Looking at the quality of life of elderly in the nursing homes, majority of us do not wish to live and suffer such a life and instruct our loved ones to not prolong life by un-necessary means. But when the actual time comes, despite this suffering many change their minds and want to continue to hold on to thread of life as long as possible. This worth reading article is about a physician who always advocated letting the nature take its course and not prolong the suffering of life by un-necessary means, but when his own time came, he refused to follow his own advice. Some excerpts from the article (f.sheikh).
“When it came to offering medical interventions to severely ill patients with no hope of recovery, my father had a fiercely strong opinion: They were inappropriate. For decades as an infectious diseases specialist, he had been asked to treat infections in dying patients. Whenever possible, he said no.
But when I approached my dad, who had developed end-stage Parkinson’s disease, to ask what his end-of-life wishes were, he indicated a desire for aggressive measures.
Bioethicists have long debated the issue of “precommitment.” Which wishes are more valid — ones that someone indicates in advance or those expressed during serious illness? My father’s case provided a vivid case study of this issue.”
“My father knew that infections were often the final straw in the deterioration of so many of the body’s vital organs and functions. In other words, infections were what helped terminally ill patients die. To perpetually treat infections in such cases, he often said, was “inhuman and morally wrong” as well as “professionally bankrupt.” My dad tried, whenever possible, to encourage patients, family members and his physician colleagues to reconsider the reflexive tendency to treat.”
“Finally, in November 2011, my mother had no choice but to admit him to a nursing home. I will never forget when I first saw him there. He was sitting in a wheelchair with his head almost on his lap. He was completely dependent on others. This image of my dad was particularly poignant: The last time I had been in a nursing home with him was when he was the medical director of one, caring for the same type of sad souls he had now become.
The time had come to clarify what types of interventions my father wanted. I knew what I hoped to hear. Not only did I know his opinions about inappropriate treatment, but he had written some notes when he began to seriously deteriorate. He said that he was “taking steps to ease my passage.” Some with his condition, he added, “have taken drugs.” Regarding his wife — my mother — he wrote that she “doesn’t deserve to struggle with me anymore.”
But when I asked what he wanted, these notions had disappeared. He said he would be willing to go to the hospital if he got sicker and even go on a ventilator. “Sometimes they can really help,” he said. Full article click link below.
http://opinionator.blogs.nytimes.com/2015/04/08/overruling-my-father/?ref=international
I recently wrote a book review on Thinkers’ Forum about a book title “Being Mortal” by Dr. Atul Gawande that dealt with the same topic. It’s a topic, like life insurance and wills etc., that we rather avoid talking about but are important to face before you have to face them. If one does not have time to read that book there are some YouTube videos about that book that you can watch.
The end of life issues are of paramount importance for many of us who have entered the later innings of life. It is one of the human quandaries that we can talk about living wills, DNR instructions and the like but few of us record such instructions and too often are forced to decide at the last moment. I had to face such end of life decisions fortwo of my sisters, both of whom passed away at almost the same age, in their sixties, five years apart from each other. The older one was ravaged by the reoccurrence of her breast cancer and it was relatively easier to wish her goodbye from the wasteful suffering and pain. The younger one was felled by severe respiratory infections on a visit to Pakistan, spent over a month in an ER setting, recovered enough to return to New York. Two weeks before her scheduled tracheal stent surgery she pulled out her temporary tracheal tube by accident and was rendered brain dead by the the time the medics got to her. It is indeed a shock to see a physically robust loved one abruptly reduced to a vegetative state in a modern hospital setting where the advanced equipment can maintain the semblence of life while the EEGs are flatlined. People have to fight the illusions of life versus the reality. It is a daily occurrence around the world yet we struggle to make the decisions. I took the lead in making the decision to unplug the life support but I am still haunted by the vision of her artificially sustained heart and lungs in her lifeless form lying on the hospital bed with occasional muscular twitches and the stories of miraculous recoveries of people after years in coma. The experience of the Lerner family is being relived around the world every day.
Every creature that is born is intrinsically programmed to live. Man desires to live, if possible, for ever. Since death is immanent, a believer in hereafter is satisfied to live for ever after this worldly life. My mother passed away peacefully at the age of 92. She was very religious and had strictly advised us not to obstruct her dying moments artificially. But my sister aged 54 almost died during her angioplasty procedure. An open heart surgery was done and she was kept alive artificially for seventeen days. It was very hard for the family to decide, even for my younger brother who is a cardiologist, to remove the devices. But my brother-in-law, who is very religious, was able to decide on the basis of his religious beliefs and we with tears in our eyes allowed the doctor to remove all the devices.
I believe this issue relates to human emotions. Emotions are so personal and intimate that we cannot theorize them. It cannot be decided by scientific reasoning or any logic. As Einstein has famously remarked, where science comes to a stop, the realm of religion begins. MIRZA ASHRAF