End of life care, or the question “how would you like to die?” is an important topic which many families, care-givers and healthcare professionals struggle to discuss with patients who are in their end stage of life. However, this question is becoming increasingly relevant as Australia manages its ageing population and resulting impact on our health system now and on into the future.
Dr Ezekiel Emanuel, an American oncologist, bio-ethicist and one of the key architects to President Obama’s healthcare reforms, was recently in Newcastle to discuss “End of Life: Ethics, Dilemmas and Decisions.” Dr Emanuel’s lecture explored end of life care options including euthanasia, physician-assisted suicide (‘PAS’) and palliative care options. Contrary to popular belief Dr Emanuel presented statistics showing euthanasia and/or PAS is accessed by a minority of patients in those jurisdictions, such as Oregon, the Netherlands and Belgium, in which it is legal. Dr Emanuel pointed to system reform and the increase of infrastructure as the answer to the world’s ageing population, rather than legalising euthanasia. He noted that while an overwhelming portion of people would prefer to die at home, 80% of people actually die in hospitals. As a way to realise this desire, one alternative to traditional treatment would be to introduce home palliative care options such that it becomes accessible to everyone.
Ensuring end of life care wishes are met
“The paramount consideration [for healthcare providers] is that a person is entitled to make his own decisions about his own life” [Rogers v Whitaker, HCA (1992)]. Whilst it is a difficult conversation to have, it is important to discuss end of life care with family, caregivers and healthcare providers. Advance Care Directives play a great role in assisting patients, family and healthcare providers with respect to end of life decisions and allowing you to clearly spell out what sort of medical treatment you would prefer, or not prefer, at any point in the future should you be unable to make decisions at that time.
Watch the NSW Government Video on Advance Care Planning.
If you wish to discuss your own Advance Care Directive, or receive advice about one, contact our office to make an appointment.
