Right to Determine Place and Time of Death: Legal and Ethical Aspects

This essay delves into the complex issue of the right to determine the place and time of death, particularly in the context of terminal illnesses and the Australian legal framework. It examines the concepts of euthanasia and assisted suicide, defining them according to the World Health Organisation and discussing their legal status in Australia, where assisted suicide is generally forbidden. The paper explores palliative care, end-of-life care, and advance care planning as alternative approaches to support individuals facing life-limiting illnesses. It analyzes the Voluntary Assisted Dying Bill 2017 in Victoria, outlining the eligibility criteria for voluntary assisted dying. The essay further discusses the challenges in implementing such legislation and the evolving perspectives on the right to die, considering the balance between individual autonomy, medical ethics, and societal values.

Running head: RIGHT TO DETERMINE THE PLACE AND TIME OF DEATH
Right to determine the place and time of death
Name of the Student
Name of the University
Author Note

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The decision of a person to live has been equated with the person’s wish to end his
life. Philosophers and social scientist argue that if right to life was to be confined within
parameters of the choice of living, then in that case it should have been named as duty to live
instead of right to life. The notion of continuing living a life that is not worth living, subject
to critical and extreme conditions, is implausible. However, the right of a person to end his
life needs clarity and in depth clarification. The right to die is not the right to be assisted to
end one’s life but it should be a right not to be restricted from asking for assistance to end
one’s life or taking the help of the ones who extends a helping hand to end one’s life which is
not worth living. Australia as a country does not observe human rights through legislative or
regulatory framework as it lacks a formal Bill of Rights, thereby defeating legal protection to
the basic needs of its citizen. Therefore, this paper would strive to discuss the right to
ascertain one’s place and time of death, in regard to terminal diseases that makes life not
worth living.
Right to die
The Right to die is the principle based on the popular opinion of the modern world
that talks about ending one’s life, especially in case of terminally illness patients who find it
difficult to live with extreme medical conditions. In this regard it is often argued that the right
to end one’s life would greatly benefit such kind of people as it would relieve them of their
hardship. Euthanasia or the right to choose to die was originated in Greece which signifies
good death, which is often associated with assisted suicide and mercy killing. Euthanasia and
assisted suicide has both been defined by the World Health Organisation. It held that assisted
suicide is the intentional act of killing oneself with the help of another who has the means to
help the victim; while, euthanasia is stated as the act by which a person wishes to put himself

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to death painlessly or escape the natural course of death due to terminal illness or any other
prolonged medical condition (Strinic, 2015).
The Australia law provides for a palliative care that doctors, medical
practitioners and carers are allowed to give to ease a patient’s suffering, even though it has
been evidenced that such care could fasten the patient’s death (Chapman & Leeder, 2014).
While, the law forbids the medical practitioners to entertain the request of the terminally ill
patients to help them end their life (ABC News, 2019). The only parameter of exercising
assisted suicide has been pointed out as and when a patient suffers from an incurable yet not a
life-threatening disease, except for a few exceptional cases.
Community support has been gathered in order to legalise the concept of medically
assisted suicide; however, it is yet to transform into a legislative framework by getting the
votes in the Parliament. Personal hardship of people could however change the intent of the
conservatives (Radbruch et al., 2016). Although positive outlook is growing in terms of
supportive approach towards Euthanasia and assisted suicide, yet the strategies as well as the
fear of the politicians for facing opposition from the conservative minorities and different
critical sources stops the government from reformation (Strinic, 2015). It could be derived
from different literatures that this kind of social change is hard to achieve and is extremely
sensitive and controversial, nevertheless the advanced medical science and technology is
making its progress in inventing ways to escape the clutch of tormenting life; the life not
worth living for the terminally ill victims. However, as of now, the medical science and social
scientists have come up with certain different care methods by which the patients seeking
assisted suicide could be consoled and comforted until he dies of natural death (Chapman &
Leeder, 2014).
Palliative care

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Palliative care refers to a special form of family-centric care given to the patients
suffering from life-limiting illness. The life limiting illness is a disease that is active,
advanced and progressive that has affected a person having negligible prospect of cure
(Palliative Care, 2019). A patient suffering from a life limiting illness would die within an
estimated time frame and therefore by the way of the palliative care, the medical practitioners
and caregivers try to optimise the victim’s quality of life. A victim of the life limiting illness
is provided with a comfortable life for the time that he shall live. Palliative care includes
physical, emotional, social for spiritual care that a terminally ill person would need in his
final months or even days. It is a kind of care that addresses individual need of the patient and
therefore the services offered to the victims usually differ however it includes the following
(Australian Government Department of Health, 2019):
 Relieving pain and certain symptoms of a victim
 Providing of equipment required to aid home based care for a victim
 Assisting families to come together and discuss about the critical medical condition in
their family.
 Linking victims and their families to other support or care help for further assistance.
 Giving grief and counselling support.
The main purpose behind implementing palliative care is to give a better and quality
life to a victim suffering from terminal illness who deserves a quality life before dying a
painful death. Palliative care is provided to people who are suffering from serious illness
which cannot be cured. Terminal diseases like cancer, last stage of kidney diseases, motor
neuron disease, lung diseases and dementia are some of the major illnesses for which
palliative care is provided (Palliative Care, 2019). A patient diagnosed with terminally ill
disease could be provided palliative care which would be beneficial for him for receiving the
palliative care along with receiving the medical treatment. It is to be noted here that period

