24th Mar 2016
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Death and dying – do you have any wishes?
advance care directive waiting to be signed

Death is inevitable – which is all the more reason for us to remember that in many instances we have a choice about the type of death we have, if not about the timing.

Just as when our children were born and we created a birth plan, drawing up instructions for when death is upon us should be something we all do. It’s not morbid. It’s practical. And it’s the only way to ensure that you are more likely to have the death that you want.

In November last year, YourLifeChoices, in association with Invocare, ran a survey that questioned people’s thoughts and beliefs on grief and loss. Part of the survey focused on individual’s responses to death and dying and perhaps unsurprisingly, of the 3290 respondents, 92 per cent had thought about their own death. So, death is very much on our minds, if not during every waking moment. But how do you feel about death? Does it scare you? Well, if you said no, then you’re in the majority with 75 per cent saying they are not afraid of dying.

Of course, thinking about and acknowledging the inevitability of death is very different to putting in place a plan for how we wish to spend our last days. While some of us will be lucky enough to go quietly in our sleep, having said our goodbyes to our loved ones, the reality is that death is usually the result of a tragic accident or a prolonged illness. Many of us are quite clear about our end of life wishes, with 67 per cent of those surveyed knowing exactly how they wish to go. Yet only 40 per cent of those surveyed have actually recorded such wishes – this leaves an awful lot to chance.

Overwhelmingly, the response from most people when considering end of life wishes is that they don’t want to linger on life support or be resuscitated if their quality of life is going to be greatly affected and many would prefer to end their days in their own home where possible. But if these wishes are not recorded, then there is absolutely no guarantee that they will be carried out. Even though relaying them verbally or in writing to your loved ones and family members is better than nothing, unless you have an advance care directive, medical staff are not legally bound to adhere to your wishes.

Having the conversation is the first step but it can be difficult to approach the topic without people recoiling in horror or telling you to stop being maudlin.  You will need to get over this as the only way you can try to ensure you have a ‘good death’ is by letting people know how you want to go. For tips on how to broach the topic, you could visit The Groundswell Project – Dying to Know Day, which promotes that talking about death is a part of life.  

Opinion: Dying a good death

Noting your wishes is only the first step to dying a good death. While euthanasia challenges many people’s beliefs and morals, it may be time to simply accept that choosing when to die is an individual’s right.

When I lost my much-loved 83-year-old grandmother 18 months ago, it was sudden and incredibly sad. Although I am somewhat comforted that the end was quick and she didn’t linger in pain, how I would have loved to have known that her end was near and that I could have spent the last days with her. But that was a luxury I wasn’t afforded. Yet, when someone knows he or she will die soon and tries to take control of the situation, out-dated legislation tells them that they must suffer until the end. Surely this can’t be right?

People who are dying after a long and painful illness fully understand the consequences of actions that will end their lives – they’ve had long enough to think about it for goodness sake. They know that they are leaving behind people who will grieve for them, but they also know that their last days will be increasingly difficult for their loved ones to witness. All most people in this situation want is to die as they choose. Isn’t that what we all ideally want? Shouldn’t we be able to achieve it without what is essentially unnecessary interference?

The arguments that rogue doctors will use their powers to end patients’ lives without their consent, or that some may abuse their position are not particularly relevant. If such doctors are intent on prematurely ending the lives of their patients then the fact that there is no legislation to support their actions won’t stop them. Remember Harold Shipman?

And neither do I hold with the irrelevant argument that we treat our animals better by not allowing them to suffer. We choose to end the lives of animals because they are unable to express their wishes and we believe this is what’s best for them.

But what we are talking about is human beings who are suffering beyond our comprehension. And when illness and disease is battling to take away the essence of their very being, surely they deserve the right to take back some control of their lives?

What do you think? Do you believe that legislation should be introduced allowing terminally ill people to choose when, and how, they die? If such legislation became law, do you fear it could be abused by unscrupulous relatives and doctors? Or should we leave well enough alone and let nature take its course?





