EOL Responsibilities

 

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I do think that Americans have the responsibility of making end of life decisions as death nears. This is because they themselves know what their wishes are and they are the only ones who can communicate that when they are fully competent. If they don’t take on this responsibility, then it becomes the an issue that their family, be it their spouse or children, must deal with. Like in the article, this can cause fights and altercations between family members, like the sister who threw a coffee pot at her brother for suggesting to end the life of their mother. If we make it a responsibility to say whether we want to be resuscitated, or if we want respirators, ventilators, or artificial nutrition, then this will alleviate a lot of problems towards the end of life. It was also, like mentioned in the article, will eliminate spending on hospitalizations and procedures that are costly, that at the end of the day the patient didn’t themselves would not have wanted. I think that if the patient has stated their wishes or has had clear advanced directives, then I think that families must support those decisions. They must set aside their own feelings and see that this is in their loved one’s best interest. If those end of life decisions have not been made by the patient, then their families must take on this role, but do it as supportively and as close to what the patient would have wanted. It just becomes difficult in situations with young children who are dying or have died, or people who die unexpectedly.

I don’t think that a patient or the family can ever “know enough” about a healthcare provider’s decision on things, but they should know the patient well enough to see whether the provider’s recommendation would fall within the patient’s best interest. It is hard for those who are not in the medical field to understand all treatments and medicines, but we should be able to understand a prognosis and what our loved one’s would want if not competent enough to make their own decisions. This is when I think the families should question the provider. They should question whether the prognosis is good and whether continuing treatments are in fact going to help the patient or just prolong the patient’s life, uncomfortably. 

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“Letting Go”

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After reading Atul Gawande’s, “Letting Go”, I feel like I have more insight about the end of life problems and process that people face when they are terminally ill. It makes me wonder if the treatments we put ourselves and our loved ones through to save their life, really improve our chances at living longer, or do they merely allow us to live longer but in an uncomfortable manner. From reading about Monopoli it is evident that after all the radiation and chemotherapy treatments that she underwent, her health worsened and she most likely didn’t die as peacefully as she could have. But it’s not my right to say that her and her family should not have fought for her life by trying every available treatment, because most likely I would have done that for one of my family members. It does really get me thinking that maybe for myself, if this situation ever happened to me, I would consider trying a couple treatments for a short amount of time, and if no progress, turn to hospice and do my best to get my family to understand that this is what I know is best for me.

I think there comes a certain point when you know that the end is near and from the story it seems better to confront it and try to have your last moments be as pain free and as special as they can be. This is what I think medicine should do, when it can’t save your life. It should make your last moments easy, not difficult. You should be able to die comfortably, not in pain or in a hospital room, by yourself or surrounded by people you don’t know. It shouldn’t be a fight till the end, it should just be a letting go and a moving on process in my opinion. As in the case of Galloway, it seemed he died very peacefully and surrounded by the people he cared about most, all because the medicine he was taking was easing his pain and allowing him to be mentally aware that his life was ending and that he needed to make the most of his last moments. I would much rather be mentally aware than in and out of consciousness or on ventilators or with 100 life saving tubes coming in and out of my body. I wouldn’t want my family to see me in that kind of state, I would rather them know I died painlessly and with them by my side, rather than alone and in an unfamiliar place. When medical practitioners know that they cannot save my life or that my health will in fact worsen, I would rather them take the time to talk to me and make my family and make us aware of end of life options, rather than trying to be positive about treatments that will most likely worsen my health and “prolong” my life. Like in the case of the 29 year old patient with an inoperable tumor, the fact that the oncologist took the time to speak with the patient as well as his family, really made all the difference in the patient choosing hospice care and having his last moments of life the way he truly wanted, which was peacefully with his family.

I will not deny the fact though, that when it comes to younger loved one’s it is harder to make these decisions. Especially when it is for a child. Wouldn’t you want to do whatever possible to save your child’s life? Indeed I would want to do whatever possible, but there does come a point where I would not bear to see my child suffer any longer, I would rather they die peacefully, in their home, with me by their side, than through intensive treatments and with intensive fear. This is where medicine should again ease their pain and suffering and just let the death take its course.

With this, it is still hard to say what a person and their loved one’s will really do when it comes to situations like this. It all depends on what kind of illness is present, what the chances are, and what the underlying wants are for the patient. But no one truly knows how you will react in these types of situations or what other issues may arise until they happen to you, making it all the more difficult of a process.

A Walk to Remember & Sisterhood of the Traveling Pants

Some movies that come to mind when thinking about a main character dying are Sisterhood of the Traveling Pants, and A Walk to Remember. In both movies, a main character dies from cancer. In the Sisterhood of the Traveling Pants, Bailey is a younger friend of a main character named Tibby. She is characterized as a young girl who enjoys filmmaking, a characteristic common to Tibby as well. Unfortunately, Bailey has cancer and gets sicker with time and eventually ends up in the hospital. Tibby visits Bailey in the hospital and offers her the “magical” pants in order to help her. Sadly Bailey dies shortly after. The movie portrays the event solemnly and consistently shows Tibby’s more vulnerable side. As common to real life, the Sisterhood portrays death through the use of a casket, all black funerals, and individuals mourning the loss through crying. 

 

In A Walk to Remember, Jamie is laying in a hospital bed, ill from cancer, with her boyfriend Landon by her side. While in the hospital, Jamie tells Landon that “God has a bigger plan for her” and that he is her angel sent from God (http://www.youtube.com/watch?v=hM9TUoD-rjA). Unlike the Sisterhood, which portrays death in a more magical, hopeful way, A Walk to Remember portrays death in a more religious way. But both movies have a sorrowful portrayal after the death has occurred. Of course, when we experience death, we are sad and we do mourn; but people experience death in many different ways.

 

At times I do believe that death in the movies can be misleading. In A Walk to Remember, Jamie was able to experience love and true happiness before her death. In reality, not everyone finds their significant other before they die. Death can be sudden and often occurs when the individual is alone. In real life when a child dies that young, they often have not experienced what true friendship is. In Sisterhood the audience hopeful that at least Bailey found what she was looking for but, unfortunately, children sometimes die unexpectedly and have not had the chance to experience love and friendship. Comparing these two movies also shows that death is not portrayed diversely in movies.  In fact, both Tibby and Bailey died from cancer in hospitals. The actions and emotions of the people who cared for them most were also similar.

 

 I do think that the language and hopefulness of the characters does prove that we as a society are a death denying culture because there is not one single way in dealing with death. We can experience anything from sadness, to anger, to even a feeling of emptiness. We can go into shock, or get sick to the stomach. There is no way of telling how we will deal with death and it is different depending on who it is, how it happens, and when it happens. These movies often teach us that it is merely sorrowful and the main character finds himself/herself getting past it through hope, yet this is not always the case in real life. We leave death to the movies and they do make us emotional, but the emotions we experience from the movie are nothing like what we experience in real life. We put death off to the movies until it happens to us.