Posted on 12/29/2009 9:35:32 PM PST by malkee
In some of the rooms in the hospice unit at Franklin Hospital, in Valley Stream on Long Island, the patients were sleeping because their organs were shutting down, the natural process of death by disease. But at least one patient had been rendered unconscious by strong drugs.
The patient, Leo Oltzik, an 88-year-old man with dementia, congestive heart failure and kidney problems, was brought from home by his wife and son, who were distressed to see him agitated, jumping out of bed and ripping off his clothes. Now he was sleeping soundly with his mouth wide open.
“Obviously, he’s much different than he was when he came in,” Dr. Edward Halbridge, the hospice medical director, told Mr. Oltzik’s wife. “He’s calm, he’s quiet.”
Mr. Oltzik’s life would end not with a bang, but with the drip, drip, drip of an IV drug that put him into a slumber from which he would never awaken. That drug, lorazepam, is a strong sedative. Mr. Oltzik was also receiving morphine, to kill pain. This combination can slow breathing and heart rate, and may make it impossible for the patient to eat or drink. In so doing, it can hasten death.
(Excerpt) Read more at nytimes.com ...
In my family, at least with my father, we took a vote. I lost.
“It is certainly wise to think through what you would wish for if suffering from a terminal disease, well ahead... “
I concur. I will make sure to do that. And to extract those decisions from my parents and my wife, at least.
Thank you for that explanation.
My opinion is that if the patient is unbearable pain, then he should be given an appropriate amount of morphine. Morphine should never be overdosed to hasten death, but if the patient is in so much pain that the appropriate amount of morphine to help with the pain could be dangerous, then you take that chance. But purposely euthanizing a human being is wrong.
Exactly ...
The purpose of hospice care is to make the patient as comfortable as possible, period. They do nothing to treat disease or prolong life; their only mission is to make death as painless as possible. Addiction is obviously not a concern, and neither is overdose; If the dose of morphine or other drugs required to reduce pain is also a fatal dose, so be it.
There are a lot of different hospice providers, and their policies vary. Physicians usually do turn over the primary responsibility to the hospice, because they have a different set of priorities; the mandate to “first, do no harm” makes some uncomfortable with palliative care that may hasten death.
“But purposely euthanizing a human being is wrong.”
Again, not being disrepectful for your opinion, but if it’s ok for the family pet to be relieved of their end game pain, maybe I want that option too. My Grandfather recently passed and he was begging the family to let him go, it was time. 20 years of parkinson’s might convince all of us. The big secret is that hospice allows for this by skipping the death inquiry.
My heart is broken for you. I can already promise that I will be a mess when my father dies. I don’t know what to say, but to ask the LORD to comfort you and mend the relationships that may have been damaged by this disagreement. I’ll pray.
Thank you, and you will get through it. I also thought I couldn’t handle it, but did. Now I am worried about the death of my mother, who is 83. God willing, we will all get through that, when the time comes. I’d appreciate a prayer in that direction.
If you'll let my cat vote, I'll let you visit my vet for "the shot." OK?
I agree that the patient needs to make their wishes clear *before* the end comes.
But I disagree with so many here that this is a cruel practice.
My grandfather died of pancreatic cancer about 7 years ago.
He was in total *agony*, yet was denied pain medicine because “he might become addicted” and “it could be bad for him”.
For the love of all that’s holy - the man was terminal. He was in his mid-80’s and there was absolutely NO hope of him pulling through. Yet he had to suffer in screaming pain for *WEEKS*.
I’ve let my family know my wishes. If I’m terminal and in pain - drug me to the moon and beyond. If the pain meds hasten my death - don’t sweat it.
I will NOT go out like grandpa did.
Heck, I wouldn’t let my *dog* suffer like my grandpa did.
I agree with you that people need to make their wishes known and document them long before there is need for it.
You are incorrect to associate a dosage of morphine with induced death. Morphine is an appropriate medical choice for those in sever pain. You do not say what the underlying diseases were that your father and uncle suffered from. To blame pain killers just says that you ae still angry at their deaths and have not come to terms with the mortality of us all. Often family members want to blame the medical personal or the mdeicine given when that is not the cause.
And what you have described is NOT from the morphine but rather from the death process. As with the originator my question to you is what was the underlying disease from which you father suffered?
Unless of course she was suffering from lung cancer or some other from of cancer that was very advanced. See to make blanket statements about what is and is not proper care depends upon the underlying condition
“my cat vote”
LOL! Acorn counted red neck’s cat vote on killin conservative. 1 million votes to kill him right away, 1 vote to kill him slow.
