Phil Browne is a registered nurse, palliative care worker and paramedic. Over 40 years, he provided end-of-life care to about 2,000 Queensland patients, witnessing what he calls intolerable suffering.
A frontline health professional for 40 years, Phil Browne was a registered nurse, palliative care worker and paramedic. During his career, he provided end-of-life care to about 2,000 patients, witnessing what he calls intolerable suffering. In this edited submission to the Queensland parliamentary inquiry into voluntary assisted dying, Phil says some of his patients begged him to help them die.
I want to tell you about some of my former patients who died bad deaths, despite receiving world-class palliative care.
Many people mistakenly believe pain is the only symptom that can be difficult or impossible to relieve in patients receiving palliative care. This is not correct. There are many symptoms that can be hard, sometimes impossible, to relieve completely. This can include pain, nausea, vomiting, breathlessness, excessive respiratory secretions, delirium and terminal agitation.
It's common for people to experience several of these distressing symptoms at the same time, leaving the patient in a severely distressed state which may persist for weeks or months.
It's important to remember we are talking about people in very poor physical condition, who have an extremely diminished quality of life. We are not talking about well people who are able to perform everyday tasks with ease.
Below are some examples of particularly distressing symptoms, apart from pain, that I observed in my patients. Sometimes it was impossible to relieve these shocking symptoms.
Excessive respiratory secretions - where the person is gurgling with every breath and their noisy struggle for breaths can be heard some distance down the corridor. Every breath is a major battle and it's absolutely exhausting. Patients feel like they are drowning. As death approaches, the "death rattles" can be very pronounced.
Faecal vomiting caused by a bowel obstruction - I will never forget seeing patients vomiting their own faeces. The look of horror on their face, and the smell, is forever etched in my memory. This is a devastating symptom that can be impossible to control without surgery, and these patients are way too sick to even consider surgery.
Large fungating ulcers - I've seen patients with large cavernous ulcerating wounds caused by advanced cancers. I recall one palliative care patient who had a massive invasive tumour of her vulva. Necrotic tissue lined the wound, causing a weeping discharge. In addition to being in disgraceful pain, this poor woman was distressed about what her family had to endure when they visited her.
I must give special mention to neuro-degenerative conditions, which include multiple sclerosis, motor neurone disease, Parkinson’s disease and Huntington’s disease.
I've nursed many people with these particularly cruel conditions that rob their victims of their basic dignity for a prolonged period - often years - during their terminal decline, leading to their inevitable death.
These people, who can be young, are trapped in a body that doesn't work for even the most basic daily functions and who, for a long time prior to their inevitable death, are totally reliant on other people. I had people with these medical conditions tell me they wished to die.
I also had numerous palliative care patients ask me to help them to die.
Often these patients had already endured prolonged suffering. They were extremely fatigued, and the best quality palliative care had failed to relieve their symptoms
I don't remember all my patient's names or medical conditions. But I vividly remember the desperate looks on their faces or specific conversations where they asked for assistance to die.
As a health professional, I believe my patients should have had the right to say enough is enough and to demand a good death, which is not always possible with palliative care.
Voluntary assisted dying legislation will not help my past patients who died horrific deaths, but it will help future generations of Queenslanders, if they meet eligibility criteria and choose to access VAD.
Read Phil's story in the Fraser Coast Chronicle