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We can’t let voluntary assisted dying negate our commitment to the ill

Natasha Michael, The Age, 22 May 2019

Palliative care doctor Natasha Michael discusses how euthanasia will impact palliative care from her personal experience with death, patients and palliative care.

The introduction of the voluntary assisted dying legislation in Victoria on June 19 will remind us of the occasional failure of medicine. Healthcare was designed with disease in mind, not people. The legislation introduces three major threats to healthcare: validating suicide as an acceptable choice; accepting substandard medical care by supporting the lack of rigour in defining eligibility; and finally, introducing into the healthcare curriculum the intentional ending of life as acceptable medical treatment. Hereby, a new generation of healthcare professionals abdicate their commitment to the sick.

For the patient, the convolutions of modern medicine, the uncertainty of therapeutics, the conundrum of multiple doctors across multiple sites bring an uncertain horizon and instil existential anguish. Their journey of illness is ultimately alienating and lonely. For many, it is the desperation for the restoration of dignity and the return of normality that drives the desire for death: “I want to die, let me die.” Not: “Kill me.”

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Many in the dark on end of life

Care Not Killing, 14th May 2019

Public ignorance about dying increases fears about the pain and indignity associated with the event, senior medical academics say today. Large numbers of people get information from fictional events while the most common source of knowledge about dying is from family and friends, according to a survey conducted for the Academy of Medical Sciences. Some 20% say they have gained their knowledge from documentaries while just 22% have gained it from medical professionals.

When people are unfamiliar with the reality of the incredible care and support of which we are capable, and when campaigners can point to gaps in provision in order to sow the seeds of doubt and fear, acceptance of assisted suicide and euthanasia is less surprising.

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‘Glimpse from heaven’: Nurses reveal what people say before they die

The New Zealand Herald, 20 March 2018

Lead author Kurt Gray said: “When we imagine our emotions as we approach death, we think mostly of sadness and terror.

“But it turns out, dying is less sad and terrifying – and happier – than you think.

“In our imagination, dying is lonely and meaningless, but the final blog posts of terminally ill patients and the last words of death row inmates are filled with love, social connection and meaning.”

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No, most people aren’t in severe pain when they die

by Kathy Eagar, Sabina Clapham, and Samuel Allingham, The Conversation, 11 December 2017

Many people fear death partly because of the perception they might suffer increasing pain and other awful symptoms the nearer it gets. There’s often the belief palliative care may not alleviate such pain, leaving many people to die excruciating deaths.

But an excruciating death is extremely rare.

  1. Click here to read the full article.
  2. Kathy Eagar is Professor and Director at Australian Health Services Research Institute University of Wollongong, University of Wollongong
  3. Sabina Clapham is a Research fellow, Palliative Care Outcomes Collaboration, University of Wollongong
  4. Samuel Allingham is a Research Fellow, Applied Statistics, University of Wollongong
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What It’s Like to Learn You’re Going to Die

by Jennie Dear, The Atlantic, 2 November 2017

For many patients with terminal diseases, Coyle has observed, this awareness precipitates a personal crisis. Researchers have given it other names: the crisis of knowledge of death; an existential turning point, or existential plight; ego chill. It usually happens as it did with my mother, close to when doctors break the news. Doctors focus on events in the body: You have an incurable disease; your heart has weakened; your lungs are giving out. But the immediate effect is psychological. Gary Rodin, a palliative-care specialist who was trained in both internal medicine and psychiatry, calls this the “first trauma”: the emotional and social effects of the disease.

In this crisis, some people feel depression or despair or anger, or all three. They grieve. They grapple with a loss of meaning. A person’s whole belief system may be called into question because “virtually every aspect of their life will be threatened by changes imposed by the [disease] and its management,” Lee has written. In a small 2011 Danish study, patients with an incurable esophageal cancer reported that after their diagnosis, their lives seemed to spin out of control. Some wondered why they had received a fatal diagnosis, and fell into despair and hopelessness. “I didn’t care about anything,” one patient said. “I had just about given up.”

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Life Lessons Disability Taught Me No.2 – Death

by Mik Scarlet, HuffPost UK, 16 August 2017

Mr Scarlet is a broadcaster, journalist, and musician.

This is the biggest thing I have learned about death; it happens at the end of life but it’s life that matters the most. The great leveller should also be the great motivator. Don’t ignore that you will die, and don’t be afraid of it either. If you live your life as well as you can when the reaper does finally come calling, you can die assured of a life well lived.

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Why the Irish get death right

by Kevin Toolis, The Guardian, 9 September 2017

In the Anglo-Saxon world, death is a whisper. Instinctively we feel we should dim the lights, lower our voices and draw the screens. We want to give the dead, dying and the grieving room. We say we do so because we don’t want to intrude. And that is true but not for these reasons.

We don’t want to intrude because we don’t want to look at the mirror of our own death. We have lost our way with death.

Through urbanisation, industrialisation and the medicalisation of death, the wake died away in most of the western world and death itself came to be silenced by what might be called the Western Death Machine.

To be truly human is to bear the burden of our own mortality and to strive, in grace, to help others carry theirs; sometimes lightly, sometimes courageously.

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A gentle parting eases the pain of death

by Clara Pirani, The Australian, 1 September 2017

Ms Pirani is the Associate Editor – Commercial, for The Australian.

With a calm quiet reassurance that so many palliative care nurses possess, honed by years spent easing the sick from this world, she transformed our truly distressing situation into an almost comforting farewell.

It’s harrowing to watch and leaves many carers, who desperately want to help their beloved achieve a peaceful death, feeling unable to cope.

Despite the challenges, Callaghan says caring for someone as they die helps family and friends accept the loss.

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