Judy Dent's husband, Bob Dent, was the first person to take advantage of the Northern Territory's Rights of the Terminally Ill Act, in 1996. Three others were able to follow his lead before the Federal Government intervened and overturned the Act in 1997. (Emphases added.)
Professor David Kissane AC
Chair of Palliative Medicine Research
University of Notre Dame
160 Oxford St
Darlinghurst NSW 2010
Dear Professor Kissane
I am writing to you in order to object in the strongest terms to the mistruths and lies you are currently spreading about my late husband, Bob Dent.
Indeed I am appalled to learn about what you saying about Bob (and myself).
I consider your comments not only a breach of my privacy but insulting, offensive and extremely hurtful to myself and to Bob’s memory.
I have been in contact with the Royal Australian and New Zealand College of Psychiatrists and have in front of me your College’s Code of Ethics.
From that Code it is clear that in your comments you are in breach of Principles 1, 2, 4, 5, 6, and 10.
In summary you have:
- Failed to respect the humanity, dignity and autonomy of my late husband (who was a patient of others in your profession). Of the many points you make in your slide, you say that Bob never received RADIO THERAPY (you make this note in bold, capitals and underlined). Yet you are well aware that Bob did not want further cancer treatment. As per the Rights of the Terminally Ill Act Bob was at liberty to refuse palliative treatment that was not acceptable to him. This was his decision to make. This was his autonomy in action. You may not like his decision but by your professional Code of Ethics, you are bound to respect it. Your slide reveals a total lack of respect for Bob’s autonomy. Furthermore, you show a remarkable lack of understanding, as either a medical professional or a human being, of what it is like to suffer from terminal bowel cancer.
- You have exploited Bob and the horrific suffering he went through in the final months of his bowel cancer. You have done this by depicting my late husband as a person who lacked decision-making ability. You combine – erroneously – factors such as depression, sorrowfulness in the face of certain imminent death and a rejection of further palliative treatment for your own political ends. In doing so you are distorting the circumstances as Bob and I lived them back in 1996. You have no right to rewrite history in this way, just so you can appear as an expert against future voluntary euthanasia legislation in this country and elsewhere.
- You have failed to maintain the privacy and confidentiality of Bob and myself (as his family) by alleging – erroneously that Bob was divorced (you forgot to mention happily remarried to me), that he was taking anti-depressant medication and, by suggesting (most insulting of all), that Bob and I had angry fights. This last allegation is entirely without a factual basis and is untrue. It is a deeply personal allegation to make of me and I resent and reject it outright. You should be ashamed of yourself.
- At no time prior to making these public allegations in your public presentation about my late husband (and about myself by default), did you seek my permission to expose our private lives in this way. You seem to be relying on hitherto private medical records to make such allegations. If you are not relying on private medical records then where is the factual basis of your allegations?
- You have misused your professional knowledge and skills to attempt to paint Bob as a mentally ill person. You describe him as divorced (with all the connotations that brings), on anti-depressants, frequently weeping, and describing life as pointless. Each of these descriptions – when coming from a psychiatrist – carry extra weight. Indeed, you appear to be diagnosing Bob as mentally ill on the basis of his political and ideological beliefs that voluntary euthanasia was his right (a stance you are well known to disagree with). This is a further breach by you of your professional Code of Ethics (Principle 6).
- For the reasons outlined above you have failed to appropriate ethical standards, regardless of whether you use this slide and say these things about Bob (and myself) in a professional or in a purely political capacity. To this end, you denigrate the memory of Bob Dent and have publicly put forward blatant untruths and lies about myself. This type of bullying and harassment is entirely unacceptable and brings your professional into disrepute (to put it mildly).
For the record:
- Bob Dent was divorced and happily remarried at the time of his death.
- Bob did not take anti-depressants for several years after his divorce. As soon as we were both divorced we married.
- Bob did not receive radio-therapy for his cancer because he did not want it.
- Bob needed a catheter both before and after the TURPs procedure.
- Bob and I never had angry fights, or any fights at all for that matter.
- Bob did not weep frequently.
The final letter of my husband, Bob Dent, is below.
This letter shows a thoughtful, considered man who was nearing the end of his life with courage and dignity.
Professor Kissane, I commend this letter to you for reading.
Indeed, I would go as far as to suggest that you could learn much from my late husband, rather than trying to rewrite his life (and death) from your high pedestal as a professor of your profession.
This would be far more beneficial in the context of a mature, public discussion on the issue of assisted suicide, than your taking Bob’s comments out of context and pretending that you knew Bob’s statement of mind, his demeanor or, most insulting of all, the intimacy of his personal life with me.
In closing, I am so upset by your presentation that no apology will ever be sufficient. I see your presentation as no innocent mistake of fact. Rather it is a calculated attempt to denigrate Bob’s memory for your own political ends. Your conduct is unconscionable.
As such, I shall seek to make my response to you as public as you have made your own misguided allegations about myself and Bob.
Judy Dent (widow of Bob Dent)
Tiwi, NT Australia
My Last Letter by Bob Dent
To the Australian Federal Members of Parliament, as dictated to my wife Judy, before the day of my planned death (22 September 1996)
“I was diagnosed with prostate cancer late in 1991. In December I was sent to a specialist urologist in Brisbane for a bone scan and possible prostatectomy [removal of prostate gland].
