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A Senior Care Taboo: Hastening Dying

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Compassion & Choices

I am a big fan of Terry Gross, the host of NPR’s Fresh Air.  Recently she interviewed Judith Schwartz,  Coordinator for  Compassion & Choices, a non-profit based in Denver.  Ms Schwartz describes Compassion & Choices as an organization that “meets people where they are, and without judgement, listens to them, hearing what it is they want for themselves as their end-of-life nears.”

Compassion & Choices supports the right to die but does not work outside the law.   Rather, it gives people information to evaluate and self-determine the choices they do have when they know they are dying.

Hospice Not for Everyone

Day Hospice

(Photo credit: Wikipedia)

Hospice is a wonderful program that has helped both the living and dying through the end-of-life process.  Editors Note: Both of my parents died peacefully in their own beds under the compassionate and supportive care of hospice. 

Hospice focuses on helping a dying patient continue living with best quality of life.  It neither hastens nor prolongs dying, but everything possible is done to help manage the physical and emotional symptoms. One of the great gifts of hospice is palliative care which delivers medication to relieve the physical pain of the dying.

Assisted Suicide (Euthanasia)

Map of the United States highlighting states a...

States with legalized physician-assisted suicide. (Photo credit: Wikipedia)

The Merriam-Webster Dictionary defines “assisted suicide” as suicide committed by someone with the assistance from of another person.  Assisted suicide is legal in three states–Oregon, Montana, and Washington.

Judith Schwarz adamantly rejects euthanasia and believes no one has the right to take away a life. She is an advocate for the end of suffering and  believes each person should be able to decide when managing symptoms is not enough.

Aid in Dying

Aid in Dying is different from for Assisted Suicide. The diagnosis of terminal illness means the patient is expected to die within next six month to a year.  When someone is on a dying trajectory, sometimes the only choice they have is determining the circumstances of their death.

To take the final step to cause one’s own death is hard.  Most people don’t take it.  Many inquire because they want to know they have some choices and control. Some fear their suffering will get worse or that they will end up in the hospital.  Patients discuss their options, choices, and decisions openly with their families.  Compassion & Choices helps family members effectively advocate.

To be eligible for Aid in Dying the person must be terminally and mentally capable of making decisions.  Some of the characteristics of people who request Aid in Dying are as follows:

  • Patients know a lot about what lies ahead.
  • They are well-informed consumers of healthcare.
  • They have good relationships with healthcare providers.
  • The have a long history of surgeries, therapies, and emergency room visits.
  • They are tired of the burdens imposed by their disease.
  • They are often at the end of the course of treatment.  There is nothing more to be offered.
  • They don’t want to experience the end stages of their disease.
  • They are terminally ill and fear the end.

Legal Options to Hasten Dying

There are a variety of choices for a successful (peaceful) death.  The following are all legal options.

  • You have the right to stop any life prolonging intervention.
  • You can request that any cardiac devices be turned off.
  • You can stop taking your medications.
  • You can stop eating and drinking.
  • You can overdose by accumulating medication (usually barbiturates), but you must be able to fill the prescription yourself and self administer.

No one makes the choice unless burdens of living have outlasted all benefit.

Role of DNR

Sample Virginia Durable Do Not Resuscitate Ord...

Sample Virginia Durable Do Not Resuscitate Order (Photo credit: Wikipedia)

It is important to tell your family what you are thinking and your wishes for end of life–as your thinking changes.  Only 25% of people have a DNR (Do Not Resuscitate order). This is a one page document which states your wishes to not be resuscitated under certain circumstances.

Make sure you have a DNR visible while you are in the hospital.  If the DNR is not visible, the EMTs are required to resuscitate the patient. You also need an Out-Of-Hospital DNR.  Keep it close by.  Your appointed healthcare agent should have a copy.  Your agent has the right to stop or withdraw treatments that have been started, if that is your wish.

Dying with Dignity

Patients wish to be treated with dignity.  Death is not the worst thing for some; prolonged dying is.  We don’t know what we will want until we have lived it.

Life precious. People change their minds.  Sometimes just having the option to opt out is enough to keep us living another day.

English: Sunset at Porto Covo, west coast of P...

(Photo credit: Wikipedia)

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