
Dignity and compassion in death can take different forms
Robust legislation should allow terminal patients to decide for themselves if, when and how they want to go without pressure from friends, family and doctors

Palliative care is intended to provide patients with a terminal illness, a dignified life at their most vulnerable stage by treating pain, reduce suffering and providing psychological and emotional support.
The World Health Organisation (WHO) defines palliative care as “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other physical symptoms, together with psycho-social and spiritual problems”.
Palliative care is a crucial cog in the health care system because it embodies compassion towards patients and their loved ones.
It is indeed, welcome that Hospice Malta, a philanthropic organisation, opened St Michael Hospice in Santa Venera last Sunday. The new facility housed in the former Adelaide Cini Institute will stand as “a beacon of quality care for those requiring palliative support”, Bernadette Bonnici Kind, chairperson of Hospice Malta, said during the inauguration ceremony.
Given Hospice Malta’s positive track record, we have no doubt the complex, which also includes a big garden, will be Malta’s foremost palliative care facility.
Indeed, in its mission statement Hospice Malta argues that it is guided by the philosophy and principles of palliative care dictated by WHO.
These principles include the provision of palliative care which is intended to “provide relief from pain and other distressing symptoms”. It also “affirms life and regards dying as a normal process” while neither hastening nor postponing death.
Hospice Malta’s principles also promote a “support system to help patients live as actively as possible until death”. A support system to help the family cope during the patient’s illness and in their own bereavement is also offered.
The palliative care offered also tries to manage distressing clinical complications.
These are noble aims because they offer treatment and support at a juncture in life when hope is replaced with emotional pain for all involved; where the beauty of life is suddenly challenged by the realisation of an impending death and separation.
It is good that the State supports Hospice Malta in its mission as a dedicated palliative care organisation that runs its own professional facilities. It is also important that the State strengthens palliative care within the public health service.
Nonetheless, sustained investment in palliative care should not come at the exclusion of a terminal patient’s choice to opt for assisted dying if it is their wish.
Some people prefer to end their suffering at a moment of their choosing rather than continue living a life that ultimately reduces their independence. This leader believes that this preference should also be respected.
Robust legislation should allow terminal patients to decide for themselves if, when and how they want to go without pressure from friends, family and doctors.
Government has an electoral mandate to introduce assisted dying and the first step later this year will be the publication of a White Paper. When interviewed by MaltaToday late last year, Reforms Parliamentary Secretary Rebecca Buttigieg said government was approaching the subject with an open mind to elicit feedback, which will then inform the way forward.
The ensuing debate should be conducted in a mature, non-partisan manner since assisted dying is a very personal and sensitive topic with its own set of ethical concerns.
This leader believes that providing the legislative framework that allows patients to make their own choice as to whether they want to continue living with their debilitating illness is also an act of compassion. It takes away nothing from those who prefer to continue living until their natural death despite the pain they may be going through. And more importantly a legal framework that enables assisted dying should not be viewed as a substitute for sustained investment in palliative care.