End of Life Care
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Serious Paul
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End of Life Care
What are your thoughts and or opinions about End of Life care? Should you discuss this sort of thing with your doctor? Do you have the right to end your life if you feel the quality of life isn't what it should be, or what you want it to be? Or if maintaining your quality of life reaches a certain financial burden? Have you made plans for your end of life?
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Ampere
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Terry Pratchett discusses this pretty well here:
http://www.dailymail.co.uk/news/article ... es-UK.html
If I'm going to be in a vegetative state, lose my faculties due to Alzheimers or something of the like...I choose to be released from this mortal coil. I've voiced my wishes with my wife and "family". I don't have a written document stating it though. I should start thinking of that though.
http://www.dailymail.co.uk/news/article ... es-UK.html
If I'm going to be in a vegetative state, lose my faculties due to Alzheimers or something of the like...I choose to be released from this mortal coil. I've voiced my wishes with my wife and "family". I don't have a written document stating it though. I should start thinking of that though.
Quoth Drunken Master:
"When Colin Powell walks out of your cabinet because of doctrinal issues, you've got problems."
Quoth Moto42:
"Bulldrek, where love and appreciation are accompanied by a volley of gunfire."
"When Colin Powell walks out of your cabinet because of doctrinal issues, you've got problems."
Quoth Moto42:
"Bulldrek, where love and appreciation are accompanied by a volley of gunfire."
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Serious Paul
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Iantha and I have discussed this more recently, as it's become more of a reality that we will both expire at some point. My personal greatest concern is not leaving a burden for my family to bear. I don't care too much about those adult diaper, breathing tube years-I'd rather wander off into the Congo and disappear into the rain forest in Brazil somewhere. But I also realize that in my particular situation the choice isn't that simple: I do have family obligations, obligations to friends.
I'd like to think that I can balance my obligations with my own desires. Obviously the future isn't set into stone; and this debate may become a moot point when they discover how we can live to be one thousand years old.
I'd like to think that I can balance my obligations with my own desires. Obviously the future isn't set into stone; and this debate may become a moot point when they discover how we can live to be one thousand years old.
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Serious Paul
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I don't like this thread. I'm not against euthanasia. I'm an advocate of it. But I don't like conversations about death. I know it's a fact of life, blah blah blah, but it hurts to think about. Nothing gets me to tears faster than conversations between friends and loved ones about what they want when they die.
<center><b><font size=1><font color="#FF9900">"Invaders blood marches through my veins, like giant radioactive rubber pants! The pants command me! Do not ignore my veins!" -Zim</font></font></b></center>
To be open and honest, this subject hits very close to home. Recently, both my father and mother were diagnosed with cancer pretty much simultaneously. My father died first, my mother died later. They didn't see eye to eye on a lot of things, which is why they divorced more than two decades ago, but this particular thing they agreed on wholeheartedly; they had very specific demands about the quality of their last days, and had both made arrangements through the NVVE (Nederlandse Vereniging voor een Vrijwillig Levenseinde, or Dutch Organisation for a Voluntary Termination of Life), which is a pro-euthanasia group that helps and supports people who are seeking a voluntary termination. They help you with paperwork, finding the right doctor, or any help in arranging it that you might need. You see, euthanasia is legal in The Netherlands, though the rules are incredibly strict, mostly to protect the doctors from being prosecuted.
