Re: Hospice/Palliative Care

In <1fb2109a-c0bb-498e-8b53-2f40b09a7567@xxxxxxxxxxxxxxxxxxxxxxxxxxxx> Eliyahu <lrooff@xxxxxxxxx> writes:

That's the difficult aspect -- the decision-making process. Appetite
is one of many "normal" functions which shuts itself down as we die,
and we need to recognize the difference between denying food to
someone who wants it and not forcing food upon someone who no longer
has the need or desire to eat because he's dying. It's not an easy
decision, and I believe it's also a grave error to base the decision
on what we think we might want in a similar situation. We're not in
that situation, we don't really know what it's like for the patient,
and we lack the ability to feel and sense what their desires are.
Even if someone said, while they were healthy, that they would want
extreme measures taken to keep them alive, that desire may change
completely once they're dealing with the reality of impending death.
We don't know firsthand what it's like to fight and struggle for
every breath for weeks on end, to experience unending pain and nausea,
or to feel our ability to move and control normal bodily functions
slipping away, so the opinions we express about it now can't and
shouldn't be seen as carved in stone and unalterable. Unfortunately,
when we get to the point of wanting to change our minds, we may not
have the ability to express that desire, or those responsible for our
care may decide that we aren't thinking clearly enough to demand such
a change.

I agree with what you're saying. While it's about the toughest thing there
is, that's one of the rationales for setting up protocols / standard
procedures etc. Obviously if we're asked, we want everything - spend every
dollar, use every resource, do whatever it takes to get even one more
minute for our loved ones. That's why it shouldn't be (only) our decisions
- it's just not fair to make it only our decision.

I really don't know the answer, as I said it's probably the toughest
question, but does it make sense to spend tens of thousands of dollars to
prolong someone's life by a day, say? OTOH, how can you deny spending that
money on humans when people are getting hip replacement surgery for their
dogs? But does the one have anything to do with the other?

In some sense it's similar to the issue of criminal justice -- if someone
hurts someone you love, what you WANT to do is go out and hurt them
yourself in retribution. Which is why we have / need laws to prevent you
from doing that. Here too, good laws could potentially help us with these
awful decisions. Maybe...

--s
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