Catholic Communications, Sydney Archdiocese REPORT
30 Oct 2012
Palliative Care is one of the fastest growing, most dynamic fields of medicine and is constantly evolving to bring peace, dignity and comfort to the terminally ill in the final days or months of their lives, says Dr Jovina Graham.
Dr Graham graduated from the University of Sydney in 2010. She hopes to specialise in palliative care and is currently working as a junior doctor and resident at the Calvary Hospice, Kogarah.
"Palliative care has only been around for the past four decades. But since its development as a specific field of medicine, there has been a massive amount of research and more and more doctors and nurses are being trained in this important field," she says.
With the advances in palliative care not only in pain-management but in relief of other symptoms, psychological care, physiotherapy and the overall emotional and physical wellbeing of patients who are terminally ill, men and women of all ages are finding peace and tranquillity in their final days.
Their families are also being given much needed support at this time.
But should read: At 28, Dr Graham who spent part of her residency at St George's Hospital during which time she spent many months in the geriatric ward tending to elderly patients many of whom were near death and suffering delirium or dementia, firmly believes there is no place in medicine for euthanasia.
"Whether voluntary or involuntary, euthanasia in all its forms should never be legalised," she says firmly adding that with the advances in palliative care which continue to evolve and improve, any pain and physical suffering can be eliminated and any fears and emotional turmoil discussed and alleviated.
Much of her work as a resident physician at Calvary Hospice involves talking at length to each of her patients and helping them come to terms with their approaching deaths.
"A big part of ward rounds at Calvary is talking to patients and working through any suffering they may have whether physical or existential," she says.
In a number of aged care facilities, the elderly suffering a terminal illness and having no family or friends to visit them, frequently decide in their acute loneliness there is nothing to live for. But this is not the case when palliative care is available, Dr Graham says.
What research studies have found is that palliative care may also extend life.
While the aim of this form of care is neither to shorten nor prolong life, a recently study published in the New England Journal of Medicine found that people with lung cancer who were treated early with palliative care survived up to two months longer than those who underwent aggressive medical care in their final months.
While palliative care still needs far more in terms of state and federal funding, particularly in rural and regional areas where there are few palliative care facilities or specialist doctors and nurses, city hospices are increasingly able to provide outreach services.
"In country areas practitioner nurses are also being trained in palliative care and eventually we hope every Australian who needs palliative care will be able to access this form of care," says Dr Graham.
But NSW continues to lag behind and currently needs at least 22 more palliative care doctors and 200 nurses to catch up with those working in other states across the country.
Catholic hospitals, as is often the case when it comes to medical care in NSW, have helped lead the way in palliative care and the establishment of hospices. One of the oldest hospices in Sydney is the Sacred Heart hospice at Darlinghurst which is part of St Vincents and Mater Health.
Another is Calvary Hospice at Kogarah which Dr Graham says is specifically engineered to be a calm and beautiful place for the terminally ill to spend their final weeks or months.
"There are lovely gardens and beautiful music including harpists who come in to play for patients. And for those who don't have families or friends, we have volunteers to visit and help make them feel cared for and loved. There are also pastoral care workers who are on hand to talk to patients and be with them in quiet prayer."
According to Dr Graham, the patients at Calvary hospice no matter what their age are calm and happy and rather than wanting to end their lives, want to live every moment of whatever is left to them.
But she is concerned that despite the advances in palliative care and the number of palliative care facilities on the increase across the state, euthanasia is once again on the political agenda, this time with the NSW Government announcing it will hold a conscience vote on the issue when Parliament resumes in 2013.
"If we start seeing euthanasia as part of the medical arsenal there would be no motivation to find new ways to control pain or to help patients deal with the approach of death," she warns.
Even in nations such as the Netherlands where voluntary euthanasia is legal, most people still do not choose to die this way. In the Netherlands assisted suicide accounts for less than 2.0% of all deaths, while those opting for euthanasia in Oregon, where it is also legal, account for less than 0.2%.
Another concern is that once euthanasia is made legal, many of the elderly who become infirm feel duty bound to end their lives so they are not a burden to their children.
"Studies in the Netherlands and other countries repeatedly show this is what is happening. But even more concerning is that many assisted suicides where it is now legal are taking place without permission," Dr Graham says. "The most recent government-sanctioned study into assisted suicide in the Netherlands has revealed that 23% of these deaths by euthanasia were not properly reported and went ahead without permission."
The legalisation of euthanasia presents an ethical dilemma to all Australians, and particularly for doctors and the medical profession, she says.
