Wednesday, May 8, 2013

Unrealistic Views about Death

I read an interesting op-ed from the Washington Post yesterday. It was written by a doctor talking about our unrealistic view of death.

In part, she bought into Elizabeth Kubler-Ross' myth that there once was a day when we weren't afraid of death, a day that never existed. But overall, I think that her words are well worth noting:

For all its technological sophistication and hefty price tag, modern medicine may be doing more to complicate the end of life than to prolong or improve it.

Sequestering our elderly keeps most of us from knowing what it’s like to grow old.

This physical and emotional distance becomes obvious as we make decisions that accompany life’s end. Suffering is like a fire: Those who sit closest feel the most heat; a picture of a fire gives off no warmth. That’s why it’s typically the son or daughter who has been physically closest to an elderly parent’s pain who is the most willing to let go.

I have long noted how we seem to move our dying out into the nursing homes on the edge of town. I like her analogy, that "suffering is like a flame." Looking back at my years working in the nursing homes, I see how the family who had visited the resident every week are more willing to let go than the family that is flying in to make the final decisions. We cannot let our own fear of death cloud our judgment in caring for our dying loved ones. Even the Church says there is a time when people can be let go.

Directive 57 of the Ethical Directives for Catholic Health Care states:

A person may forgo extraordinary or disproportionate means of preserving life. Disproportionate means are those that in the patient's judgment do not offer a reasonable hope of benefit or entail an excessive burden, or impose excessive expense on the family or the community.

And you cannot make blanket statements in regards to what constitutes extraordinary treatment. An example used in my ethics class once: A dying woman is ballooning up and her skin is cracked and weeping because her body no longer processes fluids correctly. In a case like that, it is not unreasonable to forego IV fluids.

Death is inevitable. Doctors can do a lot to postpone it, but they cannot prevent it. Sometimes it's just time to let someone go.


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