Palliative care for Stage Four Colorectal Metastatic Cancer and role of Passive Euthanasia in Dying Essay 2022

Palliative care for Stage Four
Colorectal Metastatic Cancer
and role of Passive Euthanasia in
Dying with DignityThe right to determine the time and place to die

Introduction
Melissa is a divorced woman in late thirties, with two children in pre-teens and teens, living
and working alone in Victoria. She has been diagnosed with colorectal cancer stage-4 12
months ago, has undergone a surgery along with Ileostomy and developed metastatic liver,
with poor chances of living maximum for 6 months. Her husband only leverages in financial
shared care over their children; and she is planning for advanced care planning with her
family, concerned about future childcare options for her children. She is opting for palliative
care, as other means of treatment are not working, and through palliative care, she wants to
have the right to determine her place and time of death, corresponding to the recently passed
bill of legalising passive voluntary euthanasia in Victoria in June 2019.
The essay deals with the emerging issue of voluntary euthanasia in Australia, in lieu for
terminally ill patients for bringing good death through compassionate means, by preserving
the dignity and rights of a terminally ill adult patient. Palliative care options, advanced care
planning, childhood care options have also been discussed to throw light on options available
for terminally ill patients and family members in Australia in relation to recently passed bill
of passive euthanasia.
Stage-4 colorectal cancer and treatment options
A stage 4 colorectal bowel cancer involves cancer spreading from colon tissues to liver and
abdominal civility, lungs or lymph nodes. The treatment options vary from surgery by
Ileostomy, chemotherapy, radiation therapy, hepatic artery infusion, Embolization and non-
invasive treatments (Junttila et al., 2015). In case the above-mentioned treatment options are
not successful, a patient prognosis with Stage-4 colorectal cancer opts for palliative care. In
such cases, as invasive treatments cannot improve life span of patients, treatment which eases
discomfort, pain, to make their living conditions better and stress-free. Managing the pain and
reduction of symptoms improves the living conditions of such terminally ill patients. End-of-
life-care options include psychosocial, physical and spiritual assessment and treatment
provided to terminally ill patients meeting their choices of death and last needs of life
(Blaschke, Schofield, Taylor & Ugalde, 2019). Coordinating care, providing advices, nursing,
care-giving, emotional support, respite, and support services involving family, homes and
hospitals to give meaningful addition during time of death.

Palliative treatment and advanced care planning ACP options in Victoria
In may 2019, the Victorian Budget improved better access facilities to palliative care for the
next 4 years, implicating better palliative care options for terminally-ill patients like Melissa
("More than 10,500 Victorians Set to Benefit from Palliative Care Budget Boost - Palliative
Care Victoria", 2019). Palliative Care Victoria is a strategic body contributing widely to
policies on Palliative care in Victoria, envisages in providing palliative care through
collaboration, advocacy and capacity building of caregivers in end-of-life and palliative care
for chronically ill patients. Palliative care does not only include the patients, but involves
families and primary carers in homes, for better accessibility and empowerment of caregivers.
For cancer patients within last-stage in cancer, emotional, physical, practical and spiritual
needs are encompassed by palliative care for providing the highest quality and comfortable
living until death (Fletcher, Hughes, Pickstock & Auret, 2018).
The main aim of palliative care is to integrate feelings of patients, family-members in a
common ground and provide better dying options with comfort for the patient, through
acceptance and endurance (De Lima et al., 2017). In case of Melissa, her estrangement with
her husband and in-laws has led problems for sharing care for her children. Her own parents
are critically ill, which has limited options for future childcare for her teenager children,
increasing problems for Melissa. Through palliative care integration with healthcare systems,
a common point of understanding with her husband and parents can be brought for improving
childcare after her death. Along with this advanced-care options and end-of-life-care options
are also envisaged within ambit of palliative care. Palliative care-includes easing pain, special
aids in homes, assisting in taking with family over sensitive issues, supporting cultural
obligations, counselling, emotional support and respite care provisions (Rosenwax, Spilsbury,
McNamara & Semmens, 2016). Throughout advanced cancer, palliative and end-of-life care
enables in providing comfortable life. However, including voluntary assisted dying is yet
another addition to palliative care, which improves condition of life before death for patients
like Melissa.
Patients through advanced care planning generate decisions along with their family members
so that they can provide their views, lest they become incapable to do so in future. Through
cumulative conversations, communication among healthcare providers, terminally-ill patient
and families, the process is made after proper review of patient needs and preferences
(Johnson, Butow, Kerridge & Tattersall, 2017). In case of Melissa living with Stage-4