If nothing else this draws attention to the importance of haveing a living will.
I am pretty sure what I would want done to/for me in that type of situation.
Here is an ugly question...
What if one our loved ones was in this condition and we had to make the decision, what would you do? Hopefully, we will never have to answer that question.
Can they still live if all of the life support paraphenalia was gone? If they would die, then they are artificially being kept alive. In that case, make them comfortable, but let them go.
I hate the thought of starving this woman - it is barbaric. The feeding tube should stay. But I'd remove the other machinery keeping her going.
50-60 years ago, people died. It bothers me the medical profession keeping people alive and making billions off of it.
i remember when a couple had to let their infant go. the baby never ever would have had a "life" and was being kept "alive" artificially as you said, sunesis
the parents felt they were prolonging death, not life
And what about that case recently in the UK, where an abortion was performed on a baby that had a cleft palate?
The baby would have been born with a physical deformity, and potential handicap - but I know people with cleft palates, that doesn't stop them from living full lives.
tough tought questions and I am sure there is not one answer that can be applied to all situations.
I did face this situation with my mother when I was 21. It was horrible. We continued treatment and she recovered. She lived another year and a half before she died from something else.
My uncle, faced with the same situatin a couple of years later let my grandmother go. I have always been deeply angry with him for that. But that doesn't necessarily mean he made the wrong choice - just a different one from the one I would have made.
If it was one of my children, I think I would fight until the bitter end without letting go of hope. On the other hand, if I had a newborn who was in a situation like the one ExC described, I don't know if I would fight so hard. Why the difference? I don't know - perhaps emotions more than logic.
All of that being said - is it really living if you are in a vegetative state? Where and when does quality of life come into the picture? What about pain and pain management?
I know, by the time my mom did die, she was so sick it was relief to let her go - she was suffering even with the pain meds. She had no quality of life - bedridden and so drugged up she didn't know who anyone was or even where she was.
Do the mentally handicapped or those in a vegatative state understand that that is what they are? Are they happy? miserable? Would that make a difference?
When my sister was near her death she told me that quality of life means more to you when you don't have it. I still can't fully realize that having not been thru it myself. But would I have been able to help her die had she asked? Nope!
hopefully none of us will have to make that decision.
i made it easy for my wife i hope if there is little hope for quality of life do not hook me up to the machines! period
i think the medical profession has a lot to do with it they want the money. they can keep some people alive for years and collect big bucks compliments of me and you
I'm not sure about what kind of public policies should be made, just know what I'd want for me and mine.
Having just had a kinda big health scare last week, I've been thinking through this stuff again, and I still don't want to cling to life no matter what. I'm willing to let go, maybe sooner than a lot of folks. At least I think I would.
If I get to the point of having one of those "days of the week" type of pill dispensers, or have to drastically curtail my lifestyle due to inabilities, I'm all for taking active measures to bring the end on sooner. I can't imagine being bedridden as a lifestyle, for me or mine.
As usual Mark you aren't going to ask any easy questions. I am still thinking on the last one you asked me which has been about a month or so. This one is equally difficult and incredibly complex and not being studied up on medical ethics makes it all the more difficult.
I dont know if there is one right answer as to when, every case is different and has different contributing factors that should all be taken into account.
Many people have already considered the question, have filled out Living wills and have appointed someone power of attorney to make the decision on their behalf if they are not in position to do so. So in these cases, it would seem to me that the person with the power granted to them knows what the patients wishes are (they have already discussed it, and presumably trust is a part of their relationship) and can make a decision based on all the information given by the medical community with regard to prognosis and quality of life.
Of course nobody knows anything for sure--miracles happen;wrong diagnoses and prognoses happen...there are risks the person filling out the Living Will in the first place might have or must have considered and was willing to live with ( and die with).
