Advances in Palliative Care but limited access
Catholic Health Australia (CHA) is calling on MPs considering their position on voluntary assisted dying (VAD) to be conscious that advances in palliative care have fundamentally changed the political equation over the past decade.
NSW looks set to consider the VAD issue afresh, following the introduction of a private members bill.
In an article published today in The Sydney Morning Herald, CHA Chair and former NSW Deputy Premier John Watkins AM is calling on NSW MPs to look at the issue in light of medical advances.
“The idea that supporting euthanasia is progressive, and opposing it is conservative, is obsolete. In fact, any thoughtful progressive should be worried about where the rush towards voluntary assisted dying is taking us,” Mr Watkins said.
“The critical factor that’s changed over the past decade is medical science, primarily in the field of palliative care. New treatments like intrathecal care and nerve blocking are enabling people with life-ending conditions to achieve a quality of life inaccessible last century.
“The problem is right now only a tiny fraction of our population has access to this modern palliative care. If you are among the privileged few who are very wealthy, live in the right area, or have great health insurance, you can get access to life-extending modern palliative treatments.
“But if you’re poor, live in the wrong area and have no health insurance, your chances of accessing modern palliative care is close to nil. If you are offered any end-of-life care – and there’s no guarantee you will be – it will look far more like the 20th century model than the modern possibilities.
“We could fix this. The Australian Medical Association estimates it would cost about an extra $275 million a year to make quality supportive care available to all terminally ill Australians who need it each year.
“Surely any compassionate government in 2021 should be pushing for the average person to get modern palliative care long before they get access to death.
“If we continue along the path we’re on, if we offer VAD and not modern supportive care, you can easily project the result. It will be a society in which terminally ill rich people get to extend their lives, achieve some level of closure and peace, and then die without pain. Terminally ill poor people, on the other hand, will be increasingly pressured to shuffle off and die quickly ‘with dignity.'”
John Watkins needs to understand that terminally ill people are not necessarily looking to extend their lives – and palliative care is certainly not about that; it is about caring for the patient while they are on their end of life journey.
One of the aspects of this whole debate round end of life/palliative care/ voluntary assisted dying that we rarely hear about is the person’s right to refuse or stop treatment, at any time. A couple of years ago, my father died at 91. He was still living at home with my Mum, but getting frailer and more sick of what he could no longer do – he basically was ready to die and said so, often. He ended up in hospital, coughing blood. When arriving at the ED, medical staff immediately started wanting to hook up intravenous antibiotics. My Mum told them not to – that Dad was old and ready to die if that was the outcome of his health issue, whatever it was. She was challenged on this, but stood firm and had to do so several times before Dad died about a week later, having had good palliative care from the in-hospital team and support from the family GP. We can basically keep people alive for ages, and Dad could have lived and been moved to a nursing home. But for what purpose? I am proud of my Mum’s strength to do what was best for Dad and argue back to doctors who found it difficult not to do anything. It did not involve a doctor’s intervention, but it did require medical staff to let my Mum decide what Dad would have wanted. I think we need to remember that we don’t have to accept all the medical interventions that might be offered.