The following Fact Sheet has been prepared by the South Australian Voluntary Euthanasia Society (SAVES). For further information visit their website at http://www.saves.asn.au
Cancer, the commonest cause of death in Australia, accounts for more than a quarter of all deaths.
The pain associated with cancer can be among the most severe and intractable form of chronic pain, affecting a majority of patients with advanced cancer and some with early cancer.
Although advances in the management of cancer pain is claimed to make relief attainable in most cases, various studies have estimated success in practice at between 30% and 80%. Even taking the most optimistic figure, pain relief is inadequate in 20% of cases. Furthermore, most advanced cancer patients cannot be assured of freedom from pain while retaining mobility. Some will need to remain continuously in bed, or make a "trade-off" with adverse effects of medication, to obtain adequate relief.
Where it is acknowledged that pain cannot be adequately controlled, the only legal remedy available is "terminal sedation", effectively "slow euthanasia", in which the patient is rendered unconscious until death occurs. Many find this procedure unacceptable, particularly because it may mean drifting in and out of consciousness over an extended period to avoid claims that death has been hastened.
Patients with advanced cancer commonly experience multiple other symptoms (for example, fatigue, weakness, mental haziness, anxiety, nausea). Many of these symptoms cannot be eliminated and any may adversely affect function and sense of well being. Some of these symptoms, or a combination of them, can be a major source of distress to the terminally ill.
Consequently
many Australians face the prospect of death from cancer in which:
Extremely
unpleasant symptoms during the terminal phase are inadequately controlled;
They
are totally dependant on others without hope of recovery;
They
have sound reasons for requesting that their death be hastened but
this is denied
them by the present law.
It
makes no sense that terminal sedation is permitted in some cases yet
a preferred quick release is always denied.
Most clinicians acknowledge that the process of dying slowly from cancer can be difficult and is not always optimally managed. Although improvements in palliative care and its general availability continue to be made, a time cannot be foreseen where no-one dying from cancer will need to seek a hastened death.
Statements
in this fact sheet on cancer symptoms and their control have been derived
from informed sources, including:
ááá National Health and Medical Research Council 1988. Management of Severe
Pain. Australian Government Publishing Service, Canberra.
ááá Coyle, N. et al. 1990. Character of Terminal Illness in the Advanced
Cancer Patient: Pain and Other Symptoms During the Last Four Weeks of Life.
Jnl Pain and Symptom Management, Vol.5 No.2.
ááá Report prepared for the South Australian Parliamentary Select Committee
on the Law and Practice Relating to Death and Dying 1991. (Appendix E of the
Select Committee's Second Interim Report, 6 May 1992). Care of Terminally
Ill Patients: General Practitioner's Views and Experience.
Further information contact SAVES at: http://www.saves.asn.au
Or contact: Hon Secretary, SAVES, PO Box 2151, Kent Town, SA 5071, Australia - Fax + 61 8 8265 2287