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Late Arnhem Land musician Dr G Yunupingu chose to end his dialysis treatment knowing the dire consequences that would follow, his doctor has told the ABC.
"It seems increasingly clear that having missed dialysis for the longest time that he ever did, and actually having called people to say goodbye, that he was actually making a decision for himself — just as Kerry Packer did — to actually leave dialysis," Paul Lawton said.
The kidney disease specialist said the burden of dialysis, which requires patients to be hooked up to machines three times a week for five hours per session, proved too much for the 46-year-old, just as it had for many other Australians.
"The extraordinary thing is not that patients struggle with it, but that some actually succeed," Dr Lawton said.
"People talk about it as a nightmare, or a half-life being in purgatory, where they are physically alive, but not fully able to participate in life."
Dr Yunupingu, who died on Tuesday, spent some of his final days at an itinerants campsite at Casuarina Beach in Darwin's northern suburbs, before he was taken to hospital late last week.
Dr Lawton said he had come to his opinion about Dr Yunupingu's decision after speaking with some of the musician's closest friends.
"Dr Yunupingu has decided that enough was enough and has actually made a decision to go, to pass on on his own terms, in his own way, and he was by the sea surrounded by large numbers of family and friends."
Mark Grose, the singer's manager at Skinnyfish Music, on Wednesday alluded to similar understanding.
"[Dr Yunupingu] rang Michael, his music collaborator, a few days ago and said goodbye," Mr Grose said.
"That says to me someone knows what they are about, is grateful, he thanked Michael for everything he did.
"He was fully aware of his condition. It was just a huge battle to maintain some sort of normal life given how unwell he was."
About 12,500 people require dialysis treatment across Australia, including more than 700 people in the Northern Territory.
Professor Alan Cass from the Menzies School of Health Research said people from all walks of life found the treatment challenging, and some chose to discontinue it.
"Some of the people who are on dialysis across the country make decisions to withdraw from treatment," Professor Cass said.
"And if you don't have ongoing treatment, yes, it is inevitable, over a period of weeks perhaps, that that will lead to someone's death."
Professor Cass and Dr Lawton both called for increased access to dialysis in remote communities, as well as better prevention programs.
"Dr Yunupingu's death was preventable and avoidable and is a tragedy that shouldn't have happened," Dr Lawton said.
"Not because he was neglected in Darwin, but his kidney disease could have been prevented in the first place."
Topics: indigenous-aboriginal-and-torres-strait-islander, aboriginal-language, health, liver-and-kidneys, diseases-and-disorders, music, darwin-0800
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