SAVES is not affiliated with Exit International / Dr Philip Nitschke and opposes the public availability of a 'peaceful pill'.

Following on from discussing "hard cases" in the last issue of the VE Bulletin in which Fred Robinson's plight in New Zealand was presented, here is an account of a recent death from cancer in Adelaide. These so-called hard cases are not uncommon and they demonstrate a profound failure of our legal and medical system to address unnecessary and severe suffering among the hopelessly ill.

An update of SAVES Fact Sheet 16, Dying from Cancer, is also in this newsletter. More than a quarter of all deaths in Australia are from cancer and despite the availability of state-of-the-art and often successful palliative care, significant numbers of Australians suffer miserable preludes to their inevitable deaths. They obviously and desperately need the option, with proper safeguards, of a hastened death.

Here, with her permission, is a summary of the way Janet Pfeiffer's husband, Rex, died based on the diary she kept as events unfolded. The full account has been submitted to the Social Development Committee currently considering the VE issue.

In July 1989 at age 61, he suddenly found that he had cancer of the prostate. It was well advanced into the spine. Thanks to medical knowledge and skill, we were to have seven more wonderful, fulfilling years before embarking on that last terrible year which culminated in his death in December 1997.

Rex had an operation soon after diagnosis but by September 1993 the cancer had become active again. His condition steadily worsened and by February 1996 his pain was considerable. He was warned that his bones would become brittle and break easily.

A bone scan in March 1996 was followed by 12 sessions of radiotherapy. By June the pains had returned and he could not turn in bed unaided. He reacted to morphine with prolonged vomiting.

Now in his last year, he went for major radiotherapy to his back in February 1997 and returned home from the first session to vomit for three hours continuously. Anti-nausea tablets were ineffectual and vomiting continued throughout the ten treatments. He was losing weight, in constant agony, hurting all over and could not bear to be held. A further massive one-off dose of radiation was administered, to no avail. His mouth became numb, apparently due to cancer of the skull, so that when eating he would chew his lip. Ten more sessions of radiotherapy added constipation to his trials.

On July 29 he entered hospital for three 3-hour blood transfusions. A doctor from the pain clinic offered hope of relief through a variety of treatments none of which worked. He re-entered hospital from 12 to 22 August for further radiotherapy. The doctor commented that this was a last ditch attempt. He advised that the prognosis was not good and "he wished there was some legal way of helping people like my husband". Rex's loss of mobility, dependence on others, and constant pain meant that he now had virtually no quality of life.

On 15 September immense pain returned. He was persuaded to take liquid morphine and the vomiting recurred. He was referred for palliative care in a hospice but before this could be arranged, he broke his collar bone and a rib or two, steadying himself against a door jamb. He was admitted to hospital and from there to a hospice. He stopped eating. He said on several occasions that he had had enough and asked hospice staff to help him to die.

He was now being kept in a semi-conscious condition with injections of morphine and a muscle relaxant. He continued to suffer pain in wakeful intervals. What useless prolonging of suffering! On 1 December the doctor thought he would last a few more days. Rex pleaded for help to die. On the following day he was put on a subcutaneous drip, "to prevent renal failure"! He was told he could refuse it, but he didn't because he thought it was a final injection to let him go in peace.

Rex died on December 7, just six weeks after he had first asked for final release. What was the point of those six weeks? Palliative care was not the answer for him. He was never free of pain, never comfortable and his distress was made worse by his violent reaction to morphine. The doctors really did not know what to do with him. The only remedy was forbidden by law.