Wednesday, 15 June 2016

Assisted death should be legal - inquiry findings


Another issue with huge community support, around 80% in fact, that is being held up by a few bitter white middle aged Catholic men in Canberra. As with marriage equality, voluntary assisted dying is a solid and much wanted wish in the great majority of the Australian community. Being preached to about god and religion does nothing in the face of intolerable suffering.

Why do people feel this way? Because we all likely have known someone who has died and had to go through the indignity and horror of a long drawn out and pain filled agonising death. These deaths are terrible for the dying, but also terrible for the families left behind. Instead of a peaceful passing the family is left with the nightmare of intense suffering. Various events along the way will always stay long after the death, making the grieving process worse when remembering what a loved one went through.

For example, one particular experience of mine with my late wife that will stay with me the rest of my life. Along with others, the horror of unfolding illness and agony. In the last months in hospital she developed terrible and big ulcers on her legs as fluid constantly leaked through her skin (I guess kidney failure perhaps? But she was so far gone she wasn't a candidate for dialysis I remember). These terrible ulcers caused extreme and constant pain, and special bandages layered on daily. Taking the previous days one's off caused huge distress, despite the large amounts of painkillers provided.

This particular day I walked into her hospital room and she was in the on suite toilet and shower and a nurse was with her attempting to remove the previous day's bandages. I waited outside the room door in the hallway. My wife was screaming, literally, from the pain of it. Constantly with little let up. Finally the nurse asked kindly, distressed herself now, "What do you want me to do?"  And I heard her say, resigned and defeated through tears, "I don't know..." almost wailing. It was heartbreaking. Horrifying. The nurse let her have a break for a while and I went in to see her.

That's just one memory, one event in the long long months of suffering she went through. God, painkillers, self-righteous Canberra pollies meant nothing in the face of that. She didn't deserve that. I didn't deserve that. The nurse didn't deserve that....
Coroner Olle detailed the deaths of 240 Victorians between 2009 and 2013 who were experiencing "irreversible decline" in their health due to cancer or other irreversible conditions. The report recognised two broad groups – those with a terminal illness or in the terminal phase of a terminal illness, and those with an incurable chronic illness, either progressive or stable (an advanced incurable illness). These conditions included motor neurone disease, multiple sclerosis, diabetes or chronic musculo-skeletal conditions. 

Olle reported that one-third had chosen poisoning with prescription drugs (prescribed in order to alleviate their intolerable suffering); hanging was adopted by a quarter; firearms by a further 14 per cent; and the remainder utilised self-laceration or deliberate vehicular contact. All of these deaths are highly likely to be violent, lonely, and undiscussed, resulting in grievous shock to family and friends. 

Yet there is a non-violent way which some people resolve such problems, and that is by the ingestion of Nembutal. The Coroner is aware of this, since the Coroners Prevention Unit has done "extensive research on fatal Victorian overdoses involving pentobarbitone". When such overdoses have occurred with medical advice, every encouragement is given to discuss the context of the decision with family, and to encourage them to be present to say goodbye – for many, a moment to be remembered with gratitude and warmth. A number of such deaths occur, which are not reported to the coroner, because the death is imminent and no-one has cause for complaint. Hence the Coroner's statistics in this area are inaccurate to a significant degree. 

The Coroner has conducted an inquest into such a death – that of Beverley Broadbent. Her GP had signed a death certificate indicating a fatal heart attack, and it was not until there was media attention to the death that the Coroner became involved. Her GP then said, "I had a choice between doing what was technically correct (reporting the death) and doing what was the particular wish of a woman whom I had known and respected for 15 years. I chose the latter, as I felt it would dishonour Ms Broadbent and our professional relationship to do otherwise". Many doctors do likewise, seeing no point in subjecting a dying person's family to the anxiety of a police inquiry, and a delay to funeral arrangements. Sydney Morning Herald