Let my mother go
July 22, 2012 3:20 PM Subscribe
This post was deleted for the following reason: Double. -- restless_nomad
"Why do we want to cure cancer? Why do we want everybody to stop smoking? For this?" wailed a friend of mine with two long-ailing and yet tenacious in-laws.If we treated human life with as much respect and dignity as we do the lives of our pets, people wouldn't have to ask idiotic questions like this
posted by crayz at 3:43 PM on July 22, 2012 [2 favorites]
f we treated human life with as much respect and dignity as we do the lives of our pets
As someone who was pressured by doctors into applying for a special credit card in hopes that I'd be able to pay $5,000 in hospital bills for a cat who was probably within days of dying anyway, I think it's common to err just as greatly in the other direction.
I don't see what's so idiotic about the question. My great-grandmother had fourteen cancer operations over the course of her 88 years. In the end she just decided to stop accepting treatment because everyone she'd ever known (besides her own family) was already dead. She told me that she feared God had forgotten about her. People in my family were so angry at her for refusing treatment that they all but cut off contact with her altogether.
posted by hermitosis at 3:51 PM on July 22, 2012 [1 favorite]
As someone who was pressured by doctors into applying for a special credit card in hopes that I'd be able to pay $5,000 in hospital bills for a cat who was probably within days of dying anyway, I think it's common to err just as greatly in the other direction.
I don't see what's so idiotic about the question. My great-grandmother had fourteen cancer operations over the course of her 88 years. In the end she just decided to stop accepting treatment because everyone she'd ever known (besides her own family) was already dead. She told me that she feared God had forgotten about her. People in my family were so angry at her for refusing treatment that they all but cut off contact with her altogether.
posted by hermitosis at 3:51 PM on July 22, 2012 [1 favorite]
The crux of it to me, even more than the issue or question of euthanasia, which seems pretty unambiguous to a lot of us here, is overtreatment. One of the significant quotes from the article was, it did not once occur to us to say: "You want to do major heart surgery on an 84-year-old woman showing progressive signs of dementia? What are you, nuts?"
Even very old people are treated to "the best" in medical care, and unfortunately, medicine is now amazing at helping people survive even extreme medical emergencies, like the seizures or heart disease mentioned in the article. Had a sane surgeon said to this family that surgery would not necessarily make sense for a woman of this age, the suffering the family is now experiencing might have been avoided.
posted by latkes at 3:52 PM on July 22, 2012 [2 favorites]
Even very old people are treated to "the best" in medical care, and unfortunately, medicine is now amazing at helping people survive even extreme medical emergencies, like the seizures or heart disease mentioned in the article. Had a sane surgeon said to this family that surgery would not necessarily make sense for a woman of this age, the suffering the family is now experiencing might have been avoided.
posted by latkes at 3:52 PM on July 22, 2012 [2 favorites]
I'm going on 51 and in excellent health, but I'm (electively) on my own without close family, and lemmetellya, terminal cancer (eventually) or some other disease with a pretty definite expiration date sounds way, way, way better than "dwinding" and interminable warehousing. The prospect of dementia in particular is so frightening to consider -- but after a certain point, I guess I'd be too demented to be afraid anymore.
One thing that seems to happen with age, at least for me, that makes mortality seem easier to face is that you realize that profound suffering can be far worse than dying. I mean, right now I adore life and cling to it and hope to relish it for many years to come, but for example, as my arthritis progresses and some mobility issues arise and there are painful days, I can just barely start glimpsing way in the distance the vague outlines of the concept of getting tired of living and someday being ready for a permanent rest.
posted by FelliniBlank at 3:55 PM on July 22, 2012 [3 favorites]
One thing that seems to happen with age, at least for me, that makes mortality seem easier to face is that you realize that profound suffering can be far worse than dying. I mean, right now I adore life and cling to it and hope to relish it for many years to come, but for example, as my arthritis progresses and some mobility issues arise and there are painful days, I can just barely start glimpsing way in the distance the vague outlines of the concept of getting tired of living and someday being ready for a permanent rest.
posted by FelliniBlank at 3:55 PM on July 22, 2012 [3 favorites]
So this is indeed a tragic story, and I really sympathize with the author. Nevertheless, equating longevity with this obfuscates the issue.
We should count our lucky stars that we have the healthy lives we do. On the other hand, since death is something we have a weird sort of power over these days, we have to learn to choose to die, which is certainly a spiritually difficult thing to do. Especially since for many people, choosing to die is something deeply repugnant (which is an instinct I have to admit I never fully understood).