    COMMENTS

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    AnnW
    28th Mar 2016
    9:16am
    My father passed away in 2013 after a lengthy battle with asbestosis of the lungs. I Watched him wither away to half his weight and he constantly pleaded with medical staff to end his life. He knew there was no cure for his illness & to speed up his death, he refused all medication, food and fluids, he starved himself to death. This is no way to end what had been a good life, we should have the choice of when and how we die and to end the pain and suffering.
    OlderandWiser
    28th Mar 2016
    9:20am
    People are permitted to make an Advanced Health Directive rejecting treatment in certain carefully specified conditions. This directive is made under strict supervision of doctors and lawyers. There are careful provisions to ensure it reflects the person's genuine wishes and that the person was clear-thinking when it was made. Why on earth can't this document be expanded to state under what conditions a person wants a compassionately-assisted death?

    For some people, a slow and emotionally painful death means the total loss of dignity, and knowing loved ones are suffering terribly, and the fear of dying alone and afraid. Contrast that with a planned quick jab and being allowed to say goodbye with dignity and grace, then hold the hand of a loved one as you drift away - knowing your loved ones will have good memories of a peaceful death.

    The current laws are cruel, both to the dying and their loved ones. There is no sensible argument to support them. And to those who say ''only God should decide'', I ask you the question my daughter posed. ''What is the difference between taking life into our own hands and extending it artificially, and taking it into our own hands to end it?''

    Of course we need strict rules. Yes, there will be the occasional instance of abuse or error. (There are cases of abuse now!) But overall, it would be a far better world if people were permitted freedom of choice to die on their own terms.
    Tom Tank
    28th Mar 2016
    10:38am
    Very well put.
    If the "only God should decide" lobby carry the day re dying should they not also support the fact that any treatment administered by humans is interfering with God's will?
    They can't have it both ways, not that that has ever stopped them before.
    Poppysmum
    28th Mar 2016
    11:27am
    Mine was made with out Doctor's or Lawyer's supervision - just needs a Justice of the Peace signature.
    JayUK
    28th Mar 2016
    4:42pm
    My thoughts exactly Tom.
    Maggie
    25th Oct 2017
    11:15am
    We can reject or refuse treatment at any time we like and there do not have to be any specified circumstances for this.

