An anaesthetist talks about being mortal

We have until now avoided posting any stories that reference medically assisted dying.  This story is sufficiently compelling to warrant it being given our attention, since it calls for nothing more than respect that there are such divergent views on assisted dying that it demands allowing more choice than is currently available.

Dr Ian McPhee poses some timely questions in this story published in THE AGE  (Assisted dying: the difficult conversation we need to have, February 2, 2016)

“How is it possible that doctors continue to administer futile care as if a ‘last right’ for their patients, when for themselves they wish for no such thing. As recently as this month, in the Journal of the American Medical Association, this fact was again highlighted.    The limitations of intervention are understood but this is not translated into the treatments administered to patients. In a 2014 paper, researchers from Stanford University reported that 88 per cent of more than 1000 US doctors surveyed indicated they would forgo high-intensity care for themselves at the end of life.”

“To bring focus here, my colleague Peter Saul said recently that we are facing ‘a perfect storm of ageing and expanding population with a higher burden of chronic disease’. His call to us as a society has been: “Let’s talk about dying.” It is no less directed at health professionals as it is to the public at large. ”

“For me, the recent, wide public consideration and debate of end-of-life issues has taken on special significance. Eighteen months ago, at the age of 59, I was diagnosed with a rare, aggressive T-cell lymphoma. In the interim, multiple attempts to achieve remission have failed. ”

And further into the story: “Palliative medicine is, [however], a vital part of a ‘system’ of care. I acknowledge that for many it is the difference between last months of extreme suffering, and the achieving of some respite. And while it might herald for some a meaningful end, and even approach the Gawande notion of a “good death”, there remain others, and I number among them, whose sense of what is meaningful carries with it vastly different connotations.”

For the full story:
Dr Ian McPhee is a clinical senior lecturer at Sydney Medical School and an anaesthetist in provincial practice in NSW.

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