Thursday, March 24, 2005

On The Mark -- Making that Final Life or Death Decision

I know this is difficult for your family, but because of your father’s condition, we don’t even have to ask your permission to take him off life support. We’ve kept him on life support as a courtesy until your whole family arrives.” That was what the neurosurgeon told me after I had peppered him with a series of questions.

When my father suffered a massive stroke a few months ago, all the tests showed that he was completely brain dead and that his brain was floating in blood. My mother asked me to speak to the neurosurgeon to get his opinion on my father’s condition. It was to be the last medical discussion before we made our final decision, and she had already heard from a battery of doctors throughout the night. She was confident I would ask a lot of questions but, at the same time, she already knew the answer and that the discussion was a formality.

My days as a reporter and former editor of a medical journal came back to me and I asked a lot of questions, to the point where the doctor started to get perturbed. I informed my mother of what the doctor said and she said, “OK, then, this is the right thing to do. He’ll be happy to know that we were all here when he left us.” I asked her point blank – “Are you absolutely sure? You have no doubts? A month from now you’re not going to call me and say, ‘did you ask the doctor about this procedure that was just reported on CNN?’” I had just arrived after an all-night drive and hadn’t reached finality yet, but she had. She said, “Absolutely not -- I know this is the right thing to do. And furthermore, it’s what he always said he wanted.” Even at this moment, my mother was still as solid as a rock.

My father had said many times at family gatherings that he never wanted to be kept alive by a machine. He made it clear that we should not hesitate to make this decision. (Thank you, dad, for making it easier for us at this time. You always were good at looking ahead.)

The doctors removed the life support. My father died (officially) almost instantaneously, without any movement on any part of his body, not even a flinch, staring blankly into space.

I remember asking before life support was removed – how long will it take? My older sister, though convinced it would happen fast, said, “Who knows? It could take days, and sometimes it takes a week.” I was shocked. But the doctors, without giving assurances, predicted it would happen very quickly.

The final decision has to come down to the family, but doctors play a critical and important role in these situations. In the news coverage regarding Schiavo, it appears that the doctors have been left out of the debate and discussion, which is a shame.

But, in the end, if a patient has a living will, then they should be allowed to die peacefully if doctors deem there’s no chance of the person recovering from a comatose or vegetative state.

Peacefully, however, is the operative word. In my opinion, in a living will case, the patient should be given a shot to be put to rest. If doctors and other health care providers don’t want to be a part of that, they should simply prepare the dose and give it to a family member to inject into the catheter leading into the patient’s vein.

I’ve never discussed this with anyone in my family. It’s too painful, but I think I might be alone in this opinion. I’m sure they would say that only God has a right to give and take life. I’m not even sure what my dad’s opinion would have been, but I think he would have chosen to die naturally.

I’ve learned several important points during this Schiavo issue:

  • One must make sure they have a living will so there is no doubt what the patient wants. This living will should be explicit in saying whether they want to die naturally or be assisted (should that option be available). If and when the “assisted” option is available, the decision shouldn’t be left in the hands of surviving family. That’s unfair to them because of what their religious beliefs may be.
  • There should be a more humane way to do this – we are living in the 21st Century after all.
  • The government should keep its big nose out of it…they should be ashamed about how they’re conducting themselves right now (thank you, Supreme Court, for refusing to take the case).

The decision my family made that morning in September was the hardest one I’ll ever make, yet, at the same time, thanks to my dad’s foresight, it was the easiest.


Jack Steiner said...

Those decisions are very tough to make. I have been a part of a couple.

Chandira said...

I'm with you on the injection thing, whatever's quickest, and most dignified and painless, surely?
Diana Trent made the point that Timothy McVeigh was allowed that very dignity.. He went in a few hours. Our cats and dogs have that right.
The double standards of this amaze me.

unknown said...

i totally agree with you here. If I withhold food and water from my dog I could be in trouble. If I take the dog to the vet and he injects a lethal overdose of barb's to end the suffering it's ok. I think that letting this lady starve to death is not the way to do this. The family should have the option to inject her and end her suffering. Who has paid the doctor bills the last 14 years? Prob not her parents cuz they seem to have the money for all this legal wrangling. Seems like a big waste and they should be glad the ladys husband is trying to do the best thing for his wife.

Anonymous said...

From what you described about your Father's condition, you did the right thing. It must have been an awful thing to go through, but as time goes by the memory of that moment will fade and the happier moments with your Dad will blossom to the surface. I agree with you about the injection, starvation and dehydration is inhumane. I agree the courts shouldn't get involved, but there should have been a better way.

On The Mark said...

Everyone -- Now that the polls show that something like 82 percent of those polled believe the government should stay out of it, Congress has gone into hiding.