Time to rethink labels about hospice, death and assited suicide.

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Read an interesting article this morning. There is a national group lobbying for "Death With Dignity". One comment that struck me was about the bad connotations surrounding the topic. We hear assited suicide used all the time. This article pointed out that this is not accurate. Patients are already dying, they are not choosing death over life but one form of death over another. Hospice is by any measure the compassionate method for end of life but people can still linger for months and death does not always come painlessly or easily even with the best hospice care. Five states currently have aid in dying laws but it becomes a huge political issue whenever it's brought up in state legislatures. Surveys show that 68% of Americans favor aid in dying rights but it's routinely thwarted by right to life groups and conservative legislators. Should all life be taken to its utmost final consequences each and every time? Who does this serve? It's not uncommon to see discussions on this forum about the 98 year old terminal patient with an incredible list of medical issues whose life is being drug out to the bitter end by a loved one. On one level I understand this but I'm sure glad I have no loved ones that would do this to me.


Excellent point, Windy. I see my Mom [98] and she is just a shell of herself, bedridden, very little communication that makes any sense. Even though she is on Hospice, this could be her life for another full year. There is no repair or recovery from that serious brain injury when she fell at home.

Mom's unable to read, she can't watch TV or listen to a radio, she can't join activities, she can't stand or walk or even sit up, just lays in bed or in her Geri recliner at the nurses station. She is taken to the dining hall but has to be fed. She is unable to interact with other patients at her table, nor they with her.

It is so sad when my Dad and his caregiver visits Mom... Dad is still under the impression that Mom will once again walk through the front door of their house and life will continue on like nothing had happen.

Dad future care is on hold because of the above belief. I really would prefer Dad to be in Assisted Living but he said Mom wouldn't like it, so he's holding onto the house.... same with his old car, Mom would need the car to ride in to go shopping or to the doctor... [sigh].

Thank goodness my parents had Living Wills made not long ago in case something like this happens, thus no heroic measures taken. Oh how I wish my Mom would just go in her sleep, this is no quality of life. Or have something to set her free.
I'm in Oregon - the first state to implement Death with Dignity laws. My parents have had a few friends that took this route. One was a man dying of brain cancer - has to be one if the most horrendous ways to die in my opinion. While I am very anti suicide for a variety of reasons, I think there is room in a compassionate society to allow the terminally ill a way to end their suffering.
FF, I knew your mother's situation was dire but didn't realize it was to the point that she basically has no quality of life at all. Your post brought tears to my eyes.

This is such a complex subject, but I think it can boil down to what the family wants and whether or not they realize frankly what the situation is. Outside intervention from unrelated parties, especially lobbying groups and legislator, shouldn't be a part of the equation.

As FF points out, her father doesn't realize that his wife will not be improving. In that kind of situation, who are the parties who are closest to the situation and should be making the decisions? Politicians - I think not.

I think the issue really needs to be a personal one, between the family members, but as Windy points out, right to life groups and conservatives feel they have the right to intervene if not meddle in family affairs.

I've always wondered where these people are when children and adults are being abused, when someone is suffering for months if not years in a vegetative state, and why on earth do they feel the need to meddle and interfere with a family affair?

I think it's a control and power issue more than a humanitarian issue.

And I wonder if the issue wouldn't be so problematic if our country weren't so polarized.

The point that someone is already dying is important; it's one that the forces opposed to assistance with death with dignity don't seem to grasp. It's been said repeatedly that pets are treated with end of life compassion more than humans are. And I think that a society which presumes and/or purports to be compassionate and progressive needs to address that prolonging misery is not consistent with that philosophy.
The role of hospice is to ease the transition to a natural death. I think assisted suicide is an accurate way to describe the model I see in places like Oregon, the patients themselves have to ask for the assistance and approve of the time and place. Maybe suicide is not the best word, but it conveys the intent that the patient and only the patient is in control. To take it to the next level, where loved ones, perhaps even a government body, have the final control is where most people slam on the brakes, and rightly so in my opinion. It is one thing for me to say my life has not meaning and I am ready to go, it is something else entirely for you to say it for me, no matter how much you love me or how good your intentions are.
For all of us who have had out loved ones descend down the rabbit hole into confusion or dementia there are no easy answers. I'm afraid without the capacity to voice their choice we, and hospice, just have to help them the best way we can to proceed to their natural end.
I wonder if in states that have death with dignity laws if people can designate this in their living wills or is it a decision made only after a terminal diagnosis. If I were able to check such a box on my living will I most certainly would. Excellent comments above, BTW.
Here are the current requirements for Death with Dignity in Oregon:

An adult (18 years of age or older),
• A resident of Oregon,
• Capable (defined as able to make and communicate health care decisions), and
• Diagnosed with a terminal illness that will lead to death within six months.

The patient must make two oral requests to his or her physician, separated by at least 15 days.
• The patient must provide a written request to his or her physician, signed in the presence of two witnesses.
• The prescribing physician and a consulting physician must confirm the diagnosis and prognosis. The prescribing physician and a consulting physician must determine whether the patient is capable.
• If either physician believes the patient's judgment is impaired by a psychiatric or psychological disorder, the patient must be referred for a psychological examination.
Thanks for the info Rainmom. Very informative.
No problem. Like I said, I'm anti suicide but I personally don't condider Desth with Figniy suicide - especially not "assisted" suicide. As aptly pointed out in the previous posts Death with Dignity isn't trading life for death - it a trade off of death for death which most importantly includes the trade of suffering for release. As for "assisted" - if you know the requirements in Iregon you realize that it is solely ghe patient who is pursuing their chose to end their life - the checks and balances assure that. I'm assuming where the word "assisted" comes in is that a doctor will procure the medication that will end life. And it should be note here as I did not notice it in the basic requirements - the patient must also must be able to self-administer and ingest the prescribed medication. So, for me - I'll call it Death with Dignity.
Potayto- Potaatoe.
Good Lord! Second and third lines its Death With Dignity!!! Totally forgot to proof before hitting send!!! Sorry - how embarrassing!
I'm wondering about slowly degenerative diseases like ALS. The sufferer can become incapacitated long before he/she's only 6 months away from death. Look at Stephen Hawking - he's had ALS since around 1963. That's a long time to suffer.

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