My father slipped into a pain and medication induced delirium twenty-five days after he was diagnosed and I sat by his bedside for twenty hours before he died. Unfortunately, euthanasia can only be preformed when the physician and a special second opinion doctor deem the suffering to be unnecessary, but also when the suffering is long. The second opinion doctor saw what state my father was in and ruled against euthanasia because she said my father wouldn't make it until morning anyway. She was there to protect his physician, who dearly wanted to help him find peace. Instead, they opted for palliative sedation, in which they brought him into a deep, nearly coma-like sleep where slowly his muscles, including his heart, would become weaker and eventually he would die due to a lack of oxygen. This, strangely enough, is legal and falls outside the rules of euthanasia. Strange, but at that point I had been up for so long that I honestly didn't care how they did it, and I had decided that if they didn't help him, I'd do it myself. I was the executor of his euthanasia on paper, which meant that I had limited power of attorney and would have to make the decision. I argued with the second opinion doctor tooth and nail before she finally explained that euthanasia wouldn't be necessary because my father wouldn't last for very long. In the end, I was very proud and happy to give the physician the go-ahead for the sedation. He died perhaps three hours after he got the medication, but he was calm and sleeping soundly, not the mess that he had been the two days previously.
My mother held on a lot longer than my father did through sheer force of will. She had been a last stage cancer patient for better part of a year before she told me she wanted to see Italy one last time. She said she felt strong enough for two weeks in Italy and so the arrangements were made, and she and I went together, to visit family and to enjoy the country one last time. My mother was in good spirits and while her health was diminished severely, she could still walk under her own power. All arrangements were made in Italy as well, and we were looking to enjoy a few days in the sun. Many months prior to this, my mother made arrangements with her physician as well about euthanasia, and she was very clear on when and how she wanted to go. Her physician said that for months my mother had been past the point of him having ethical objections to the voluntary termination of her life, since all options had been exhausted and it had become a case of upping her pain medication to the point where her body would give out. So all was taken care of, this time we were a lot better informed and prepared than with my father. So, having been eligible for euthanasia for months, we went to Italy. Unfortunately, while the first week was awesome, the second week she rapidly deteriorated, and was brought to the hospital. I sat by her bedside for 35 hours before she passed away, but unfortunately, she suffered quite a bit before she went. It killed me to see her suffer -- literally, something died in me during that time -- but as best as I could I tried to find ways for her to be transported back to The Netherlands so she could die. Unfortunately, public options were no longer open to us, and private ones were going to cost me more money than I could round up, even with the discount I managed to get (thanks Sam!), and so we were stuck in Italy, a country where the pope still rules and probably the last country that will recognise a person's right to die. Fortunately, the head doctor was a man of science rather than faith, and he went above and beyond to ease her suffering as much as he could. And in the end, my mother died in the saddle, which is quite befitting of how fucking hardcore she was.
So yeah, I've got some experience in the field, I feel, and I can wholeheartedly say that every should have a right to take their own life. Whether they are physically or mentally ill or not, there's no logical reason I can come up with why it should be illegal. And it doesn't matter to me what label you slap on it, either; suicide or euthanasia, I don't care. Suffering is not something that can be measured, quantified and made concrete. It's entirely subjective and thus doesn't fit and will never fit in a scholarly and academic box that can be labelled and presided over by a judge.
My father slipped into a pain and medication induced delirium twenty-five days after he was diagnosed and I sat by his bedside for twenty hours before he died. Unfortunately, euthanasia can only be preformed when the physician and a special second opinion doctor deem the suffering to be unnecessary, but also when the suffering is long. The second opinion doctor saw what state my father was in and ruled against euthanasia because she said my father wouldn't make it until morning anyway. She was there to protect his physician, who dearly wanted to help him find peace. Instead, they opted for palliative sedation, in which they brought him into a deep, nearly coma-like sleep where slowly his muscles, including his heart, would become weaker and eventually he would die due to a lack of oxygen. This, strangely enough, is legal and falls outside the rules of euthanasia. Strange, but at that point I had been up for so long that I honestly didn't care how they did it, and I had decided that if they didn't help him, I'd do it myself. I was the executor of his euthanasia on paper, which meant that I had limited power of attorney and would have to make the decision. I argued with the second opinion doctor tooth and nail before she finally explained that euthanasia wouldn't be necessary because my father wouldn't last for very long. In the end, I was very proud and happy to give the physician the go-ahead for the sedation. He died perhaps three hours after he got the medication, but he was calm and sleeping soundly, not the mess that he had been the two days previously.
