Palliative care must be the focus

Work on poor access to palliative care, not assisted dying, writes Helen Lord

MIKE Gaffney MLC, Member for Mersey, has noted that in Tasmania the choices available at the end of life are inadequate (Talking Point, December 9). The availability of assisted dying is being referenced, but access to proper palliative care, the provision of specialist medical care to alleviate pain and suffering, remains available to less than 40 per cent of Tasmanians.

In my 30 years of medical experience as a GP and palliative care specialist in Tasmania I have seen profound suffering when palliative care has not been made available in a timely manner, and in my opinion improving access to good care at the end of life would remove any need for physician assisted suicide or euthanasia.

Intolerable suffering at the end of life is intensely personal, and the alleviation of this will also be different for each individual, requiring care from a range of skilled professionals. Providing an easy path to an early death, through administering anaesthetic agents without any respiratory support, sends the message that life is not worth the extra caring effort required at its close.

Assisted dying is contrary to the moral codes which have successfully guided the caring professions for millennia; physician assisted suicide and euthanasia are opposed by most medical and nursing professional groups around the world.

Mr Gaffney states that he will introduce laws that will allow death without causing harm to others. This is unrealistic. All of us live in relationships and our choices do affect those around us, and not only them, but vulnerable people from all walks of life who may find themselves at risk of coercion should Assisted Dying become law.

Early death deprives not just the person of time, but also family and friends of the opportunity to say goodbye and often the opportunity leave a legacy of good relationships. Instead of the “rush” to bring in assisted dying legislation just because other places are doing this, what is needed are the conversations around how we wish to live and die with illness; conversations around what level of intervention and what level of analgesia would be acceptable; the where and how of living and dying.

What is not needed is a debate about who should and should not be allowed to have access to the unnatural death of assisted dying. This debate divides society into those eligible and those not eligible, making this form of death an elitist type of death for a minority.

Once assisted dying becomes legal there will be moves made to have it available to larger groups of people. This is evidenced in the Netherlands and Belgium, with euthanasia now available to those with mental illness or intellectual disability, to children and to dementia patients without their consent.

Providing access to an early death is the same as saying that suicide is now statesponsored and acceptable. This is in direct conflict with community concerns about suicide and health messages on suicide prevention. Suicide rates in countries and states overseas that have introduced assisted dying legislation have been shown to increase.

I encourage all our parliamentarians to look at supporting legislation that will improve the quality of end of life care in all its complexity, rather than following a path that leads to the normalisation of suicide and ultimate devaluing of the worth of human life.

I HAVE SEEN PROFOUND SUFFERING WHEN PALLIATIVE CARE HAS NOT BEEN MADE AVAILABLE IN A TIMELY MANNER

Dr Helen Lord is a lecturer in palliative medicine at the Hobart Clinical School, works as a GP in Kingston and is a Visiting Medical Officer for Northern Palliative Care Services in Tasmania.

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