DIFFICULT DECISIONS - AN UNPLEASANT TOPIC

It is widely believed that one of the most unique characteristics that distinguishes the human race is the knowledge of our own mortality.  We're all going to die and no matter how well we deny it death is the "gorilla in the room" of each of our lives.

It's one thing to take responsibility for our own end-of-life decisions, and we all must, but it is a more difficult task to take responsibility for someone else's.  Many of us have found or will find ourselves in that very situation. When a loved one is seriously ill or incapacitated there are choices and decisions to make.  In the midst of sorrow and grief we are thrust into the seemingly  impossible end of life decisions.

There are so many factors that come together ranging from the emotional to the practical to the ethical.  In many cases there is no absolute right or wrong but only what is right for you , your loved one and your family.

What would the patient want?


First we have to deal with the sadness at the immanent loss of a loved one.  Then we have to deal with the enormity of the decisions we are being asked to make.  This is an overwhelming sense of responsibility.

Comfort, love and the minimization of pain are at the top of the list of concerns.  How much extraordinary medical measures are we willing to have performed and to what benefit.  What is the patient's "quality of life"?  Are we sacrificing comfort for negligible gain?

Beyond "extraordinary" measures, how much "ordinary" measures are we willing to have withheld?   There can be questions of feeding tubes, antibiotics, IV nutrition and even fluids.  These are questions that need to be fully discussed with the doctor and family members.  There are differing opinions as to what is needed for the most comfortable passing.

Why the Republican "death panel" myth is cruel


During the course of the Healthcare Reform debates of the past year one of the most irresponsible false issues raised was the allegations of so called "death panels" to force end of life decisions.  This is not only nonsense but hurtful.  The truth is that this portion of the bill dealt with insurance paying for the doctor consultation visit regarding end of life decisions.  It is imperative that we discuss these decisions with medical professionals in order to make the most informed, humane decisions.  The doctors do not make these decisions.  They offer the choices and discuss the prognosis with the loved one who is responsible for making the decisions.  It is criminal to think that anyone should be asked to make life's most important decisions without the benefit of being as well informed as possible.

Tough decisions are easier in good times ....


Don't wait until the dreaded time arrives.  Have discussions with loved ones while they are well and able to make their wishes known.  Discuss your own end of life philosophy and wishes with your loved ones to spare them from having to wonder.  Consult a legal professional, fill out healthcare proxies and make a living will.  No one wants to deny his own immortality but doing so now will alleviate some stress later.

With decisions made you can spend your energy and focus on the patient.  Give your comfort, love and support.  I held the hand of a loved one and spoke to him and comforted him while he passed from this life. I know this helped to make his final moments peaceful for him but also made his passing easier for me to accept as well.

Death is one of the few experiences that we all have in common and yet it is one of the most difficult and least discussed topics in our modern civilization.