The best the person given power of attorney can do is get as much information as possible and make the best decision based upon the patients wishes made clear at the signing of the documents. In these cases it is the role of the person who has the power of attorney to advocate as fiercely as possible for what the person wished with regard to the best treatment plan and/or decision to end the persons life... The person also has a responsibility to deal with his/her own relationship issues with the patient to be sure the decisions made are clear and right decisions for the person, and not extensions of ego needs.
I would think that when these moments of decision come these things would need to be sorted out, with a counsellor, clergy or someone who is trained to listen for whose needs are being met with any decision.
All this is to say, that accepting power of attorney on behalf of someone else or signing a Living Will is not a light or casual thing. It should be undertaken with great seriousness , deep reflection and emotional/spiritual maturity.
As for the other situations, there is no one right time. i would suggest that these decisions are best made after a circle of people can be brought together as an Ethics Committee, which most hospitals have, to consider the specific situation. This committee, usually including medical professionals, psychologists, clergy. lawyers, social workers, etc. is able to act as a clearing committee--that is an objective, but well informed ( according to their different disciplines) body of people that guide, inform or enlighten the decision maker.
Often, if the person is in the care of the hospital, it is not even in the guardians hands. They may include the guardian in the decisionmaking process, but ultimately it is their decision whether to pull the plug or the feeding tube -unless of course the state is called into it by either party on the patients behalf.
I cannot at this time form an opinion about the right to die for others. Everyone approaches the end of life differently. Everyones definition of the quality of life is different. Everyone, even those in a vegetative state has a right to life, and the highest quality of life possible, but they also have the right to die, to choose death or to empower someone else to make the decision for them.
I do believe that no one should be forced to suffer mental or physical anguish just because the law or that particular hospitals policy is to extend life no matter what, or because a supposed 'loved one' is not able to let the person go.
I also believe that many of us at times are not fully prepared for death -ours or a love ones , nor is their an adequate worldview that brings death and its place in life into the picture, hence the huge dilemma.
The truth, in the end, is that we are only human. We can only see so far, and any decisions made will be human ones, questionable ones. The best we can do imo is get ourselves out of the way as much as possible and make the best and most humane decision for the person and be willing to live with that. Will it be the right decision? Who knows? God only knows.
Personally, I think that people should be allowed to choose whether to be kept alive with a feeding tube .. It is invasive and unnatural. I don't want one. Most creatures throughout creation die when they cannot eat or drink. I don't think that death is necessarily the worse thing that can happen to us, sometimes life is.
Same goes for a breathing machine--it is invasive, I suppose its good to give loved ones time to say goodbye or save organs to give life to another, but beyond that I think that this kind of technology violates the integrity of a person's body and soul.
Ethical decisions like this are like trying to untangle a snarled up ball of string. It must be approached with great care and patience, respect for life and death, and each piece ( and there is a complex web of issues to consider) carefully pulled into the light and given adequate consideration.
Its never going to be easy and I dont think that there is ever going to be one blanket right answer that covers every situation
I really am sensitive to what this family is feeling, it has made me think.
I would not like to be on life saving support, and i plan on having a living will. My oldest child is so upset about my choice she would want everything done and to prolong "death" in actuality for as long as possible.
she has a hard time discussing this with me she gets so upset. My son says he would do it hehe ( you got to know the boy) but I certainly would not want my children to have hurt or bitter feelings toward the situation amoung themselves. aslo my parents are aive what say would they have? I think they would also get sentimental about this and not do as I would chose.
it is tough a dear friend just pulled her husband off a respirator he lived for three or four hours... she is ok his very elderly parents were devastated he was their youngest child. But she knew his wishes and the hospital granted them because she was his wife. Im single so I guess I will have to go to a lawyer to write it out clearly for them so they would not fight or feel bitter about anything they would or would not do for me. tough tho.
An interesting story by a "vegetative state" survivor, Kate Adamson. She suffered a double brain stem stroke at the age of 33. Although she was totally unable to communicate with the world, her brain was fully functional.
