I came across an article in The Age,
28th October, 2009, where
Professor Megan-Jane Johnstone from
Deakin University said, "right-to-die
lobbyists had used people's fear to hide
the fact that most deaths were made easier
by modern pain relief..."

She said that, "I think palliative care needs
to reclaim the 'good death high ground.'
Euthanasia has totally hijacked this plateau,
but the reality is that palliative care can
help substantially in the majority of cases.
Palliative care is about quality of life until
they die, and then dying well."

However, a survey last week found that 85 percent
of people agreed that, "a doctor should provide
a 'lethal dose" if , "a hopelessly ill patient,
experiencing unrelievable suffering with absolutely
no chance of recovering asks for (one)."

I'd be interested in posters views on this issue -
having recently experienced a death in the family
where a 'lethal dose' could have relieved the prolonged
suffering of an elderly (very ill) family member.

I have to agree with you. Doctors should give the lethal dose if their patients' ask for it and are in such pain that they do not wish to go on. After all, there is little 'quality of life' when a patient is in dispair and when they have to take pain killers to be able to function properly. It seems to me that a person is in charge of his own life and it is up to them to decide this matter, especially if they have been ill for a long time.

Foxy, may I offer my sincere condolences for yours and your family's loss. I hope that the good memories of a life well-lived might live on in your hearts.

"... the reality is that palliative care can
help substantially in the majority of cases.
Palliative care is about quality of life until
they die, and then dying well."
(Megan-Jane Johnstone)

IMHO, predicting the substance of the hired help in relation to the quality of one's final days might rely on the degree to which the person concerned (aka patient, subject, case) can trust in the kindness of strangers.

Yes it would be a more comfortable finale to die peacefully and with as little pain as possible, but without the sacrifice of one's freedom to remain true to reality at the pinnacle of a human life; the last breath, the last heart-beat, the last wish.

As far as I'm concerned, if ANYONE who is either terminally ill, suffering a disability that is not expected to be remedied within a year, or is over a certain age (really old); ASKS for Euthanasia they should be allowed to get it.

Palative care should improve- but it's nobodies right to say to someone who is no longer able to walk "Well, no, you can't die now- you're clearly not in enough pain- but enjoy your stay with us".

I'd rather not spend day in, day out on drugs in a bed I won't be able to leave.

I'll pass thanks.

When my 98 year old mother is given enough "palative care", to be feeling only reasonable pain, she doesn't know who she is, & talks to the birds sitting on the end of her bed.

When the level is reduced, she wishes she was dead

Her wishes should be no ones business but her's.

Hasbeen describes exactly how it is out in the real world.
I work in palliative care and with the elderly in our community.

The real problem with palliative care is that it focuses on those dying from cancer or other painful terminal diseases.

There are also many people dying from illnesses and diseases like end-stage motor neurone disease, multiple sclerosis, dense strokes, heart failure, Parkinsons disease, emphysema and many other muscle or nerve wasting diseases that do not always involve the patients actually experiencing pain.

These people therefore often do not have any painkilling drugs such as morphine prescribed for them until the very last days of their lives, when it is often prescribed for severe emotional or physical distress by some caring doctors.

These people then are left to slowly die of 'un-natural causes', without the use of morphine or similar drugs which can be used to assist in slowing the breathing down to hopefully hasten death a little quicker.

Even some cancer stricken palliative care patients do not respond to some morphine medications, and do have awful deaths.

I know this because I have had to care for them, and their families, while they beg me to help them end it. Euthanasia is these peoples only way out.

I am seventy years old. Chronic Diabetic on insulin and many medications.
I dread the day that I cannot live at home and have to be 'placed' in a nursing home or some such.
I have tried to live a useful life having volunteered for many jobs and been enthusiastic in fields such as the Arts and Politics.
Surely, when things get worse, I have earned the right to expire peacefully?

Ah, Foxy, you can sometimes cut so close to the bone!

It is, of course, a vexed issue. The way I would attempt to resolve it (were I to be setting government agenda) would be to put the question to a referendum, or perhaps more correctly, initially, a plebiscite, in order to formally determine the view of the Australian electorate at large as to what they thought of this whole situation, that of 'in extremis', but nevertheless one conducted in close accord with the provisions of the Referendum (Machinery provisions) Act 1984.

Suspecting that, in a general sense, somewhere around 70% of Australians might favour the right of a person suffering some unrelievable medical situation, to call a halt via medication that would terminate their life, to do so, I would seek to emplace that right in the form of a Constitutional amendment that restricted the Parliament from legislating in this area so as to effectively restrict or deny this choice.

