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Access to palliative care needs to be part of euthanasia debate

Author: Rob Gill
13 April 2015
  • Practical and clinical aspects of palliative care not sufficiently considered in euthanasia/ assisted suicide debate

Australians missing out on access to quality palliative care need to be part of the debate over euthanasia and physician assisted suicide, according to a group of Melbourne-based clinicians and researchers.

The Director of Melbourne’s Centre for Palliative Care (CPC), Professor Peter Hudson and colleagues from the University of Melbourne and St Vincent’s Hospital had their work published in the international Journal of Palliative and Supportive Care. They argued that the euthanasia and assisted suicide (EAS) debate typically focused around ethical and legal matters without sufficient consideration of practical and clinical aspects of palliative care.

Co-authors included Rosalie Hudson from the University of Melbourne’s nursing department, CPC deputy directors Jennifer Philip and Mark Boughey, Brian Kelly from the University of Newcastle and Cees Hertogh of Amsterdam’s EMGO Institute for Health and Care.

Professor Hudson said most discussion around EAS was conducted in an environment far from a care setting. “It is removed from the experiences of those diagnosed with a terminal illness, their family carers and the palliative care health professionals who deliver end-of-life care on a daily basis,” he said.

According to Professor Hudson, provision of resources for training and research to ensure the provision of adequate palliative care was a matter of priority. He highlighted the fact that a majority of Australians with a terminal condition missed out on access to good palliative care.

“There is insufficient health care professional training about end of life care and little investment in research. Less than one per cent of the cancer research dollar is allocated to palliative care, yet one in three people diagnosed with cancer will die of the disease,” he said.

The overwhelming majority of people with a terminal illness wanted to be cared for in their own homes for as long as possible. However inadequate resourcing often meant that only about 15 percent of Australians were able to die at home.

The authors argued the need for public awareness that requests for EAS were uncommon. Less than one percent of those with advanced illness referred to hospital palliative care services expressed a sustained desire for EAS.

Associate Professor Jennifer Philip said that patients and their relatives had many misconceptions of what dying involved, which could influence their views over EAS.

“There appears to be much public fear that people are hooked up to machines and that medical technology takes over at the end of life. Yet there are many opportunities for people with advanced disease to make decisions about levels of treatment and what treatments are acceptable,” she said.

Associate Professor Mark Boughey acknowledged that not only patients and the public were confused about the nature and process of dying, but also some doctors and other health professionals.

“While palliative care cannot always relieve suffering, we have witnessed thousands of deaths where the patient has been comfortable, able to communicate their wishes and say farewells. Families have commented on how peaceful the death was,” he said.

Professor Hudson maintained that more research was required to inform the discussion around EAS. In countries where it is currently legal, it would be important to have answers to questions about the longer term impacts on family and health care professionals involved, he said.

See more articles in Opinion

Comments | 1

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june

Over many months and years I have watched and helped my sister dying of cancer .
She has not been able to have her pain well controlled,Pathological fractures of her ribs, rods inserted in her leg and shoulder .radiation therapy to help control her pain, narcotics that do not work nothing has given her quality of life. I have listenred to her crying and begging to die
What is palliative care about ? Words are cheap
This is not an isolated case.

18/04/2015 06:06:43


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