What are you dying to know?

July 13, 2014

Did you know?

– 75% of us have not had end of life discussions
– 60% think we don’t talk about death enough
– Over 70% of us die in hospital though most of us would prefer to die at home
– Very few of us die with an Advance Care plan (less than 10 percent)
– The number of Australians aged 65 and over will double by 2050 increasing our need to plan while well and share our wishes with our loved ones.

Organised by The Groundswell Project, Dying To Know Day – August 8 – is about opening up community conversation and action about death, dying and bereavement in Australia. Big or small actions all make a difference to breaking down the barriers and stigma about this issue.

Dying To Know Day is encouraging all Australians to develop their death literacy, to make end of life plans and share these wishes with their families, to get informed about end of life and death care options such as dying at home, home and community-led funerals and natural burial, and to be better equipped to support family and friends experiencing death, dying and bereavement.

To support Dying To Know Day, you could organise an event in your local community, such as hosting a Death Cafe, or act on a more personal level by writing your will or having that all-important conversation with your loved ones about dying, death and end of life choices.

Bianca Nogrady is an Ambassador for Dying To Know Day. For more information, visit the website at www.thegroundswellproject.com/dyingtoknowday/

“I’m sorry I didn’t kill you, Mum”

June 15, 2013

In a brave, powerful and heartbreaking piece in Daily Life, journalist Tracey Spicer writes about the death of her mother, and the terrible choice she faced as her mother lay in agony. She writes with brutal honesty about her actions, and it is a piece well worth reading. Read it here.

Life after death: the Lazarus effect

June 13, 2013

From Radio National’s Late Night Live with Phillip Adams, 11 June 2013:

Dr Sam Parnia works at the bleeding edge between life and death, pushing back further and further against death by developing new resuscitation techniques that are able to bring people back from cardiac arrest who previously would have been long gone.

As a result of hearing patients’ experiences while being brought back, Dr Parnia is also conducting a unique study into awareness during cardiac arrest. He is interviewed by Phillip Adams on Radio National, listen here.

Our unrealistic attitudes about death, through a doctor’s eyes.

May 14, 2013

From The Washington Post:

Modern medicine has achieved some remarkable things in the past century; improving life expectation from just 47 years in 1900 to 78 years in 2007. But one less desirable side effect of that success has been the growing perception that medicine is able to prolong and preserve life in the face of any medical challenge and even against the ravages of old age.

Physician and writer Dr Craig Bowron addresses what these unrealistic expectations mean for the doctors working on the front line, in this excellent article.

“We want our loved ones to live as long as possible, but our culture has come to view death as a medical failure rather than life’s natural conclusion,” he writes.

“For all its technological sophistication and hefty price tag, modern medicine may be doing more to complicate the end of life than to prolong or improve it.” Read more here.

The right to die

May 2, 2013

Should voluntary euthanasia and/or assisted suicide be legalised in Australia?

That’s the question asked by a new report from non-profit think tank Australia21 this week. It’s not a new question – the right to die is one of the most hotly debated issues in the 21st century, and for good reason. It address the fundamental issues of personal autonomy, independence, and control over what happens to us and our bodies.

The report, titled “The right to choose an assisted death: Time for legislation?” brings together a range of views on the issue, including both those who are in favour of legalising voluntary euthanasia, and those who are against.

The authors recommend the following:

a) State governments should develop legislation now to permit and regulate voluntary euthanasia and assisted suicide in defined and limited circumstances;

b) The Federal Parliament should restore powers that were withdrawn from the Territories so these parliaments may do the same; and

c) Until the above happens, each Member of Parliament should consider exercising his or her right to introduce a private member’s bill on voluntary euthanasia and assisted suicide.

One thing I was most surprised about, when I was writing The End and talking to those who work with the dying, was to discover that in general, the palliative care profession is not in favour of legalising VE and assisted suicide. You would imagine that working with the dying, these experts would be wholeheartedly in favour of enabling people to choose to exit the stage before the worst.

But that is not the case. As Senior Australian of the Year (and palliative care specialist) Professor Ian Maddocks explains in this article in the Sydney Morning Herald, dying enables some extraordinary, significant and often wonderful things to be said and done, that might otherwise not be said and done. This sentiment was echoed by other palliative care experts interviewed in The End – a sense that the dying process brings about resolution, completion of a life and that this is so important that it is worth enduring for.

Another concern is whether voluntary euthanasia laws can ever be truly workable and safe so that they protect the against abuse. In this 2004 interview, retired anaesthetist and pioneer of palliative care services in Australia, Dr Brian Pollard, makes a case against voluntary euthanasia.

