With special guest:
Dr Charlie Corke
… in conversation with Bill Kable
Our guest today is Dr Charlie Corke who as an intensive care specialist regularly sees people who are reaching the end of their lives, where a decision has to be made, care or cure?
Unfortunately many of us have not thought about our own death and how we can make it a good death until it is too late. We are not going to live forever so we need a Plan B and Dr Corke’s new book Letting Go: how to plan for a good death provides a guide on how to do that planning.
Because many of us now live into our eighties and beyond, decisions have to be made about the use of medical technology. Intensive Care Units only began in Australia in the 1960’s and since then patients can be kept alive in one sense of the word but often with no quality of life and with little or no prospect of a cure. This is where a decision needs to be made, usually by family members if the patient is unable to communicate. Should the switch be turned off?
It is an individual decision as to how much pain and indignity a person is willing to put up with in order to cling to life. If you are one of those who is prepared to put up with anything only because it keeps you alive then this needs to be spelled out clearly. If on the other hand you would prefer to die at home, surrounded by family, without pain and not in a prolonged way then again this needs to be spelled out in a direction that is clear and not open to interpretation.
An interesting aspect of this subject is that if patients leave it to the doctor to decide then often the doctor’s training is likely to kick in. Doctors are trained to cure at all costs and try any treatment even if prospects are limited and this may not be what you want. The decision maker could be a family member or some other nominated agent and sometimes because of the doctor’s usual response it might be necessary to fight for what the patient wants. Dr Corke has been in situations where the decision maker has said we know what the patient would want but we want something different.
The best approach is to assess what Dr Corke describes as your “values”, meaning what is important to you in your life. If you make that decision and hold to it for a number of years then it is unlikely that you will decide that these values are not so important and that you can live without them.
Dr Corke has a wealth of real life examples after over twenty years of practice and he shares some of them with us in this program. We all have to die; most of us are likely to face a decision on treatment at some stage either through accident, illness or ageing so this book should start thousands of conversations, starting with our program today.
Dr Charlie Corke
Dr Charlie Corke (MB BS., BSc., MRCP(UK), FCICM) is one of Australia’s leading Intensive Care specialists and is currently President of the College of Intensive Care of Australia and New Zealand. He is the regional clinical lead for the Advance Care Planning program and is the originator of the MyValues approach to advance care planning (www.myvalues.org.au). Dr Corke lectures widely on medical communication and end-of-life decision-making, was featured on the ABC in the film In the End, and is a regular contributor to radio.
Song selection by our guest: Hold on my Heart by Sarah Blasko