Dying with dignity

[flowerseverywhere]

Some states have dying with dignity laws. It enables people who are on hospice or with certain diagnosis to work with their treating physicians. They prescribe medication which enables the patient to choose when to end their lives. These are generally people with end stage cancer or typed of diagnoses for there is no known cure. You have to live in the state. The physicians who participate do so voluntarily.
There are some people trying to expand the legislation to their own states, including mine.
So I’ve informally asked some people what they thought. Two said they are Christian and no matter what the suffering for the patient or family they oppose any such law permitting it. An ICU nurse and a friend who volunteers in hospice both emphatically say yes.
If you live in a state where it is legal, have you any experience with it? I am heavily leaning towards yes because you don’t have to do it and if you do choose to, it is between you and you god in whatever form you believe. Plus no physician is required to take part.

[iris lilies]

Yes, I have lots of experience with it: in family pets.

I do not understand why pet parents allow their pets to suffer through to the bitter end, assuming the parents understand the pet’s health problem. I have been in several positions where I didn’t see how close my dogs or cats were to dying. I have learned since that if it’s a bulldog who looks like he’s done, he’s very close to death. I don’t like to see them get that close to death.
Because I don’t really know what kind of paying they’re having.

That is not so true with cats, they hide their illness very well.

Thinking of the 4 parent deaths we’ve had, all 4 were not capable of making an informed decision about pulling the plug on their lives at the end. But to be fair, 2 of them were unconscious due to heart attacks, and were on machines for a short while until family members pulled the plug.

I don’t know that there is really a big demand for this. I think proponents of these laws believe there’s a bigger interest than there really is. But that said, sure, send whatever legislation through that supports suicide options for the terminally ill. This might include chronically depressed people, you know. I’m also not sure that it’s always gentle because killing the living organism can be violent.

[GeorgeParker]

Two said they are Christian and no matter what the suffering for the patient or family they oppose any such law permitting it.That's the big problem with a lot of legislation -- People who want to pass or block laws so they can impose their religious beliefs on everybody else. >:( It's true for same-gender marriage, and for anything else related to LBGTQ+, and for removing books/movies from libraries, and for people who want to ban wearing a swimsuit if you're more than 100 feet from the beach, and for abortion restrictions that go too far, and for "death with dignity" laws.

There are pros and cons to allowing assisted suicide that have nothing to do with religion. The main one is the possibility that the person who is near death might be tricked or coerced into assisted suicide by relatives who want to avoid end-of-life medical expenses and increase their inheritance by having the person die quickly. So there need to be safeguards in place to protect against that. But for people to say "No one can ever be allowed to do this because my religion forbids it" is just plain wrong and evil.

[pinkytoe]

Colorado passed it in 2016 I believe. They also have an end-of life program called Five Wishes which many states now have.

[iris lilies]

https://deathwithdignity.org/news/2020/03/2019-report-on-oregon-death-with-dignity-act/

This recent summary of the 23 year old Oregon law show it is seldom used. An average of 50 people a year take the ending-life medication. Interestingly, nearly half get the meds but don’t take them.

I wonder if it is difficult to find physicians to prescribe these medications. Kinda like abortion, it can be legal, but finding a physician to perform an abortion is not straightforward. Of ourse we could always legislate that physicians are required to do work they consider against their principles and oath to serve.

[GeorgeParker]

If I had my druthers, my preferred way of dying would be to strap an oxygen mask on my face and connect it to carbon dioxide. Odorless, colorless, tasteless. To your body it feels like you're just breathing normal air, but because you don't get any oxygen from it you quickly get sleepy, pass out, and eventually die. That sounds to me like it's probably the most peaceful way to die. But it probably isn't one of the legally approved death-with-dignity options, simply because no one thought to include it.

[GeorgeParker]

Apropos this thread:

Being mortal : medicine and what matters in the end by Atul Gawande <<----( I love this author! )
Summary: Medicine has triumphed in modern times, transforming birth, injury, and infectious disease from harrowing to manageable. But in the inevitable condition of aging and death, the goals of medicine seem too frequently to run counter to the interest of the human spirit. Nursing homes, preoccupied with safety, pin patients into railed beds and wheelchairs. Hospitals isolate the dying, checking for vital signs long after the goals of cure have become moot. Doctors, committed to extending life, continue to carry out devastating procedures that in the end extend suffering. Gawande, a practicing surgeon, addresses his profession's ultimate limitation, arguing that quality of life is the desired goal for patients and families. Gawande offers examples of freer, more socially fulfilling models for assisting the infirm and dependent elderly, and he explores the varieties of hospice care to demonstrate that a person's last weeks or months may be rich and dignified.

[jp1]

If I recall correctly wasn’t CO one of the methods Kervorkoan used?

[dado potato]

New York Times 9/12/21 edition had a front page investigative report on the use of antipsychotic drugs by nursing homes. Due to staffing shortages, nursing homes have a tendency to medicate residents with drugs which make them lethargic - to sleep all the time. I have to question the ethics of the MDs who diagnose the aged with schizophrenia, but of course there has to be a prescription for the drugs. The medicated patients slowly starve to death.

With the possible exception of a Green House for elders (with shahbazim), I would not expect dying with dignity in a nursing home. By the way, Atul Gawande said good things about the Green House Project.

