By Anthony Barich
Specialist physicians across all fields need to learn to prepare people for death and “think palliatively” with the projected dramatic rise in people over 65, Palliative Care Australia vice president Dr Scott Blackwell said.
Perth-based Dr Blackwell, who will take over as PCA president next month, told The Record that physicians have become so good at curing and helping people live longer that they are often unwilling to admit they can do no more for patients and help them live the rest of their lives in dignity and comfort.
This would placate the perceived need for euthanasia in a country that sees up to 80 per cent of those being surveyed saying they accept euthanasia being legalised, yet case studies in countries where it is legalised show less than two per cent of people who have died actually used it.
“What people are ‘voting’ for is peaceful death,” Dr Blackwell said. “It’s one of those times in life where I tell people often, you’ve given so much of yourself to others for so long, maybe it’s time to receive (help across all aspects of their lives that palliative care can facilitate), and it takes them a while to cotton on to that concept.”
A White Paper released on 12 July by The Economist Intelligence Unit said that for the first time in the history of humanity, people over the age of 65 will soon outnumber children under the age of five.
“This will happen some time during the next few years,” the EIU said. By 2030, the number of people aged 65 and older is projected to reach 1 billion, or one in eight of the global population, rising even more sharply by 140 per cent in developing countries.
Compounding the effects of an ageing population, the EIU said, are falling birth rates, particularly in the developed world.
“It’s this argument that makes me certain of the importance of all health professionals becoming aware of palliative care and to be able to recognise when it’s time to think palliatively,” said Dr Blackwell, a Perth GP who worked for Silver Chain for 15 years. “If we don’t take that attitude we’ll never have enough palliative care services to look after all the people who’ll die over the next 50 years. It’s got to become a mainstream service.
“They’ve got to understand that part of their job is about living and part of their job is about dying.”
Palliative care was forced to emerge as a specialist service in the post-World War II era as it coincided with rapid advances in medical science, and “people providing those very high-level specialist services have actually lost touch with the person they’re dealing with”, he said.
“The next 20 to 30 years is about getting back the concept that palliative care advanced – the holistic view that treatment is about body, mind and spirit – across the whole breadth of medical services, so the patient is not just what illness they have.”
If all medical professionals are able to “think palliatively” and are willing to admit at a certain stage that further treatments may be unnecessarily burdensome, may actually make things worse and incur exorbitant costs, the patient can be helped to tie up loose ends, mend relationships and die a dignified death, he said.