"While medical advances have transformed many illnesses that once
proved rapidly fatal into chronic conditions, improving the quality
of this resulting longer life has been more difficult to achieve."
proved rapidly fatal into chronic conditions, improving the quality
of this resulting longer life has been more difficult to achieve."
The quote above is from the US version of the BMJ. While the verity of the statement may seem blindingly obvious even to those not afflicted with chronic conditions (or employed to treat those with chronic or terminal conditions) there remains a gaping void regarding guidelines for merciful and minimally invasive End-of-Life care.
Fear of death is one of our most powerful motivators. Just like opposable thumbs or the ability to read and write, fear of dying provides an evolutionary advantage. Those who fight and run away, live to procreate another day.
But all things must come to an end. Everyone will die. And regardless of whatever religious flapdoodle informs your philosophy, no reasonable person would say that 'earthly' life could ever be eternal.
But how many of us really accept that? Hardly anybody does. I have noticed that in the very elderly, even those who are living semi-independently, the idea of death seems less fearsome. In some cases, it seems almost comforting.
Unfortunately, when 87 year old 'Marie' has had a fall due to a stroke, and lies with a broken hip, bloated, demented and intubated in a hospital bed, she's in no position to tell her physician that it's time for her to get off the bus. She can't object to the MRI, the CAT scan, the hip replacement, the NG tube, the dialysis or the temporary pacemaker. She can't cry out when she develops the almost inevitable sequellae of the terminally bed-bound, co-morbid patient: Pressure sores, pneumonia, infection by antibiotic-resistant orgamisms, and organ failure.
The people that will be making the medical decisions for Marie will be her doctor and her relatives. The young, healthy relatives, who fear death, love Marie and believe in miracles. And Medicare's paying.
So, here are my Advance Directives, which will outlive me, floating forever in cyberspace. They are for the four people most likely to be around when I've reached the night's plutonian shore. Kurt, Linda, Jake and Catherine. (Listed by age, in descending order. Looks like Catherine might get the job. Ha!)
Fear of death is one of our most powerful motivators. Just like opposable thumbs or the ability to read and write, fear of dying provides an evolutionary advantage. Those who fight and run away, live to procreate another day.
But all things must come to an end. Everyone will die. And regardless of whatever religious flapdoodle informs your philosophy, no reasonable person would say that 'earthly' life could ever be eternal.
But how many of us really accept that? Hardly anybody does. I have noticed that in the very elderly, even those who are living semi-independently, the idea of death seems less fearsome. In some cases, it seems almost comforting.
Unfortunately, when 87 year old 'Marie' has had a fall due to a stroke, and lies with a broken hip, bloated, demented and intubated in a hospital bed, she's in no position to tell her physician that it's time for her to get off the bus. She can't object to the MRI, the CAT scan, the hip replacement, the NG tube, the dialysis or the temporary pacemaker. She can't cry out when she develops the almost inevitable sequellae of the terminally bed-bound, co-morbid patient: Pressure sores, pneumonia, infection by antibiotic-resistant orgamisms, and organ failure.
The people that will be making the medical decisions for Marie will be her doctor and her relatives. The young, healthy relatives, who fear death, love Marie and believe in miracles. And Medicare's paying.
So, here are my Advance Directives, which will outlive me, floating forever in cyberspace. They are for the four people most likely to be around when I've reached the night's plutonian shore. Kurt, Linda, Jake and Catherine. (Listed by age, in descending order. Looks like Catherine might get the job. Ha!)
IF I AM IN A SITUATION THAT, IN ANY WAY, RESEMBLES THAT OF 'Marie' UP THERE IN THE FIFTH PARAGRAPH, I WANT YOU TO END MY SUFFERING AND SEND ME ON MY MERRY WAY. I DO NOT WANT TO BE POKED, INTUBATED, SCANNED, DIALYZED, TPN'ed OR FITTED WITH A PACEMAKER. I DO NOT WANT TO BE RESUSCITATED. I WANT (as I have always wanted) TO BE LEFT TO MY OWN DEVICES.
After death, I want my unembalmed or cremated remains to be placed in an egg carton,
(I'm not kidding.) and buried in our plot next to the old Quaker Cemetery. I would prefer no rites or words be said over my carton, but if Kurt wants to do that, it's OK. And Pastor Kennedy will preside over pagans. He's real good that way.
After death, I want my unembalmed or cremated remains to be placed in an egg carton,
(I'm not kidding.) and buried in our plot next to the old Quaker Cemetery. I would prefer no rites or words be said over my carton, but if Kurt wants to do that, it's OK. And Pastor Kennedy will preside over pagans. He's real good that way.
I don't expect to be going any time soon. But I hope that others will read this and, if they see some sense in it, they will discuss this with their loved ones AND their physicians. There are legally binding forms that you can fill out which will define the extent and limits of the measures which you wish should be taken in order to prolong your life.
It's time for everybody to think about it.
- Maggie
It's time for everybody to think about it.
- Maggie
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