Thursday, April 16, 2015

When opposition to life-prolonging treatment changes

"The time had come to clarify what types of interventions my father wanted. I knew what I hoped to hear. Not only did I know his opinions about inappropriate treatment, but he had written some notes when he began to seriously deteriorate. He said that he was 'taking steps to ease my passage.' Some with his condition, he added, 'have taken drugs.' Regarding his wife — my mother — he wrote that she 'doesn’t deserve to struggle with me anymore.'
But when I asked what he wanted, these notions had disappeared. He said he would be willing to go to the hospital if he got sicker and even go on a ventilator. 'Sometimes they can really help,' he said.
I tried a different tack. 'Are you content,' I asked, 'living in a nursing home, being confined to a wheelchair and sleeping most of the time?'
The man who had dreaded ever winding up this way answered, 'Yes.'...
In my father’s case, however, I simply could not throw his previously stated wishes out the window. Ultimately, my mother, sister and I concluded that it was impossible to advocate such specific choices so fervently in one’s lifetime without their being a part of one’s permanent makeup — even if they could no longer be articulated. I realized that other families, in similar situations, might choose the opposite strategy.
We did not tell my father we were overruling him but rather quietly put him into the nursing home’s hospice program in early 2012. Many months later, he caught an infection — one that was probably treatable. Instead, the staff gave him morphine to ease his discomfort. Within 24 hours, he had died."

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