Chal­lenge for clin­i­cians

The Australian - - COMMENTARY -

As a pro­fes­sor of nurs­ing who spe­cialises in health law and ethics, and the re­cent widow of a man who re­ceived ex­em­plary pal­lia­tive care, I know bet- ter than many the value of good pal­lia­tive care for pa­tients and their loved ones. I chal­lenge clin­i­cians to swear they have never cared for a pa­tient whose death did not go to plan, whose end of life was dif­fi­cult, mis­er­able and undig­ni­fied, de­spite their un­stint­ing ef­forts, where the only so­lu­tion to end their suf­fer­ing was to of­fer phar­ma­co­log­i­cal obliv­ion. They are the peo­ple that VAD is about.

The crit­i­cal dif­fer­ence with VAD is who is in con­trol — the doc­tor or the pa­tient? The crit­i­cal is­sue is that in the fu­ture all our pa­tients want is to be in con­trol. Pro­fes­sion­als must ac­cept it and we shouldn’t muddy the wa­ters by mak­ing it about us. Mary Chiarella, Nurs­ing School, Univer­sity of Syd­ney, NSW The AMA rightly con­tin­ues to op­pose in­volve­ment of doc­tors in le­galised eu­thana­sia. It is a slip­pery slope ripe for abuses and mis­takes and places doc­tors in the in­iq­ui­tous po­si­tion of hav­ing to de­ter­mine el­i­gi­bil­ity and to as­sist in the process. My ad­vice is to keep lawyers and politi­cians out of it — they have been try­ing to come up with leg­is­la­tion that sat­is­fies all re­quire­ments and safe­guards for 20 years with­out suc­cess.

Doc­tors and nurses know how to man­age ter­mi­nal ill­ness; we should leave it with them. There is a fine line be­tween ad­min­is­ter­ing in­creas­ing doses of drugs to main­tain com­fort, know­ing it will has­ten death, and de­lib­er­ately ad­min­is­ter­ing a lethal dose. But it is an im­por­tant fine line that we cross at our peril. Ran­dal Wil­liams, Burn­side, SA

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