I just want to make some remarks so that people understand there is a difference between euthanasia and sedation.
When my husband died of cancer at home, his pain level was very very high, and over the previous month, his body had become accustomed to high levels of morphine and other pain relievers. I want to point out that he was still walking to the bathroom, with my son’s help, the day that he died, so he was not “overly” medicated.
He was unable to take any fluids or food, and he had torn out his PIC line by himself, and refused to have it reconnected, so he could not be given any fluids. His body was shutting down, he was dying, he was aware, he was still whispering to us, and the morphine did not completely relieve his pain, no matter how much he was given.
He was given palliative care to the best of medicine’s ability to do so even at the end. He received the last rites that last day, but could not take the host; he was able to respond to our priest, his friend. Nothing was withheld, he was simply unable to take anything and became uncomfortable when the fluids he had been given in the PIC line just accumulated and did not hydrate him. He was conscious until about the last hour.
People who have relatives dying on hospice should not fear genuine palliative care—not everyone is aware the last several days, and some final comas last several days to a week before the body completely shuts down and dies. People often refuse — as opposed to having withheld — food and water when they are dying. You cannot force a dying person to eat, and often fluids simply stay in the location of the IV or PIC and do not circulate.
My father, when he died, was in a coma for a day before his death. He was in the hospital in ICU so he received every kind of care that could be given. It didn’t make any difference, except that he had a lot more pain than my husband did, and was very clearly unhappy about it.
When my mother died of cancer 35 years ago, she was in a coma for a week before she died. Her death was peaceful, but she had it in her stomach, so there was no question of her getting anything by mouth. Her IV infiltrated, and was not able to be started again due to her extreme weight loss from the disease, and she did not indicate discomfort in any way, just was “asleep” and barely breathing for a week.
People die in different ways. Moistening the lips, using IVs or PIC lines when they function are fine, pain relief is mandatory in my nursing experience, and people should not fear that they are “hastening” a loved one’s death by giving all that is necessary for the dignity of the dying person.
I say all this to say that death varies from person to person, depending on the cause, and that people who are dying often refuse what they genuinely do not want. Deep sedation, and withholding of food and fluids are both wrong, but at the very end, the doctor and other caregivers must accept the inevitable and do what is most comfortable for the dying person.
I’m not re-reading this before I post, so I hope there are no errors. If so, oh well. Death comes to us all. Sometimes, pain relief, like morphine, can shorten someone’s life beyond what medical science could sustain. When there is no use in doing that, then pain relief should take precedence, in my humble opinion.
Thank you for your thoughtful post. Very true.
As the author of this commentary noted, I recognize the difference between deep sedation and euthanasia. I too believe that sedation is a very humane and effective method to treat intense pain. However, when sedation is used as a means to starve and dehydrate the patient it is wrong and that is what the author was warning against.
No errors, just a truckload of sense and compassion. God bless!
Thank you. This issue is too deeply personal for it to be a political issue.
I would also prefer my pain alleviated, even if it risks shortening my life. If I had reason to want to be awake (to visit with someone, say things needing to be said) and was willing to deal with the pain, then that's cool too.
But how sad it would be to deny pain relief for a dying person solely in order to make sure you aren't risking their life. What kind of life is that??
A voice of reason. Good post.
I agree with everything you wrote.In my sister’s case she wanted to be resuscitated so they could not begin hospice.I was asked many times to override her decision and get Power of Attorney to begin hospice but she had no pain.She did have some discomfort and she was given something for it.I was condemned by some people because of this.She was aware till the end and she did ask for help for pain.By then we had Power of Attorney and started hospice 8 hours before her death.She stopped eating on her own and her body could not handle any food or liquid.At the end she could barely talk but she put her hands together in prayer.We prayed till we were hoarse because she would know when we stopped.This was about 8 weeks ago.