Terminal Care - Live and Let Die?
Culture challenge of the week: Live and let die
The last time I saw my father he was standing on his stoop, sweetly smiling and waving goodbye. As we backed out of his driveway, I thought about how healthy he looked and how grateful I was that my children and I had seen him this way once again.
Had it been up to a hospital nurse 12 months earlier, Dad would have been dead.
It is important that you know just how vulnerable you and your loved ones are to a system of medical care that is abandoning its promise not to "give advice which may cause death."
One night I received a call from my family in Florida that Dad was dying. I was told that I should get there fast. My husband and children and I quickly made the trip for what we feared would be our final goodbyes.
Dad was in very bad shape. He suffered from severe heart problems, failing kidneys and a damaged liver. From the first moments of arriving at the hospital, a nurse pulled me aside and said I should sign a "do not resuscitate order." "If his heart stops," she said, "it would be cruel and painful to try and resuscitate him in his condition."
I told her in no uncertain terms that I would not sign the order. The nurse also approached my sister with the same intensity. I soon discovered that a family friend had been cornered in the hallway and told she should persuade a family member to sign the order.
I vividly remember standing by my father's bed and telling him, "Dad, the nurse has tried several times to get us to sign an order preventing anyone from helping you if your heart should stop. I told her that we will not sign, that we want you to have all the help you can get."
I'll never forget how my father looked up at me with worried eyes as he told me he had been approached numerous times by the staff to sign the order. There he was, heavily medicated at times, vulnerable and trusting that he would be cared for, yet pressured to sign an order he found immoral — an order that would deny him the very care he had gone to the hospital to receive.
My father was released several days later to be with his family. He was expected by the medical staff to die at any moment. But they were wrong. Dad didn't die that week, or the next, or even the following month.
On two separate occasions, Dad's heart failed, and a quick response from EMTs got it pumping again. He began recovering: His kidney function doubled, his liver returned to a healthy state, and his heart grew strong enough to have a pacemaker implanted that gave him a new lease on life.
Because we were firm in our belief that life is precious, that medical professionals should not withhold basic procedures that can save lives, Dad had the opportunity to live.
From: http://content.healthaffairs.org/cgi/content/full/29/2/324
Boris Veysman writes, in
‘Shock Me, Tube Me, Line Me’
Follow These Orders For MeHow to save your family members from premature deathIn my role as a doctor, I’ve met countless disabled, disfigured, machine-supported people who enjoy living and wish to continue doing so as long as possible. Among my fair share of unsuccessful resuscitations, I’ve also been fortunate to save some patients whom I should have lost. There were those who were asking to die when they were in agony and delirium, and thanked me when they were fixed and well. I’ve met intensive care survivors who lead full, productive lives, often with few or no memories of their ordeals and heroic procedures because their sedation was done correctly. So here are my educated instructions.I refuse to have a DNR or DNI order for myself. Go ahead, doctor and family. Give me some comfort meds, then shock me, tube me, and line me. Cut, slash, pump, and burn if you think I have a chance to be me again.
Life is precious and irreplaceable. Even severe incurable illness can often be temporarily fixed, moderated, or controlled, and most discomfort can be made tolerable or even pleasant with simple drugs. In chess, to resign is to give up the game with pieces and options remaining. My version of DNR is "Do Not Resign." Don’t give up on me if I can still think, communicate, create, and enjoy life. When taking care of me, take care of yourself as well, to make sure you don’t burn out by the time I need your optimism the most.
My DNI? It means "Do Not Ignore" early signs of trouble when my failing body and mind need support so I can continue to function in ways that matter. And Do Not Ignore my needs for companionship, stimulation, and purpose, as these, too, make life worth living. To leave me in the hospital bed alone staring at the TV is torture. (My overarching orders at all times: "Do Not Torture.") Surround me with people; bring the kids so I can teach and talk to them. Discuss the news with me. Let me use my e-mail. Treat my depression, dehydration, malnutrition, muscle wasting, and pain with potent pills, infusions, tubes, and hormones. I don’t aspire to play for the Yankees, so throw in some anabolic steroids if that might contribute to wellness. I choose high-quality life, and I agree to chance adverse effects in doing so.
Recall the great people of our time who thrived with disability, and my willingness to savor life just like them. People like Stephen Hawking, who has ALS and quadriplegia—and is a theoretical physicist and a bestselling author. People like Christopher Reeve, who had spinal cord injury and quadriplegia, followed by amazing activism and acclaimed writing, acting, directing, and producing. Give me a motorized wheelchair and a feeding tube if I need them, along with a tracheostomy to help me breathe and dialysis to filter out toxins. Those do nothing to stop a good mind and a strong spirit, while permitting both to overcome obstacles of blood and flesh.
It’s so easy to let someone die, but it takes effort, determination, and stamina to help someone stay and feel alive. Only after you made every effort to let me be happy and human, ask me again if my life is worth living. Then, listen, and comply. At that point, if I wish to die, let me die. But until that happens, none of us realize what I can accomplish with another day, another week, another month. So do it all for me. Then ask someone to do it all for you.
Rebecca Hagelin continues, My father was a physician for nearly 45 years. During his practice, he watched in disbelief as medicine began to change from a "healing art" that focused on "the good of the patient" to a "science" that works for the "good of society."
Although many in the medical community still have healing as their first priority, others have adopted the philosophy that only the fit should survive, that the "professionals" know who is better off dead, that the value of life is determined by someone else's definition of "quality."
I originally shared this story about my dad several years ago, but it is incredibly relevant to what is happening today. The euthanasia movement has infiltrated the medical community for many years, and with the new government-run health care program that is killing freedom and insurance and care choices, it is certain that the elderly and very ill will be the primary victims of medical care rationing.
To understand the depths of the threats to the vulnerable, visit the website of the International Task Force (www.internationaltaskforce.org), where theres a phone number you must have handy if your ill loved one is being denied food and water or other basic life necessities: Liberty Counsel attorneys intervene, for no charge, on behalf of the vulnerable: You can contact Matt Staver at 800/671-1776 or learn more about them at www.lc.org.
Final goodbyes are just that — final. I'll always be grateful that Dad's didn't come on someone else's schedule.
• Rebecca Hagelin can be reached at rebecca@howtosaveyourfamily.com.
Reposted from http://www.washingtontimes.com and http://content.healthaffairs.org/cgi/content/full/29/2/324
posted by i dont think so @ 30.6.10
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