Editorial
Welcome to the May 2012 homepage edition of i2P-Information to Pharmacists. Rollo Manning has been having some time out having staples removed from the site of his open heart surgery.He is now at home recuperating in Darwin, having arrived home last Friday, beating a cold and hasty retreat from Canberra.We all wish him a speedy recovery and hopefully, he will be fit enough to contribute by next month.
This month, Pharmedia discusses the toll that is taken when someone complains about you to an authority without good cause. Well, the good news is that you can now take action to protect yourself if such a complaint is made, and that may even include action for defamation. Read about a recent case involving two doctors, with Mark Coleman drawing on personal experience to illustrate.
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Harvey Mackay: Strategic Thinking
Mark Neuenschwander: I`ve been thinking about...Recent Comments
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The Right to Die
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PDF version | Neil Johnston |
Neil Johnston is a pharmacist who trained as a management consultant. He was the first consultant to service the pharmacy profession and commenced practice as a full time consultant in 1972, specialising in community pharmacy management, pharmacy systems, preventive medicine and the marketing of professional services. He has owned, or part-owned a total of six pharmacies during his career, and for a decade spent time both as a clinical pharmacist and Chief Pharmacist in the public hospital system. He has been editor of i2P since 2000. | |
For the last decade, Australians have been talking about their average age increasing, to the extent that at least 25% of the population will be over the age of 64 within twenty years.
With that increase in age comes an increase in lifestyle illness and the need to invest in aged care facilities and to provide funding for medicines on the PBS that will increasingly be utilised.
It seems demand will outstrip available resources.
But another social/ethical issue accompanies the ageing process and lifestyle illness, and that is quality of life.
What purpose is there to living a long life if it has no quality or becomes too unbearable and draining for the individual and their surrounding family?
So when somebody decides they wish to die ahead of schedule because of unbearable pain and suffering they suddenly find that right has been taken away from them by politicians.
Euthanasia is a subject that has been kept under the radar for a long time but containment now appears impractical as evidence of suffering will simply increase with the volume of aged persons.
Dr Philip Nitschke has attempted to provide information and facilities to assist people to achieve a dignified death. He has formed an organisation called Exit International and written a book called “The Peaceful Pill Handbook” that promotes a veterinary drug “Sedalphorte” ( a border-controlled drug believed to be pentobarbital) as a means of providing euthanasia.
The handbook is banned in Australia and it is not so long ago that pentobarbital was prescribed by the bucketful on the PBS.
Recently, Exit International attempted to run a television advertisement arguing for euthanasia, and featured an actor playing a man with a terminal illness asking to be allowed die with dignity.
The advertisement was an attempt to relaunch the debate in Australia on the right to die, 14 years after the Northern Territory government became the first in the world to introduce a voluntary euthanasia law, only to see it overturned by the federal authorities.
The last time a similar advert was shown on Australian television was more than 10 years ago. It featured a woman suffering from what she believed was terminal bladder cancer pleading to be allowed to die. Her disease went into remission and the case became a rallying cry for the anti-euthanasia lobby.
In the new advert, which has been banned by the broadcasting regulators on the grounds that it promotes suicide (which is illegal), the man argues: "I chose to marry Tina, have two great kids. I chose to always drive a Ford. What I didn't choose was being terminally ill. I didn't choose to starve to death because eating is like swallowing razor blades.
"And I certainly didn't choose to have to watch my family go through it with me. I've made my final choice. I just need the government to listen."
Exit International stated that the ban violated the right to free speech, and said they would relaunch a new version of the ad within days.
The right to die has become the subject of agonised debate in many countries.
An increasing number of individuals are circumventing local laws by travelling to the Dignitas clinic in Switzerland, where they are given medical advice and assistance to commit suicide, which is legal under Swiss law.
In Australia, the pendulum is swinging in favour of euthanasia.
In a recent news item published by NT.News.com they state:
“ABOUT nine out of 10 Territorians want their voluntary euthanasia laws back, nearly 15 years after Canberra took them away "for their own good".
This comes as Greens leader Bob Brown told the NT News he'd use the new minority government set-up to try to remove the Commonwealth block on the issue.
More than 85 per cent of respondents to the NT News's Reader Issues Survey said the Rights of the Terminally Ill Act should be reinstated.
Support was evenly spread across the age groups - although it was marginally higher (about 87 per cent) with those aged 65 and over.
Should the Rights of the Terminally Ill Act be reinstated in the Northern Territory? - leave your comment below
NT euthanasia campaigner Dr Philip Nitschke said Territorians had a "proud history" on the issue, and that 85 per cent support was "fantastic".
"It's usually in the mid-70s (across Australia). That's one of the highest results we've ever seen," he said.
"I guess it probably reflects the Territory's original reasons as to why they passed the law. It's the most secular place in Australia.
"It's the place where people like to think they can do anything."
If Mr Brown's Bill succeeds, it would still require the Territory Parliament to vote on the issue again.
Dr Nitschke said he doubted today's NT politicians had the "drive, interest or guts" to bring the law back - even if the federal block was gone.
