My life, my death, my choice…

By Bill Alcock

Despite 80% of Australians favoring physician-assisted suicide for people who have lost quality of life, the government refuses to legislate accordingly.

sml-sq-doctor-beside-elderly-patientThere is just no way I will linger on in a nursing home indefinitely suffering from dementia, Alzheimer’s, incontinence and the like.

I just cannot understand why, when 80% of our citizens are in favour, the government refuses to legislate to allow us to choose euthanasia when quality of life is lost. It must be costing the country billions of dollars to keep patients who do not want to be there in nursing homes when their quality of life is lost.

In my opinion everyone should have the right to choose medical assistance for a dignified and peaceful death, if quality of life is lost, provided this choice has been documented in an advance health care directive whilst of sound mind.

I am an 91-year-old veteran affairs pensioner. I recently had open-heart surgery at Prince of Wales Hospital in Sydney. I have several other failing parts and I am scared stiff that I may be confined indefinitely to a nursing home.

When quality of life is lost and the sufferer is confined in care with Alzheimer’s, dementia, incontinence and the like, palliative care is definitely not enough.

My wife had uncontrollable diabetes and an inoperable heart condition. She was admitted to hospital on 17 September 2015. On 19 Sept her treating doctor rang to advise me that she was failing to the extent that she would have to be transferred to a nursing home.

This is not what my wife wanted at the end of her life. I called her enduring guardian, and he conferred with her doctor, showing the doctor my wife’s written choices in her advance health care directive: no resuscitation, no treatment that would prolong life, no further food or sustenance.

The doctor instructed the treating nurse to administer morphine injections on the hour; my wife, Pat, passed away peacefully with family by her side. I hope I get a compassionate and caring doctor like my wife’s doctor if ever I am in the same position.

When our pets lose quality of life, the vet eases them out in a dignified manner. Why not humans?

I find it very difficult to believe that anyone with an ounce of compassion can deny those who have lost quality of life, be it degeneration or terminal illness, the right to make a choice for a dignified and peaceful death provided this has been documented in an advance health care directive whilst of sound mind.
When the end is nigh it is best to avoid hospital. The health system is geared to actively treating patients and prolonging life, not to recognise the dying.
There are thousands of patients in hospitals and nursing homes with no quality of life, lingering on indefinitely while awaiting the blessing of death to release them from their despair. If ever I am unfortunate enough to be placed in the same situation I hope there is a sympathetic doctor around to end my life in a dignified and peaceful manner.

In light of the government’s unsympathetic attitude I have no option but to direct in my advance health care directive that, if I should lose quality of life, I do not want any medical treatment that will prolong my life and I do not want any further sustenance or fluid. Although it will take me a few days to die, this option is better than the alternative. It would give me great peace of mind if I could get medical assistance to die in a dignified manner if I should lose quality of life.

Fate worse than death

It is my firm opinion that enforced prolonged life when quality of life is lost is a fate far worse than death, I fear degeneration far more than I fear death. It is inhumane to leave those who have lost quality of life indefinitely suffering.
Times have changed. In my grandparents’ day there were no nursing homes: my parents cared for them at home, the family doctor called every other week to check on them and issue scripts and, when they lost quality of life, he asked for a family conference and was given permission to ease them out with analgesics.  It was not called euthanasia but compassion

My strong belief is the right for everyone to make a choice for euthanasia should they lose quality of life has been influenced by two family occurrences:

  • A heavy smoker with cancer of the throat deteriorated quickly. I could hear him gasping for breath as I entered the main hospital entrance. He could not communicate, did not recognise anyone and was being fed intravenously. Fortunately I was able to persuade a sympathetic doctor to ease him out in a dignified manner.
  • A mate who served with me in World War Two had always expressed the wish not to be confined in a nursing home. The doctor put his arm around him one day in my presence and said to him: “Don’t you worry Tom, when the time comes I will ease you out.”

This gave Tom great peace of mind. However the time came when Tom had to go in a nursing home: he was given medication to stop him wandering at night, crying out and disturbing other patients. He deteriorated quickly, became incontinent in bowels and bladder, was bedridden, unable to communicate and did not recognise anyone.

When I approached the doctor for help he said: “Sorry, I cannot do anything for him now as all medication in a nursing home has to be documented”. Tom was allowed to lie in his bed in this state for 15 months. Surely you must agree that this is an extremely cruel fate to impose upon someone who had served his country with distinction.
I would strongly recommend that everyone prepare an advance health care directive and appoint an enduring guardian, so that he/she has the authority to liaise with the doctor in the preparation of a health care management plan when quality of life is lost.
The health care management plan should provide that you not be subjected to any intervention or treatment aimed at prolonging life, and that any distressing symptoms (including any caused by lack of food or fluid) are fully controlled by appropriate analgesics or other treatment, even though this may shorten life. For those wishing to avoid prolonged confinement in a nursing home and distress to loved ones, I would strongly recommend that they take this action whilst of sound mind.

Let me make it clear that is not my intention to impose my views on anyone. However I consider that euthanasia should be an option for those who have documented their wishes in an advance health care directive.

* Bill Alcock is a CLA member in Port Macquarie NSW.

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