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“I have seen too many people express a desire for death when actually all they are asking for is help.”

This week the Victorian Parliament’s Legal and Social Issues Committee issued a report with 49 recommendations about end of life care in the Australian state. The first 48 were about improving palliative care and advance care directives so that all Victorians can get high-quality end of life care. The 49th was a majority recommendation that euthanasia and assisted suicide should be legalised.

Guess which recommendation got all the media coverage?

Also unnoticed in the media coverage is the fact that there were two minority reports from committee members.  The report by Dennis Mulino, in particular, is worth reading as a thorough evidence-based analysis of where the majority went wrong.

Mr Mulino’s report includes the extensive evidence from palliative care specialists that requests from terminally-ill people to die are actually asking for help to live. They are naturally scared of what might happen, but those fears are transformed when they are told of the real options that will allow them to control their pain and suffering.

Dr Natasha Michael:

The people who are saying ‘I want to die’ are people who are saying: my suffering is so unbearable at this point in time, with my pain, my distress or the burden I am placing on my family, death has to be a better option. The answer to that is not injecting them with a drug or providing barbiturates; the answer to that is saying, ‘How can I help you with these factors that are making you feel that death has to be the better option?’

If you have an unskilled practitioner, you do not have the ability to distinguish these complex psychosocial phenomenons. The risk is too high … I have seen too many people express a desire for death when actually all they are asking for is help.

Associate Professor William Silvester:

I am amazed by the number of times that I have gone to walk away and some has called me back and said, ‘Look doctor, I didn’t tell you, but in fact I’ve been thinking about euthanasia, and now that you’ve been able to lift such a weight off my shoulders and I can now be sure and confident that I am going to get the care that I want at the end in the way that I want it, I can now concentrate on living as well as possible. I don’t have to think any longer about getting Nembutal or saving up all of my prescription tablets or whatever so that I can do something before I lose control, because now I can see that even when I reach a point where I no longer have control, I will still get what I want and I will not get what I do not want.

Associate Professor Peter Hunter:

We do know that in almost all patients, if we do a proper assessment and understand that the drugs are available, we can alleviate pain and we can do a good job of that.

I have never not been able to control anyone’s symptoms around pain once you have got them on the right treatment path, be it narcotic analgesia or infusion pumps et cetera, so I think that if anyone dies in pain, that is an absolute travesty because there is capacity to really manage that effectively in this day and age.

Click here to read Mr Mulino’s report.

Click here to read the full report.

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