“Your mother didn’t choose a terminal illness. She only chose not to let the disease pick when and how she would die.”
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“What is fundamentally the difference between a doctor pulling a plug on a machine that provides lifesaving nutrients to a person that could potentially stay ‘alive’ on it for years, and a doctor prescribing pills to a person with mere days or months to live to end their unnecessary suffering?”
“I was reluctant to force the issue. What remained unsaid came with its own set of consequences.”
Death. Mortality. End of Life. Something inevitable, yet rarely discussed and a source of intense discomfort for most. When mentioned, it is considered inauspicious and rude in many cultures. Death is an integral part of the workday for a Critical Care Physician like me. But it was never a topic of discussion in Medical School or training.
Jewish law states the dying are to be considered, for legal purposes, “like one who is alive for every purpose”, capable of wielding the same power over their lives until their very last moments, as they did in their days of health.
Most view dementia as a person leaving them. But they’re not. They’re evolving into a new person, similar but not exact. Their capacity to perform tasks and retain memory of recent events doesn’t disqualify them from continuing to be loved and treated with dignity and respect, especially when the end is near.
Had she been the family’s beloved old Labrador or suffering Boston Terrier, we would have taken her to the vet for a final loving, humane act, a choice unavailable to her family, doctors, or caregivers.
Although many individuals shy away from contemplating the inevitability of death, most would agree that they would like to die well. A new review of existing literature, published in the American Journal of Geriatric Psychiatry, asks what makes a “good death” according to those involved in the process.
When determining an ethical standard of discussing physician aid in dying (PAD) during medical decision-making, it is important to begin with the caveat that physicians are not ethically obligated to assist a patient in ending his or her life, even if the physician informs the patient of the right to do so.
Don’t wait until you’re at death’s door to explore your passions, deepen your relationships and find your posse.
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