Speaking with doctors in Belgium, the Netherlands and Oregon, I’d learnt that in those places, palliative care and assisted dying are seen as things that go together – and assisting a patient to die may sometimes be the ultimate offer of help for those beyond the skills of even the most dedicated palliative care experts.

Spencer Ratcliff had never witnessed such pain as he saw during his partner Deb's final days – pain which palliative care staff were unable to relieve: 'I said, "What are we supposed to do? Just sit and watch her scream herself to death in pain?"' — Photo: Andrew Denton

Back home in Australia, the law forbids assisted dying. Without a law to protect or guide doctors and nurses, I wondered: how does palliative care here deal with those same kinds of patients?

Richard Chye is the director of palliative care at St Vincent’s Hospital in Sydney. When I asked him if I could spend a week in his unit to learn what it is they do, I was upfront with him. I told him I believed there should be a law for assisted dying in Australia – not a subject often raised within their walls – and that it would be one of many things I’d like to discuss with him and his team.

To my surprise, and to his credit, he agreed.

By the end of that week, two things struck me about the doctors and nurses of Sacred Heart. First: their deep commitment to, and compassion towards, their patients. And second: the universal acknowledgement of how hard they found it when a patient was beyond their help.

'I think we do provide dignity and good care, and the majority of the time, symptoms are managed well. But there are occasions when a symptom isn’t controlled, or someone has a rough journey – for whatever reason, you know – and you do think about that.'

Nursing unit manager Ken Webb

Please note: this podcast is not about suicide. If you are interested in increasing your understanding of suicide and how to support someone experiencing suicidal ideation, visit the Conversations Matter or beyondblue websites.

If you (or someone you know) require immediate assistance, contact one of the following 24/7 crisis support services: Lifeline (13 11 14), Suicide Call Back Service (1300 659 467), MensLine (1300 78 99 78), beyondblue (1300 22 4636), Kids Helpline (1800 55 1800) or eheadspace (1800 650 890).

Hear more Listen Better Off Dead: Interview with Alex Broom Embed player

Alex Broom, Professor at Sociology at the University of NSW, spent six months embedded in a Catholic hospice. His was the first study in Australia to explore patients’ views on assisted dying.

What he got was a unique insight into the gulf that exists between many patients’ expressed wish for help to die, and the response they receive.

Know more

• Article: 'The speech on dying you were prevented from hearing', by Michael Short – Sydney Morning Herald, 26 May 2015

• Article: 'OPINION: Time to act on medically assisted dying', by Brian Winship – Newcastle Herald, 19 June 2015

• Blog post: 'Denton lacks understanding of dying process – a social worker’s perspective', by Elissa Campbell – Palliverse, 13 November 2015

• Video: 'Even the best palliative care can't always help' – Dying For Choice, 19 September 2013

In this episode

• Nancy
• Fran
• Nam
• Therese Compton
• Ken Webb
• Philip Redelman
• Spencer Ratcliff

Our theme music was composed by Zig Zag Lane for Zapruder's Other Films, and edited by Jon Tjhia. Music used in this episode includes '23:17' (Ólafur Arnalds and Nils Frahm), 'In the Deep Shade' (The Frames), 'We're All Leaving' (Arcade Fire), 'They Move on Tracks of Never-Ending Light' (This Will Destroy You), 'Black Sands' (Bonobo), 'Petra' (Blue Dot Sessions), 'All of Me Wants All of You' (Sufjan Stevens), 'Says' (Nils Frahm) and 'Forty-Eight Angels' (Paul Kelly).

Your stories

If you're suffering, or someone you love has died badly – in a hospital, in palliative care, in a nursing home, or at home – add your voice and tell your story here.

Further information

Better Off Dead is produced by Thought Fox and the Wheeler Centre.

Executive producers Andrew Denton and Michael Williams. Producer and researcher Bronwen Reid. For Better Off Dead, the Wheeler Centre team includes Director Michael Williams, Head of Programming Emily Sexton, Head of Marketing and Communications Emily Harms, Projects Producer Amita Kirpalani and Digital Manager Jon Tjhia. Editing, sound design and mix on this episode is by Martin Peralta. Additional editing by Jon Tjhia.

Thank you

Thanks to Stanley Street Gallery, and to Paul Kelly and Sony ATV for the use of his song ‘Forty Eight Angels’.

The series

Subscribe in iTunes, or your favourite podcast app. #betteroffdeadpod

Better Off Dead is produced by Thought Fox in partnership with the Wheeler Centre. It is written and created by Andrew Denton for Thought Fox.

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