"Who are we to judge if a patient's life is no longer worth living? Life is a gift and as doctors our aim and sole motivation is to do all we can to help a patient and make them as comfortable as possible."
SHARED FROM ARCHDIOCESE OF SYDNEY
30 Oct 2012
Palliative care brings peace dignity and comfort to the terminally ill and their families
Dr Graham graduated from the University of Sydney in 2010. She hopes to specialise in palliative care and is currently working as a junior doctor and resident at the Calvary Hospice, Kogarah.
"Palliative care has only been around for the past four decades. But since its development as a specific field of medicine, there has been a massive amount of research and more and more doctors and nurses are being trained in this important field," she says.
With the advances in palliative care not only in pain-management but in relief of other symptoms, psychological care, physiotherapy and the overall emotional and physical wellbeing of patients who are terminally ill, men and women of all ages are finding peace and tranquillity in their final days.
Their families are also being given much needed support at this time.
But should read: At 28, Dr Graham who spent part of her residency at St George's Hospital during which time she spent many months in the geriatric ward tending to elderly patients many of whom were near death and suffering delirium or dementia, firmly believes there is no place in medicine for euthanasia.
Dr Jovina Graham is completing her residence at Calvary Hospice, Kogarah. Photography courtesy Catholic Weekly
Much of her work as a resident physician at Calvary Hospice involves talking at length to each of her patients and helping them come to terms with their approaching deaths.
"A big part of ward rounds at Calvary is talking to patients and working through any suffering they may have whether physical or existential," she says.
In a number of aged care facilities, the elderly suffering a terminal illness and having no family or friends to visit them, frequently decide in their acute loneliness there is nothing to live for. But this is not the case when palliative care is available, Dr Graham says.
What research studies have found is that palliative care may also extend life.
While the aim of this form of care is neither to shorten nor prolong life, a recently study published in the New England Journal of Medicine found that people with lung cancer who were treated early with palliative care survived up to two months longer than those who underwent aggressive medical care in their final months.
While palliative care still needs far more in terms of state and federal funding, particularly in rural and regional areas where there are few palliative care facilities or specialist doctors and nurses, city hospices are increasingly able to provide outreach services.
Dr Jovina Graham describes palliative care as one of most dynamic and evolving medical specialties
But NSW continues to lag behind and currently needs at least 22 more palliative care doctors and 200 nurses to catch up with those working in other states across the country.
Catholic hospitals, as is often the case when it comes to medical care in NSW, have helped lead the way in palliative care and the establishment of hospices. One of the oldest hospices in Sydney is the Sacred Heart hospice at Darlinghurst which is part of St Vincents and Mater Health.
Another is Calvary Hospice at Kogarah which Dr Graham says is specifically engineered to be a calm and beautiful place for the terminally ill to spend their final weeks or months.
"There are lovely gardens and beautiful music including harpists who come in to play for patients. And for those who don't have families or friends, we have volunteers to visit and help make them feel cared for and loved. There are also pastoral care workers who are on hand to talk to patients and be with them in quiet prayer."
According to Dr Graham, the patients at Calvary hospice no matter what their age are calm and happy and rather than wanting to end their lives, want to live every moment of whatever is left to them.
But she is concerned that despite the advances in palliative care and the number of palliative care facilities on the increase across the state, euthanasia is once again on the political agenda, this time with the NSW Government announcing it will hold a conscience vote on the issue when Parliament resumes in 2013.
"If we start seeing euthanasia as part of the medical arsenal there would be no motivation to find new ways to control pain or to help patients deal with the approach of death," she warns.
Modern medications and the multi disciplines of palliative care help ensure quality of life and death with dignity
Another concern is that once euthanasia is made legal, many of the elderly who become infirm feel duty bound to end their lives so they are not a burden to their children.
"Studies in the Netherlands and other countries repeatedly show this is what is happening. But even more concerning is that many assisted suicides where it is now legal are taking place without permission," Dr Graham says. "The most recent government-sanctioned study into assisted suicide in the Netherlands has revealed that 23% of these deaths by euthanasia were not properly reported and went ahead without permission."
The legalisation of euthanasia presents an ethical dilemma to all Australians, and particularly for doctors and the medical profession, she says.
"Who are we to judge if a patient's life is no longer worth living? Life is a gift and as doctors our aim and sole motivation is to do all we can to help a patient and make them as comfortable as possible."
SHARED FROM ARCHDIOCESE OF SYDNEY
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