Volume 177 - Issue 3
The intention to hasten death of terminally ill patients
Authors: Mathew Piercy, Gerald B Fogarty, Aubrey W Jansz, David M Gawler, Luis Vitetta, David Kenner and Avni Sali
Med J Aust 2002; 177 (3): 165-167. || doi: 10.5694/j.1326-5377.2002.tb04714.x
Published online: 5 August 2002
Published online: 5 August 2002
To the Editor: The study by Douglas et al1 reports that the purposeful hastening of death in terminal illness is both widely practised and an acceptable method of palliative care for over a third of Australian surgeons.
Yet the study is based on a questionnaire strongly favouring theoretical scenarios rather than actual practice. The framing of the questions maximises reporting bias towards "hastening death" by the use of absolute terms (eg, "Have you ever . . .?"; "[Are] there any circumstances . . .?"1). The study also fails to determine the stage in a terminal illness at which hastening of death had been, or might possibly be, acceptable to the surgeons, nor the reason for its implementation.
If the patient's symptoms are already adequately controlled and the dying process is not prolonged, we do not see why it is necessary to administer doses in excess of those required to control symptoms. Whose symptoms are we treating?
References
- Douglas CD, Kerridge IH, Rainbird KJ, et al. The intention to hasten death: a survey of attitudes and practices of surgeons in Australia. Med J Aust 2001; 175: 511-515. <eMJA full text>
- Douglas CD, Kerridge IH, Rainbird KJ, et al. The intention to hasten death: a survey of attitudes and practices of surgeons in Australia. Med J Aust 2001; 175: 511-515. <eMJA full text>
- Ray JB. Pharmacologic management of pain: the surgeon's responsibility. Surg Oncol Clin North Am 2000; 10: 71-87. a2
- Chochinov HM, Wilson KG, Enns M, et al. Desire for death in the terminally ill. Am J Psychiatry. 1995; 152: 1185-1191. a3
- Back AL, Wallace JI, et al. Physician-assisted suicide and euthanasia in Washington State. Patient requests and physician responses. JAMA 1996; 275: 919-925. a4
- Vitetta L, Kenner D, Kissane D, Sali A. Clinical outcomes in terminally ill patients admitted to hospice care: diagnostic and therapeutic interventions. J Palliat Care 2001; 17: 69-77. a5