My mother held on a lot longer than my father did through sheer force of will. She had been a last stage cancer patient for better part of a year before she told me she wanted to see Italy one last time. She said she felt strong enough for two weeks in Italy and so the arrangements were made, and she and I went together, to visit family and to enjoy the country one last time. My mother was in good spirits and while her health was diminished severely, she could still walk under her own power. All arrangements were made in Italy as well, and we were looking to enjoy a few days in the sun. Many months prior to this, my mother made arrangements with her physician as well about euthanasia, and she was very clear on when and how she wanted to go. Her physician said that for months my mother had been past the point of him having ethical objections to the voluntary termination of her life, since all options had been exhausted and it had become a case of upping her pain medication to the point where her body would give out. So all was taken care of, this time we were a lot better informed and prepared than with my father. So, having been eligible for euthanasia for months, we went to Italy. Unfortunately, while the first week was awesome, the second week she rapidly deteriorated, and was brought to the hospital. I sat by her bedside for 35 hours before she passed away, but unfortunately, she suffered quite a bit before she went. It killed me to see her suffer -- literally, something died in me during that time -- but as best as I could I tried to find ways for her to be transported back to The Netherlands so she could die. Unfortunately, public options were no longer open to us, and private ones were going to cost me more money than I could round up, even with the discount I managed to get (thanks Sam!), and so we were stuck in Italy, a country where the pope still rules and probably the last country that will recognise a person's right to die. Fortunately, the head doctor was a man of science rather than faith, and he went above and beyond to ease her suffering as much as he could. And in the end, my mother died in the saddle, which is quite befitting of how fucking hardcore she was.
So yeah, I've got some experience in the field, I feel, and I can wholeheartedly say that every should have a right to take their own life. Whether they are physically or mentally ill or not, there's no logical reason I can come up with why it should be illegal. And it doesn't matter to me what label you slap on it, either; suicide or euthanasia, I don't care. Suffering is not something that can be measured, quantified and made concrete. It's entirely subjective and thus doesn't fit and will never fit in a scholarly and academic box that can be labelled and presided over by a judge.
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Serious Paul
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Damn, Deev, if we could get people here to approach the end of life the way you and your parents did . . . . well, damn, things would be a lot better here.
There is then a need to guard against a temptation to overstate the economic evils of our own age, and to ignore the existence of similar, or worse, evils in earlier ages. Even though some exaggeration may, for the time, stimulate others, as well as ourselves, to a more intense resolve that the present evils should no longer exist, but it is not less wrong and generally it is much more foolish to palter with truth for good than for a selfish cause. The pessimistic descriptions of our own age, combined with the romantic exaggeration of the happiness of past ages must tend to setting aside the methods of progress, the work of which, if slow, is yet solid, and lead to the hasty adoption of others of greater promise, but which resemble the potent medicines of a charlatan, and while quickly effecting a little good sow the seeds of widespread and lasting decay. This impatient insincerity is an evil only less great than the moral torpor which can endure, that we with our modern resources and knowledge should look contentedly at the continued destruction of all that is worth having. There is an evil and an extreme impatience as well as an extreme patience with social ills.
Amen.Marius wrote:Damn, Deev, if we could get people here to approach the end of life the way you and your parents did . . . . well, damn, things would be a lot better here.
<font color=#5c7898>A high I.Q. is like a jeep. You'll still get stuck; you'll just be farther from help when you do.
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Jeff Hauze
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You were planning for the termination of care and the end of life. Many (probably) of the patients I see don't have a plan anything like that, even when they have terminal diagnoses and unrecoverable complications.DV8 wrote:I can never really tell when you're being sarcastic. If you're not being sarcastic, how would that improve things in the U.S.?Marius wrote:Damn, Deev, if we could get people here to approach the end of life the way you and your parents did . . . . well, damn, things would be a lot better here.
