Several similar situations have arisen in the past few weeks forcing me to think on a topic I generally avoid.
No its not Death, its the phase right before death. What happens if death is not sudden? What happens if Death comes after a prolonged illness and lots of suffering.
What happens when there is a prologed illness and lots of suffering but no death?
No, I am not talking about euthanasia here. However, I am talking about the fine line between euthanasia and living wills. There are several occasions when there is no living will, especially in India. People announce and let their wishes known that I would never wish to live as a vegetable, but most skirt around the topic altogether.
In those conditions when you have to decide on behalf of your loved one whether to pull the plug because they didnt wish to live like that, how do you?
I was advised recently in no uncertain words that extending the life shoulndt be at a cost of the quality of life. Granted yes, but if a surgery will add another five years to someone's life then would you decide against it? If chemotherapy might cure the cancer would you decide against it simply for what the person might endure for the two or three months while undergoing therapy?
It is so unfair to ask someone's children or loved ones to make that decision. How does one decide when their loved one has suffered enough. I agree, its inherently selfish on the part of the ones that are left behind but I would not be able to pull the plug on anyone.
I agree its a lot worse when it comes to medical insurance and affording the treatment. There was an article in the paper recently about a poor farmer and his wife not being able to afford treatment for their 4 year old daughter, stood outside the hospital and offered to sell their teenaged son to raise the money. The hospital intervened on finding out and waived most costs, but that is rare. (Of course I was so proud and happy that in rural India someone decided to sacrifice a son to save a daughter but... that is a different post)
I guess its been on my mind, Would you want someone to pull the plug on you? Alternatively would you be able to pull the plug on a loved on?
Thursday, October 18, 2007
Living Wills
Posted by Aditi at 3:32 PM
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21 comments:
nah! not me! i mite tell someone to do the needful but i don't think i can be brave enough to pull the plug on someone i love, well but u never know wat situations do to you. rt now whn all looks good and fine, you act rationally more than emotionally; but whn the time comes who knows.
I would want someone to pull the plug on me if ti came to that and I hope I would do the same.. but lets hope that never happens eh?
hmmmm
"I was advised recently in no uncertain words that extending the life shoulndt be at a cost of the quality of life."
that is what bothers me about the complete post twin, if i'm guessing right :(
take care
no comments
Oh Aditi, we always want to run away from such situations. Don't we?
Like Brick said, I might tell someone to pull the plug off me but wont be able to do the same for someone I love. No, not possible.
And what Adi is saying here? Aditi, sometimes you look a bundle of mysteries to me. I hope everything is ok. :|
yes i would pull the plug and let someone pull the plug on me. y not? cold yes, very, to be precise.
many a times we hav read abt someone getting killed for petty sum of money as small as 50p. ...its not THAT 50p which was so valuable..but it was just a tipping point for that person to commit such a grave crime over a small issue.
so the ques...whether u will pull the plug, or sm1 else pulling out plug for u ..i think, it mostly depends on 'tipping point'...circumstances maybe small or big..but the ultimate decision depends on tht tipping point.
(yeah, i hav just completed reading 'tipping point'...lol)
=) tk cr
so everything is possible..its just abt reaching tht point.
A thought provoking post. I think if I was brain dead and the quality of life I would have is not worth living I would want someone to pull the plug on me.I would never want my family seeing me everyday in a vegetative state.
Don't think you are able to anticipate what would happen if it actually happens; anyhow, it would be better to cross that bridge when it comes...
Thanks for your comments on Blogtrotter.
Some very deep questions here...
I might tell someone to pull the plug on me but I could never do that for another person.
Like they say, its the life in your years not the years in your life that matter!
Interesting post Aditi and a very sensitive topic. I blogged abt it long time ago.
I value quality over quantity, be it a dress or life.
Keshi.
Aditi, I think such thoughts come to mind when hopes die. I think when a person dies, it's not only that person who died but what also dies is some part in each of the others associated with the dead. It leaves a void, a null in others life too and I don't know how can someone create that void knowingly and bear the guilt forever.
well my deary, i deal with that on a regular basis at school and at work. its called a durable medical power of attorney and or you can have a court appointed proxy for financial decisions and someone else for medical decisions or many other things...
yes, it may seem unfair to you to ask someone else to make that decision for you, but then again, if your loved doesnt then a MEDICAL team will. they wont think about what the person woulda wanted. the medical team will think wats medically logical and whats financially logical for the hospital and the family enduring the costs. quality of life is a kinda of the back burner.
i think the best thing to do is weigh in all the options - good, bad and the ugly. do the pro's and con's.. figure out the quality of life and quantity of life ratio and then weigh in what the person wants to do?? is the person willing to do it.
for me -> I DO NOT WANT TO BE A VEGETABLE. if i get there, i will have a DNR (do not resuscitate) on my chart. so if i do go into any medical problem, they'll just let me die. i dont want to live on machines if im brain dead.
either way, i think the best thing to do is something i already said 'weigh in QUALITY of life vs. QUANTITY of life options and then what the person really wants'
see ya SOONNNNNNNNNNNN =)
Alright be warned that it is going to be a lengthy comment !