Just some more food for thought.
The one question I would have on this issue is this: if the person's brain is functional (i.e., the person can perceive and can think), but unable to communicate in any fashion, what if the guardian, the hospital, or the courts guess wrong? What if that person hadn't given up the fight?
I will accept the implicit right of a person to end his or her own life. Not the right-ness, but the right. I will accept a person's right to decide what he or she would want in advance (in fact, I believe that everybody should make that decision so as not to put their relatives in a position). But if the person hasn't declared their wishes in advance, what gives us the right to play God? Because, as I asked earlier, what if we're wrong?
This case is really personal to me. I took care of Terri in a nursing home in the mid 90s. I was a nursing assistant. I can tell you that I saw her respond to stimuli. Not always, but enough that it sure seemed to me that she was in there somewhere, at least sometimes aware of what was going on around her. I worked there over two years and observed her daily even when I didn't personally take care of her. She loves oldies rock.
I've heard of two recent cases where people have awakened from 19 and 20 year comas. I just happened to hear of them on the news - I imagine if I studied the subject I would find lots more. What if Terri might wake five or so years from now?
Her parents and siblings are willing and able to tend to her.
But if the person hasn't declared their wishes in advance, what gives us the right to play God? Because, as I asked earlier, what if we're wrong?
There is a time to be born and a time to die.
It could be argued ( I won't get into it)that artificially prolonging life is also playing God and interrupting the natural forces and flow of life and death.
There are no easy answers, I don't know if we will ever know what is absolutely right or wrong in this lifetime, the best we can hope for is solutions that we can honestly and thoroughly accept, be willing to be responsible for and carry with us through the rest of our life and death.
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Zshot
If nothing else this draws attention to the importance of haveing a living will.
I am pretty sure what I would want done to/for me in that type of situation.
Here is an ugly question...
What if one our loved ones was in this condition and we had to make the decision, what would you do? Hopefully, we will never have to answer that question.
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Sunesis
I guess I'd think about it in this way.
Can they still live if all of the life support paraphenalia was gone? If they would die, then they are artificially being kept alive. In that case, make them comfortable, but let them go.
I hate the thought of starving this woman - it is barbaric. The feeding tube should stay. But I'd remove the other machinery keeping her going.
50-60 years ago, people died. It bothers me the medical profession keeping people alive and making billions off of it.
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excathedra
i remember when a couple had to let their infant go. the baby never ever would have had a "life" and was being kept "alive" artificially as you said, sunesis
the parents felt they were prolonging death, not life
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Steve!
And what about that case recently in the UK, where an abortion was performed on a baby that had a cleft palate?
The baby would have been born with a physical deformity, and potential handicap - but I know people with cleft palates, that doesn't stop them from living full lives.
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Abigail
tough tought questions and I am sure there is not one answer that can be applied to all situations.
I did face this situation with my mother when I was 21. It was horrible. We continued treatment and she recovered. She lived another year and a half before she died from something else.
My uncle, faced with the same situatin a couple of years later let my grandmother go. I have always been deeply angry with him for that. But that doesn't necessarily mean he made the wrong choice - just a different one from the one I would have made.
If it was one of my children, I think I would fight until the bitter end without letting go of hope. On the other hand, if I had a newborn who was in a situation like the one ExC described, I don't know if I would fight so hard. Why the difference? I don't know - perhaps emotions more than logic.
All of that being said - is it really living if you are in a vegetative state? Where and when does quality of life come into the picture? What about pain and pain management?
I know, by the time my mom did die, she was so sick it was relief to let her go - she was suffering even with the pain meds. She had no quality of life - bedridden and so drugged up she didn't know who anyone was or even where she was.
Do the mentally handicapped or those in a vegatative state understand that that is what they are? Are they happy? miserable? Would that make a difference?
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ChattyKathy
Thought provoking post Abi!
