13 August 2013

Thinking about End of Life

| johnboy
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Chief Minister Gallagher is kicking off a long overdue discussion on end of life issues. With a forum report on the issue:

new report on end of life issues has called for increased community engagement and awareness on end of life care and suggested some clarification to the laws dealing with advance care directives, Chief Minister and Minister for Health, Katy Gallagher, said today.

The Chief Minister welcomed the release of the final report from the ACT Local Hospital Network Council Forum on end of life issues and decision-making.

“End of life care is an area of our health system that is often not discussed widely in public, but is something that is a very important aspect of managing an illness for many people in our community,” the Chief Minister said.

“I was pleased to open the Local Hospital Network’s forum on end of life issues back in May this year, and welcome this report containing six recommendations that stemmed from this forum.”

The key recommendations include:

— Greater involvement and understanding across the community in end of life care issues;

— increased information and awareness of the usefulness and benefits of advance care planning;

— create a greater acceptance of the value and importance of advance care planning amongst all careers and professionals in end of life settings and support training to increase their adoption;

— clarify and simplify the legal framework for advance care planning and move towards a common framework and set of documents for them;

— take steps to make advance care planning easily available and ensure that when they done they are acted upon;

— options in end of life situations should be openly discussed so that futile care can be recognised and patients directed to the most appropriate care and palliatiation.

Now if we can just get serious about euthanasia maybe we can stop wasting 90% of the vast health budget on the last sixth months of life.

Give me a six month prognosis, let me set a date and any friends or family who want to say goodbye can make appropriate arrangements, I can read the obits, and check out on schedule.

Better than months of being carved up by surgeons and gasping through tubes.

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I watched my Auntie, who was suffering greatly with a number of ailments, (including chronic arthritis, which had left her bed-ridden), finally refuse any furthur treatment and starve herself to death.
It was the only option she could see left available to here after medical staff refused to become involved in any sort of euthenasia. (Which I understand, from a legal, ethical and moral viewpoint it must be a mine field for them).
However, watching my Aunt appear in court, on an ambulance gurney, to prove here sanity to a judge, so she could have teh force feeding tubes removed was, to say the least, very un-dignified for her.
And I think this is the thing here.
It’s not just about how the rest of the family / community feel, there must be a point at which a being no longer wishes to continue it’s existance in this life / incarnation / on this plane, whatever your view on the after-life / religion. At that point, surely, if you’re of sane mind you should be allowed to make a decision and have it respected.
Let these people have some dignity as they pass.

On another note, I sat with some close family friends a couple of weeks ago who’s father had collapsed, un-expectedly on a shopping trip.
He was in a vegetative state after a couple of operations there was no more that could be done for him and the decision was made by his wife and family to “let him go”.
There is a good deal more to this than you may think, forms to be filled out, questions to be answered, hoops to jump through, all completely understandable but I thought that the way the staff at TCH handled the whole thing was outstanding.
Most of us will only go through this a couple of times, but these poor women and men face it every day.
Must be tough for them.

Having watched a few members of my family suffer long waits to die in hospital, I fully advocate the use of “Assisted suicide” kits (essentially a plastic bag, tie cord and helium canister) . My grandmother we watched suffer for 6 months (after being told “she’ll be gone by the end on the month” a couple of times), and I wouldn’t wish that kind of horror on even my worst enemy.

Provided there are safe-guards in place (such as 2 independent psychological reviews, to ensure it is actually their choice and they know what they’re doing) to prevent people killing off relatives etc, I don’t see why it couldn’t work.

I remember seeing a documentary a few years ago about this exact subject, which followed a terminal cancer patient who decided that since our laws prevented her from killing herself, she would fly to Mexico and buy illegal barbiturates and do it herself in the comfort of her own home. Her reasoning was – worst case she gets caught trying to buy them, and gets put back into hospital to die, best case she gets to end things how she wants, in her home, with her family.

The real issue stems when people use the term “assisted suicide”, since it conjures up the idea of people wanting to commit suicide, as opposed to the actual purpose which is to ease suffering.
Again though, I think with proper safe-guards in place (psychological counseling for a minimum period) it could even work for those who aren’t ill and are looking for a “way out”.

troll-sniffer8:27 pm 13 Aug 13

I like the idea of having a big jar full of pills. I take one or two at bedtime. All but one pill in the jar is benign and I wake up the next morning, with another day to make the most of. One night though, the slow acting death pill is in the hand, and I never wake up.

cranky said :

Makes voting for Philip Nitschke in the Senate a lay down misere.

And give Zed the boot.

Maybe Katys more clever than I’d thought. 🙂

Makes voting for Philip Nitschke in the Senate a lay down misere.

And give Zed the boot.

Masquara said :

Tetranitrate said :

PoQ said :

We wouldn’t allow animals to go through what we regularly drag people through.

