A most uncomfortable topic

Actually, it would be more apt to see this as a lack of true compassion - ‘to suffer with’ - replaced by a
utilitarian attitude toward impaired and dependent family members.

“There is one ethical guidepost for all the protocols: Terminal
sedation should not become so routine that the end of life is scheduled
like elective surgery, for the convenience of the doctor or the family,
or because the patient’s care is no longer economically viable.

“Physicians occasionally feel pressure to turn up the medication,
said Dr. Pauline Lesage, Beth Israel’s hospice medical director. The
pressure may come from weary relatives, who say, in effect, “Now it’s
enough; I just want him to disappear.”

There are chilling glimpses in this piece of the cultural down slope
we’re on that’s gradually changing the way we think about end of life
care. At least we’re still able to catch the discomfort in having these
situations, and using these terms.

“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.

“Mr. Oltzik received what some doctors call palliative sedation and others less euphemistically call terminal sedation.”

Thank God for good and great and ethical health care professionals
like my friend Nancy Valko, who responded to the Times piece with this:

“In my experience, it’s more often the doctors and ethicists rather
than the families who are ready for the patient to “disappear” and not
“waste” health care resources. Terminal sedation is proving to be how
so-called “assisted suicide” is flowing down to the general public.
It’s no accident that terminal sedation is allegedly becoming more
popular than the one-time lethal overdose in Holland. Terminal sedation
accompanied by the deliberate withdrawal of food, water and basic care
without a medical indication is an easier way to fool oneself-and the
public. Having been a hospice nurse myself, I know the difference
between making someone comfortable with sedation and pain medication
versus deliberately causing or hastening death. Everyone deserves a
natural lifespan.”

Well said.


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