"In some ways, the Territory Assembly is now more conservative in its breakdown than it was even back in '96," he said.
He said CLP chief minister Marshall Perron was able to get the law passed in a time when there was "almost no Opposition".
Dr Nitschke said the best explanation he ever got as to why politicians shied away from an issue that had such strong support came from former prime minister Gough Whitlam.
"He said, 'Don't expect politicians to take on an issue that will attract the ire of the church. It doesn't look good on your CV at pre-selection time to be known as someone who's anti-church'," he said.
"(So) to take up a prominent position and then find themselves being actively campaigned against by (Catholic Archbishop Cardinal George Pell) or someone is something they could just do without.
"I think that's probably the most likely explanation for why they run dead on it - pardon the pun."
No matter what your beliefs entail, pharmacists in Australia will begin to have requests for information about euthanasia in the immediate future.
There needs to be some form of national debate within pharmacy circles to get ahead of any potential to fall foul of the law.
If compassionate requests for advice are made what are the boundaries?
It would also seem to me that when pharmacists become comfortable with the concept of euthanasia, some will endeavour to provide professional counselling services to ensure their patients are properly informed.
Research Reports
Dr Richard Hallinan B Med FAChAM (RACP): X-Concord 2012 Seminar Summary - “Benzodiazepines and dependence”, with an emphasis on people on opioid pharmacotherapies | open full screen
Staff Researcher: Encouraging news for heart patientsPractice Development
Gerald Quigley: Don’t Give Up
Chris Foster: Seventeen Handy Tax Planning Tips for 2012
Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA: Taking care of pharmacists’ health – what is it worth? | open full screen
Peter Sayers: The Climate Change in Evidence-based medicineNeil Johnston: An Evidence-Based Conversation Between Ken Harvey, Gerald Quigley and Neil Johnston | open full screen
Neil Johnston: An Evidence-Based Conversation Between Ken Harvey, Gerald Quigley and Neil Johnston- Part 2 | open full screen
Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA: Tax time – a donation to PSS is a gift to your profession and a deduction for you | open full screen
Information Technology
Neil Retallick: Good news for community pharmacy from the Minister of Agriculture | open full screen
Dr Ian Colclough: While doctors remain disempowered doctor shoppers needing help will die. | open full screen
Dr David More: Australian Health Information Technology Links to 30 April 2012Preventive Medicine
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Submitted by Peter Kennedy on Thu, 30/09/2010 - 10:55.
Paul, giving a dying patient who is in great pain, the large doses of analgesics which are required to relieve his pain, knowing that this might, as an UNINTENDED adverse effect, accelerate the natural process of dying, is not euthanasia but good medical care. This is available to all, not just a select few, though it is true that our health systems need to invest a lot more resources into providing good palliative care to everyone who needs it.
If you are aware of any case where somebody gave a patient an overdose of an analgesic drug, purportedly for pain relief but with the intent of killing him, you should tell the police.
Submitted by Paul Drinkwater on Wed, 22/09/2010 - 10:33.
I agree that the Territories should be able to introduce legislation, in the same way as the States, without federal iterference.
I support voluntary euthanasia. Currently there is much hypocrasy about the subject. It happens frequently in hospitals under the guise of providing analgesia, but is only available to a select few
Submitted by Peter Kennedy on Wed, 22/09/2010 - 09:40.
How ironic that you end with a motherhood statement calling for pharmacists to ensure their patients are properly informed, when the entire preceding article is a diatribe of the usual long-discredited myths and misinformation.
Nobody is being "denied the right to die". What Nitschke and his group want is the right to kill - and to kill not just people with serious illness or disability, but perfectly healthy people. Nobody has ever had the "right" to kill, which politicians can neither give nor take away.
The fascist ideologue Nitschke, aided by "useful fools", surreptitiously tries to legalise murder by promoting the myth that there are people being forced to endure "unbearable pain and suffering" which no dose of any drug or treatment can relieve, or the myth that doctors are somehow legally prevented from prescribing such treatment because it might accelerate the natural dying process. And the myth that people are being forced to undergo expensive, burdensome or futile treatments which add little or nothing to their lifespan or quality of life.
" it is not so long ago that pentobarbital was prescribed by the bucketful on the PBS" - well I suppose to some people 40 years ago is not so long ago. Then thank God we got benzodiazepines and other far safer hypnotics and sedatives and could happily discard the extremely dangerous pentobarbitone. (I'm not sure why you call it by its USA name which has never been used in Australia).
Any pharmacist or scientifically trained person should know that the "results" of a self-selected "survey" are meaningless. Such surveys are routinely "mobbed" by organised groups. (Nitschke's organisation is based in the NT.)
Most ludicrous of all is the assertion that politicians are in terror of doing anything which is opposed by the Catholic Church, no matter how much the politicians want to do it. Governments seem to take less than zero notice of the Church's views. If anything, governments seem to go out of their way to take an opposite position from that of the Church - whatever the issue - contraception, aboriginal affairs, abortion, adoption, industrial relations, homosexuality, asylum seekers, poverty, war, marriage/divorce, foreign aid or anything else.
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