Taking control at the end of life
Our own mortality: Everybody is forced to confront it eventually. Yet the art of dying well has been lost in Western culture. Instead of accepting it, we have been taught to preserve life even if it means prolonging pain and suffering.
I try to address these issues with every patient. Most have simple answers like “pull the plug” or “we’ll see how it goes.” There are no simple answers, and when it goes unanswered I am forced to discuss it with distraught families in the ER or ICU. There I find distressed people, often in conflict over the decision, ridden with guilt over the decision not to continue treatment. Aggressive doctors might not give the option, instead battling the Grim Reaper to the end at great dollar and emotional cost.
Persons with substantial medical problems prior to cardiac resuscitation in the hospital almost never live to discharge. Resuscitating patients because families say “Doctor, do everything,” pains me, I look into patients’ eyes and see one of three things ranked in increasing horror as follows: 1. No light, no spark of recognition, the spirit is gone but the body goes on. 2. Lights are on, no recognition or understanding, but there is fear and pain because my interventions. 3. Worst of all, lights are on, there is recognition, understanding, fear and pain, but now they are incapable of asking me to stop. Because quality-of-life issues are very individual, people need to document at what point they feel they would prefer to suffer no longer and be allowed to die in as much comfort as possible.
Modern medicine is capable of prolonging most life,cardiac resuscitation and medical care that can sustain bodies long after spirits departs. People need to think about what is right for them, document it, discuss it, keep it available so their wishes are respected. I want people to be informed because ignorance can result in needless suffering.
If the Sierra Nevada Memorial Hospital Wellness Center Tuesday May 21 at lecture at 7 p.m. is inconvenient, I would be happy to speak with other groups on this topic in the future. Knowledge is power.
Andris E. Radvany M.D.
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