Resolving conflict in end-of-life care

Ashby, Michael A; Kellehear, Allan; Stoffell, Brian F

doi:10.5694/j.1326-5377.2005.tb07024.x

Topics

We need to acknowledge the inevitability of death to have some choice in the manner of our dying

The tragic story of Maria Korp, the Victorian woman with severe irreversible hypoxic brain damage after an alleged murder attempt, has been prominent in the Australian media over the past few weeks. The clear, considered, and humane intervention by the state’s Public Advocate to authorise the cessation of artificial feeding has drawn both widespread praise, and some condemnation, especially from right-to-life activists.1 Once again, care and decision-making at the end of life is in the public arena.

1 Centre for Palliative Care, University of Melbourne, St Vincents Hospital, Melbourne, VIC.
2 Palliative Care Unit, Faculty of Health Sciences, La Trobe University, Melbourne, VIC.
3 Medical Ethics Unit, Flinders Medical Centre, Bedford Park, SA.

Correspondence:

1. Milanovic S. Anguish over removal of Korp’s feeding tube.The Sydney Morning Herald 2005; 26 July. Available at: http://smh.com.au/articles/2005/07/26/1122143820335.html (accessed Aug 2005).
2. Gostin LO. Ethics, the constitution, and the dying process: the case of Theresa Marie Schiavo. JAMA 2005; 293: 2403-2407.
3. Weir R. Abating treatment with critically ill patients. New York: Oxford University Press, 1989.
4. Faunce TA, Stewart C. The Messiha and Schiavo cases: third-party ethical interventions in futile care disputes. Med J Aust 2005; 183: 261-263. <MJA full text>
5. Glare P, Tobin B. End of life: case 2. Med J Aust 2002; 176: 80-81.
6. Ashby MA, Mendelson D. Gardner; re BWV: Victorian Supreme Court makes landmark Australian ruling on tube feeding. Med J Aust 2004; 181: 442-445. <MJA full text>
7. Airedale NHS Trust v Bland [1993] AC 789.
8. Murray SA, Boyd K, Sheikh A. Palliative care in chronic illness. BMJ 2005; 330: 611-612.
9. Kellehear A. Health promoting palliative care. Melbourne: Oxford University Press, 1999.
10. Kellehear A. Compassionate cities: public health and end-of-life care. London: Routledge, 2005.
11. Ashby M. Natural causes? Palliative care and death causation in public policy and the law. Adelaide: University of Adelaide, 2001.
12. Ashby M, Stoffell B. Therapeutic ratio and defined phases: proposal of ethical framework for palliative care. BMJ 1991; 302: 1322-1324.
13. Austin Health. Respecting patient choices. An advance care planning program. Available at: http://www.respectingpatientchoices.org.au/indexb.php (accessed Jun 2005).
14. Ellershaw J. Clinical pathways for care of the dying: an innovation to disseminate clinical excellence. J Palliat Med 2002; 5: 617-621.
15. Kirk P, Kirk I, Kristjanson LJ. What do patients receiving palliative care for cancer and their families want to be told? A Canadian and Australian qualitative study. BMJ 2004; 328: 1343.
16. National Breast Cancer Centre and National Cancer Control Initiative. Clinical practice guidelines for the psychosocial care of adults with cancer. Sydney: National Breast Cancer Centre, 2003.

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