In so doing, I would strive to ensure that avenues remained open to address issues deriving from this most vexed area of legislation. But note, my first action would be to put the issue beyond the meddlesome reach of those who, never approaching the likelihood of really influencing the likely outcome of such a plebiscite, would seek to nevertheles interpolate some dogmatic prohibition upon the determination of an Australian Parliament to permit such choice. If'n you get my drift.

There would be many tangential issues that would require to be addressed with legislation if such a right to choice in this matter were to be so entrenched. For example, the law relating to life assurance contracts: there would have to be some form of protection against what could be considered abuse of such contracts, whether by the assurer or the assured.

My main objective would be to put this matter on the public agenda in such a way as to effectively preclude the dogma-merchants and would-be grandstanders from leading or channeling the debate, and thus coming to have a greater say in it than anyone else.

Thanks so much for all your comments.

This is a tough problem, and I
realize that many of us aren't really
sure of what we'd do - when faced with
such a difficult situation of having
to make a "life or death" decision.

I totally agree with the organisation -
"Dying with Dignity NSW" who feel that it's time
lawmakers had a full debate on the issue.

My personal experience with a family member
who'd suffered a series of severe strokes,
and continued to have them, who was in a
semivegetating state, had lost their
functional and mental independence - and yet
was being given fluids and other vigorous
support to preserve their life, despite the fact
that the family member was in great pain, and suffering,
with no chance of getting better.

I could not understand why the doctors just could
not let them die in peace and serenity.
Why did they pursue such vigorous therapy that
would benefit no one except their own satisfaction
in thwarting death, regardless of the consequences?

"Why did they pursue such vigorous therapy that
would benefit no one except their own satisfaction
in thwarting death, regardless of the consequences?"

There is profit in it.

Foxy
I'm back! From the naughty corner! I keep writing a list of nominees to become Soylent Green perhaps they wouldn't agree....(naughty laugh) (Sigh) Back to the corner? :-(

Seriously though, I believe that the only person whose life it is who can/should determine their OWN (premature?) demise.

I would debate strongly that neither church, government, Dr nor some well meaning 3rd person has that right let alone the ability to comprehend the individuals choice

There are few issue that come to mind here.

We allow people to choose illogical often unfathomable emotive reasoned life styles
(e.g. I have a sister in law who is a nun in the order of perpetual virgins) in her vocation she doesn't do anything she couldn't do out of the order. While I don't agree with her choice of either vocation or beliefs, it is none the less her choice.
Why then do we become all omnipotent and dictate to someone who believes that 'that's it, enough is enough I want out'.

Most people argue that it's OK in cases of terminal disease etc. But we fail to acknowledge the insufferable misery pointlessness of old age to some. That is terminal. The idea of sitting in a nursing home waiting for the end bothers me no end.

Likewise we acknowledge that mental illness is often incurable and medication may or may not work or in many cases reduce one's life to that of a feeling-less facsimile.
In a recent show STEVEN FRY (bi polar) discussed this in detail. It is a common complaint of sufferers of this disease. And reason sufferers stop medication.

I remember one call where BP (F) 60's rang after taking a lethal dose to talk to a non demanding person. Tired of 'the emotional pressure to acquiesce to everyone else' needs' and years of of HER unrelenting pointlessness,emotional torment and pain?. She was calm , resolved and logical ( the worst type of call ) . Any intervention would arrive too late. You couldn't stop it what do you do?

How about the doctors preference in life and death decisions. Doctors have a concience and feelings and are not robots I had a stroke 3.6 years ago and the doctor said I wouldn't make it till the morning. I am still here and life is still sweet. We have a court case in Qld about a doctor killing patients and euthenasia wants to legaly make doctors kill people. I havn't said it very nicely but it is the still same result. When you take away the absolutes anything goes. Most people complain about the safety and the loss of freedoms that I enjoyed as a youth and most trace back to watering down absolutes. Give a little here bend the rules there and very soon you have a society out of control. It is sad to see loved ones suffer for it is not easy to die but bending the rules is not the answer.

Why is it anyone's business but my own over when or how I should die. As long as I am of sound mind it will be a time of my own choosing. All I need is some nembutal. I hasten to add that I am a long way from going just yet, but if I suffer a debilitating incurable disease, I shall certainly take the steps to end my life. I do not believe any myth about life after death and it is usually the devoutly religious who want to prolong suffering by a refusal to pass any law by which a person may make a choice and to get medical help to undertake this step.

Will no one rid me of these meddlesome priests ?