Being a from a generation before this fellow, I definitely hope that this is something we learn to cope with in society sooner rather than later. My grandmother died recently at the ripe old age of 92, having lived quite well up to the end, and having died quite well I believe too. I hope I can help grant this privilage to my mother, and I hope I will be granted the same as well.
posted by Alex404 at 3:56 PM on July 22, 2012 [3 favorites]
We should count our lucky stars that we have the healthy lives we do. On the other hand, since death is something we have a weird sort of power over these days, we have to learn to choose to die, which is certainly a spiritually difficult thing to do. Especially since for many people, choosing to die is something deeply repugnant (which is an instinct I have to admit I never fully understood).
Being a from a generation before this fellow, I definitely hope that this is something we learn to cope with in society sooner rather than later. My grandmother died recently at the ripe old age of 92, having lived quite well up to the end, and having died quite well I believe too. I hope I can help grant this privilage to my mother, and I hope I will be granted the same as well.
posted by Alex404 at 3:56 PM on July 22, 2012 [3 favorites]
"You want to do major heart surgery on an 84-year-old woman showing progressive signs of dementia? What are you, nuts?"
The problem is that we shouldn't expect a devastated family to have the presence of mind and experience to say this. A doctor damn well should said it to them.
posted by tyllwin at 4:04 PM on July 22, 2012 [3 favorites]
The problem is that we shouldn't expect a devastated family to have the presence of mind and experience to say this. A doctor damn well should said it to them.
posted by tyllwin at 4:04 PM on July 22, 2012 [3 favorites]
A doctor damn well should said it to them.
This crazy doctor wants to kill my aging parent! Let the lawsuits commence!!
There's no way in the world most doctor are going to say such a thing, with the possible exception of cases where the immediate family is making it explicitly clear that they're already on the same page.
posted by Sing Or Swim at 4:08 PM on July 22, 2012
This crazy doctor wants to kill my aging parent! Let the lawsuits commence!!
There's no way in the world most doctor are going to say such a thing, with the possible exception of cases where the immediate family is making it explicitly clear that they're already on the same page.
posted by Sing Or Swim at 4:08 PM on July 22, 2012
My great-grandmother lived out her final years in the senility of a nursing home. I was three when she passed; I remember the trips to see her but not the woman herself.
My grandmother was recently relocated by my mother to a nursing home, and this was much more painful to me since Grandma clearly wanted to communicate her unease and frustration at her condition in her phone calls but was unable to do so. She has since demented further and may not remember me any longer (she certainly doesn't remember my wife, even though she made a memorable trip to be at our wedding).
In our conversations, my mother has said that she expects to go the same way, physically healthy but mentally unsound. I'm 3,000 miles away and expect to stay that way, so the job of taking care of her will fall to my younger sister (and perhaps my father if he has the longevity and ability of his mother). Not once has she mentioned any plans about leaving on her own terms—but then again she's not yet sixty and feels fine.
My sister doesn't want children. Regardless of if she partners or who she partners with, I'm most concerned about who will take care of her, because I expect I'll be long gone of a heart attack or stroke like the men in my family, and it doesn't look like children are in the cards for my wife and me.
I hope that the US can figure out what to do about end-of-life care in the next fifty years.
posted by infinitewindow at 4:10 PM on July 22, 2012
My grandmother was recently relocated by my mother to a nursing home, and this was much more painful to me since Grandma clearly wanted to communicate her unease and frustration at her condition in her phone calls but was unable to do so. She has since demented further and may not remember me any longer (she certainly doesn't remember my wife, even though she made a memorable trip to be at our wedding).
In our conversations, my mother has said that she expects to go the same way, physically healthy but mentally unsound. I'm 3,000 miles away and expect to stay that way, so the job of taking care of her will fall to my younger sister (and perhaps my father if he has the longevity and ability of his mother). Not once has she mentioned any plans about leaving on her own terms—but then again she's not yet sixty and feels fine.
My sister doesn't want children. Regardless of if she partners or who she partners with, I'm most concerned about who will take care of her, because I expect I'll be long gone of a heart attack or stroke like the men in my family, and it doesn't look like children are in the cards for my wife and me.
