Just this week, it was announced that the New South Wales Parliament would debate the right for an adult over age 25 (who is also a resident in New South Wales-clearly to prevent NSW becoming the Euthanasia capital of Australia), to legally end their own life with, of course, with the assistance of a qualified medical practitioner.
There are strict criteria around this:
(i) The person has been medically assessed independently by their own medical practitioner and a specialist in the terminal illness in question with the expectation that person would die from their condition at some stage during the following 12 months.
(ii) The patient must be independently assessed by either a psychologist or psychiatrist
(iii) The patient retains the right to rescind the request at any time with also a 24 hour cooling off period.
(iv) Close relatives also have the right to appeal the decision in the Supreme Court.
Although I am a great supporter of ending a person’s suffering, personally I would like to see what I call “compassionate medicine” practised well, on a much wider scale. I am referring to compassionate medicine as a sensible and compassionate way of allowing a person who fits the above criteria to end their life quickly and without suffering, apart from deciding a due date and time for the demise, which is what happens in the case of euthanasia.
There is a wonderful drug that is legally available through a medical practitioner known as morphine. Morphine given in progressively increasing doses to a person with a terminal illness places them in a peaceful oblivion, also working as a respiratory depressant. Often, a secondary infection intervenes, hastening death.
I still think euthanasia should be an option for people who fit the above criteria for whom compassionate medicine has proven to be ineffective. But, I still believe compassionate medicine is the best initial approach.
But, here is where I am about to become controversial and discuss the “elephant in the room”. Most people, for some strange reason, appear uncomfortable to discuss this aspect of humans in the later stages of their existence. There are many more people languishing in nursing homes, not living, but purely existing; waiting for death. As a doctor, I wholeheartedly believe in prolonging everyone’s life, but no one’s death.
When a person develops an illness where there is clearly no quality of life, with no real possibility of recovery, in my opinion, they are no longer living but have entered their death phase. I am referring to people with Alzheimer’s disease where they no longer recognise their loved ones; a stroke where a person is bedbound or some other defined illness where a person’s quality of life is no longer present. This can be easily recognised by what I crudely refer to as the “bum wiping rule”. If there is no prospect of you being able to wipe your own backside again, what on earth is the medical profession, nurses or the nursing home trying to achieve? Why are we continuing chronic therapy such as blood thinners, cholesterol lowering or BP treatment and more importantly why do we administer antibiotics when these people develop the inevitable infection?
In my view, we should stop all chronic treatments, avoid antibiotic use and only administer pain relief and sedation, allowing the person to pass away quickly without tubes in veins and orifices and urgent trips to the hospital in ambulances.
This is compassionate medicine which stops the needless suffering of very ill people and their relatives watching them waste away over months to (at times) years, not to mention the incredible, senseless waste of money and medical resources on people with no chance of recovery.
At present, with our current approach, all we are doing is prolonging the agony for dying, vulnerable people who deserve to die rapidly and with some dignity.