Planning death helps seriously ill

SHABNAM DASTGHEIB
Last updated 20:22 14/04/2014
VICTOR ADLAM
MICHAEL BRADLEY/Fairfax NZ

ALL SORTED: Victor Adlam says he wanted to take a weight of his shoulders by working out how his final treatment would happen.

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Having control over his death has given one very ill Auckland patient complete freedom from the "rubbish" that comes with dying.

Bayswater resident Victor Adlam, 73, has scleroderma, an auto-immune disease which means he can't eat any food and is fed through a tube.

Adlam has chosen to finalise his wishes through the advance care planning (ACP) initiative.

With his condition and age, making what he wanted clear had lifted a weight off his shoulders, he said.

"There's no confusion over my passing," Adlam said.

"I don't want to hang about so I have made my boys aware: get shot of me and go get a bottle of whisky."

ACP gained recognition in New Zealand in 2010 after clinicians attended the first international conference in Melbourne. It grants patients the right to plan their death care, including choosing to decline lifesaving treatment to die naturally.

Adlam said the paperwork took about three months to finalise but the emotional side of having the conversation took a bit longer to get over.

"It gives you peace of mind. You don't leave a whole lot of rubbish and junk behind. It's good for my boys."

He had been able to specify his wishes over what kind of intervention he would allow, what would happen to his body and how his assets should be distributed, Adlam said.

An Auckland District Health Board spokesman said it would encourage others to have the same conversation.

"Particularly people who want to plan for the care and treatment they want in the future ... as they approach the end of their lives."

It was not clear how many people were using ACP at the moment but more than 2500 ACP-related conversations had taken place in the Auckland region in the past year, he said.

Through ACP, patients talk with health professionals and their families about how they want to die, knowing they will probably lose the capacity to make their own decisions as they near death.

There is no charge for the service.

Wednesday is the first national awareness day for ACP called Conversations that Count.

Patients who choose to, can outline their values and beliefs and choose where they want to be at their time of death.

They can also specify whether they want family members around and if they want feeding and breathing tubes in their final days.

In a submission to the National Ethics Advisory Committee in December, the Royal New Zealand College of General Practitioners discussed the potential ethical challenges of ACP.

If a health professional did not personally agree with a patient's choice they were still duty-bound to follow it if the individual was competent and made their decision free from undue influence, the submission said.

There was still a duty of care to the patient.

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