And now a video of the kitty in question.
http://www.youtube.com/watch?v=z9Zppcjecww&feature=related
“if it’s ok for the family pet to be relieved of their end game pain, maybe I want that option too.”
You are not an animal. An animal is just a body. You are a soul who temporarily inhabits a body. It matters.
Besides, there is a difference between managing pain and killing with an excessive dose of painkillers.
“My Grandfather recently passed and he was begging the family to let him go”
There is a clear difference between letting somebody go, which is what people did before modern medicine, and administering a lethal dose of drugs. Or worse, withholding food and water.
“20 years of parkinson’s might convince all of us.”
To let go, yes, while pain is managed.
My mother died in great pain in 1968. The doctor told me she was going to pass.
“So, why don’t you give her something for the pain?”
“She’s too weak; it would kill her.”
“Didn’t you just tell me she was going to die anyway?”
“Yes.”
“Then what difference does it make if she gets some painkillers?”
“Can’t do that. It would kill her.”
And so on, et cetera, et cetera, et cetera.
I definitely approve of the management of pain. And if that possibly hastens death by a few hours, well, that death is attributable to the proximate cause. However, intentionally giving an overdose is murder, and intentionally taking an overdose is suicide.
“Yet he had to suffer in screaming pain for *WEEKS*.”
How would you regard the possibility of the relatives of such a person obtaining painkillers illegally, and administering them without prescription?
Done.
There’s no ethical or moral objection to taking a quantifiable risk to life on a medication used for some other reason, as long as responsible people understand the risk.
The older “war on drugs” mentality was loath to dish out opiates for any purpose, lest the business in same increase and they be seen as more acceptable. That was immoral.
I’m surprised that modern medicine hasn’t been able to top morphine, a chemical known for over 100 years, in pain killing capability. A few have suggested heroin (acetylmorphine) as allowing for a more cheerful mental state if one must be heavily drugged and no recovery from the condition is expected. The modern “war on drugs” in all its vigor manages to interdict something like 10% of the flow of all kinds of high-inducing and addictive stuff into the USA, so I can’t see the harm of adding heroin back to the pharmacopoeia. But not all agree.
Nearly a year ago, my father, living with heart and kidney failure by virtue of dialysis, had a heart attack on Inauguration Day and was put in intensive care. He had requested "full code" where everything is done to preserve your life. The doctor asked him if he really wanted a ventilator if he was brain dead. Dad said no. The doctor then, without explanation to us, secretly changed Dad's orders to Do Not Resuscitate. When Dad learned of this, he asked me to get a lawyer to reinstate his "full code" wishes and to name my sister and me as the ones to make the decision if he were unable to make the decision for himself.
When we went over the "DNR" forms with the lawyer, we could see that "extreme measures" included withdrawal of food and fluid.
The nurses took excellent physical care of Dad, but they and his primary care doctor pestered us constantly to go back to DNR. They acted like missionaries for the religion of death before your time. They harped on "all the tubes" and the dialysis machine, all of which he was used to. None caused him any pain. They also harped on "palliative care." We believed this to be the equivalent of hospice, so didn't consider it. We were unable to ask them questions we would have liked to because of their bias toward death or early exit.
Dad's choosing to live--it amounted to two weeks more of life, brought him the chance to see all his family and many friends, plus spend some time with his beloved lady friend. He had an individual message for each of us. He listened to and told stories. With his brother, he watched his Steelers win the Super Bowl. All the while, the nurses told me what a rotten quality of life he had. (Starving, dehydration and lethal drugs would be better?)
Two days after the Super Bowl, I learned from a nurse that his personal physician had reinstated the DNR. I spent hours that day getting the lawyer back in to represent Dad's stated interests. I asked my father if he wanted to continue the treatments he was getting, and he said "Oh, yes!" Those were his last words. That night, his blood pressure began to drop despite the medicine he had been given. For about an hour, my cousin and I held his hand and told him stories of our happy lives with him. Then he slipped away.
Death sure isn't for sissies, nor is witnessing death, but I still haven't gotten over the time we lost with him wrangling with the nurses and doctor. Many of the people in the ICU waiting room had the same problem and were distraught over it. Some got lawyers.
When he calls, you'll know and it will be time to go. Easing the burden may not be His plan...
This was my father's choice. It should have been respected.
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