    What is important though is to have our wishes recorded in an Advanced Health Directive for a possible time when we cannot speak for ourselves e.g.after a stroke.
    Cranky
    28th Mar 2016
    9:27am
    Death by chocolate!
    Moriac
    28th Mar 2016
    10:13am
    Vote green the only party that differentiates on dying with dignity, the other main parties are frightened of losing catholic votes.
    Anonymous
    28th Mar 2016
    11:00am
    And tax dollars.
    particolor
    28th Mar 2016
    12:14pm
    I don't want to Die of being in the Wrong Place at the Wrong Time ! :-(
    I don't go near Airports or Railways anymore !! :-(
    And as for Vote Green :-) :-) :-) :-) Or Labour :-) :-) :-) :-)
    And Liberal ! :-) :-) :-) :-) :-)
    roy
    28th Mar 2016
    3:05pm
    Vote independent.
    Young Simmo
    28th Mar 2016
    3:37pm
    A simple solution is turn on the TV and listen to Potato Head Shorton, that will bore you to Death.
    Patriot
    28th Mar 2016
    5:55pm
    No more boring than any of the others promoting lies!
    Young Simmo
    28th Mar 2016
    6:06pm
    The best part about using Potato Head is you go to sleep before you die. Just look at the rest of the Labor Party, they are all asleep.
    OlderandWiser
    30th Mar 2016
    7:27am
    Don't vote Green. They might be right on dying with dignity, but their other policies are a disaster.
    Poppysmum
    28th Mar 2016
    11:25am
    Rainey, my Advanced Care Directive did not require either a doctor or a Lawyer to have it verified. It just needed a signature from a Witness and Justice of the Peace. In fact my Doctor kept refusing to accept it and have it put on the practice records, as he did not personally believe in such a document, but persistence prevailed.
    trood
    28th Mar 2016
    6:02pm
    Sounds like you need a new doctor, just because the ACD is now in his records against his wishes he may not act upon it when necessary.
    OlderandWiser
    29th Mar 2016
    9:28am
    I had a huge battle to get doctors to recognize and abide by a relative's ACD. A good friend fought a huge battle to get them to honour his wife's. Both were made correctly with doctor and lawyer signatures. In both cases, the doctors and lawyer agreed that had the document not been signed by doctor and lawyer there would have been no hope of enforcing it. Doctors often dispute that an ACD is enforceable, and signature by only a JP would give them fuel. I would not risk it.
    SKRAPI
    28th Mar 2016
    11:58am
    I think people should be helped to die if they R terminally ill & request this , pallative care isn't always the best. It is a person's right to go if they want to even if they aren't terminally ill & have their Cognitive abilities I feel it is their life , their decision.
    If that person is young & well they should get all the help possible to change their mind , but sometimes an older person has just hd enough. And if they want to go , again their decision. But a good idea to prepare & discu
    ss with family anyway whatever U decide.
    particolor
    28th Mar 2016
    12:24pm
    Yep ! Agreed.
    tia-maria
    28th Mar 2016
    4:03pm
    SKRAPI fully agree
    Genuine response
    28th Mar 2016
    12:23pm
    Watching both my parents and others I have know suffer long from illness's as they got to their time on this earth, was horrible and degrading. I do to suffer in that way and will find a way of ending my life if it's too much too bear.
    As for family or religious sects saying "it's not right to end a person life" is total crap. It should be a choice of when we or others want to die.
    Everyone should have a will determining how, where, and when they want to die, and with technology now, there could be a clause if the person changes their mind so it can be changed.
    It is your own life and no one has the right to say when you can die. If God was looking after you, their would be no suffering, he made a choice to give you free will and that's what it's about. I'm not religious just spiritual and have very good reasons why.
    Funny face
    28th Mar 2016
    12:53pm
    Yes I most certainly do! Once you watch someone you love suffer so much and beg you to end it ( daughter at 28 with cancer) it us cruel not to be able to help. My other daughter has multiple sclerosis, has since she was 19, now 45. I have told her that if she gets to the stage " that she has had enough" we will hold to Switzerland! Why should I gave to put her through that? Why can't it be done here? Uf the politicians are to scared to make a decision, hold a referendum! It would be overwhelmingly " yes"!. They waste enough money in other stuff!
    Polly Esther
    28th Mar 2016
    1:16pm
    This is all very well and yes you may have the right to self terminate, ( I won't disagree with that) but please what ever you do, do not walk out purposely in front of a train or bus or car etc.
    Imagine how that poor train or bus driver etc. may be affected.
    It could start off a chain reaction.
    Young Simmo
    28th Mar 2016
    1:30pm
    Yes Polly Esther, I agree 100%.
    nena
    28th Mar 2016
    3:35pm
    I in favour of making a Legal Advance Health Care Directive and I do have all forms but it is confusing to fill it throughout.

    I was wondering if I can just state that whatever health issue affects me in a way that after treatment I would not be able to stay safely in my own home then please, let me die as soon as possible. No food, only water to drink and palliative medication.
    OlderandWiser
    31st Mar 2016
    9:05am
    Nena, take it to your doctor, or contact a community nursing service. They will help you fill it out.
    OlderandWiser
    31st Mar 2016
    9:09am
    Don't try to do it yourself. If it isn't done correctly, witnessed by a doctor and lawyer, it won't hold up legally.
    Scrivener
    28th Mar 2016
    5:32pm
    Falling off the perch - what perch!!!
    Patriot
    28th Mar 2016
    5:57pm
    Quick, Easy & Dignified are my wishes!
    Chook
    28th Mar 2016
    6:07pm
    The right to die with dignity should not be a decision made by politicians or doctors. If politicians cannot pass legislation because of their own beliefs they are not acting in the best interest of their constituents because recent surveys indicate that 80% of the population believe euthanasia should be legalised.
    trood
    28th Mar 2016
    6:08pm
    Oh to live in Holland or Belgium and save all this rigamarole!
    Christina
    28th Mar 2016
    8:27pm
    Yes, if you do not want others to decide how and where you should die, it is essential that you fill in an ADVANCE HEALTH DIRECTIVE. All information is available from the Department of Health (which actually promotes it) and the local VE organisation in your state (DWDWA in West Australia).
    But what is also important is to organise an ENDURING POWER OF GUARDIANSHIP - a trusted person who will act for you when you are unable to communicate your last wishes. In WA you can download all information and forms from the Public Advocate website.
    And of course, do talk to your loved ones about this - it will put your mind to rest to know that your wishes will be known to them.
    OlderandWiser
    30th Mar 2016
    7:31am
    An Advanced Health Care Directive ONLY stops treatment. It doesn't allow anyone to compassionately assist death. Stopping treatment can actually prolong pain and suffering in circumstances where death is inevitable and really should be mercifully expedited.