In all of this, it’s important to distinguish between voluntary euthanasia and assisted suicide.

Voluntary euthanasia describes the situation in which a person performs an action with the intention of ending the life of another person, at the request of the person whose life is ended, and that person is competent.

Assisted suicide describes the situation in which a competent person dies after being provided by another – a doctor or other person – with the means or knowledge to kill himself or herself.


Mobile phones to carry end-of-life wishes

April 14, 2013

The Conversation: One of the issues with advance care directives is them not reaching the attention of the right people at the right time. Someone may record their end-of-life wishes ahead of time, and notify their family or GP, but if they happen to end up in hospital with neither of those parties present and unable to communicate their wishes, their planning is wasted.

One solution proposed by a number of experts interviewed by The Conversation is for advance care directives to be recorded electronically on mobile phones, perhaps using some kind of specially-designed app that can be accessed by medical staff. Read more here.

Suicide: a legitimate end-of-life option?

March 29, 2013

From The Washington Times Communities, 28 March 2013:

Suicide is a tragic waste. There is no way to reconcile the loss of a life cut short by misery, leaving behind desperate questions , recriminations and grief. But what if the person contemplating suicide is doing so because they are nearing the end of their life – whether through illness or old age – and do not want to be drawn into the healthcare system or leave their family with the burden of enormous healthcare costs?

But for some people, suicide is the lesser of several evils. Several countries and states (Switzerland, Luxembourg and the US states of Oregon and Washington) recognise this and have enshrined in law the rights of the terminally ill to be helped to end their own lives.

This article by Julia Goralka describes the mindset of her aged friend Mary, who is contemplating just such a scenario. It’s a thought-provoking scenario to confront, especially in an age when suicide ruins the lives of so many families and when medical interventions can have such a significant impact on quality of life that it seems almost churlish to reject that option. Read the article here.

To CPR or not to CPR … that is the question

March 12, 2013

There has been much discussion of CPR – cardiopulmonary resuscitation – in the US media this week following the news that an elderly women in a nursing home had died after a nurse refused to perform CPR on her.

The woman, aged 87, was a resident of an independent living facility with a policy to not perform CPR in medical emergencies. While there was initial outcry about the woman being left to die, it has since emerged that she had told her family that she wished to “die naturally … without any life-prolonging intervention.”

As Dr Jennifer Black, a physician in the town where this took place, has written in this very excellent article, the chance that CPR would have been of much benefit for such an elderly woman is also debatable. As Dr Black writes, CPR is often a brutal, desperate measure that generally has pretty poor odds of success. Yet thanks to television shows such as ER and Chicago Hope, we are given the impression that CPR is almost a guarantee of return to life.

Another article by Dr David Dosa, associate professor of medicine and health services, policy and practice at Brown University, uses the events of Bakersfield to illustrate the importance of documenting one’s end of life wishes. Read it here.

The Conversation Project

March 6, 2013

Want to have THAT conversation about death with your loved ones, but don’t really know where or how to start it? You’re not the only one. According to not-for-profit organisation The Conversation, 60% of people  say they don’t want to burden their family with tough decisions, but less than half have communicated their end-of-life wishes to their family.

The Conversation Starter Kit – an initiative of The Conversation – can help. It’s a kit designed to help people start the all-important conversation with loved ones and their doctor about their end-of-life preferences.

The starter kit came about after a group of concerned doctors, media and clergy got together in 2010 to talk about what death could be and share their experiences of good deaths and bad deaths. This meeting spawned a grassroots public movement, with the goal of making it easier for people to start conversations about dying, and encouraging people to talk as often as need be to ensure that their wishes are known when the time comes.

Find out more at The Conversation website.

The hardest conversation of all

February 23, 2013

Life Matters, ABC Radio National: We’re not very good at talking about death, especially our own. But it’s perhaps one of the most important conversations we can have with our loved ones – a conversation that is unfortunately often left until the last possible minute and sometimes, until it’s too late. Radio National’s Natasha Mitchell talks death and end-of-life conversations with Professor Dale Larson from Santa Clare University, and singer/songwriter Tansy Mayhew. Listen here.


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Death is a lot like birth. Sometimes it's a peaceful, even beautiful event that goes according to plan. Sometimes it's a horrible bloody mess that is utterly beyond all control. Most of the time, it's a bit of both. We have this idea that death is something that just happens to us. It's true, you will, at some point, die, and that is not subject to negotiation with any earthly power. But that doesn't mean that we are powerless in the face of death. Some of us can actually have a lot of say in the kind of death we have. Read more.