Tuesday, August 24, 2004

Physician-Assisted Suicide

Now here is a very controversial subject! I have fairly strong feelings on the subject and want to share a story to illustrate where my beliefs stem from.

First of all, as I've written in prior postings, it is not uncommon for people facing end of life to at least consider taking their own life so as not to prolong a painful ending to their life. There are several fears that seem to bring this option into serious consideration:

1. fear of uncontrollable pain
2. fear of dependency on others
3. anxiety as to what happens after death
4. anxiety waiting for the "unknown" time when death will finally take you, without your control over its timing (fear of a lack of control - ties into #2).

I'm certain there are other issues that I haven't heard yet, but these four seem to be common themes.

For most people, when these fears are addressed directly the desire to end one's life early usually dissipiates. Some of the ways to address the above are by ensuring adequate pain control, setting up home aides to help with caretaking so as not to tax familial caregivers, providing spiritual support in whatever capacity that takes, and allowing the patient to maintain as much control as possible for as long as possible.

However, there are certain conditions and/or circumstances that seem to question whether physician assisted suicide might be a reasonable option.

My Aunt Abbey was a beautiful and eccentric woman. I remember sipping my parent's grasshoppers at her poolside; her vibrant, hearty laughter; her stripped blond hair, styled just so; her dark and cozy living room.

Aunt Abbey had saved up all of her left-over prescription pills throughout her entire life. She had a lifelong fear of becoming seriously ill to a degree that would incapacitate her. She decided that as soon as she knew she was going to die, she would take her own life.

The symptom that first presented itself, informing my Aunt's doctor that she had ALS (aka Lou Gehrig's disease) was her inability to swallow. Not only was she diagnosed with a disease that would take her life excruciatingly slowly, increasingly incapacitating her over a period of years, but her means of ending her life was taken with her first symptom. This disease progressively degenerates neurons, paralyzing you slowly as it spreads throughout your body, while keeping your mind completely intact. Talk about torture!

My Aunt filled out all of the appropriate paper work. She did not want mechanical ventilation. She wanted to die as soon as her lungs became paralyzed. As is usual, my Aunt listed her husband as her DPOA (Durable Power of Attorney). By signing a DPOA, you are giving your designated person the right for to make decisions for you should you become unable - mentally or physically - to make decisions for yourself. When my Aunt got to the point that she would die if not given mechanical ventilation, however, my Uncle was by then the DPOA. Instead of following my Aunt's request, he couldn't bear to let her die. She was intubated and forced to continue to breathe. My Uncle hired an in home nurse and kept my Aunt, on the mechanical ventilator, at home. She lived for years like this.

To make matters worse, my Uncle began a love affair with my Aunt's nurse. So not only was my Aunt trapped inside her body and able to move nothing more than her eyes for years, but she was then forced to watch as her husband "moved on."

This may sound like an extreme case. But ALS is a devastating disease, even when the sordid love affair isn't thrown into the mix. And I can't help but wonder if my Aunt might have taken her life by other means, much earlier, had she been give this choice legally.

I hope and pray that my Aunt Abbey rests in peace.

And so yes, I am in favor of physican-assisted suicide in certain, very carefully screened circumstances.


Jennynyc said...

That's a horrible story! I do believe in physician assisted suicide. I have always heard of ALS as one of the worst ways to die. My aunt Mary has MS, and I worry about her future. She doesn't do regular medicine but does do homeopathy.

no milk said...

i love this post, very sad. these were some of the thoughts i had when i was in the hospital. i may blog about it at some point, unless my morbid thoughts move to other more lighthearted things like the presidential elections