THE Queensland Government’s inquiry into aged care, end-of-life and palliative care issues and voluntary assisted dying (VAD) provides an opportunity to explore care provision preferences with stakeholder groups.
Two essential voices in this conversation belong to our Aboriginal people and Torres Strait Islander people.
These people – my people – have not only survived but also flourished in harsh environmental conditions over countless millennia, yet today consistently display health and wellness outcomes at levels below our non-Indigenous counterparts on every indicator scale.
As we find ourselves in the space of considering how our Aboriginal and Torres Strait Islander people view these life-limiting treatments, particularly VAD, let us firstly acknowledge that as Indigenous people, our diversity in relation to connection to country and cultural and family knowledge is extensive.
It would therefore be inappropriate to attempt to present a “one size fits all” perspective to the thinking of our people however a logical starting point to an understanding of death and dying would be a parallel examination of views of life and living.
Dreaming Stories and Torres Strait Islander creation legends are revered for their power – not merely as ethereal, imaginative tales of action and consequence, but as timeless, value-laden and complex repositories of lore and cultural mores for both individuals and communities.
The theme of “Transformation” underpins many of these stories, with key characters often undergoing metamorphosis and transcending as they progress on their life and spiritual paths.
Stagnation for creatures and the physical environment in these ancient stories (and their modern interpretations) herald periods of tension leading to new learning and possibilities for growth and empowerment.
The acceptance of the gamut of human experience and emotion was therefore highlighted as an integral part of the journey of life.
These stories consistently demonstrated that our traditional peoples of land and sea honoured, accepted and revered life at every stage and during every challenge and triumph of living alike.
Circumstances were rarely hidden or deemed “too difficult” to face, even in the direst of circumstances, and the physical and spiritual dimensions of creation sought harmonious co-existence.
These stories equip us with an appreciation for the understanding of a necessary “ebb and flow” of life energies.
We learn the importance of not just acknowledging the chapters of our respective stories, but learn to embrace them as gift.
Ever ancient, ever new, these stories, through their telling and re-telling, have endured and continue to guide living, behaviour and decision-making amongst our families and communities.
These stories also highlight for us additional perspectives on life that cannot be dismissed when discussing the broader worldviews of our people.
Our co-belief in natural forces (referred to by some as “supernatural” forces) that cannot be seen, yet are at work in our midst, shape our approach to living and decision-making, which may be at odds with established cultural norms.
This is particularly true for our people who are fortunate enough to still maintain strong connection to country.
These beliefs should not be considered un-sophisticated or primitive, but as touchstones attuned to our inherent sense of right and wrong.
Also important is our practice to “think backwards and forwards” in our deliberations.
This style of discernment is common to many of the world’s Indigenous groups and call us to consider “what would our forebears have done in this situation? Why? What might be the impact on my great-great-grandchildren?”
In this way, cross-generational reflection prioritises our responsibility of not merely acting for the interests of this present generation, but being called as caretaker of our ancestors’ wisdom and descendants’ futures.
For many of our mob, these beliefs and practices comfortably co-exist with Christian values and beliefs.
VAD therefore may be viewed by our people with suspicion – the ultimate goal of this process seemingly disruptive to the flow of nature’s rhythm and energies.
This is not to say that end-of-life scenarios are easily attended to by our people or that we are naive in our views or incapable of understanding Western medical approaches – rather, we are called to understand that whether we are called to care for a child or elder with life-limiting illness, the ministering of this care should be undertaken with integrity and honour, ideally with cultural guidance from family members and with care preferences respected as part of the cycle of natural living.
Also, we should not feel impelled to anticipate a time frame for this care, but focus instead on the delivery of compassionate and loving care.
I have witnessed abundant love extended to frail members of our communities in their last days and hours, and recall with fondness my dear friend “Lena” – a young Aboriginal mother, sister, aunt and cousin who battled with sickness for three years before finally succumbing to her ovarian cancer.
She spent many hours planning the details of her care while she could and let those caring for her know her wishes with regards to pain relief.
As she lay unconscious on her bed in the hospice of her choice –her family and network of friends moved in and through her room, pausing at times to sit with her – to eat and yarn and confirm their ongoing presence and support for her children after her passing.
Sometimes these messages were whispered, at other times, spoken conversationally … but always with respect and dignity and, yes, even tasteful humour.
Her children were not held back from their mother, singing to her, massaging her face and hands.
When Lena returned to the Creator Spirit, the duties for those with familial responsibilities continued.
She was laid in the arms of Mother Earth, and her family and friends wept then drew together with arms outstretched to receive the children who had now been entrusted to their care.
All connected with Lena’s passing were gifted with the knowledge that their mother, daughter, aunt and friend had seen her wishes honoured, and knew that she had been given the opportunity to live her life to the full until her passing.
In our conversations about VAD, may we remember the ways of our First Peoples.
Their stories reach out to us even now, teaching us that there is mutual giftedness in both surrendering to care and participating in the rituals of caring for the other.
In the cacophony of voices within this conversation, may we be attentive to the gentle wisdom calling us to embrace life in times of peace and pain.
Darlene Dreise works for St Vincentís Health Australia and is chair of the SVHA Reconciliation Action Plan.