Before our experience, I believed that Palliative Care was a positive thing and that it would be helpful. But having had contact with a QLD public health service, which did nothing except greatly increase stress and provide very poor quality, inexperienced doctors, I now see it as something that just provides third rate care to very vulnerable people and aims to save money by reducing overall hospital costs.
I have had a look at the end of life strategy, I think it’s out of balance with too much focus being placed on “identifying people AS Soon as Possible” who may benefit from Palliative Care. It should be identifying people when appropriate and when in the best interests of the person. As soon as possible may have more potential to reduce future health costs by discouraging the person from choosing active treatments which may not be proven as cost effective, but this will not always be in the best interest of the person.
People should have treatment options and possible outcomes fully explained to them so that they can make real choices and not be pressured by health workers who spend too much time around sick people, are more likely to be depressed than the general public and are not always able to be objective or see the value that a person may place in a few extra years or months of life. The Palliative Care industry in many countries, is busy trying to produce research to prove that early palliative care reduces hospital costs as this will lead to more investment in palliative care. But what benefits people making money from Palliative Care does not necessarily benefit the person who is ill.
Doctors and medical staff are often very poor at handling issues such as death so when a person is labeled “palliative” , the natural tendency of many doctors and medical staff is to avoid the person and ignore their health needs. So being “labeled” as early as possible can do a great deal of harm. People should not be labeled as palliative early in their disease process. Most people will make appropriate choices about their care if options are fully explained at an appropriate time.
The strategy claims to have an aim of “ensuring respect for patient choice and for the patient remaining in control as much as possible as they approach death”.
In practice, the strategy works in the opposite way, as patients are subjected to Palliative Care Staff who believe they know what is best for the patient. Without even thinking , they tell patients what they will “choose” because they think they know best. They assume what the patient wants and needs without asking because they believe that they know best and never learn the skills needed to present all options and possible outcomes to patients. In practice, Palliative Care rips control away from the patient. The strategy should include a program for medical staff to learn how to logically and objectively present options without unconsciously imposing their own values and objectives on to patients, especially when there is so much increasing pressure to reduce hospital costs.
Choices need to be explained by a medical professional who understands the particular disease that the person has, Palliative care staff often have very limited knowledge about the person’s actual disease as they are often just skilled in symptom management so their value in assisting people making decisions can be limited, and their skills are more appropriate in the later stages of an illness. People are currently being disempowered and made to feel like a burden to the system, so that they will more likely choose the cheapest options for care. The strategy is causing harm to the people who it claims to help.