most palliative care services are covered by Medicare, so are free for patients.

palliative-care-tnd

Palliative care must improve instead of euthanasia being legal, some have said. Photo: Getty.

This can include home visits, overnight nurse stays, massage therapy, music therapy and the hire of equipment like beds and wheelchairs.

However, for people who wish to die at home, their location can determine what services can be accessed at no cost.

Despite almost 70 per cent of Australians saying they would like to die at home, almost no private health insurance funds cover services delivered in the home.

What are the other gaps?

Palliative Care Victoria estimates about 10,000 Victorian deaths – one in four – occur every year without access to palliative care.

Only one in six public hospitals have a hospice care unit, which can sometimes mean long waiting lists for patients who don’t have time to wait.

Woman’s fight for right to choose

As the Victorian Government considers recommendations to legalise assisted dying, one woman fights for her right to have a choice.

Dr Michael, who’s been a vocal opponent to voluntary assisted dying legislation, said the biggest gap was in the bush.

“The great disadvantage we have is in rural and regional communities,” she said.

“There is inequity of access to beds, inequity of access to specialist trained nurses and doctors, and that can only come from investment. Investment from organisations and investment from government.”

One manifestation of this gap is in the palliative care workforce.

The ratio of specialist palliative care doctors to patients is almost halved in regional and remote locations compared with major cities.

Professor O’Connor said other groups were missing out too.

“Some of those would be people who die in residential aged care, and there are particular population groups that tend to miss out. We need to be especially mindful of the needs of our Indigenous peoples and people from different cultural backgrounds,” she said.

Choice key to a ‘good death’

Professor O’Connor said a “good death” was about choice, and that choice may soon include voluntary assisted dying.

“A good death is what a person wishes it to be,” she said.

“If a person wants to have family or other significant people around them, that should be able to happen. If they want to die in a particular setting, especially at home, that is possible to do.

“Obviously people commonly talk about being symptom-free and especially pain-free, and the other variations are as many as there are people, really.”

Dr Michael agreed that choice was key, but she doesn’t want that choice extended to voluntary euthanasia.

“A valid death is listening to what the patient and family wants, ensuring that there is proper resourcing around what their needs are and ensuring that we respect the dignity of every human being,” she said.

-ABC

Stay informed, daily
A FREE subscription to The New Daily arrives every morning and evening.
The New Daily is a trusted source of national news and information and is provided free for all Australians. Read our editorial charter
Copyright © 2024 The New Daily.
All rights reserved.