The " Fear Factor " !

When that Euthanasia law was voted down by a single vote in the New South Wales parliament many people with terminal diseases despaired of achieving a painless end to their lives.  The lucky ones hoped that a bed might be found for them in palliative care, where the objective is to go further with pain relief than is usually provided in the general hospital system.

Much media attention was focused on a custom that has prevailed for a very long time. Some humanitarian doctors believe that pain relief is more important that a few extra hours of life and deliver an opiate dose that both eases the suffering and lets life slip away.  This is illegal and the practice is tending to cease as public debate causes those with objector views to report such instances to the authorities.

Australians will be dismayed to learn that a recent report found that errors in opiate use were three times higher than in other healthcare settings.  The researchers had looked at opioid errors in three inpatient palliative care services in metropolitan NSW.   In forty-two percent of these cases the patient received a lesser dose than was initially ordered., with more than half of them requiring additional treatment as a direct consequence of this opioid error.

It seems that many who hoped for a pain free death are not getting their expectation and the most likely case is the " fear factor " that this euthanasia debate has generated in individual minds. Those tasked with delivering opioid doses can not be sure that a colleague may have an anti-Euthanasia mindset and question the validity of the measure delivered.  They could be dragged before a coronial enquiry and stripped of their medical license if found guilty.

Significantly, the majority of patients examined had terminal cancer and were aged in their seventies. This was the very people that Euthanasia law was intended to serve, allowing them to avoid the painful end that many cancers deliver by choosing the timing of their individual deaths.  Instead, they are put at the mercy of others and we now find that this same fear factor is diluting the legal dose they are entitled to receive.   Some are experiencing an unnecessarily painful death in the very institution designed to prevent this happening.

Perhaps we need to review that very complex law that got voted down.  It required the patient to make arrangements well in advance and be examined by a psychiatrist.  There were age restrictions and to be mercifully terminated  the patient had to jump through all the hoops the politicians thought necessary to placate opposing religions.

Really, this is something that very properly belongs in confidence between the patient and their attending doctor.   If a terminal patient is in extreme pain and asks his or her doctor to end it - that should be where the decision is made - and exactly where it rightfully should be made.

Strangely, if those with the care of an animal allowed it to suffer the agony some patients faced before death we would prosecute them and deliver punishment in a court, and yet that is the kind of mercy we deny humankind !