I meantioned a friend the other week here on this forum, who I knew back in 2000-01 who was a casual agency nurse. She was a fairly heavy drinker, and although it's an anecdote, late one night when she was reasonable sloshed and nothing much on the television, she told me how it was fairly normal practice when she was posted back at the same hospital for a while, and was aware of the individual 'subjects', and left alone with suffering patients on life support, just to turn off the oxygen for five minutes and wait, before returning the supply back to the original setting and leaving.

Bending the rules for her, but for the patient, bent to breaking point.

I guess it helps free up ICU beds before public holiday seasons.

Seano that is an awful story! That nurse sounds like he/she should be locked up for attempted murder or torture.

Foxy's poor relative <"...was in a semivegetating state, had lost their functional and mental independence - and yet was being given fluids and other vigorous support to preserve their life..."

I am sorry for what you and your family have been through Foxy, and yes I have heard of cases like this.
However, as a general rule, if a person is no longer able to give consent themselves, then the next of kin can speak for them.
Usually, if the situation is dire and there is no hope for recovery, then the next of kin can ask for no active treatment for the patient.

This is not the same as euthanasia, but is just allowing nature to take it's course.
What often happens though is that some family members hold onto false hope and refuse to give up- asking medical staff to continue treatment and keep the patient alive. There are often arguments among family members about this subject.

Living wills are the only answer to these dilemmas.

"Seano that is an awful story! That nurse sounds like he/she should be locked up for attempted murder or torture."

Sorry Suze. I'm at the stage with my own illness now where I tend to speak the truth or stay stum, but please bear in mind that it was only two or three minutes of torture because five minutes without oxygen is certain death + 2 minutes to be sure, and not as painful an ending as my friend saw in the prolonged life of the victim.

As was said on the previous page, doctors (and nurses) do have consciences however well-disguised at times, but that night when she confessed this to me did come as rather a shock that I can't forget to this day, and the friendship was over not long afterwards. The high-paying, low effort casual work that she had was very important to her in keeping some sort of income, and I could see that she brought the subject up that night because she was uncertain about the righteousness of one sort of torture; life against the other, death.

At least she had the capacity to think of the consequences to these victims, but I would never provide her personal details, nor the particular hospital where she had been posted at the time.

Still, if I was one of those patients under her palliative care, I don't know whether I would have wanted her to do what she did or not. It is too late when one cannot speak or write on a piece of paper either of two simple words: yes or no.

Dear Suze,

In our family's case there were no family
arguments. We simply wanted nature to
take its course, as you menioned in your
post. The family member had become anorexic
(they were not able to eat), and fluctuated
between fever, difficulty in breathing,
and pain. Doctors insisted that they could
do nothing. Yet they continued giving
intravenous antibiotics, fluids and other
support.

We had to deal with the agony of the deterioration,
and the suffering.

I realize that many people feel that most deaths
are made easier by modern pain relief. But the reality
is - not all are. I don't believe that if laws were
passed that they'd be misused. Today, most
Australians are born and die in hospitals under the
supervision of medical personnel. What I am questioning
is the fact that sometimes the personnel decide to
keep patients alive long beyond the point at which
they normally would have died.

Patients can be hooked up for days, months, or even
years to machines that sustain their lives, and this
step may be taken even if the patients are in constant
pain or even if they are permanently (or semi permanently)
comatose. So, technologies that were intended to save people
from unnecessary death may actually have the effect of
depriving them of a dignified death.

I therefore agree completely with those that say -
it should be a matter of choice -
especially for those who are hopelessly
terminally ill and are experiencing unrelievable suffering
with absolutely no chance of recovery.

"... sometimes the personnel decide to
keep patients alive long beyond the point at which
they normally would have died."

Foxy, I presented at the 'usual' public hospital on Feb 17, 2008 at around midnight with asthma: normally overnight stay w/ oxygen mask, conscious, gone before breakfast.

Five days later, they brought me out the coma. I was forced to endure morphine for asthma and had some strange and unwanted hallucinations due to mis-medication, but one thing I can't forget. The man in the adjoining bed that I could see suffering in silence mostly, but occasionally groaning, right in front of my bed, right before my eyes, for the next three days.

Therer was an old b&w photo on the window pillar of his younger days, taking a mark for what looked like Swan Districts Footy Club by the colours on his top. Now, both his arms and legs had been amputated at the elbows and knees. Unlikely that he'd ever take another mark for ANY footy club at that stage. What a ROTTEN photo to have to look at, thought I.

