Choosing a dignified end

How legislative change could provide more end-of-life choices for the terminally ill.

Dying With Dignity, a group founded in the 1970s, wants to legalise medically-assisted dying or Voluntary Euthanasia (VE) in New South Wales.

It is currently an offence in this state to assist a person to die. Nurses, doctors or family members who assist a dying person to end their lives risk deregistration and criminal prosecution.

Dr Sarah Edelman, a Clinical Psychologist and a member of Dying With Dignity, says the group’s main goal is to influence the political process to bring about legislative change. This would enable people who are hopelessly ill and suffering to exercise the choice to end their lives peacefully without fear of loved ones or medical practitioners being criminally charged.

People who support Medically Assisted Dying recognise that legal safeguards should be in place – for example, against greedy relatives – so that people don’t feel pressured to end their lives.

There are already several countries that have legalised VE including US states Washington (2009), Oregon (1997) and Montana (2010); the Netherlands (2000); Switzerland; Belgium (2002); Luxembourg (2009); and Albania (1999). Research and case studies show that the models are working well.

Surveys and case studies also over- whelmingly show that public support for the issue has been steadily increasing over the past 20 years:

  • 85% of Australians support VE when a person is terminally ill and suffering (Newspoll 2009)
  • 75% of Christians support VE (Newspoll, 2007)
  • 58% of those with non-Christian religions support VE (Newspoll, 2007)
  • 91% of those with no religion support VE (Newspoll, 2007)
  • 80% of nurses who responded to a NSWNA survey (1997) supported VE in some circumstances.

VE is talked about but rarely asked for

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Sharon Wiley, a Palliative Care CNC at Sacred Heart Hospital

Palliative Care is an important aspect of medically-assisted deaths and in Belgium and Oregon (the more recent converts to VE), the amount of spending and resources on palliative care have increased substantially.Sharon Wiley, a Palliative Care CNC at Sacred Heart Hospital, says euthanasia is often about control not just dignity.

‘From a palliative nurse’s perspective, dying with dignity is a very important goal of the care provided in palliative care. However, based on my own experience of caring for many palliative care patients the topic of euthanasia is often raised but rarely requested.

‘Advances in palliative care have meant improvement in the available medications including opioids that are simpler to administer and are very effective in relieving suffering. Each request needs to involve open, sensitive communication in the clinical setting. This usually involves comprehensive palliative care support from a multidisciplinary team. The request for euthanasia is often about control rather than dignity.’

Dr Edelman agrees that palliative care is important. ‘We feel palliative care is really important. The issue for us is about choice and we feel that the option of end-of-life choices should be part of palliative care.’