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Important to finish the book of life


Professor Ian Olver has devoted his life to cancer treatment and research and believes people still have much to offer at the end of their life.

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Legalising euthanasia and ending someone’s life has been likened to “ripping the last page out of a novel”, according to one of Australia’s leading cancer researchers and medical oncologists.

Professor Ian Olver, director of the Sansom Institute for Health Research at the University of South Australia and a former head of the Cancer Council Australia, said there was often a lot of “valuable things” that could be written on the last page of a novel and similarly, people at the last stage of life also had something valuable to offer.

“Even if people are sick and bedridden, if they are relieved of the burden of the physical they can concentrate on other things – like relationships or even the spiritual,” he told The Southern Cross.

“Sometimes they recognise the spiritual side for the first time when they are ill. Spirituality is not just religion, but religion is one expression. If anyone asks, ‘why I am here?’ or ‘what is the meaning of my illness in the context of my life?’… that is asking a spiritual question. And they need to explore the answer to it so they can find the meaning and achieve peace.”

A lay Minister with the Uniting Church, Prof Olver said in today’s world there was “less of a scenario” of people having to suffer at the end of their life.

“Over the last couple of decades we’ve seen the strong rise of the importance of palliative care as part of medical care. It’s not all about getting good at using drugs to treat symptoms, it’s about the psychosocial and spiritual support of the patient.”

Prof Olver was one of more than 30 of Australia and New Zealand’s top palliative care practitioners who co-signed a letter authored by Professor Douglas Bridge that was published in the Medical Journal of Australia’s MJA InSight newsletter recently. The letter was in response to an opinion piece by palliative care specialist Professor Emeritus Ian Maddocks, who asked whether it was time to consider an integration of palliative care, euthanasia and physician-assisted suicide (EPAS).

In the letter, the 33 practitioners said “supporting people when they are dying is utterly different to intentionally causing them to die. What Professor Maddocks calls ‘a single effective intervention’ is in fact an act of killing”.

Prof Olver described the public debate around euthanasia as being “quite trite” and added that using pain as the reason was no longer valid.

“Everyone has a story of a relative who has suffered and I’m sympathetic to that, but it may be that they didn’t get good palliative care. The opposite of suffering is not death, it’s the relief of suffering.

“And things like pain and discomfort are not often the be-all and end-all,” he added, pointing to the example of the marathon runner “hitting the wall” in the last five or six kilometres.

“That’s some of the most severe pain you will experience but because there is the greater goal of finishing one of life’s great athletic challenges, the pain is put into its place.

“Sometimes repairing relation-ships or even being able to enjoy relationships puts physical things to one side. It’s not saying that there is not a problem, but there are a lot of ways to deal with physical symptoms and probably 90 per cent of people can have their physical symptoms dealt with.”

Prof Olver worked with many dying patients during 30 years as a medical oncologist at the Peter MacCallum Cancer Centre in Melbourne and the Royal Adelaide Hospital, but said his views on euthanasia were “significantly influenced” by one woman he treated many years ago.

In her 40s, the woman was dying of bowel cancer and despite chemotherapy, the disease had spread to her lungs. Returning to the centre, she told Prof Olver she felt “wretched” and after having talked it over with her three teenage daughters, she wanted to die.

They discussed the situation. It appeared the woman felt she was no longer of any value as she couldn’t do anything for her children. She was also frightened that her end of life would mirror that of her father who died of lung cancer.

“I assured her that with the proper use of opiates we would be able to calm her breathing at the end. I also told her that her youngest daughter was having a lot of trouble coping with the fact that she was dying and she might appreciate spending more time with her.

“The woman withdrew her request for euthanasia and died five days later – quite peacefully – with that daughter having much of that time at her mother’s bedside and by the time the mother died her grief reaction was much more ‘normal’.

“So the mum, although she didn’t know it, still had much more to contribute. Everyone who asks for euthanasia should be counselled to try and discover whether there is anything valuable left for them to do – and in most cases there would be.”


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