I feel that we're all here for a reason, and that we'll die when the time is right. I agree with many of the doctors in the Frontline video-that we should always offer treatments. At the point where there's nothing left to do, except keep the patient on a ventilator and/or feeding tube, that's the time when the family needs to make a decision. Personally, if I were in the situation, I'd want every treatment done. No matter how much it hurts, no matter how much pain or agony it causes, if there's any sort of chance that I'll improve afterward, I want it done. At the point where the doctors say, "She's going to be on life support. There's no further treatments we can do.", that's when I'd give the okay to let me die. But never before. I feel that allowing someone to die, without doing something that might have a chance of helping, is unfair. There are so many instances in which someone who's given 2 months to live makes it several more years. The advances in medical technology are moving so quickly! If we were to allow everyone to die after we try one thing, we wouldn't learn much about medicine. It's those people who defeat the odds that help us advance medicine. As Jerome Groopman, M.D. said, "There's very stark and important advances that have occurred by very much chasing that tail end of the curve. Severe diseases like leukemia, initially treated with chemotherapy, might have a 5 percent or a 10 percent improvement. Some people might say, "Well, that's meaningless." Of course for the individuals in that 5 or 10 percent, it's 100 percent. But it's not only to help patients, which of course is the primary goal, but it's to learn from that and try to build on it and expand, and then move to 15 percent or 20 percent, because generally in medicine, progress, advances occur incrementally, in small steps. There's rarely a eureka moment with this dramatic breakthrough that just shifts the paradigm."
I'd have to say that I agree very strongly with what David Muller, M.D. said in the interview on the "Big Issues" page of the website (Link below): "So that if you take someone who's 20 and has acute leukemia and is going to die, and you've got to look at them in the face and say, "Look, I've got a therapy, but it's very, very dangerous, and the percent of people who die from it is a high percent, 10 to 20 percent, which is very, very high," I think that's an easier discussion for doctors to have, and for many patients, an easier decision to make, because they've got a shot and they've got a long life ahead of them, and in a sense, the potential benefit is worth the risk.
If you have someone who's 70 or 80 or 90, and it's not just age that has to do with it; it's everything that we talked about that comes with it -- chronic illness, frailty, dependence in a lot of different ways -- and that person has leukemia, maybe not acute leukemia, maybe it's chronic, and they need to have an intervention that's very, very aggressive and might bring them to the brink of death, it's a different kind of discussion to have. But I don't think that it's about the therapy and how dangerous it is. I think it's about the context in which you have that discussion."
So, basically, I feel that we have a responsibility as health care providers to offer any treatments necessary. But when you get to a certain point, where there are no other options, that's when it's time to discuss with the family what to do.
To me, this topic could go so many different ways. I don't have a strong opinion one way or another. It is really dependent on a case-by-case basis and what the individual wishes. It's ultimately up to the patient or the family members to make decisions. It is up to the health care provider to offer any available treatments. Personally, as a health care professional, I would never EVER give someone a lethal injection or push them to the point of death for any reason. I would take them off life support at the wishes of the patient or family, but I would never push that point of death on purpose.
"This life in us; however low it flickers or fiercely burns, is still a divine flame which no man dare presume to put out, be his motives never so humane and enlightened; To suppose otherwise is to countenance a death-wish; Either life is always and in all circumstances sacred, or intrinsically of no account; it is inconceivable that it should be in some cases the one, and in some the other." -Malcolm Muggeridge
Links:
http://www.pbs.org/wgbh/pages/frontline/facing-death/interviews/
http://www.pbs.org/wgbh/pages/frontline/facing-death/
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