When my sister was near her death she told me that quality of life means more to you when you don't have it. I still can't fully realize that having not been thru it myself. But would I have been able to help her die had she asked? Nope!
That's what I have at the moment.
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coolchef1248 @adelphia.net
hopefully none of us will have to make that decision.
i made it easy for my wife i hope if there is little hope for quality of life do not hook me up to the machines! period
i think the medical profession has a lot to do with it they want the money. they can keep some people alive for years and collect big bucks compliments of me and you
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George Aar
I'm not sure about what kind of public policies should be made, just know what I'd want for me and mine.
Having just had a kinda big health scare last week, I've been thinking through this stuff again, and I still don't want to cling to life no matter what. I'm willing to let go, maybe sooner than a lot of folks. At least I think I would.
If I get to the point of having one of those "days of the week" type of pill dispensers, or have to drastically curtail my lifestyle due to inabilities, I'm all for taking active measures to bring the end on sooner. I can't imagine being bedridden as a lifestyle, for me or mine.
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mstar1
As usual Mark you aren't going to ask any easy questions. I am still thinking on the last one you asked me which has been about a month or so. This one is equally difficult and incredibly complex and not being studied up on medical ethics makes it all the more difficult.
I dont know if there is one right answer as to when, every case is different and has different contributing factors that should all be taken into account.
Many people have already considered the question, have filled out Living wills and have appointed someone power of attorney to make the decision on their behalf if they are not in position to do so. So in these cases, it would seem to me that the person with the power granted to them knows what the patients wishes are (they have already discussed it, and presumably trust is a part of their relationship) and can make a decision based on all the information given by the medical community with regard to prognosis and quality of life.
Of course nobody knows anything for sure--miracles happen;wrong diagnoses and prognoses happen...there are risks the person filling out the Living Will in the first place might have or must have considered and was willing to live with ( and die with).
The best the person given power of attorney can do is get as much information as possible and make the best decision based upon the patients wishes made clear at the signing of the documents. In these cases it is the role of the person who has the power of attorney to advocate as fiercely as possible for what the person wished with regard to the best treatment plan and/or decision to end the persons life... The person also has a responsibility to deal with his/her own relationship issues with the patient to be sure the decisions made are clear and right decisions for the person, and not extensions of ego needs.
I would think that when these moments of decision come these things would need to be sorted out, with a counsellor, clergy or someone who is trained to listen for whose needs are being met with any decision.
All this is to say, that accepting power of attorney on behalf of someone else or signing a Living Will is not a light or casual thing. It should be undertaken with great seriousness , deep reflection and emotional/spiritual maturity.
As for the other situations, there is no one right time. i would suggest that these decisions are best made after a circle of people can be brought together as an Ethics Committee, which most hospitals have, to consider the specific situation. This committee, usually including medical professionals, psychologists, clergy. lawyers, social workers, etc. is able to act as a clearing committee--that is an objective, but well informed ( according to their different disciplines) body of people that guide, inform or enlighten the decision maker.
Often, if the person is in the care of the hospital, it is not even in the guardians hands. They may include the guardian in the decisionmaking process, but ultimately it is their decision whether to pull the plug or the feeding tube -unless of course the state is called into it by either party on the patients behalf.
I cannot at this time form an opinion about the right to die for others. Everyone approaches the end of life differently. Everyones definition of the quality of life is different. Everyone, even those in a vegetative state has a right to life, and the highest quality of life possible, but they also have the right to die, to choose death or to empower someone else to make the decision for them.
I do believe that no one should be forced to suffer mental or physical anguish just because the law or that particular hospitals policy is to extend life no matter what, or because a supposed 'loved one' is not able to let the person go.
I also believe that many of us at times are not fully prepared for death -ours or a love ones , nor is their an adequate worldview that brings death and its place in life into the picture, hence the huge dilemma.
