Currently People die slower and sicker than ever before despite (or because of) medical advances
* Average time from diagnosis of life limiting illness to death is 18 months
*Most of us want to die at home or in our community but only 20 % do.
- Advanced Care Directives
- Increased funding for Community Palliative care services
- Increased funding for Carer support and respite
"Death and Dying are not medical matters. They are a normal aspect of the Human experience" Dr Alida Lancee
WITH A FREEDOM OF CHOICE BILL DOCTORS WILL CONTINUE TO FOCUS ON IMPROVING QUALITY OF LIFE
The cornerstone medical care of the terminally ill will always remain the optimisation of quality of life with excellent palliative care. It is well known however that this care is not sufficient to ensure an acceptable dying experience for all.
Diagnosing a terminal illness, assessing mental capacity and providing palliative support and information all require the expertise of a suitably qualified professional and will continue to be the cornerstone of health care for the terminally ill.
90% of patients who have an assisted death in Oregon are enrolled in hospice and have received expert palliative care.
DOCTORS DUTY IS TO RELIEVE SUFFERING
The Hippocratic Oath is generally considered incompatible with contemporary medicine and has widely been replaced by the Declaration of Geneva. In contrast to the claim that assisted dying is a violation of the Hippocratic Oath,many healthcare professionals actually consider being prevented from respecting the wishes of dying people in conflict with their medical ethics.
Please also refer to Emiratus Prof Max Kamien's talk here
51% of Australian GPs would be willing to prescribe life ending medication at their patients request under a suitably safeguarded legal framework.
A conscientious objection clause in the Bill means those who did not want to participate in a request could choose not to.
MENTAL CAPACITY ASSESSMENT
Doctors routinely assess mental capacity as part of their day-to-day duties. Determining mental capacity already plays a key role in end-of-life decision making, such as the right to refuse treatment.Doctors are already required to make complex decisions about patients’ end-of-life care; this includes discontinuing futile treatment and respecting patients’ requests to refuse treatment, both of which may hasten death.
The proposed Bill would require two independent medical practitioners to assess the persons mental capacity and refer to a psychiatrist if there was any doubt regarding their decision making capacity or state of mind.
DOCTORS CAN MAKE A REASONABLY ACCURATE PROGNOSIS
Many doctors are experienced in assessing life expectancy. Evidence shows that errors in prognosis are more likely to be over-estimates of life expectancy. There are several prognostic tools doctors already use in their approach to management of people with a life limiting illness.
Many government and insurance document accept "terminal illness" as a condition with a prognosis less than 12 months.
EXPERT PALLIATIVE CARE IS NOT SUFFICIENT FOR ALL
Research shows that even in hospices approximately 2% of dying people receive no relief of their symptoms in the last three months of their life.
Suffering encompasses much more than just pain;
Breathlessness ,Severe weakness , loss of autonomy, being less able to engage in activities and loss of dignity can deeply affect those at the end of their lives, but cannot necessarily be relieved by palliative care.
Public support is overwhelming for end of life law reform.
82% OF THE GENERAL PUBLIC
79% OF RELIGIOUS PEOPLE
86% OF DISABLED PEOPLE
65% OF AUSTRALIAN GP’S
AUSTRALIAN NURSING FEDERATION
“SLIPPERY SLOPE” IS UNFOUNDED
In Oregon, where an assisted dying law has operated safely since 1997,there have been no cases of abuse of the law and no widening of its initial, limited scope.
Assisted deaths in Oregon accounts for just 0.3% of total deaths and this rate has not increased
ASSISTED DYING IS NOT SUICIDE, THE PERSON IS ALREADY DYING
“I am not suicidal. I do not want to die. But I am dying. And I want to die on my own terms.”Brittany Maynard, who had an assisted death under Oregon’s Death with Dignity Act in November2014, aged 29.
Suicide implies the person's rejection of life through a mental illness. The terminally ill do NOT reject life, their BODIES are dying and sometimes trap them in unbearable suffering. Death then comes as a relief of this suffering.
ASSISTED DYING IS NOT KILLING, THE PERSON CHOOSES TO DIE QUICKER THEMSELVES TO STOP THEIR SUFFERING
If a request for assisted dying is approved, the dying person would administer the life-ending medication themselves if they are able to do so. They would only be eligible for physical assistance if they are not capable to self administer.
PEOPLE ARE NOT PRESSURED TO DIE QUICKER
One Third of terminally ill people in Oregon who are prescribed the assisted dying medication do not take it. They die from their disease but felt comforted that the option was there.
THERE IS STILL A NEED TO CHANGE THE LAW EVEN WHEN LESS THAN 0.5% A OF ALL PEOPLE WHO DIE WILL USE IT
Although the number of assisted deaths would be relatively small, the number of people who would take comfort from knowing the option is there if they need it is much higher.
The population as a whole is reassured that safeguarded legislation is in place should they need it.
Removing the fear of dying a horrible death and having control over one's dying course would enable an improved quality of life in the final stage of life for all.