Jan 25, 2018

Open Letter: A Catholic Perspective on Voluntary Assisted Dying

These views are a reflection of the contributor and we believe it is important to give everyone a platform to share their opinion. 

Catholic health and aged care services in Australia have a long history of providing palliative care and will continue to care for people in the best way possible at their end of life.

We don’t think of voluntary assisted dying (VAD) as good clinical care. For those people who may choose to access VAD, we would explore the reasons for that but will not be changing the way in which Catholic services currently deliver compassionate palliative and end of life care; we will continue to optimise quality of life and support people and their families.

Our care for people who are sick, frail, aged or disabled is founded on love and respect for the inherent dignity of every human being.

Aged care is integral to the mission of the Church: Catholic Health Australia is committed to developing a culture which affirms life and healing, and which promotes the common good through just and compassionate health, aged, disability and community services and organisations.

For Catholic palliative care providers, VAD is not a part of our practice and is not something that we can assist any person with in their home, in our residential aged care facilities, or in our hospitals.

We will be working with residents, patients, their families, our staff and the medical community to continue to provide compassionate care to those who may be considering their care options.

Catholic health and aged care services provide specialist palliative care which is oriented to caring for, and accompanying, a dying person and his or her carers in the final phase of life, upholding that person’s dignity and respecting his or her spiritual, physical, emotional and social needs.

It also encompasses care for bereaved family and others. Though it is integral to all health care, the relief of symptoms has a special place in the care and support offered to people with advanced and inevitably progressive disease.

For this reason, Catholic Health Australia is a fierce advocate for accessible and affordable palliative care – Australia needs better funding models for palliative care, improved clinical training pathways for palliative care specialists and to raise awareness of the benefits of palliative care in the community.

Catholic healthcare practitioners are called upon to respect, love and care for patients and residents in care (and their families).

They seek to give hope at a time when many people find it very hard to face the dependency, helplessness and discomfort which may accompany the process of dying.

Catholic health care witnesses to the belief that God created each person for eternal life. Christians affirm that death is the end of life on earth and the beginning of an eternity of fuller personal life with God. Death is thus regarded with awe, profound respect, faith and hope.

In receiving physical, psychological, social and spiritual support, patients may need help to make the most of what remains of their lives, not only by the alleviation of their suffering but also by the respect accorded their personal dignity and the quality of their living.

Vulnerable patients may need to be protected from pressures which lower their self-esteem or encourage self-abandonment.

They may need help not only with the many symptoms of illness such as pain and discomfort and its psychological sequelae such as anxiety, fear and distress, but also with its spiritual effects such as crises of faith, hope and love. Depression, for example, is often an unrecognised and untreated symptom of illness.

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I believe all aged care provider groups will face a variety of challenges as VAD is introduced in Victoria.

Many people object to the concept of voluntarily ending a person’s life and so for staff of any care facility, this will be a very confronting part of their work. Catholic Health Australia supports the right of any individual to conscientiously object to providing VAD services.

Catholic health and aged care services wish to support and uphold our staff who may be receiving enquiries about VAD.

As the bill has only just been passed, our hospitals and aged care facilities and services are assessing the impact and discussing the implications with staff, including how our services will continue to provide compassionate care to those who may be making VAD requests.

Catholic providers of health and aged care services will seek to ensure that staff and volunteers receive counselling and support required if a person they have been caring for makes such an irreversible decision to access VAD.

To give you some context about the scale of the Catholic sector – Catholic Health Australia represents Australia’s Catholic hospitals and aged care providers.

Together, Catholic Health Australia member organisations form the largest non-government grouping of hospitals, aged and community care services in Australia.

Catholic care providers in Australia have almost 10,000 hospital beds across more than 80 hospitals. Approximately 1 in 10 Australians who are receiving care in hospital, are in a Catholic hospital.

In aged care, Catholic services provide residential and in-home aged care services.  There are over 25,000 residential aged care beds in Catholic facilities in Australia, and over 20,000 home care services.

Turning to just Victoria, we have 3,100 residential aged care beds, which is 9.2% market share in Victoria.

The passing of the bill made me reflect on where we were at exactly two years ago, back then I said;

It is understandable that a person living with a terminal illness and perhaps suffering terrible pain as a consequence will consider – at a point – the prospect of ending their life.

The cause for this way of thinking may be more complex than one may at first understand. For those living with a terminal illness, a loss of mobility, cognitive ability, pain, an increasingly diminished sense of self and – importantly – an exhausted capacity for hope, poor mental health can be, and often is a factor that must be considered.

Should we not, as a society, be first dedicating a greater level of resources to improving the living person’s ability to experience a meaningful period of life, leading to death, rather than accepting that the wish to suicide be the product of clarity, unaffected perspective, and a mind free of mental illness?

Palliative care improves the quality of life for patients by treating and relieving the suffering of the whole person; it addresses the physical, psychosocial and spiritual.

Those living with terminal illness require some the greatest levels of support. Should we not be investing more to ensure that those who are dying may live in the confidence that they will be provided with comfort and dignity?

It seems that two years later, all that has occurred is giving people an option of removing their pain by removing them, rather than making greater investments in how we can provide the greatest levels of support.

What do you have to say? Comment, share and like below.

We encourage comments from our readers and industry stakeholders but ask that comments are respectful of other people’s opinions and views that differ from your own. 

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  1. Have to ask why ‘someone suffering a terminal illness and suffering terrible pain’ is not receiving something to alleviate the terrible pain? Or are we afraid that the dosage necessary to alleviate that terrible pain may also bring about the end a little more quickly than may otherwise happen?

  2. Whether I agree or not is immaterial, but that was a very good and informative opinion piece and article. I’m glad I had the opportunity to read it and think \ reflect about the topic.

  3. I’ve worked in Catholic Aged Care, high care dementia, palliative care and management. My experience has been that the organization is quick to overrule legally made Advanced Care Directives and interpret pain relief and analgesic use as weakness.

    If your personal wishes clash with those of the Church Catholic aged care is happy to disregard them, in my experience. I can provide numerous examples but to do so here risks identifying residents. Examples that include withholding prescribed PRN analgesia and feeding in direct contravention of written consent. Make no mistake, this veil of compassion hides a dark side that holds no regard for individuals wishes.


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