When I was moved out of the ICU in a private room for the last two days, I had nightmares about this poor fellow trying to attack me (walking on his stumps with no forearms - I could not fight him back) in a covered walkway by a weedy garden on an overcast late afternoon both nights, and the same nightmare continued every time I tried to sleep for the next week, so I stayed awake that week until the exhaustion and copious amounts of beer helped me finally sleep and forget.

I can't forget the misery and indignity that poor fellow suffered as his last days, and hope with all my heart that he made it to somewhere civilised after he died. I doubt that he would be still stuck in that terrible place today.

I must knock off posting for the night after this.

Thank you for your understanding, Foxy.

Dear Seano,

Thank You for sharing your heart wrenching
experience.
No wonder you had nightmares.

As for that poor soul you mentioned -
all I can say is:

"Eternal rest grant to them, O Lord.
And let perpetual light shine on them.
May they rest in peace. Amen."

Professor Megan-Jane Johnstone says that "palliative
care can help substantially in the majority of cases."
However, as you pointed out, what about the few in
great pain and suffering for which no pain relief is
effective?

Some people fear that condoning the right of people
to end their lives will lead to misuse. I don't buy that.
Effective safeguards can be put in place. As someone
in The Age newspaper pointed out, "the right-to-life
movement" is basically a religious argument put forward
by people intent on imposing their values on society
at large. That may well be - however seeing as about 80
per cent of the population seem to support dying with
dignity legislation - lawmakers must have a full debate
on this issue. The legislation will come, of that I'm
sure.

Again, Thanks for your input.

Foxy
Off topic but watch this 3 minute Chomsky video http://news.bbc.co.uk/2/hi/programmes/hardtalk/8339487.stm?ls

Worth a topic?

Dear Examinator,

I can't watch this video (or any other),
on my antiquated computer. It doesn't
have the capability. I hope to be getting
a new computer for Christmas.
I would have loved seeing the Chomsky interview
on the American involvement in Afghanistan.

I imagine it would be worth starting a topic
on the subject. Chomsky's opinions are always
rational and well argued.

Dear Foxy and Seano,
Yes I do agree we need legalized euthanasia in some form or another.
However, as a nurse I can tell you that it is always at the resident Doctors mercy as to how a patient is treated in hospitals.

At present we don't have legal euthanasia, so they can't be seen to do anything to hasten anyone's death- or they can be charged with manslaughter or murder. Believe me, there are plenty of people working in hospitals who feel the need to closely scrutinize any deaths that may appear to have happened too quickly.

Of course there are suspicious deaths from poor medical practices or accidents which certainly should be investigated and acted upon, however I have heard of some instances where palliative patient deaths have been vigorously investigated.

Many times, family members argue over drug use in the final days of palliative patients lives. Some family members (usually those against euthanasia or for religious reasons) do not want the large doses of drugs required for effective pain relief because they believe it may prematurely kill the patient- even though they are already in the late stages of their illness.

Some Doctors and Nurses are afraid of this because often these family members call for post mortems after death- and there can be allegations against medical staff.

Euthanasia needs to be made legal before you will see any changes in these practices.

Yes Foxy there are few who would disagree with your sentiments. If we are ill, and without hope, when we die should be our decision regardless of the disease. When we know we have had enough we should have access to a pill able to be used when we want, thereby making the decision when we die our own. It should not be the decision of a doctor, other than for prescribing the pills without prejudice, or any other person who wants to make it their decision.

People should be allowed to die either with family present or alone. There should be no repercussions to family. No human being should be made to suffer any of the indignities of dying that I have seen in my lifetime.

I should add I have the fear of stroke, because it runs in my family on the female side, scares the daylights out of me. I don't want to die as my mother did and I do not want an old age that is a burden to me, my family and the health system. I simply don't want that and if it is in my power, one way or another, I will make the decision for myself. However, it should be easy to do. People should not have to go outside the country to obtain the medication, or go to another country where euthanasia is legal, to die. It ludicrous.

Why is there no official discussion? Why are the politicians not willing to make the laws as they should be. Are they scared of a minority few religious nutters?

Dear Suze,

I am grateful to know somebody 'at the coalface' if you will, an yet honest and able to see both sides. Back in 2001, I could not see why the late-night actions of my friend were justified, but if I can be EXTREMELY careful in mentioning possible benefits, I now see how she may've known more about the situation than I did then, and in her casual role, she had freedom that official doctor's reports did'nt. It is human nature when a horse has a broken leg to solve the problem efficiently, and I would hope respectfully considering I don't know anyone who speaks fluent horse-sense.