[GeorgeParker]

If I recall correctly wasn’t CO one of the methods Kervorkoan used?CO is carbon monoxide. CO2 is carbon dioxide. It was carbon monoxide that Kevorkian used, Carbon dioxide is easily and legally obtained in pure compressed form, whereas carbon monoxide probably isn't. In 2011 someone died in a McDonalds restroom because of a carbon dioxide leak. https://www.reuters.com/article/us-mcdonalds-death/carbon-dioxide-leak-blamed-for-death-at-mcdonalds-in-georgia-idUSTRE78D7U120110914

[GeorgeParker]

Atul Gawande <<----( I love this author! )And this is as good a place as any to put in a plug for The Checklist Manifesto.

Review: http://atulgawande.com/book/the-checklist-manifesto/


"Atul Gawande has made a name for himself as a writer of exquisitely crafted meditations on the problems and challenges of modern medicine. His latest book, The Checklist Manifesto, begins on familiar ground, with his experiences as a surgeon. But before long it becomes clear that he is really interested in a problem that afflicts virtually every aspect of the modern world–and that is how professionals deal with the increasing complexity of their responsibilities."




(http://atulgawande.com/book/the-checklist-manifesto/)

[catherine]

And this is as good a place as any to put in a plug for The Checklist Manifesto.

Review: http://atulgawande.com/book/the-checklist-manifesto/


"Atul Gawande has made a name for himself as a writer of exquisitely crafted meditations on the problems and challenges of modern medicine. His latest book, The Checklist Manifesto, begins on familiar ground, with his experiences as a surgeon. But before long it becomes clear that he is really interested in a problem that afflicts virtually every aspect of the modern world–and that is how professionals deal with the increasing complexity of their responsibilities."




(http://atulgawande.com/book/the-checklist-manifesto/)

Yes, good book. Can't say I read the whole thing, but it's required reading for my Optimize program, which provides summaries, via pdf, video, mp3s of tons of great books.

Reminds me of a recent article I read about Matt Amodio, the emerging Jeopardy champion, who annoys people by framing his questions as "What's...." intead of "What is" or "Who is". He is in AI at Yale and he said that he does that because not having to think about specific ways of framing questions when answering clears your mind for more productive tasks, like thinking of the answer.

A checklist is like that.

[Gardnr]

Some states have dying with dignity laws. It enables people who are on hospice or with certain diagnosis to work with their treating physicians. They prescribe medication which enables the patient to choose when to end their lives. These are generally people with end stage cancer or typed of diagnoses for there is no known cure. You have to live in the state. The physicians who participate do so voluntarily.
There are some people trying to expand the legislation to their own states, including mine.
So I’ve informally asked some people what they thought. Two said they are Christian and no matter what the suffering for the patient or family they oppose any such law permitting it. An ICU nurse and a friend who volunteers in hospice both emphatically say yes.
If you live in a state where it is legal, have you any experience with it? I am heavily leaning towards yes because you don’t have to do it and if you do choose to, it is between you and you god in whatever form you believe. Plus no physician is required to take part.

This began in the Netherlands, from where we immigrated. Dad always thought it was wrong......until he was dying of lung cancer. About 6w prior to his death he said (to me when we were alone) "maybe that's not such a bad idea".

There is an extensive work-up process. The "tools" are provided. The patient has absolute control as they MUST administer the cocktails and meds to themselves-many people wait too long and then have regrets. I suppose others have family who will administer and just not say so.

I believe Oregon was the first state to legislate this.

RN in full support. I know people have moved to OR for this very reason.

[herbgeek]

I would support this, after watching my dad die of lung cancer last year. When it got to the point where he needed morphine for his pain, he asked my sister to give him the entire bottle and be done with it. He was in hospice care, and the hospice nurse had the medications shipped to us to manage pain/discomfort/disorientation. She didn't (because its illegal) and we got to watch my dad suffer to the end and not be able to breathe.

[Gardnr]

I would support this, after watching my dad die of lung cancer last year. When it got to the point where he needed morphine for his pain, he asked my sister to give him the entire bottle and be done with it. He was in hospice care, and the hospice nurse had the medications shipped to us to manage pain/discomfort/disorientation. She didn't (because its illegal) and we got to watch my dad suffer to the end and not be able to breathe.

I'm so sorry Herb.

I've seen a lot of people die in my career. Dad's 4 month progression to death from lung cancer was the worst! And he stated to me he knew it was going to feel like he was slowly drowning without relief. (An accurate description of blebs slowly filling up).

[herbgeek]

Thank you Gardnr. It was awful to witness.

[iris lilies]

I think death by lung cancer is a pretty awful way to go.


Knowing what we all know, did you all consider moving the patient to a “death with dignity” state?

According to this article there are ten.

https://deathwithdignity.org/learn/death-with-dignity-acts/

[Gardnr]

I think death by lung cancer is a pretty awful way to go.


Knowing what we all know, did you all consider moving the patient to a “death with dignity” state?

According to this article there are ten.

https://deathwithdignity.org/learn/death-with-dignity-acts/

Did you read up on the process?

It is neither quick nor easy. Dad only lived 4 months.