AS shown by the sporadic debates over voluntary euthanasia, attitudes in Australia towards death and dying are no longer as rigid – or as religiously driven – as they once were.
Voluntary euthanasia is still a step too far for many Australians but at the same time there is a growing acceptance that the health-care system cannot cure every ill, and that for some patients, treatment will necessarily be more palliative than curative.
Federally, a national palliative care strategy – Supporting Australians to Live Well at the End of Life – was published in 2010.
In NSW, an arm of the state health department – the Agency for Clinical Innovation – has established a blueprint for palliative and end-of-life care. One of its reports – a Fact of Death Analysis – looks at the final-year hospital admissions of some 49,000 NSW residents who died in 2011-12. This report confirmed “a relatively low level” of palliative care, even though many of those admitted to hospital in their final year of life were being treated for the illnesses that would eventually kill them.
Lobbying for more palliative care services, a retired palliative care specialist, Dr Yvonne McMaster, argues that an increase in palliative care spending would save money for the health system in the long run.
That said, the financial aspect is only part of the argument. The Agency for Clinical Innovation says the more that a community recognises the limits of medical treatment when approaching the end of life, the more that death will be “de-stigmatised” and “considered a natural event”.
Looking at the situation in the Hunter Region, Dr McMaster says the Hunter New England Local Health District is short of palliative care specialists when measured against the appropriate population benchmarks. Unfortunately, there is nothing unusual about this region being underfunded for medical specialists. While the main focus in cancer funding will always be on treatment and cure, there needs to be a recognition that proper palliative care can do an enormous amount to ease the burden of illness when further treatment is either impractical or of little benefit. As part of its push, the NSW Cancer Council is seeking feedback from the public as part of its campaign for better palliative care.
Whether in a hospice, a hospital or at home, palliative care can make dying with dignity a reality, and not just a hope.