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Independent and proud until the end

Diagnosed with terminal prostate cancer, Francoise's ex-husband Karl chose an assisted death in Queensland: "I want everyone to know that this alternative exists for people like Karl".

Despite having divorced in 2009, Karl and I lived in separate levels of our family home and maintained a warm, familial friendship. Just after Covid hit, we spent more time together due to the lockdown. Then in May he was diagnosed with terminal metastasized prostate cancer. The medical team delivering the sad news were teary. Karl sat erect, before asking about treatments.

Yes, he was assured treatments were available. For the next two years Karl accepted all that was offered including chemotherapy. His focus was on living. Stoic always despite the many side effects he had to deal with, he continued following his interests; he was a good musician with a lovely voice, he fixed antiques, mainly Chinese ones, drove his beloved old Mercedes, practiced his Tai Chi and went on walks in the local parks. I took him to all his appointments and supported him with kindness, as he had no other family of his own. 

As 2022 ended, his cancer marker PSA had soared and there were no other treatments available for him, other than radiology to manage his bone pain. He was taking many medications to help with pain and other symptoms and was referred to palliative care. The discussion centered around pain management and getting his 'affairs' in order. 

Finally, and reluctantly, Karl had to face his mortality.

His health deteriorated rapidly and by his 77th birthday in March 2023, he could only manage a tiny mouthful of his roast duck and Black Forest cake. Loss was ever present loss of control over his bodily functions, loss of appetite, loss of ability to play his guitar, loss of his singing voice, and too weak to walk, without clinging to the walls and furniture. 

Clearly the next step for Karl was aged care or palliative care which he had no interest in doing. Fortunately, he did not need to consider suicide as VAD had been made available in Queensland to those 'with a terminal illness that would kill them within twelve months'. Without it, I have no doubt that Karl would have ended his own life, rather than be 'cared for' out of his home and by anyone other than me.

He contacted Queensland's VAD Support service. We were saddened that his GP told us he was a conscientious objector. Karl had appreciated his GP's help and manner but was disappointed to learn this. We also learnt that very few local GPs had volunteered to participate in VAD. The three who did however were wonderful. Karl was very clear about his reasons for choosing VAD. He already felt dead as he could no longer recognise himself in the frail helpless way he now had to live. He had no spiritual beliefs that condemned him to wait till death finally released him from his misery.

The only sorrow that he expressed was that he would no longer see me.

A touching tribute from a man who loved me dearly for 26 years but who drove me to distraction at times. The warmth I felt for him as a person did not dissipate over the years of friendship. 

The date was set, the place our garden. As Karl suffered with nausea he chose intravenous administration of the VAD substance, for fear he would throw up the medicine.

With no hesitation from Karl, the process started with me singing to Karl as he had requested - good night, Irene became good night, Karly.

He fell asleep from the first injection, the other administrations followed. Fifteen minutes later the stethoscope confirmed Karl's suffering was finally over. I was so glad it was. It did not take me long to remember Karl as he was before the cancer, and to my surprise I do chat to him from time to time, although I have no belief that he can hear. It's nice though as I often told him that he would live on in our memories for as long as we, my family and I, lived. 

I am someone who advocated for VAD to become legal for many years for all of those people like me who have seen terrible deaths. That is now be avoided for those who meet the still stringent eligibility requirements. I have been shocked, however, to discover how many people, on hearing of Karl's choice, who were unaware that it is legal in Queensland now. I want everyone to know that this alternative exists for people like Karl independent, proud people who know what they want. A dignified death at a time and place of their choosing.

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