I have just spent the last hour or so reading all the post on Teri Shivo and the Pope and their deaths. And it made me wonder how many people have seen some one die. And how many people have seen some one forced to live. I see it every day, it is my job. I reall seeing Teri's mother on TV pleading to stop the torture of her daughter and reinsert the feeding tube, and I couldnt help but think torture....just what would you call the last 15 years? If that isnt torture I dont know what is.
I have a patient right now that has been on deaths door step several times. And for this patient I believe would be a blessing. But her family is forcing her to stay alive because of all the guilt they have. So what do we do? We stick this patient with needles to draw blood, we stick IVs in for meds, we stick more needles to check labs, we stick needles in the arteries to check blood gases and on and on. And then by the miricle of medicine we SAVE the patient, and in a few weeks or months we repeat it all over again. Then we have problems with the feeding tube which sometimes requires surgical consult, then we deal with infection and on and on. The bottom line...we cant fix this patient. And if anyone out there thinks that laying in bed making a groaing sound and opening your eyes every now and then, and having no control of your bodily functions, is life or quality of life then you need to experience it one way or another. As far as function the brain stem controls vital function like breathing and heart beat, it doesnt make us who we are, that comes from our brain and it is too bad that when our brain stops that our heart doesnt also.
as far as the morphine goes. We give morphine to make patients comfortable. It takes away the air hunger and allows patients to breath easer. Last month I lost 2 of my most favorite patients with in a few days of each other. One was with the 101st AB landed on D-Day and fought through the rest of the war with them. My other patient was a Vietman Vet. I have tears in my eyes thinking about them now, God knows how they touched my life and the profound respect I have for them. The Hospice nurses were able to make them comfortable with morphine at least we could help to ease their suffering.
Dehydration is a much better way to die then to drown in your own secretions.Patients are kept comfortable by keeping the mucus membranes of the mouth moist with glycerin swabs. although by the time patients reach this point they are usually unresponsive.
With IVs for hydration,when renal function decreases the fluids build up in the lungs and patients gurgle and drown in their own fluids, you only need experience seeing this once to leave a lasting impression.
Death is not always a bad thing. And there has not been a person born that will escape it. It is sometimes more cruel to force a person to live than it is to allow them to die. I do things every day that I do not agree with, but it is the will of the patient or the family. I have had patients refuse to get treatments for cancer that most likely would have saved their lives but they choose not to do it. I have also had kept patients alive when there is no hope and only agony. I do not make the choices, I only carry out the wishes. I only hope that some of my patients and GOD will forgive me for the times we forced them to remain alive only to look forward to another bout of agony. Health care providers get accused of playing God. It is the familes that do that, we only do what we are told. I wish I could play God some times, I would reach out and slap patients and family members upside the head to knock some sense in them.
If nothing else I hope this has opened peoples eyes to have a living will drawn up. So that your lives do not become a media circus and court battle. God forbid that one of your loved ones should have to make the choice based on what you told them in private and not have a signed will in hand to prove it to the world that is really what you wanted. They would be accused of every thing from wanting to collect the insurance in case of your death, to keeping you alive so as to collect your pension.
