ADVANCE health directives instructing medical staff not to resuscitate very ill patients have come under the microscope in Albany, the only regional centre to host hearings of the Parliamentary Joint Select Committee on End of Life Choices to date.
At Centennial Park on March 7, Patricia Marshall, 77, told the eight-MP committee chaired by Morley MLA Amber-Jade Sanderson, that she had spoken to her GP about an advance health directive.
She said a directive would have no effect if somebody were to collapse at home where an ambulance officer, without access to the document, would be legally bound to revive the patient.
“Something has to be done about these advance health directives,” she said.
“[They] might be in the hospital in the bottom of a thick file.
“They have to be somewhere central and they have to be binding.”
After Mount Lawley MLA Simon Millman asked if Mrs Marshall was concerned the documents might be “treated as relatively fluid directives”, she said they were not being applied satisfactorily and so did not account for the wishes of patients.
She said directives were normally filed only with GPs and local hospitals, and that a central repository, accessible to all medical staff, would help.
When Baldivis ML A Reece Whitby observed there was “quite a population of retirees in Albany”, Mrs Marshall said the city’s senior citizens had been discussing the matter of euthanasia “in quite some detail”.
“So, we have come to the right place,” Mr Whitby smiled.
After The Weekender last year asked Ms Sanderson if her powerful committee planned to convene in Albany, it decided to do so.
The only other regional centre announced for hearings is Broome, where the committee will take evidence next month.
In a written submission, Virginia Jealous told the committee a ‘death care choices’ meeting of 50 people in Denmark on October 22 had supported better access to information about advance health directives.
In Perth on February 26, University of Western Australia research fellow Craig Sinclair told the committee he supported the “rights-based approach” to end-of-life choices that operated in Canada.
Dr Sinclair, who has a PhD in psychology and is based in Albany, said he would prefer an approach grounded in autonomy and equality of access to assisted dying.
Within such a framework, safeguarding the integrity of the decision-making process, rather than providing a criminal defence for medical practitioners, would be paramount.
He said that, particularly with dementia, many people chose assisted dying to maintain independence and control, rather than to avoid severe pain.
Also in Perth, on March 1, Albany-based palliative care physician Kirsten Auret told the committee her UWA medical students rarely expressed concerns about competent patients who refused life-sustaining treatments.
“The concerns that have been voiced by both our academics and our students are around how difficult it can be at times to assess competency in making very complex decisions in medically unwell patients, particularly those with delirium, dementia, and neurodegenerative diseases,” Professor Auret said.
“The issue of discomfort for our students is not the withholding or withdrawing or refusing of life-prolonging treatment; it is the issue of capacity and how do they do that safely and effectively.”
In a written submission, Harley Dekker, a Year 10 student at Albany’s John Calvin School, said euthanasia was against his Christian beliefs.
“My grandpa died of cancer after being told that he could live for another three months, but he only lasted five days,” Harley wrote.
“God states in his bible that he doesn’t like people choosing when they get to end their life.
“I am extremely worried that if euthanasia is legalised lots of old people will choose the euthanasia way.”
In their submission, Gerald and Carolyn den Boer, who last year moved from Albany to Byford, also opposed euthanasia.
“The main reason for doing so is simply because we believe the Bible to be the Word of God, and it is His Word that God forbids all murder and assisted suicide,” they explained.
“It is of great concern to us that if euthanasia is legalised it will have bad ramifications down the track.
“Already in Europe there are cases when people are euthanised when their families desire it for selfish reasons.”
In his submission, Albany resident Andrew Vermeulen said his father-in-law had died in September after a 12-year struggle with dementia.
He stressed that his father-in-law’s life had purpose until the day he died, even though for the past eight years he was unable to speak and had lost control of bodily functions.
“Legalising euthanasia will result in less compassion in society,” Mr Vermeulen argued.
“I’d plead with the government to support good palliative care facilities so that our loved ones can die in good, caring and loving environments.”
On March 2 in Perth, neurologist Robert Edis told the committee that palliative care services in Albany, Esperance, Bunbury, Geraldton and Broome were good.
“In our experience of the country areas, they all muck in together,” Dr Edis said.
“If they live in a farming community, they may go to Katanning Hospital or something, and there will be a palliative care component to their beds.”
The committee is halfway through its inquiry, with calls for written submissions now closed, and hearings expected to wrap up in Perth in April.