Euthanasing humans is more complicated than euthanasing animals for social reasons – not being speciesist here, but it has to be taken into account that animals don’t have financial assets and aren’t potentially prey to greedy relatives …

Sadly there’s truth in what you say for there are some who can hardly wait to get their hands on the assets.

tuco said :

poetix said :

If you don’t think about death most days, you’re just drifting. It’s just around the corner (-:

Just keep passing the open windows.

Defenestration: curtains for some.

poetix said :

If you don’t think about death most days, you’re just drifting. It’s just around the corner (-:

Just keep passing the open windows.

justin heywood said :

“…maybe we can stop wasting 90% of the vast health budget on the last sixth months of life…”

I’ve seen raise that factoid before Johnboy. A quick Google search brings up various values, including a claim that your figure something of an urban myth.

So, dare I ask….source?

Awww – it’s spreading already!

ScienceRules3:02 pm 13 Aug 13

Masquara said :

“end of life” – that would be DEATH, no? How very Orwellian.

The term “end of life” as used in medicine today usually refers to the process of dying, the treatments and palliatiave care available to the patient and the involvement of friends and family. The transition from “normal” life to death can take months and since we’re particularly bad at talking about it in our society (witness almost all the comments above), it great that this awareness campaign is under way.

It’s an important discussion to have with your family, as uncomfortable as it might be. It’s also important to have an enduring power of attorney to cover your health choices and also to have made crystal clear, in writing, just how you want to be treated if your death isn’t an unexpected “lights out” event.

Tetranitrate said :

PoQ said :

We wouldn’t allow animals to go through what we regularly drag people through.

Euthanasing humans is more complicated than euthanasing animals for social reasons – not being speciesist here, but it has to be taken into account that animals don’t have financial assets and aren’t potentially prey to greedy relatives …

If you don’t think about death most days, you’re just drifting. It’s just around the corner (-:

“Nobody gets out of here alive.”

justin heywood said :

“…maybe we can stop wasting 90% of the vast health budget on the last sixth months of life…”

I’ve seen raise that factoid before Johnboy. A quick Google search brings up various values, including a claim that your figure something of an urban myth.

So, dare I ask….source?

I read it in Crikey, and have had it confirmed by health officials in person when asked about it.

Tetranitrate12:45 pm 13 Aug 13

PoQ said :

I thougt it was Kant, but apparently it’s Szasz:

“…Philosopher and psychiatrist Thomas Szasz goes further, arguing that suicide is the most basic right of all. If freedom is self-ownership – ownership over one’s own life and body – then the right to end that life is the most basic of all. If others can force you to live, you do not own yourself and belong to them…”

http://en.wikipedia.org/wiki/Philosophy_of_suicide

Pretty much, and denying people the option of painless and dignified death is unbelievably cruel. We wouldn’t allow animals to go through what we regularly drag people through.

http://www.youtube.com/watch?v=jdxd_EFDd4s

Be in a Chuck Norris movie.

I thougt it was Kant, but apparently it’s Szasz:

“…Philosopher and psychiatrist Thomas Szasz goes further, arguing that suicide is the most basic right of all. If freedom is self-ownership – ownership over one’s own life and body – then the right to end that life is the most basic of all. If others can force you to live, you do not own yourself and belong to them…”

http://en.wikipedia.org/wiki/Philosophy_of_suicide

justin heywood12:21 pm 13 Aug 13

“…maybe we can stop wasting 90% of the vast health budget on the last sixth months of life…”

I’ve seen raise that factoid before Johnboy. A quick Google search brings up various values, including a claim that your figure something of an urban myth.

So, dare I ask….source?

“end of life” – that would be DEATH, no? How very Orwellian.

Frozen then into a wood chipper at 3000 feet over Canberra. Rossco rain for everyone

more about the point up unto death guys, not immediately after!

When my time comes, I would like to be snap frozen and flung into space only to be brought back 500 years later ………Buck Roger’s style.

“In the year 2014, the Australian’s cheaper version of NASA launched the last of their deep space probes. Aboard this compact starship, a lone astronaut……. Captain P “Buck” BO…….. was to experience cosmic forces beyond all comprehension. In a freak mishap, his life support systems were frozen by temperatures beyond imagination. Ranger 3 was blown out of its planned trajectory into an orbit one thousand times more vast, an orbit which was to return PBO to Earth…… 500 years later…..”

Da DA DA, Da Da DA DAD DA, Dad Da Daaaa……….

When my time comes, I would love to be given some sleeping pills, placed in a casket packed with high explosives, then placed in an old car, or by a group of letterboxes, or whatever, and blow some shit up. It’ll give my paid mourner something to cheer about too. Euthanasia and disposal all taken care of.

I’ll have to give some thoughts to where I’d like to be euthanised.

Death panels!

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