End of Life Decisions    Improvement of the dying experience plan byDrAlida Lancee

1 Criminal code 1913 does not distinguish between wilful murder and end of life medical intervention to relieve suffering with an earlier death as a side effect. One has to prove in court that the doctrine of double effect was applicable. Or face a murder sentence.This creates fear in medical practitioners and hesitation to provide adequate symptomatic relief in case this is misinterpreted as an attempt to hasten death. Especially in in institutions . The result is that many terminally ill do not receive adequate symptom relief and suffer needlessly. Their loved ones are left with painful memories which often complicate the grieving process.

Solution:

End of Life law reform

2.Death and dying are not medical matters, they are a normal very individual but emotional aspect of the human experience.Every person has their own moral and belief structure around this issue and should be able to have achoice in what their dying experience should look like.Most Western Australians (over 80%) want to be able to have control over where and when they die.The days are long gone where doctors were an authority over death and dying.Medical practitioners in our modern society are but one member of a patient-centred health care team.In our free society we have autonomy over our beliefs, moral values and health care decisions.The health care team is guided by each patient’s values in all health care decisions.How we choose to die should be no different.Each health practitioner in turn has the right to choose if they can comply with any such request or if they need to refer to another practitioner who has no such objections.

Solution

*Freedom of Choice at the End of Life legislation

*End of life Service to educate the public, health practitioners and allow “handover of care” if needed

3 Death and dying should be a family and loved ones focussed affair ,not a medicalised hospital based experience.Most people want to die at home or in their community but only 15-20% do so. Most (60%) die in hospital and 10% in ICU

Solution

Increased funding for community based palliative care services and allocated small community based hospice facilities not located at a hospital

Increased respite and help for carers of dying persons to allow as many people as possible to die at home among loved ones.

4 Death and dying are still taboo subjects often avoided in conversation and as a result of medical advances death is tried to be delayed as along as possible even thought this often prolongs and increases suffering.

Solution

Universal advanced care planning for all over 75YO as part of the 75 health assessment with GP’s to allow open communication of ones mortality and for wishes to be documented.

Medic-alert bracelets can be worn by those who do not wish to be resuscitated and to indicate an advanced health directive is in place.

Database of directives on website

These directives are legally binding and all health practitioners are required to abide by the persons written wishes.