Now when it comes to the loved ones, then I might go the extra mile and with the medical advancement in this era you can always cheat death! BUT provided the life after the examination is worth living. I mean yes I know many people have had the chemo theraphy thinking it would do the trick to all. Many people back out in the middle because it is like plain super exposure to the ultra rays. So painful that. :-( the after effects are not so cool as well.. I once saw a lady perform an operation for Breast Cancer to remove her left bust and left her right bust - prodigious one that too like that. Now it saved the "loved one" from death, but it is the embarrassment that surely would be hurting her. The right is sure different to the left now !!
However, what matters in the end is an open minded talk with the patient too and not just make decisions by our own ways. Yes sometimes we cannot ask but again to live like a vegetable that is something which is more subjective.
That is the magic of love I tell ya. Sometimes life is too cryptic and some questions like what you have in mind WILL never fetch you an instant solution that is acceptable to all that matters. It is more of pick-what-you-want-to-do-depending-on-situational-gravity. Right now sanity would prevail when I say this coz I am not working with a situation in hand, this would be an entirely differnt one sometime later when i am in distress.
If a by pass surgery is to be done to save a real imp person in my life, yes I will do that. Spend lakhs without thinking. BUT it all depends in the end if the person in context has the endurance to survive 1) the scare of death 2) the operation 3) the recuperation period 4) unwanted sympathy.
So it is all subjective ....
@ another brick in the wall
yea that is true... one never really knows how they will react when it boils down to it
@ sanjay
yeah that is definitely a worse case scenario
@ adi
hmm i wish i had the answers u seek .. i still dont
@ cuckoo
ahh what is life without mystery hehe
yeah i agree i for one usually try and avoid such situations..
@ deepti
hmmm.. to each its own i suppose =)
@ naren
ok
@ starry
fair enough but then would you be able to do the same if the roles were reversed?
@ gmg
fair enough...thanks for stopping by
=)
@ ash
i agree =)
@ keshi
i think i might have missed that entry...
@ dust
hmm but what happens when hope is not dead and u have to make such a decision?
@ choco
hmmm well a DNR is different.. you are asking that of the hospital but what happens when the family has to sign a consent form to take u off life support?
@ vik
well i think that u are right its a question of how much endurance the person has to survive the procedure as well but sometimes ppl can surprise you.. are u willing to sit back and say nope so and so doesnt have what it takes to survive a bypass so lets just not have it done?
**I value quality over quantity, be it a dress or life.
I meant I value quality over quantity even if it's a dress that Im buying..:) so is life.
Keshi.
Aditi:
Should'nt that be what you should be doing? I mean what is the whole point in making the guy undergo the operation when he/she is not really prepared for it. Being scared to be operated upon is one thing I will discount, but if it is truthful feeling, then I sure would swallow my own hand to overcome the hurdle rather than force my interest.
Sometimes you just have to let it go in best interests. I would rate such experiences - hard to swallow, similar to love. The more you hold tight and close to your heart, it moves away from us. Sometimes, like I said it is so subjective, it is worth going with the flow and calling it quits with the patient and "enjoy and treasure" the last few with the patient.
I think I will stick on to this conviction, emotional repercussion is another thing I will battle alongside - bravely !
I sure would like to know what you would do? I know there would be so many things running in your mind when you wrote the note but I surely want to be the devil's advocate and would like to know what you would do? Please do write whenever you get a chance.
yes thats called a durable medical proxy... that the family member is assigning someone to make their medical decisions including being taken off life support.
it sucks, i know it sucks. on my rotations i saw a family struggle between decisions when i was at the ICU. i also saw a son say that his mother just wanted his dad dead for the money, and the mother say the son wanted his dad alive so that he can change his will and get the man to sign it and take all his money
when it comes to things like this.. its EASIER if the sick person has ASSIGNED one person to make the decision and has listed in certain conditions what that person woulda ideally have wanted done. like if im on a machine for so many days and im brain dead take me off..
like if im in coma for so many days and this is the reason, take me off. blah blah.....
so its easier for that person to amke the decision and not get blammed for it by the rest of the family.
Very thought provoking post Aditi. I too have thought many times about it and here I posted something similar. Take care
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