Australian Palliative Care Nurses at odds with Federal Euthanasia Bill

Nurses voice concerns over Dying with Dignity Bill 

This article by Karen Keast first appeared at the Nursing Careers Adult Health website on the 14-10-2014

The Australian Greens' proposed voluntary euthanasia legislation has received a mixed response from nurses.

Palliative Care Nurses Australia (PCNA) is at odds with the Medical Services (Dying with Dignity) Exposure Draft Bill 2014 while the Australian College of Nursing (ACN) has welcomed the Bill but called for changes and greater consultation.

A Senate committee is reviewing the draft Bill that proposes to allow doctor-assisted suicide for terminally ill patients.

PCNA president John Haberecht said the organisation does not support the Bill.

Mr Haberecht said health professionals and the community, unless they've had a direct experience, are often unable to understand just how well supported patients and their families can be at end of life.

"The very title of the Bill suggests that the only way to die with dignity is through euthanasia or assisted suicide, which is offensive to health professionals who work every day to ensure that patients at or near end of life have their symptoms managed as effectively as possible, that they have the best psychosocial care possible, and that their families are supported through this difficult time," he said.

"The experience of many of us working in palliative care is that one of the main reasons people ask about help to die sooner than they would naturally, is that they fear unmanageable pain or other distress.

"When reassured that this won't be the case, most patients are satisfied."

Despite the organisation and most of its members not supporting the Bill, Mr Haberecht said it's healthy for the community, palliative care nurses and other health professionals to have the debate.

"Part of that debate will be about the question of choice - whether each one of us has the right to choose euthanasia/assisted suicide, and whether we can expect others to administer the medication that would shorten our life?"

Mr Haberecht called for consultation about the Bill with Aboriginal and Torres Strait Islander communities.

PCNA wants all Australians, who need it, to have access to specialist palliative care services.

Mr Haberecht said improved palliative care, especially pain management, in aged care facilities is needed while every aged care facility should use a palliative approach with appropriately trained staff.

He said adequate resourcing of palliative care community services, both specialist and non-specialist, is important along with support for families and carers of people wanting to die at home.

In its submission to the Senate inquiry, the ACN has called for greater detail and clearer definitions around several areas in the Bill, including what constitutes a 'dying with dignity medical service'.

Adjunct Professor Debra Thoms, CEO of ACN, said the proposed Bill refers to medical practitioners yet multidisciplinary health care teams usually provide care to terminally ill patients.

"Nurses are significant members of these teams providing 24-hour care," she said.

"When caring for a terminally ill patient, it is a nurse's role to explore with the patient and his/her significant others the patient's wishes for end of life care and to provide information and counselling about options.

"ACN suggests that this role has not been given due consideration in the drafting of the Bill."

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