What I'm used to, an advanced metastatic lung cancer with lungs full of malignant fluid will come to the hospital because they're having trouble breathing. Which is a good reason to come to the hospital, but even after it's explained that there's nothing to prevent this from continuing, they still want "everything done." If this patient's respirations become too labored they want them intubated and mechanically ventilated. If their heart stops, or their body stops maintaining enough blood pressure to stay alive they want chest compressions to keep the blood flowing, electric shocks to restart the heart and medications in the critical care unit to raise the blood pressure.
Right now in the unit we have a young lady who became very ill and had prolonged oxygen deprivation to her brain sometime last month. She has very few organs which function now, can no longer speak, probably can no longer think, and is mechanically ventiliated. But she's a "full code," and her family still wants full life support for as long as we can possibly keep it going. It's horrifying.
There is then a need to guard against a temptation to overstate the economic evils of our own age, and to ignore the existence of similar, or worse, evils in earlier ages. Even though some exaggeration may, for the time, stimulate others, as well as ourselves, to a more intense resolve that the present evils should no longer exist, but it is not less wrong and generally it is much more foolish to palter with truth for good than for a selfish cause. The pessimistic descriptions of our own age, combined with the romantic exaggeration of the happiness of past ages must tend to setting aside the methods of progress, the work of which, if slow, is yet solid, and lead to the hasty adoption of others of greater promise, but which resemble the potent medicines of a charlatan, and while quickly effecting a little good sow the seeds of widespread and lasting decay. This impatient insincerity is an evil only less great than the moral torpor which can endure, that we with our modern resources and knowledge should look contentedly at the continued destruction of all that is worth having. There is an evil and an extreme impatience as well as an extreme patience with social ills.
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Jeff Hauze
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Ampere
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Sounds like an excellent reason to discuss and plan for our own demise. Consider that Marius' example can happen to anyone at any time. It may sound morbid, but being a 20-something or 30-something and planning for our own ending seems only prudent.
If you really don't want to linger on in a vegetative state, and are serious about it...make plans now while you can. Tomorrow could be the day when you walk in front of the bus.
[Grim? Yeah, but entirely true]
If you really don't want to linger on in a vegetative state, and are serious about it...make plans now while you can. Tomorrow could be the day when you walk in front of the bus.
[Grim? Yeah, but entirely true]
Quoth Drunken Master:
"When Colin Powell walks out of your cabinet because of doctrinal issues, you've got problems."
Quoth Moto42:
"Bulldrek, where love and appreciation are accompanied by a volley of gunfire."
"When Colin Powell walks out of your cabinet because of doctrinal issues, you've got problems."
Quoth Moto42:
"Bulldrek, where love and appreciation are accompanied by a volley of gunfire."
Re: End of Life Care
Yes. Everyone should. I'm surprised it's not part of standard medical practice to make sure every patient has clear instructions on file, and doubly surprised it's not a law.Serious Paul wrote:Should you discuss this sort of thing with your doctor?
I still don't know about that.Serious Paul wrote:Do you have the right to end your life if you feel the quality of life isn't what it should be, or what you want it to be?
For my own part, I don't want to remain alive but insensate when supported only by machines without any reasonable expectation of recovery.
No. Because I'm retarded, that's why. My parents have been encouraging this, as they recently updated their own wills and end-of-life plans, but I still haven't.Serious Paul wrote:Have you made plans for your end of life?
My father granted me his medical power of attorney, because, as he said, I'm the only person in the family capable of making the necessary choice without ever feeling any guilt. That was both flattering and...I don't know what else.
Re: End of Life Care
Probably, like me, when the time comes, it's more a privilege than a burden.3278 wrote:My father granted me his medical power of attorney, because, as he said, I'm the only person in the family capable of making the necessary choice without ever feeling any guilt. That was both flattering and...I don't know what else.