The truth, in the end, is that we are only human. We can only see so far, and any decisions made will be human ones, questionable ones. The best we can do imo is get ourselves out of the way as much as possible and make the best and most humane decision for the person and be willing to live with that. Will it be the right decision? Who knows? God only knows.
Personally, I think that people should be allowed to choose whether to be kept alive with a feeding tube .. It is invasive and unnatural. I don't want one. Most creatures throughout creation die when they cannot eat or drink. I don't think that death is necessarily the worse thing that can happen to us, sometimes life is.
Same goes for a breathing machine--it is invasive, I suppose its good to give loved ones time to say goodbye or save organs to give life to another, but beyond that I think that this kind of technology violates the integrity of a person's body and soul.
Ethical decisions like this are like trying to untangle a snarled up ball of string. It must be approached with great care and patience, respect for life and death, and each piece ( and there is a complex web of issues to consider) carefully pulled into the light and given adequate consideration.
Its never going to be easy and I dont think that there is ever going to be one blanket right answer that covers every situation
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Sunesis
Ex Cath, I really like your comment - prolonging death. I hadn't thought of it in that light before, but it makes sense.
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mj412
I really am sensitive to what this family is feeling, it has made me think.
I would not like to be on life saving support, and i plan on having a living will. My oldest child is so upset about my choice she would want everything done and to prolong "death" in actuality for as long as possible.
she has a hard time discussing this with me she gets so upset. My son says he would do it hehe ( you got to know the boy) but I certainly would not want my children to have hurt or bitter feelings toward the situation amoung themselves. aslo my parents are aive what say would they have? I think they would also get sentimental about this and not do as I would chose.
it is tough a dear friend just pulled her husband off a respirator he lived for three or four hours... she is ok his very elderly parents were devastated he was their youngest child. But she knew his wishes and the hospital granted them because she was his wife. Im single so I guess I will have to go to a lawyer to write it out clearly for them so they would not fight or feel bitter about anything they would or would not do for me. tough tho.
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markomalley
Well, I appreciate all the feedback on this admittedly difficult situation.
Here are some cases to consider:
Tanya Liu, diagnosed as brain dead from May, 2002, to March, 2004
An interesting story by a "vegetative state" survivor, Kate Adamson. She suffered a double brain stem stroke at the age of 33. Although she was totally unable to communicate with the world, her brain was fully functional.
Just some more food for thought.
The one question I would have on this issue is this: if the person's brain is functional (i.e., the person can perceive and can think), but unable to communicate in any fashion, what if the guardian, the hospital, or the courts guess wrong? What if that person hadn't given up the fight?
I will accept the implicit right of a person to end his or her own life. Not the right-ness, but the right. I will accept a person's right to decide what he or she would want in advance (in fact, I believe that everybody should make that decision so as not to put their relatives in a position). But if the person hasn't declared their wishes in advance, what gives us the right to play God? Because, as I asked earlier, what if we're wrong?
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bowtwi
This case is really personal to me. I took care of Terri in a nursing home in the mid 90s. I was a nursing assistant. I can tell you that I saw her respond to stimuli. Not always, but enough that it sure seemed to me that she was in there somewhere, at least sometimes aware of what was going on around her. I worked there over two years and observed her daily even when I didn't personally take care of her. She loves oldies rock.
I've heard of two recent cases where people have awakened from 19 and 20 year comas. I just happened to hear of them on the news - I imagine if I studied the subject I would find lots more. What if Terri might wake five or so years from now?
Her parents and siblings are willing and able to tend to her.
I pray she wakes up before she starves to death.
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mstar1
There is a time to be born and a time to die.
It could be argued ( I won't get into it)that artificially prolonging life is also playing God and interrupting the natural forces and flow of life and death.
There are no easy answers, I don't know if we will ever know what is absolutely right or wrong in this lifetime, the best we can hope for is solutions that we can honestly and thoroughly accept, be willing to be responsible for and carry with us through the rest of our life and death.
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