Before such a difficult procedure could be performed, it was necessary to check the lymph nodes in the groin area to see if the cancer had spread out of the prostate. An incision was made across my lower abdomen from hipbone to hipbone and several lymph nodes were removed. They were all cancerous.
It was now too late to remove the prostate and instead, both testicles were removed. The incision was sewn up, but two days later a large haematoma [blood clot] developed at the right-hand end of the incision. I had then to return to theatre for the incision to be recut and resewn.
My bone scan at this stage was inconclusive so I was sent back to Darwin hoping that the removal of my testicles and consequent loss of testosterone production would stop the cancer progressing. Unfortunately this also made me impotent. (I had been told that impotence was a remote possibility.)
Six months later a hernia developed under the same right-hand end of the haematoma. Darwin specialist surgeon Mr Dan Campbell repaired the hernia, but one year later it popped out again. Mr Campbell did a second repair job on the hernia, and again one year later it recurred. Mr Campbell was apprehensive about attempting a third repair on the same site.
I approached another specialist surgeon, Mr Jonathan Wardhill, but he took one look and declined to even consider such a repair. Fortunately, a plastic and reconstructive surgeon, Mr Chandra Arianayagam agreed to do the job, and this repair is still holding.
By mid-1995, I was having difficulty urinating as the cancer in the prostate gland had closed off the urethra. I had to have a catheter inserted in order to empty my bladder. I continued with daily self-catheterisation until the passage closed right over. An indwelling catheter and leg bag was the next step.
In August 1995, a trans-urethral resection of the prostate (TURP) was done by a Perth urologist, to chip away the cancer and reopen the urethra, so that I did not have to use the catheter and leg bag to collect the urine.
By May 1996, the urethra had once again become blocked and I again had to make use of catheter and leg bag — an embarrassing and uncomfortable situation, especially in Darwin’s climate. In June 1996, I had another TURP and this operation worked reasonably well, but the rest of my body was deteriorating quickly.
I have lost 25 kg in weight. My latest blood tests, taken on 2 September 1996, indicated an acceleration of the cancer, with the prostatic specific antigen rising to 1298 (normal is 0 to 4). The red cell picture was suggestive of infiltration of the bone marrow by the cancer.
This was confirmed by a chest X-ray. The full results of these tests were withheld from me by Dr Guy Bannick of Palliative Care. I have always wanted to know everything, the bad news as well as the good. I could easily have broken some of my ribs by allowing myself to be hugged and surely should have been warned of this?
Dr Philip Nitschke, my after-hours doctor, requested a copy of the X-ray report from the Darwin Hospital for me. The X-ray also revealed an area of collapsed lung which could have been contributing to my breathless distress.
Two specialists, Mr Wardhill, who performed the 1996 TURP, and Dr Sid Selva, oncologist, have both said nothing further can be done. (I did have three months hormonal therapy supervised by Dr Selva, but the cancer is hormone resistant and was not slowed by this treatment.) Already my urine flow is diminished. Further TURPs are not advisable, even if my weakened body could tolerate a general anaesthetic.
I have no wish for further experimentation by the Palliative Care people in their efforts to control my pain. My current program involves taking 30 tablets a day!
For months I have been on a roller-coaster of pain made worse by the unwanted side-effects of the drugs.
Morphine causes constipation — laxatives taken work erratically, often resulting in loss of bowel control in the middle of the night. I have to have a rubber sheet on my bed, like a child who is not yet toilet trained.
Other drugs given to enhance the pain-relieving effects of the morphine have caused me to feel suicidal to the point that I would have blown my head off if I had had a gun.
I can do little for myself, and require 24-hour nursing care. My haemoglobin has fallen to 8.3 (normal is 13.5 to 18.5). My red cells are decreased in number and deformed because of the cancer in the bone marrow. This anaemia causes shortness of breath and fainting because of the cells’ inability to carry the required oxygen.
An attempt was made to alleviate the symptoms of the anaemia by giving me two units of a healthy person’s blood. The procedure took all day, was uncomfortable, and did no good whatsoever.
There is now a constant fear of a fall which could cause terrible injury to my fragile bones. I cannot even get a hug in case my ribs crack. If I were to keep a pet animal in the same condition I am in, I would be prosecuted.
I have always been an active, outgoing person, and being unable to live a normal life causes much mental and psychological pain, which can never be relieved by medication.
I read with increasing horror newspaper stories of Kevin Andrews’ attempt to overturn the most compassionate piece of legislation in the world. (Actually, my wife has to read the newspaper stories to me as I can no longer focus my eyes.)
The Church and state must remain separate. What right has anyone, because of their own religious faith (to which I don’t subscribe), to demand that I behave according to their rules until some omniscient doctor decides that I must have had enough and goes ahead and increases my morphine until I die?
If you disagree with voluntary euthanasia, then don’t use it, but don’t deny me the right to use it if and when I want to.
I am immensely grateful that I have had the opportunity to use the Rights of the Terminally Ill Act to ask my doctor Philip Nitschke to assist me to end this interminable suffering and to end my life in a dignified and compassionate manner.
I did want to write this statement in my own hand, but the weakened state of my body makes this impossible. It has been dictated by me and written down for me by my wife. ”
21 September 1996