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Facing End-of-Life with Dignity

Facing End-of-Life with Dignity

Death. 

It’s a perfectly natural part of life, but somewhere along the way we’ve developed an unhealthy and sometimes cruel aversion to it. Not discussing imminent death only prolongs suffering for the patient and the family, while leaving many personal emotional issues unresolved. 

According to a New York Times blog by Maggie Jones, even doctors struggle to talk about dying with their patients, and often fail to bring up the subject at all. As a consequence, patients suffer needless and often painful interventions at the end of their lives that can add thousands of dollars to a single patient’s medical costs with with no benefit. 

We’ve got doctors who are uncomfortable with the subject, patients who don’t want to burden loved ones, family members who don’t want to upset the patient, and a group avoidance of the inescapable reality of death, a perfectly normal and natural event. Sure, it’s emotionally charged, but better to deal with it than to hide our heads in the sand.

Doctors owe it to their patients to be truthful, allowing families the opportunity to discuss end-of-life issues and settle important practical matters. Uncomfortable as the topic of death may be, it is not in the best interests of the family to hold on to a false hope. Nor is it a sign of weakness on the part the patient to accept the inevitable. 

I’m all for hospitals and every life-saving technique they can employ, but there comes a point at which they can do more harm than good. I would hope that I can count of medical professionals to tell me when that time comes.

Watching a beloved family member endure painful medical interventions is one thing when you have hope of prolonging life in a meaningful way. It’s quite another when all hope is lost.

As for me, I’d rather face death with some dignity than to spend my last days pretending that it won’t happen to me. I prefer not to go out hooked up to machines in a sterile environment and enduring all manner of medical intervention to no avail. I prefer to know the truth and to deal with it appropriately.

End-of-life-choices have to come from a place of compassion and honesty from all parties. It’s too important to ignore. It’s a discussion we should all be having with our families… and our physicians. 

Some excellent information on end-of-life issues can be found at Medline Plus, A Service of the U.S. Library of Medicine and the National Institutes of Health.

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11 comments

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3:34PM PDT on Apr 8, 2009

Wendy Flay your comment made me laugh. It's so true that when we have babies we're only thinking about ourselves 'having a baby'. We're not thinking about bringing another person into this world who is going to die one day. It doesn't bother us much because, as parents, hopefully we won't be around to see it ourselves. I often laugh at the old Bill Cosby line that he used when telling about chastising his young kids, "I brought you into this world, I can take you out of it". Which apparently made them behave themselves very quickly.

3:23PM PDT on Apr 8, 2009

I am convinced that the reason behind our antiquated anti-euthanasia laws is that they can't make any more money from us after we die so they try to keep us alive as long as possible with more and more 'tests' and 'procedures' or anything they can think up because after we've gone, it all stops. Then they turn to the next unsuspecting vulnerable person.

3:19PM PDT on Apr 8, 2009

Doctors should never offer to force feed anyone, especially a 99 year old. I believe we should all have the choice to go when and how we choose. It's our own body and no one else has the moral right to force us to suffer longer than need be. I also don't beleive we should use religion to make people suffer longer. Religion (superstition) should have no say in the matter. Nor should medical practitioners interfere unless requested by the person who is ill or aged, or their loved ones. Doctors try to medicalize everything from birth to death, when these are all completely natural processes. We wouldn't treat our cats & dogs the way we treat elderly people. My best friends mother starved herself to death because she couldn't get help to die with dignity. She had motor neurone disease for many years, poor woman. A family friends grandmother hung herself because she also couldn't obtain euthanasia. This is disgusting in the 21st century when we now have drugs that would bring about a peaceful and gentle end at home with our family, if we so choose. The only thing blocking it are our ultra-conservative and backward anti-euthanasia laws.

9:06AM PDT on Apr 8, 2009

No need to prolong agony. Mom died paralyse from a stroke or two at the hospital after not being able to eat, she lasted 10 days, they ask me if I wanted them to "force feed her", I said no tube, her heart stop, 2 days in coma, too much uric acid. At 99 no one is expected to live forever. She was in better shape than I am prior to her first stroke. We all had hope she would make the 100.
Last month my cousin 74 had a stroke/ heart attack, they tried by-pass first, she had a leak in her aorta, they open her up, too brittle, nothing to do, she died 3 days later in coma. Too much plaque=they knew that but as doc I suppose they swore to do their all best to save humanity from their ailments or experiment for their next patients? Most of us all look for that famous Fountain of Jouvence forgetting no one as yet found it.

8:43AM PDT on Apr 8, 2009

I am 61 not 25, I am of the opinion "do not ressucite", as my condition of past infart,stroke and a tired heart per doc.
Cremated, in commun ground:earth to dirt. Easy for me to say as I have no more family. My Soul will soar...So did my mom & dad. They are there in my heart.

8:38AM PDT on Apr 8, 2009

Margaret - that sounds lovely. I would encourage the memorial service; as that is a way to celebrate your life, share memories and share grief. Also, on the living will/do not rescitate order; you also need to add that you want NO LIFESAVING DEVICES INCLUDING FEEDING TUBES. If that phrase is not included, the Doctors can place a feeding tube that may prolong your suffering - even though they know you are dying. If it is not written down, even your family members can not order it not be placed. This happened to my husband's Uncle. They knew he was dying and he had a do not ressicate order on file. Even though the family said NO, the doctors said that he was legally bound to put in the feeding tube and the Uncle was in pain for almost 2 weeks before he died. Both she and my other Aunt added the no feeding tube to thier living will after that.

4:59AM PDT on Apr 8, 2009

Ann, you've said it so well, Thank you.
I shall print your comment, sign it as approval, communicate it to my family and keep it in my wallet as my last will, in case I'm found as vegetable somewhere...
Cheers !

4:57AM PDT on Apr 8, 2009

Ann, you've said it so well, Thank you.
I shall print your comment, sign it as approval, communicate it to my family and keep it in my wallet as my last will, in case I'm found as vegetable somewhere...
Cheers !

4:34AM PDT on Apr 8, 2009

Parents always talk about how wonderful life is and how thanks to them giving birth you, you are alive but they hardly ever talk about the future death they gave you with the same breath leaving it as something to scare the ---- out of you when you become more self aware. Perhaps if I were in pain I would change my mind but I want to live for ever. I wanted my relatives to live for ever. It's in my DNA, it's from that first survival soup.

4:18AM PDT on Apr 8, 2009

Several years ago I decided to have a living will saying, "do not resuscitate". I don't want my adult childern going through what I did with my mother.
I have also decided not to have a formal wake. Instead I will be cremated and my ashes dispersed at sea.Why, because it's an archaic custom and exhausting for the childern. I talked it over with my adult childern first before I made my fianl decision.
Then to spend indecent amounts of money for a funeral, when the money could be put to good use in other areas;like a vacation or money for college for my grand childern.
I haven't decided yet about having a " memorial service", will talk that over with the family.

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