    We need a change of legislation!

    The vast majority want compassionately assisted dying legalized. I dispute the right of legislators to ignore public opinion on this issue and make their own rules. It's WRONG. Anyone who has ever watched a loved one dying slowly in emotional agony (and sometimes physical, despite doctors' claims that they can eliminate pain) will agree that compassionately assisted dying should be legalized - with very strict controls that are quite easy to implement if common sense is applied. Yes, there will be abuses. There are now. You can never create a perfect world!
    MD
    29th Mar 2016
    8:14am
    I would suggest that the right to die as one sees fit is more the result of informed decision than a "choice". For those of the everyday milieu; and more-so nowadays, it seems most expect to live interminably . Those of us from the 'Boomers' generation have experienced exponential growth of lifetime expectancy due largely to advances in medicine and to a lesser degree the influence of our 'Nanny State' ideologue. Although most folk would like to live to 'ripe old age' oftimes the unexpected onset of illness catches many unawares and least prepared mentally or physically, to deal with life/death decisions. The resultant outcome being that everyone - family, friends, the stressed health system and associated professionals labour under the strain. To be sure, a good many seem almost to thrive with the 'ills and ailments' resultant level of attention.
    Perhaps at an earlier point in life; as opposed to waiting till something happens, some thought needs to be given to our impending demise - most seem hell bent on ignoring or running away from it. This in turn only exacerbates the issue.
    Maybe it is incumbent on everyone; partners, children, siblings, friends inclusive, to address this at a point in time when everything seemingly appears rosy.
    Ben Franklins' quote "Nothing is certain except death and taxes" applies to each and every one of us. I wont be late for my own funeral, probably a lifetime first for me, I'll be dead on time !
    Scrivener
    29th Mar 2016
    1:51pm
    I am well aware that the cops and the PC brigade, such as religions, get into our beds, but our death beds too? Isn't that going a bit too far - even for people who claim they speak for God? Whoever she is.
    PIXAPD
    30th Mar 2016
    10:38am
    DEATH itself is the 'last enemy', and shall be destroyed when the Lord returns, for those who 'sleep in the Lord' will be raised.
    Young Simmo
    30th Mar 2016
    12:19pm
    Sorry PIXAPD but I can't swallow that rubbish. I might change my mind when you walk from Perth to Rottnest unassisted.
    Franky
    30th Mar 2016
    8:24pm
    everyone is entitled to their belief, but don't push it onto others! It's only YOUR belief and not the truth.
    After all, belief is not knowing...... otherwise you wouldn't have to believe it.
    Franky
    30th Mar 2016
    11:59am
    Everyone can write a medical directive to be signed by your doctor and given to your attorney or loved ones. This should ensure that you won't have to suffer needlessly.
    OlderandWiser
    31st Mar 2016
    9:08am
    No, Franky. It DOES NOT. Nobody is allowed to help you die, and anyone who thinks doctors can eliminate the pain dying people suffer is a fool. Emotional pain is far worse than physical. And along with loss of dignity and fear of prolonged incapacitation, the dying have to endure the knowledge that their loved ones are suffering terribly watching them die slowly.

    We MUST change the law on compassionately assisting dying. The current system DOES NOT provide adequately for the elimination of suffering.
    Snowflake
    6th Apr 2016
    2:22pm
    Without a shadow of a doubt a person should be able to choose when they wish to die. Not politicians who have a religious bent on the sanctity of human life. If they were really concerned about that they wouldn't have sent so many young men to certain death in all the wars we have been involved in. Besides, being an aetheist I don't give a damn about stupid religious doctrine and its influence on my life. I decide, end of story.


    Tags: death, dying, grief, loss

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