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Neglected to death - is this the Howard Government's aged-care philosophy?

By Nicholas Tonti-Filippini - posted Friday, 14 May 2004


The Parliament also included in the legislation the requirements that the legislation not be used to aid and abet suicide or to commit homicide. A reasonable belief that a person intends suicide remains a lawful reason to override their wishes. The purpose was not to facilitate suicide but to allow patients to refuse to be subjected to a treatment that is in some way problematic for them.

The Austin Hospital's version of palliative care apparently involves a plan that does not include sustaining the patient.

Now, with government support, that "palliative care" is to be extended to those living in aged-care facilities and at home, through their general practitioners.

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The inclusion of food and fluids in the document would seem to be based on the judgment made in the BWV case last year. A Victorian Supreme Court judge authorised the withdrawing of food and water from BWV who had an advanced degenerative brain disorder.

The judge said that his judgment applied only to the circumstances of that case which were reportedly circumstances of great suffering. Much evidence had been given about the nature of BWV's suffering and the particular difficulties of sustaining her.

The Austin Hospital program would seem to have taken the judge's decision to include tube and intravenous feedings in general and apply it to a broad range of people classified by their disability or by their prognosis, not on the basis of the burdensome nature of the treatment offered.

Many people do fear being subject to unwanted, burdensome medical treatments. But it is another matter to advocate that they opt for being neglected to death. There is a basic level of care and support that is owed to people, if we are to remain a civilized society.

At base the Austin program involves a premise that respect for a human person and his or her protected status as a human being does not depend on who they are but on the meaningful nature of their interactions. This is a priority of existential dignity over essential dignity. Is this the Howard government's aged-care philosophy?

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Article edited by Robert Standish-White.
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About the Author

Dr. Nicholas Tonti-Filippini is an Independent Consultant Ethicist. He is a chairman of the Research Committee for Matercare International and a founding member of the Board of Directors for Matercare Australia

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