I hope that the US can figure out what to do about end-of-life care in the next fifty years.
posted by infinitewindow at 4:10 PM on July 22, 2012
I feel thin, sort of stretched, like butter spread over too much bread...
posted by kaibutsu at 4:14 PM on July 22, 2012
posted by kaibutsu at 4:14 PM on July 22, 2012
"Why do we want to cure cancer? Why do we want everybody to stop smoking? For this?"
Relevant.
I will continue to drink like a fiend and indulge in unhealthy yet pleasurable pastimes until I drop, and if I drop early, so be it.
posted by Decani at 4:21 PM on July 22, 2012
Relevant.
I will continue to drink like a fiend and indulge in unhealthy yet pleasurable pastimes until I drop, and if I drop early, so be it.
posted by Decani at 4:21 PM on July 22, 2012
There's no way in the world most doctor are going to say such a thing
Obviously not in that language. But I think they can probably say "I would not recommend this," or "I doubt you would be pleased by the most likely outcomes," or "I would not do this if it were my own parent" without added fear of legal problems. Hell, they can be sued now for not making the consequences clearer.
posted by tyllwin at 4:22 PM on July 22, 2012
Obviously not in that language. But I think they can probably say "I would not recommend this," or "I doubt you would be pleased by the most likely outcomes," or "I would not do this if it were my own parent" without added fear of legal problems. Hell, they can be sued now for not making the consequences clearer.
posted by tyllwin at 4:22 PM on July 22, 2012
Doctors' approaches to this aren't just about legal liability concerns or about making money; there is a culture of do everything you can, right away. As far as I can tell most just lack any kind of meaningful education in thinking critically in when not to give care. Even "palliative care", as suggested in this article, is code-language for providing more medical treatment - even if that just means increasing doses of pain medication.
posted by latkes at 4:25 PM on July 22, 2012
posted by latkes at 4:25 PM on July 22, 2012
This is pretty much the same piece as this (I guess the Guardian didn't mind reprinting it?)
posted by Ralston McTodd at 4:28 PM on July 22, 2012
posted by Ralston McTodd at 4:28 PM on July 22, 2012
(That was sort of muddled. What I meant was, the doctor in the article uses "palliative care" to say, in coded terms, "We could increase her pain medication until she is dead")
posted by latkes at 4:29 PM on July 22, 2012
posted by latkes at 4:29 PM on July 22, 2012
as much as I value any discussion on a topic that is intensely relevant to me personally, we talked about this article in May
posted by ninjew at 4:40 PM on July 22, 2012 [1 favorite]
posted by ninjew at 4:40 PM on July 22, 2012 [1 favorite]
From my (short) experience working pastoral care in a hospital, doctors do think about hospice care but they're doctors - their job, education, culture, and entire being is tied up in "fixing" people. Death is a word that is avoided at all cost. It is avoided to the point where it is not taught. Watching doctors teach residents how to work through the "life" test to pronounce that a person is dead - it was maddening to see how far away from the word "dead" they ran to. And, of course, that is just part of our culture. "Passed away", "gone to the other side," etc etc. Dying just isn't in the cards anymore. It was fun learning that pastoral care departments are being left in charge of actually talking about death (even in end of life discussions, it is all about ending care, not actually about death) and considering how small these departments are, and how isolated from the rest of the hospital they can be, "death" isn't showing up on the menu anytime soon.
posted by Stynxno at 4:50 PM on July 22, 2012
posted by Stynxno at 4:50 PM on July 22, 2012
What I meant was, the doctor in the article uses "palliative care" to say, in coded terms, "We could increase her pain medication until she is dead"
Which is exactly how I read the passage:
"Perhaps more palliative care. This can ease her suffering, but the side effect can be to depress her functions. But maybe it is time to err on the side of ease."
I take certain comfort in that my mom's GP and I have already begun communicating on this sort of level.
posted by Thorzdad at 4:58 PM on July 22, 2012
Which is exactly how I read the passage:
"Perhaps more palliative care. This can ease her suffering, but the side effect can be to depress her functions. But maybe it is time to err on the side of ease."
I take certain comfort in that my mom's GP and I have already begun communicating on this sort of level.
posted by Thorzdad at 4:58 PM on July 22, 2012
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I have long, long felt that our culture's obsession with living forever and keeping people alive by any means possible was blindly wrong-headed and, frankly, cruel (with a heavy dollop of profit-motive thrown-in, on my more cynical days)
posted by Thorzdad at 3:40 PM on July 22, 2012 [1 favorite]