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care is not a conventional medical treatment but a care service in order to improve the quality
of life of the victim. A palliative care could be opt for at any stage of the illness (Australian
Government Department of Health, 2019).
A palliative care team includes medical health professional who are trained to help the
victim and his family e in order to manage the life limiting illness as well as the quality of life
of the patient. It includes doctors, medical specialists, physiotherapists, psychologists, nurses,
social workers, occupational therapists, speech therapists, trained volunteers, et cetera.
Palliative care is different from other kinds of care as it can be received at any point of a
patient’s illness and it lets the patient continue his medical treatment along with experiencing
the care system. This kind of care could be provided at home, at a hospital or at a residential
care facility (Australian Government Department of Health, 2019).
End of life care
End of Life Care refers to the type of care that is offered to terminally in in patients
during their last few days, weeks or months of their lives, striving to lower the grief and
distress that a patient and his family might be going through to because of the thought of
death. Death and its thought is a terrible feeling for a patient, his family, friends and
associated people and therefore this type of care is obtained to minimise the stress and bitter
feeling (Betterhealth.vic.gov.au, 2019). The main objective of end of life care is to elevate the
standard of living, if not physically but mentally for the terminally ill patients and their
families, during the last few days of their lives. It has been solved and found out that the care
that patients receive at hospitals are deteriorating and not appropriate for or them and that is
the reason the Australian Commission on Safety and Quality in Healthcare has come up with
this excellent idea of providing a quality end of Life Care to the dying patients and their
grieving families (Safetyandquality.gov.au, 2019). End of life care and palliative care are

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more or less similar with the only difference being that end of life care is provided at the far
end of the life of a patient while palliative care could be opted for at any point of time.
Advance Care Planning
Advance care planning or ACP refers to the discussion and planning between the
patients, the loved ones and the Healthcare professionals in regard to their future health Care
strategies and program in order to build a better lifestyle in order to tackle their life
threatening diseases (Healthywa.wa.gov.au, 2019). It provides a direction to the Healthcare
professionals especially when the patients and their family members are not in in mental state
to take decision about their Healthcare choices. An adult patient can take part in advance care
planning at all stages thereby reducing his anxiety and stress and subsequently improving
their state of mind and even sometimes physical health as well. Its main objective is to help
people live a better life even when death is approaching so that patients could die with their
personal values and dignity (Healthywa.wa.gov.au, 2019). Studies have shown that end of
life Care, palliative care and advance care planning have provided improved results to the
patience as well as their near ones.
It involves a process of planning the current as well as the future healthcare
arrangements of a patient keeping the beliefs, values and preferences of the victim and his
loved ones intact (Healthywa.wa.gov.au, 2019). An advance care plan is often required by
patients with advanced chronic illness, extreme dementia or any other life limiting diseases.
A patient wish to opt for an advance care plan is required to make a conversation with their
family members or next of kin so that they can be a support system for the patient while he or
she undergoes the program. One of the distinct features of advance care planning is the
appointment of a substitute decision maker whose decision replaces the patient's opinion

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when such patient is not in a mental state to take a logical decision for himself
(Advancecareplanning.org.au, 2019). Therefore it could be held that by this process the
patient is accommodated to communicate with someone close to him along with choosing a
decision maker to take decision on his behalf which would aid the patient to live a better and
less stress full life (Radbruch et al., 2016).
Legislative framework
Voluntary Assisted Dying Bill 2017 was introduced in the Victorian parliament. It was
introduced by the Andrews labour department, under the recommendation of the president of
the former Australian medical association, Mr Brian Owler (Gardner, 2017). This made
Victoria the first state of Australia to have legally recognised and introduced the concept of
voluntary assisted dying (VAD). The challenges of implementing the regulation was
observed by the medical Journal of Australia who estimated that there were a number of
eligible patients who lacked the access to it, while there were a few who were keen to adopt it
even though they were not eligible. As per the provision of this legislation, voluntary assisted
dying or VAD, applicable in Victoria only, lists down certain conditions for a person to be
eligible (Wilson, Oliver & Malpas, 2019):
a) Patient suffering from advanced, incurable and progressive disease, thereby
experiencing extreme suffering (Karapetis et al., 2018);
b) A medical condition assessed by two medical practitioners, who opens that the patient
shall not live more than 6 months (Duckett, 2019),
c) The patient must be over 18 years of age and I have decided in Victoria for 12 months
at least, along with holding the capacity to make a logical decision,
d) Patience meeting all the above criteria and having a mental illness in addition shall
not be disallowed to access the benefits of this legislation (Walker, Egan & Young,
2018).

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Conclusion
As held by the given case study, Melissa, suffering from stage 4 bowel cancer that has
taken the shape of a terminally ill disease. In this regard Melissa, 37 years old and a mother
of two, approached a healthcare team at the metropolitan health service and have been having
a frank conversation with her oncologist and other health specialist. She is required to be
eligible for being approved to determine the time and the place where she would choose to
die. She has the liberty to communicate the same with substitute decision maker and arrive at
a mutually agreed point. In this situation Melissa requires palliative care as means to pursue a
better and positive living, while an advanced care planning is more importantly for her as she
is at a condition of her help that she might lose her mind or the temperament to take a
reasonable decision. All over by choosing the advance care planning her and her substitute
decision making person would obtain the right to determine the time and place where she
would choose to die.
Therefore to summaries the overall discussion of the paper, Melissa would be
benefited by opting for the advance care planning which would help her to convey her
thoughts with a professional or even with her family member pertaining to her decision
regarding choosing a time and a place where she would like to die.

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