The euthanasia controversy - Decision-making in extreme cases

P. A. Komesaroff, J. N. Lickiss, M. Parker, M. A. Ashby

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7 Citations (Scopus)


A 34-year-old woman was diagnosed with cancer of the breast. The primary tumour was removed and an axillary dissection was performed, revealing lymph node involvement. Further local and systemic therapy was recommended, but the patient declined further treatment and decided instead to leave the city and move to a commune in southern Queensland where 'alternative' medical practices were promoted. The patient was married with a daughter, aged four. She had been working as a high school leacher and had been to that time a keen sportswoman. Although her husband was in favour of pursuing conventional approaches to treatment he accepted her decision and accompanied her, with their daughter, to the commune. There, she lived according to a Buddhist philosophy and engaged in regular meditation and other practices designed for cleansing and healing. After two years, she remained well and considered herself cured. The family returned to the city to resume their lives. The patient went back to teaching and gave public talks about how she had conquered breast cancer without drugs. Unhappily, about six months after their return she suffered an acute spinal cord compression at the T9-10 level, leaving her paralysed and without bladder and other functions. Medical help was eventually sought, and although emergency radiotherapy was attempted it was without effect She was advised that significant recovery was most unlikely and was subsequently admitted to a hospice for long term care. There were no other medical issues at this time and she was in no (physical) pain. Naturally, she was distressed about this outcome but maintained a warm relationship with her husband and child. She became determined that she would return home and announced that if this were not possible she would prefer to die. After a few weeks in the hospice, elaborate arrangements were made for her to go home on a weekend visit. She left in high spirits an the Saturday morning, only to return about six hours later, it having emerged that her husband was unable to perform the complex tasks involved in caring for her (which included pressure care, and attending to bowel and bladder function). When seen on the following Monday morning, she announced that after careful thought she had realised that she would never be able to live the kind of life that satisfied the minimum conditions she demanded. Accordingly, she had decided that she wanted to die. She asked the treating doctors and nurses for assistance in dying. Her husband was distressed about this decision but said that he understood it and that it was consistent with what they both believed and had discussed many times in the past.

Original languageEnglish
Pages (from-to)594-597
Number of pages4
JournalThe Medical Journal of Australia
Issue number11
Publication statusPublished - 1 Jan 1995
Externally publishedYes

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