Euthanasia no substitute for palliative care


On a daily basis, Palliative Care Victoria receives distressed calls from people seeking help for someone who is dying and suffering needlessly.

In hospitals, aged-care facilities and homes across Victoria, people are dying difficult deaths without re­ceiving palliative care and the sup­port their carers need.

Inadequate training of health pro­fessionals in caring for the dying per­son creates a reliance on a small, specialist palliative care work force that cannot meet the current need.

The fact that too many Victorians are dying bad deaths is not news. A number of these difficult deaths have been the impetus for calls to legalise euthanasia.

Public attention has focused on the quest for euthanasia without giving adequate attention to the solution that 99 per cent of Victorians want: timely access to high-quality palliative care.

The reality is, many Victorians benefit from improved quality of life and die with dignity and in comfort with the support of palliative care. But we need to make this readily available to everyone. Many people don’t know about palliative care, many are not referred, and gaps in services mean many miss out.

Victoria’s Auditor-General high­lighted the need to improve palliative care in his April 2015 report, while The End of Life Choices Inquiry Report in June 2016 included 29 recom­mendations to improve palliative care. Much of the focus of the Vic­torian government’s response to the recommendations of the End of Life Choices Inquiry will be on its deci­sion to introduce legislation that would legalise a physician-assisted death for terminally ill people who meet specific criteria. This will be welcomed by those who seek this.

However, the vast majority of Victorians do not want to die by a lethal dose of drugs. They want the right to choose and receive high-quality palliative care.

People dying in suffering should be given the same priority as a per­son experiencing a heart attack or other life-threatening event. Sys­temic failures to provide safe neo­natal care or meet ambulance emer­gency response times are addressed by governments as urgent priorities.

Similarly, systemic failures in car­ing for dying people deserve to be addressed by the Victorian govern­ment with as much urgency and pri­ority. Euthanasia may become a choice, but it is not the solution.

The solution requires substantial increases in funding to improve ac­cess to high-quality palliative care and end-of-life care across Victoria. It requires urgent and full imple­mentation of Victoria’s new policy framework as a priority, along with the transparency of funding and ser­vice provision recommended by the End of Life Choices Inquiry.

Regrettably, increases in palliative care funding have declined in the past two years in spite of the recom­mendations noted above. Funding in Victoria is about one per cent of ex­penditure on public hospitals. To im­plement the recommendations of the Auditor-General and the End of Life Choices Inquiry, palliative care ser­vices need at least $50 million in ad­ditional funding each year, as well as substantial capital funding.

Without concerted and compre­hensive action to address the sys­temic failures in how we care for people who are dying across Victoria, there can be no genuine choice; we could only hang our heads in shame and mourn the loss of a truly com­passionate society.

Odette Wanders is chief executive officer of Palliative Care Victoria.