October 2017

Samaritan traveller a guide for end-of-life journey

Over the past months I have followed the “euthanasia debate” – the ongoing argument between those who champion the ‘right to life’ as opposed to those who assert the ‘right to choose’. Such slogans, however, oversimplify the reality, says Sister Mary McDonald.

BY Mary McDonald SGS

Recently I was having coffee with a group of women when the conversation moved to the proposed Victorian euthanasia laws. “I can’t wait till the law is passed in Victoria and will soon spread to the other States, hopefully to Queensland first,” one woman said.

There were a few nods, but no one spoke. I started to say that I didn’t agree, and before I could say anymore, Laura interrupted: “Of course, Mary, being a Catholic nun you have to agree with the Church’s party line”.

I waited for someone else to move into the silence. No one did. So I replied by saying that while I agree with the teaching of the Church on the sacredness of life, that was not the perspective from which I was going to respond.

“Well do tell us Mary, what you were going to say?” said one of the women.

I explained that I was going to speak about my 15 years as a volunteer with the Buddhist-sponsored home hospice organisations – Cittamani on the Sunshine Coast and Karuna in Brisbane. Clare wanted to know more about my experience.

I told them that after an initial training program, volunteers commit to three hours a week to go to the home of the person who is terminally ill. Sometimes it was to give some respite to the primary carer, but often it was to sit and have conversation with the dying person, or just be a silent companion. I never came as a “Catholic nun”. We only gave our first name and no contact details.

I was privileged to accompany many people in the last months or weeks of their life. I witnessed some extraordinary experiences of the healing of life’s hurts, gifts of grace and peace, struggles to forgive and be forgiven, regrets acknowledged, shifts from despair to hope.

“That’s pretty impressive, Mary, but it doesn’t change my mind,” said Laura. Sue added, “I don’t think Mary was trying to do that.” Conversation moved to other topics.

Later, I thought back to one palliative care journey. I was asked to visit a Catholic woman in her early sixties who was in home palliative care. The family had told the nurse that at times Liz became quite agitated and kept saying she had lost her peace. Liz and the family decided to ask for a visit from a Catholic nun – as distinct from one of the Buddhist nuns.

On my first visit Liz told me she had lost her peace and my job was to help her find it. My weekly visit usually began with general conversation then Liz liked to share some thoughts on the daily Gospel reading. We usually finished with a decade of the rosary.

After a few visits little had changed, so I was wondering what other approach was needed. Liz, a chain smoker, assured me that she liked my company because I accepted her, smoke and all, and to just keep on visiting.

Several weeks later, I visited on the Feast of the Sacred Heart. I mentioned the feast day and we sat quietly in the heart and love of Jesus. Then I began the aspiration, “Sacred Heart of Jesus”. Liz took up, “I place my trust in you”. We continued mantra-like to murmur our trust. Suddenly, Liz said, “I have the answer! The name of the crypt where my ashes are going is the Sacred Heart”. “So Liz,” I said, “you will be in the heart and love of Jesus forever”.

A few weeks later, Liz died peacefully surrounded by her husband, family and friends. Her peace was a great gift to all.

At our monthly carer’s meeting, we often heard experiences of the healing of life’s hurts, forgiveness and peace. Some organisations offer assistance with the writing of a person’s biography. It’s an opportunity to see life as a whole and not only from the end point. Volunteer biographers are trained in questioning, eliciting memorable moments and, with permission, taking notes and recording responses. Old photos prompt laughter and tears. Then of course, there is the decision-making about what to include. The final product becomes a generous gift to family and friends. Often too, it shifts the perspective of the dying person and bestows the gift of gratitude and peace.

Such transformation takes time. The timeframe offered for the choice of assisted suicide could negate this process. Some would argue that you can still have home palliative care experiences as well as the option of assisted dying. This may be true, but this argument is often used to deflect from one of the key tenets of ‘free choice’ advocacy: the assurance of an ‘on-demand, quick and pain-free end to life’.

Over the past months I have followed the “euthanasia debate”, the ongoing argument between those who champion the ‘right to life’ as opposed to those who assert the ‘right to choose’. Such slogans, however, oversimplify the reality.

If the Voluntary Assisted Dying Bill is passed this week in Victoria, terminally ill adults who have “sound decision-making capacity” with no more than a year to live are assured that they can legally kill themselves using a drug or drugs supplied with the State’s approval.

Under this model, there is no requirement for psychiatric assessment and no need to involve the patient’s treating doctor or family. Two new doctors with no knowledge of the patient or end-of-life expertise have the power to authorise the required drug. This can eliminate the role of the family physician who may have given many years of trusted care. As Patrick O’Neill wrote recently in The Tablet:

“The role of the physician at this time is to walk alongside the patient, absorbing some of their anger against the disease and their feelings of loss of control over the direction of their life. The hope is that they can then stop fighting for life to preparing for a good death.”

The diagnosis of a terminal illness is most confronting for the person and family directly involved. People often feel overwhelmed, lost and frightened. Some people still confuse pain minimisation with euthanasia. Services that offer palliative care do not solely focus on death and dying, rather, the focus also takes in symptom management, pain control and psychological and spiritual support.

The denial of death is central to our society. This manifests in various ways – for example, in our speech, by avoiding the word “death” and using instead “passed on”, “gone from us”. The overwhelming media focus is on staying as young as possible, as beautiful as possible, for as long as possible. In many religions a belief in an afterlife is integral to faith so maybe another contributing factor for the choice of euthanasia is the decline in religious affiliation.

Toby Hall, Chief Executive of St Vincent’s Health Australia, summed up powerfully our society’s denial of death in a recent Fairfax opinion piece. He said:

“Dying is something that has become hidden away and to be desperately resisted at all costs… And in the vacuum created by our disconnection from dying, we have allowed fear, misinformation and myth to flourish. Death is portrayed by an ill-informed media as inherently painful, undignified and traumatic…”

Many palliative care and hospice organisations offer assisted living particularly through palliative nursing care either at home or in a hospice. The obligatory training program for palliative care workers and volunteers provides information and practical skills. While these are helpful, there is no set way to accompany another person. Each person’s final journey is uniquely theirs, as the old folk song reminds us, “No one can walk this journey for us, we have to walk it for ourselves”.

The Samaritan traveller is a guide for this end-of-life journey, as Pope Francis reminds us:

“The predominant school of thought sometimes leads to a ‘false compassion’ which holds that it is… an act of dignity to perform euthanasia. Instead, the compassion of the Gospel is what accompanies us in time of need, the compassion of the Good Samaritan who ‘sees’, ‘has compassion’, draws near and provides concrete help”.

Mary McDonald

Good Samaritan Sister Mary McDonald has had a long involvement in and commitment to education, the environment and social justice issues. She holds degrees in arts, education, environmental education and theology. Mary lives in Brisbane where among other things, she gardens, plays Mahjong the Chinese way and tutors at Lourdes Hill College.

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