Archbishop Tutu is wrong or misinformed about the life or death issue of euthanasia. The right to live and to die in dignity is one of the basic principles of palliative care. Archbishop Tutu is asking for good patient-centred care, in particular palliative care.

His recent statement in the press that “I have prepared for my death and have made it clear that I do not wish to be kept alive at all costs” is supported through palliative care. We know that with palliative care people do not have to “endure terrible pain and suffering.” Palliative care can control pain and enable people to live well, in comfort and dignity until the moment of their natural death.

Euthanasia is not a palliative care practice and palliative care “neither hastens nor postpones death.” This means no to euthanasia but yes to the choice of not prolonging dying through medical interventions that no longer help the person undergoing these interventions.

An advance care plan gives people some control over the way they live until the moment of their natural death and the Hospice Palliative Care Association of South Africa have developed a document to guide people in documenting their wishes for care when they are seriously ill and diagnosed as “terminally ill.” This can be downloaded from the website www.hpca.co.za.

Palliative care gives people the opportunity to discuss their fears and anxieties about the end of their lives. We recognize that people adapt to changing circumstances and change their minds about wanting hastened death. In discussing a person’s fears and anxieties, the palliative care practitioner can help to allay unrealistic fears and will work to control problems that may be realistic fears, such as pain.

Currently, in South Africa, less than 20% of people have access to palliative care. We should be putting all our efforts into ensuring that palliative care is available for all who need this care which is a human right for all people rather than supporting development of a law that will put the lives of vulnerable people at risk.

I am saddened to hear Archbishop Tutu speak about the topic of assisted suicide and his support for this issue. This is a dangerous conversation, especially in South Africa; and it worries me to consider how would we protect vulnerable people with regard to being ‘offered’ euthanasia. We know that with palliative care, it is possible to have good quality of life with physical comfort and dignity until the end of a natural life. We also know that people who request euthanasia do so because of despair and a gap in the care they are receiving. Many people when discussing euthanasia and the timing of their death say – ‘not now but when things get really bad.’ They change their minds when receiving palliative care and palliative care can make sure things don’t get ‘really bad’.

I would like to have a conversation with Archbishop Tutu to discover his understanding of end-of-life care and what has led him to this philosophy of despair.

For interviews contact Dr Liz Gwyther on 021 531 0277.