The Age – 17 November 2014
Jack de Groot
“We accompany people and their loved ones each day as they go through their own processes of dying.”
The hijacking of the term “dying with dignity” by today’s supporters of euthanasia and assisted suicide is an insult to the dedicated doctors, nurses and pastoral carers who daily provide compassionate care, pain alleviation and spiritual comfort to the sick, the dying and their families.
Debates about euthanasia and assisted suicide are emotionally harrowing. All the more so when they occur during election campaigns. The timing and manner of the current debate exacerbates the fear of dying held by many in the community and diverts attention from the conversation about providing the dying with the innovative medical and healthcare they need, in homes, hospitals and aged-care facilities.
Funding for end-of-life palliative care by governments and private health insurers is inadequate and undervalued. The first step in public policy regarding death and dying is to guarantee that those who need palliative care services can get them. For people who are poor or vulnerable, who are mentally ill or incarcerated, who live in rural and remote communities, it is crucial that they can get the palliative care services to which we are all entitled.
Overseas experience shows that where euthanasia legislation has been enacted, pressure has been applied to the frail aged, disabled and mentally ill to follow the now “normal” path of physician-assisted death. That path has little to do with dignity.
Usually the most terrible stories of suffering are told to advance a change to law that will allow euthanasia and decriminalise assisted suicide. This is understandable, but hardly a credible and rigorous presentation of the realities of care for those who are dying.
Many thoughtful people in our society support the notion that we should be able to die with dignity, yet still oppose the proposed euthanasia legislation because it’s bad law. We all accept that people should not have to suffer unnecessarily. The proponents of euthanasia law reform equate a refusal to support the legislation with forcing the dying into interminable suffering. But the risk is that a change to the legislation simply forces the suffering into the additional and equally interminable dilemma of choosing their moment of death. Making it possible for people to end their life legally is not about dying with dignity.
With developments in the provision of palliative care in the home, and innovations in pain management, there is the prospect of an ever-improving quality of life at the end stages. The evidence for it and experience of it is strong. A recent Grattan Institute study showed that most Australians want to die at home. There is a very understandable desire for each one of us to die in the places where we have loved and been loved. It also makes economic sense for those enacting public policy. It will mean less time in hospital, and that is a saving. It may also be a lot less expensive than seeking a new legal process of multiple safeguards for someone to either commit suicide or be euthanised.
For those who die in the care of a hospital there are positive and loving care options available that can be further expanded. St Vincent’s and other healthcare providers will continue to provide such dignity-based care.
Dying with dignity is not a new thing that those promoting euthanasia and assisted suicide have discovered. At Caritas Christi and in our provision of high-quality, person-centred palliative care, it has been a daily experience for tens of thousands of families for more than 75 years. We accompany people and their loved ones each day as they go through their own processes of dying over months, weeks and days; as they die and as their loved ones grieve and mourn for their loss. It is more the norm than the exception that we hear and see the most beautiful expressions of love, human affection, reconciliation and alleviation of suffering. It is dignified.
It is on the back of inaction on funding and investment in palliative care and a lack of education of the community about dying and death – as well as some false premises that all death is undignified and that suffering must be avoided at all costs – that euthanasia and assisted suicide are proposed now as “rights”.
Dying, death and dignity are worthy topics of our public conversation. But they should not be manipulated. The truly compassionate response to our dying family members is the highest quality, evidence-based palliative care. It needs to be well-funded and researched, valued by governments and insurers, and promoted so as to always be innovative to meet the needs of our community.