Gail says her death will probably involve “unbearable pain”

Gail Armstrong, aged 68, has breast cancer, which has metastasized into her bones and stopped responding to treatment. Gail told told The Newcastle Herald “I don’t want to die…I have been fighting this.” However, her cancer is considered “untreatable and unsurvivable”.

Gail expects to suffer “unbearable pain” as she nears the end of her life and says “I know that once it starts to press on your spinal cord that the pain is excruciating and the painkillers won’t do anything for it.”

According to Gail Armstrong “This should not be a debate between palliative care and assisted dying – I think we need both of those. But I also know there are some deaths that cannot be relieved in palliative care, and I think mine will be one of those.”

It would ease her fear and anxiety, and allow her to enjoy the rest of her life, if she knew she could ask for, and receive, assistance. “Knowing I had the ability to do that, if my life became intolerable, would be the biggest comfort I could get,” Ms Armstrong said.

Click for article by Anita Beaumont in The Newcastle Herald 28 October 2017 ‘Voluntary assisted dying legislation could offer comfort to terminally ill patients

Following is the personal submission sent by Gail Armstrong to the NSW Parliamentary Working Group on Assisted Dying

Firstly may I say that I was very dismayed to read the headline quote from Luke Foley in the Sydney Morning Herald several Saturdays ago, appearing to make this very difficult subject about something IT IS NOT. There should be enough belief in the integrity of our community to not assume that, with very limited and tightly controlled legislation in place, elderly Australians will be put under pressue (by their families?) to end their lives prematurely rather than become a burden. Elderly Australians may already be ending their lives unnecessarily and prematurely, out of fear and uncertainty about the lack of control they will have over their end of life when they become seriously ill.

There are very few people you will encounter who know that they will die in the near future and exactly what the nature of their death will be. I do know my fate.

I was diagnosed with breast cancer fifteen years ago and had successful treatment. I was then diagnosed with a different type of breast cancer seven years later resulting in a bi-lateral mastectomy that was expected to make me safe. Three years ago I was diagnosed with metastatic breast cancer in my bones, after investigation of sudden serious lower back pain. There are many thousands of Australian women who have fortunately survived breast cancer but an increasing number are presenting with metastatic cancer in their bones many years later (in the highly publicised case of Olivia Newton-john, 25 years later). This is a very painful condition, especially if it manifests in your spine.

At diagnosis it was already too late for me. It was considered “untreatable and unsurvivable”. I have had the good fortune to have responded very well to the combination of treatments since given me, which have slowed the growth of these cancers for three years. However, this treatment no longer works for me. I now have bone cancer in my 5 lower vertebrae, in my thoracic vertebrae, at the base of my skull, at multiple sights in 5 of my ribs, multiple sites in my hips, in both shoulders, one leg, one arm and a thumb. One month ago it was found that I now have lesions in my spleen and liver.

Apart from this illness I live a good life and I do not want to die any earlier than I must, however I am very aware that I will suffer unbearable pain if my cancers run their normal course and they grow into my spinal cord. This type of pain can not necessarily be relieved with pain medication. I have resigned myself to the expectation that I may be forced to end my own life, earlier than would be necessary, while I am still competent enough to do so. I will have to do this alone without a loved one by my side and without assistance of any kind (especially no medical expertise). I think it is cruel that I will be forced to this, and unfair to my survivors that I will then be regarded as a suicide death.

I believe in the Palliative Care system and the good work that is done for so many people at the end of their lives, however this is not what I choose for myself. This is not a battle between palliative care and VAD, both should be available to enable a qualified choice for someone who is facing a painful and inevitable death. I want my death to be civilized and at the time and location of my choice, and not isolated and alone. I have excellent medical care from my GP and Oncologist and they would probably both be dismayed to know that several times every day I think about my looming death and worry about what I must do. I want to be relieved of this constant worry, on top of everything else I’m facing. I just want the comfort and security of knowing that I can be assisted to have a dignified end-of-life. I am not afraid of dying but I am very afraid of the pain that may precede it.

If the proposed legislation is put in place, I am sure I will qualify at some time in the future. I would hope to be able to ask a compassionate Doctor for a prescription for a reliable medication that would give me some control over the time of my death that would be lawful. I would expect to administer it myself if necessary. It may be (and I would hope) that I would not HAVE to use it, but the comfort I would get from the knowledge that I had the means would be immeasurable.

I am telling you this story because I think it is important that legislators sometimes try to put to one side their personal or religious beliefs, and instead think of the individual story behind every one of the patients that may have to ask for this solution for the end of their life.The proposed legislation seems rightly limited and would be tightly controlled to ensure that it is not misused. I ask that you and your colleagues support it for the sake of people like me.

Regards Gail Armstrong