Time to plan for end of life

Helping people to decide in advance what medical treatment they want or don't want to receive in the event of a terminal illness or injury is the aim of a project under way by Southern Cross University's Professor of Aged Services Colleen Cartwright.

Professor Cartwright has developed an Advance Health Care Directive, which allows people to make choices in advance about their health care, easing the trauma often faced by family and friends.

Professor Cartwright, who is also the chair of the Aged Services Learning and Research Collaboration (ASLaRC), will be one of the guest speakers at a seminar at Southern Cross University's Coffs Harbour campus on September 14, titled "Decisions at the end-of-life: working together to improve practice".

The seminar, hosted by NSW Health, will be attended by more than 100 leading medical professionals, health workers and carers, and will be moderated by Dr Norman Swan, the producer of ABC Radio's Health Report.

Professor Cartwright said that while many people had appointed someone to have Enduring Power of Attorney in case they could not manage their financial affairs, few people made plans for their health care (not covered by an Enduring Power of Attorney).

Two options that are available to do that are to appoint a family member or friend as an Enduring Guardian and to complete an Advance Health Care Directive.

"People often don't think about these things until there are high-profile cases such as Maria Korp in Victoria and Terri Schiavo in the United States. They are nervous about contemplating end-of-life issues, but they need to think about it as an insurance policy. It gives them certainty that people will know their wishes and it takes away those difficult decisions from family members," Professor Cartwright said.

"Times of trauma bring about the best and worst in families. There is often conflict of agreement about the treatment and families can be fractured. We should be trying to avoid the bitterness that can result."

Professor Cartwright said the Advance Health Care Directive gave people the opportunity to say at what point treatment should stop in the event of a life-threatening illness or injury.

For example, it gives people the choice to say that if they have a terminal illness and their heart stops that they do not want to be revived, or that they do not want to be put on a permanent ventilator.

"In many cases the medical treatment is not prolonging a person's life, but prolonging their dying. To withhold or withdraw medical treatment to allow death to occur naturally is nothing to do with euthanasia."

Professor Cartwright will be conducting a pilot study on Advance Care Planning and has received strong support from the Mid North Coast Division of General Practice. She said Advance Health Care Directives should be filled out in consultation with close family and signed off by a GP.

Enduring Guardian forms are available from the Office of the Public Guardian, (02) 9265 1441, Tollfree:1800 451 510. For information about Advance Health Care Directives, contact Professor Colleen Cartwright on 66593382.