Discussion Paper on End-of-Life Medical Care To be Launched

Current practices in end-of-life medical care require major change to ensure more Australians experience ‘better’ deaths, according to a panel of medical, ethical and legal experts.

The panel has issued a comprehensive discussion paper and blueprint for change following robust debate at a one-day forum jointly sponsored by the Schools of Population Health at the University of Melbourne and Monash University earlier in the year. The meeting identified the need for improvement in end-of-life care and the associated barriers and drivers for change.

Head of Monash University’s School of Public Health and Preventive Medicine, Professor John McNeil said the forum had been organised to address the changes wrought by an ageing population and rapid technological advancement that now enables doctors to treat many medical ailments into advanced years.

“People are living longer and consequently the practice of medicine and the way we live and die has changed,” Professor McNeil said.

“Therapeutic and technical advances have improved and extended lives of many Australians, but at a cost - a new older generation of people is living with more complex disease and gradual decline in quality of life. “This creates new challenges for medical practice in particular, balancing the imperative to ‘cure’ with the personal, social and financial burden it can create. End-of-life care implies an awareness of this balance.”

More than 52 per cent of Australians now die in hospital, despite the fact that most would prefer to die at home. In 2011, more than 146,000 people died in hospital in Australia.

“As the population ages, we are seeing an increasing amount of surgery that is of marginal benefit. We now know that a high percentage of surgical patients over 80 years of age will have complications following surgical procedures resulting in extended hospital stay and increased mortality.”

The major focus for change recommended was education, with other key issues discussed including clinical behaviour, clinical leadership, practitioner confidence, and hospital procedures.

“The benefits of improving the system are multiple - extending to patients and families where there will be improved quality of life-before-death, medical teams and carers to alleviate psychological, moral and emotional distress and conflict, and an improved allocation of resources within the health care system more broadly,” Professor McNeil said.

“We hope to engage the new federal government and all state governments to achieve the panel’s stated desired outcomes for change and sustainable improvement.”

Parliamentary Secretary for Health in the Victorian Government, Ms. Georgie Crozier, will officially launch the White Paper, ‘Best Practice in End of Life Care’, on Thursday 21 November, from 5-6.30pm, Monash University Conference Centre, Level 7, 30 Collins Street Melbourne