Palliative Care Australia Policy on Physician Assisted Dying

PCA Policy on PAD

DWDV Comment

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States that palliative care practice does not include deliberate ending of life (euthanasia), even if it is requested by the patient.

This is a statement of policy, not a statement of fact. It is based on an ideological principle which is not explained or revealed. Although PC policy is based on the recognition and respect for patient autonomy, PCA does not allow such autonomous requests.
 

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Defines palliative care as a concept of care that provides coordinated nursing, medical, and allied services for people who are facing a life-limiting process. This care is delivered, where possible, in the environment of that person’s choice. This care provides physical, psychological, social, emotional and spiritual support for patients and families and friends. The scope of palliative care includes grief and bereavement support for the patient and family and other carers during the life of the patient and after the patient’s death.
 

This is an admirable statement of the aim and scope of palliative care.

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Believes that all palliative care services should be available to everyone in need of such services and that adequate funding for quality palliative care services should be provided.

While the statement identifies an admirable aim, it is a statement of belief: it is an aim that has not been met for any other area of medical service, and it is unrealistic to expect this to be achieved for palliative care in the foreseeable future. It does not address the question as to whether everyone with a ‘life-limiting process’ wants such services.
 

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Believes that dying is a natural process and that declining and withdrawing futile treatment is acceptable.

This is a statement of belief. It conflicts with the fact that the death of many people with ‘life-limiting processes’ is affected, influenced and hastened by medical intervention, itself not a "natural" process, and that many people don't want every intervention available.
 

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Acknowledges that while pain and other symptoms can be helped, complete relief of suffering is not always possible, even with optimal palliative care.

This is a statement of fact (see studies). It is the principle reason why some people request hastening of death. It fails to acknowledge that with profound terminal sedation, complete relief of suffering is possible. However, not all in PC accept the validity of profound terminal sedation.
 

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Recognizes and respects the fact that some people rationally and consistently request deliberate ending of life.

This is a statement of fact. PCA the "respects" the fact by totally ignoring the request. It fails to recognize that such requests are made with the intention of achieving ‘complete relief of suffering’.
 

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Recognizes that there is a wide range of views about the deliberate ending of life in Australian society, and also within the caring professions.

This is a statement of fact. It demonstrates that PCA’s view is not unique, and fails to recognize that others in the "caring professions" (including some of PCA's members) accept the occasional need for deliberate hastening of death.
 

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Welcomes open and frank discussion within the community and within the health professions about all aspects of death and dying, but recognizes that an informed discussion about euthanasia cannot be had until quality palliative care is available for all who require it.

This is a contradictory statement. The second part denies action on the first. It effectively quarantines any discussion about euthanasia until PCA determines that everyone has access to quality PC (which itself is undefined), a decision presumably they reserve the right to unilaterally make.

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