Well, well. I see 12thMonkey is busy dispensing the world and the word according to 12M.

I’ll give you my answer to your question for Toliver – how is it any of your, or my, or anybody not a close relative’s damned business, as it isn’t our personal decision?

Feel free to state that it is not a path or option you, at present, would not choose to pursue or exercise, but the crux of the matter here is the ability of others to dictate the answers to such questions.

And yes, for the record, I’ve been through situations where the topic was not too far off from open discussion, and I find that prolonging someone’s inevitable suffering (oh, and feel free to take all the ‘news’ about sedation or pain management strategies, and insert them in the personal orifice of choice, sideways, if you’ve never actually dealt with them personally or at the side of a loved one in agony) to be one of the most barbaric, ignorant, superstitious, and inhumane by-products of ‘civilization’ so far invented.

I’ve got a close friend who is in charge of nursing staff at a local terminal care facility. The stories she related when we discussed the topic were absolutely bizarre – the lengths that some people are willing to put their loved ones, usually either completely catatonic and rapidly fading, or only kept near the edges of lucidity by enormous, unstoppable pain and discomfort, through just to be able to tell themselves that ‘nanna’ or ‘gramps’ or whoever is still with them for a bit longer – the utter selfishness described makes Terry Schiavo’s parents almost look like semi-interested bystanders.

All the hand-wringing about people having a bad day offing themselves suddenly becoming a national, self induced holocaust are delusional fantasy, at best – why? Because even if the laws, and societal norms are adjusted, responsible and dedicated medical professionals are hardly going to shrug and hand out death dealing prescriptions because of unsightly water weight gain, or, as in your example, for simple paraplegia. Oh, and the folks that are beyond or not under medical care (and even a few how are) are going to try and take matters into their own hands, just as they do today, and probably at not much, if any, greater rates than today.

Yes, while there may be the establishment of facilities such as Dignitas following a legal change and modification of societal norms (something which I realize a lot of social cons can never see as anything but a BAD thing), the biggest impact will be in existing facilities – where physicians and families will no longer be forced to avoid what may, circumstantially, actually be the best course of treatment, and is something everyone agrees is the best course of treatment – quite frankly, to stop the suffering, in the only manner available. To imagine that it’s going to become a standard option at the local “Doc in a Box” primary care facility is being a bit hysterical.

Hell, it’s something we can do for the family dog, but not for a member of the family, even is EVERYBODY is in agreement it’s the best thing to do.And if the patient, the family, and the physician(s) all agree, then what business is it of anyone else?

None.

Wind Rider on December 11, 2008 at 11:51 PM

12M – yes, how dare you post your opinion on a blog discussion board! The sheer GALL of it! heh.

Ok, re-read some of your examples – and, ya know what – interesting that your reach a comprehensive enough conclusion on the cases you cite, given only a cursory presentation of the situations, and, I’m presuming, only a lay understanding of medicine from you perspective.

Regardless, I still maintain the position that it is, and should be, a private decision, between patient, family, and physician(s) – and as long as none of us are none of those, well, I feel just as strongly that no one else should have any right to interfere in that decision. Agree with it, pity it, loathe it, feel free – but do it from the sidelines.

One thing that would short-circuit a lot of the hypothetical scenario generation is a statement of intents and wishes, a form of living will. Ensuring that your family COMPLETELY understand what your wishes are. So there is no question, or second guessing, or making things up as it goes along.

If you want to be sustained for every excruciating second made possible by the bleeding edge of human medical technology, wether it’s because you’re afraid of dying, or you firmly believe it to be God’s will, so be it.

On the other hand, if you’re interested in getting on with discovering what is on the other side, cause this side holds nothing but pain and misery for you and your family, you should be able to do that, as well.

Afraid of abuses? Incorporate transparency into whatever procedures are allowed, with requirements for second or third party independent professional concurrence on a patient’s untreatable, terminal status (i.e. a physician or physicians totally unconnected to the case).

On a tangent, it often strikes me as somewhat schizophrenic, the Christian Conservative positions on life and death. While they deride and cluck at Obama (who I voted against fwiw) for openly saying that some of the questions involved are ‘above his pay grade’ as far as the moral and theological aspects go, they will, in a heartbeat, say exactly the same thing, basically, as their reasoning for opposing any sort of intervention whatsoever, in either beginning or end of life issues.

But back on topic – does anyone out there really want little Suzi 16 year old to get a check out pill cause Billy the Football Star dumped her before prom? Er…no. Can we allow families and physicians to make unmolested decisions and choices, without the world turning into some sort of Logan’s Run scenario where everyone is euthanized (or just plain killed) at 30 something?

I think so.

If we can put a man on the moon, and we can do it for the family dog, why can’t we get from point A to point B on saving Grandma 3 months of the final ravages of untreatable cancer, if that is what she wants?

Beuhler?

Wind Rider on December 12, 2008 at 12:52 AM

12M – the example of your grandfather is noted – and I wonder if it is possible that a lot of the discussions you reference weren’t of a contingency type nature – the doctors telling him the worst case scenario, to prepare him IF things didn’t go well with the course of treatment. And his discussion with his wife – was it contingent upon a turn for the worse, or just the possibility? I wonder about that.

The key is that there was apparently still hope, for apparently good reason. As such, it isn’t really the scenario I’m thinking of. I’m thinking of a patient, who after feeling out of sorts for months, and several unsuccesful biopsies, is finally diagnosed with advanced stage liver cancer, which would shortly metastasize throughout his body, and had already weakened him to the point that once the experimental nuclear medicine techniques were attempted, unsuccessfully, he was too weak to be a viable liver transplant candidate. Who, for 5 agonizing months, lost almost 65% of his pre-illness body mass, and was covered with unhealed sores all over his skin, which was severely jaundiced in appearance and almost paper brittle the last month. An early exit was not discussed, beyond his explicit instructions that was not what he desired, due to his religious convictions, and that is what the family abided by. If he had wished it, there was an ample supply of morphine, in various forms, on hand, and his wife, a registered nurse, was fully aware of how to dispense it to do the job, if he’d wanted.

Now here’s the point, and why I’m so disgusted with people who believe they have the right to dictate to either him, or his wife, or me, his son, that IF he had asked for us to help him on his way, that the answer MUST be . . . no.

Until they lie in a bed the way he did, experiencing the pain he felt to the end, even through a morphine induced haze, or sit at the foot of that bed, helpless, feeling the last pulse beat of a dying heart at the end of an emotionally, financially, and frankly soul-draining experience, well, then excuse my french, but they can just pucker up and kiss my ass and then sing hallelujah for all I care, because if they’re simply talking the talk, without having walked the walk, they’re not much more than pretentious prigs in my book.

Wind Rider on December 12, 2008 at 1:17 AM