I'm moved by your post, but the family aspect complicates things far more than the simple relationship between the trusted nurse and patient, and IMHO it is that human kindness that can both inspire a dying patient to stay alive through the night, or discuss the misery that makes us perhaps wish we were horses.

If there was a way to maintain that relationship between a dying patient and their most trusted friend at that most important time, and if there could be that same wonderful person at the bedside over expected 8 hour periods throughout those days, then I believe it would enable correct decisions to be passed to the doctor about life or death, but the nurse who takes care of a bedpan and walks away is not quite enough. A friend when you're losing your ability to communicate is the most important thing, and family can be misled or have alterior motives if there is inheritances involved. I will never willingly enter another hospital in Australia after the morphine-for-asthma madness, but what was lacking mostly, and what I suspect might be lacking for the dying, was a good person who happens to be a nurse, that one can get to know and trust with their last wishes.

I believe that you are that kind of human being and hope that the admedistrivia doesn't stop yop from that most important part of nursing.

PS: Suze, I remember that quack who dropped by after lunch, after I had waited for treatment at the 'other' hospital since early morning to get those painful six 25-day-old foreign country stitches removed, and how he demonstrated the procedure to his valued med-student, twice, and left me to rot or pull the other four out myself.

I can imagine his lesson-plan if euthanasia was legal. "Okay Winston, now I will demonstrate the procedure of euthanasia, so please get your eyes off the nurses and close your mouth and pay attention to this while I kill the patient with the six stitches in his abdomen - I will not repeat this technique twice, so watch closely!"

Suze, it might be best we leave that 'grey' area and don't legalise euthanasia while the lunartics are running the asylums.

That's all. Good night and thank you all for today's discussions.

Thanks to everyone for all your inputs.

I came across a letter in The Age, Saturday,
October 31st, 2009, written by Dr Rodney
Syme and Judith Hoy Jones, from the
"Dying with Dignity," organisation.

Here's a part of it:

"...Dying With Dignity Victoria supports
palliative care, and does not claim that
a dignified death will occur only through
voluntary euthanasia. For some who find
no relief from suffering through palliative
care, physician-assisted dying can provide
a "good death."

By taking a general "swipe and gripe" at
right-to-life and dying with dignity
groups, Professor Megan-Jane Johnstone
evidenced a poor understanding of what most
Australian dying-with-dignity societies are
working towards. Her report did little to
contribute to the necessary debate about
the ability or inability of individuals
to make rational choices about their own end
of life."

As we can see this issue needs to be brought
out into the open and discussed publicly.
Questions need to be asked...

Palliative care undoubtedly can help very many
people to a good death. But what about the ones
who have very painful deaths?

If the population takes a stand, the laws will
come.

When they told my father he was dying and there was no hope they killed him right there and then. Then they kept him alive so he could lose all his dignity and self respect. He tried to go to the toilet by himself because he could not bear for his daughter to take him. I found him in a heap on the floor.

Dear Missus,

I'm so sorry about your father.

Cases like yours are the reasons why the
time has come for a full debate on the issue.

This message needs to be sent to the politicians
and lawmakers.

When my dad passed away, myself, my bother and sister had to make what was for me the toughest decision ever, and that was to allow the machine that was keeping him alive to be turned off.

Now we were told by the doctor that once the machine was turned off that he would pass. And he did, very peacefully and with my mother beside him.

Although I am in favour of allowing someone to end their life, I can honnestly say that I don't really know how I would have acted if he was able to have asked me to turn the machine off.

To this day, my mum does not know that I agreed to have the machine turned off and I would suggest that she would have stayed by his side for days, perhaps weeks if he had been allowed to continue living on life support.

This is a very complicated and delicate subject.

Dear Rehctub,

My mother did stay by her husband (my step-father)
for months, until the day he died. He was in
severe pain, and it wasn't with peace and dignity.
He deteriorated to an unrecognisable state in
front of our eyes and suffered dreadfully.

Dear foxy
It has been five years since my dad passed and, although I would give anything to have him back,(in good health that is) I draw comfort in knowing that my decision helped place him in a better place as we can all continue to enjoy the memories we have of our loving father.

Even my mum says that she would love to have him back, but not in the state he was in. As I say to her often, he has simply gone before you and is awaiting your company one day.

Although it is a free country and we are all entitled to an opinion, I have doubts whether one can have a 'valued opinion' on this matter unless they have chosen the path of a loved one first hand like I and no doubt many other have.

As I say, it is a very tender subject.

Dear rehctub,

Thank You for sharing your experience and thoughts.

I wish you well.