Everybody’s going to die eventually. A fact that many try to ignore. The grim reaper is a specter many dread but there are those who look forward to the end of this life and are ready to face whatever may be offered on the other side.
When that time does comes there are some of us who do not want any obstructions in preventing it. Sorry to start one of my posts with this morbid sentiment but it seems that the recent death of 87 year-old Lorraine Bayless at the Glenwood Gardens Retirement Home in Bakersfield, California has raised an issue here that involves a person’s “right to die”.
Most of the focus from the media on this story has centered on a care-taker’s decision not to administer CPR to the dying Ms. Bayless. An act that on the surface seems cruel and heartless for someone to do to one who is under their care. But allowing people to die under certain conditions is not that callous when you take some important facts into consideration, quality of life being the most paramount. Take for example this account by Iona Heath, GP and president of the Royal College of General Practitioners in the Great Britain, of a patient with similarities to that of Lorraine Bayless.
Some years ago, an elderly patient on my list was admitted to the hospital after she collapsed. She was in her late eighties, a widow and very frail. She was admitted to a coronary care unit and received the highest possible standard of care including fibrinolytic treatment delivered according to the latest evidence-based guidelines. She made a good recovery and was discharged home, apparently well, a week later.
I went to see her and found her to be very grateful for the kindness she had been shown but profoundly shocked by a course of treatment that she perceived to be completely inappropriate. She explained to me that not only her husband but almost all her generation of friends and acquaintances were already dead, that her physical frailty prevented her doing almost all the things that she had previously enjoyed and that she had no desire to live much longer.
No one had asked her about any of this or attempted to discover whether the effective and therefore recommended treatment for her condition was appropriate in her particular case. She died three weeks later while asleep in bed. SOURCE
I don’t know what Ms. Bayless’ situation was like. Most people who are commenting on this likely don’t either. But according to the accounts I have read thus far, she was not only aware that her caretakers had instructions not to make heroics efforts to save her life should she fall seriously ill, but it has also been reported that she had signed a DNR order (do not resuscitate) in the event of her impending demise. This to me signifies that she was prepared and intent on meeting the so-called angel of death on her own terms.
Furthermore, it’s not clear if a daughter of hers, who is herself a nurse, was Ms. Baless’ Medical Power of Attorney, but if she was she expressed her views that exonerated the facility where her mother died conveying that she “was satisfied with her mother’s care.” This appears to indicate that Glenwood Gardens had honored her mother’s wishes to not implement heroic measures should her condition warrant them.
We seldom can choose when, where and how we die but we can and should be allowed to choose death as an option when we feel there no longer exists a life that we find rewarding, especially as our health deteriorates to the point where pain accompanies us each waking moment of each day we draw breath.
Those of us who rejoice in life and make take offense that someone failed to help Ms. Bayless hang on to what we treasure do so without fully understanding that death itself should not be feared. A life without purpose is not something people want or choose. When age and physical condition inhibit and even prevent a meaningful and healthy life then the choice to accept the end when it comes without reservations or artificial means to sustain it should be a choice that we all honor.
Mourn not for me since I have lost my breath
My pain was such that it made me wish for death.
- script on a tombstone near the Welsh border
Other articles of mine on this topic:
Active Euthanasia – Dying With Dignity
Death With Dignity – Our “Inalienable” Righ to Die as We See Fit
Moral Qualms With Right To Die Legislation
stephenpruis
Very well said. The question is “just because we can, should we?” Doctors, because of their oaths, are not in a position to deny a service. Doctors, because of how they get paid, have incentives to do far more than is needed. My best friend’s father had a painful and expensive hip replacement surgery six weeks before he did (he had had three heart attacks prior).
We need a national dialogue on end of life care. I don’t expect to have one. It is sad.
lbwoodgate
“Doctors, because of their oaths, are not in a position to deny a service.”
True but there are those who want a death with dignity consideration to be a part of their service. Read this piece by Dr. Iona Heath to get a feel for how some are viewing this.
We definitely need a national dialogue on this. Just need to get past the objections from fundamentalist christians.
john zande
I’ve never heard o the DNR order. That’s a very good idea.
lbwoodgate
My wife and I did our wills a few months back and we had a DNR included in them so the kids wouldn’t have to face that tough choice.
john zande
It’s an excellent idea. It’s a clear, unencumbered expression of your will. I have a verbal agreement with my wife. If its only machines keeping the organic machine running, turn them off.
Hansi
I don’t know Larry. When it comes to ending life, be it old age or in the womb, I think only born-again Christians should be making them decisions. They are closer to God than us heathen, and know what He wants, what we want, notwithstanding
lbwoodgate
Yep. The word of God is not to be toyed with, except when it talks about compassion and sharing with those who are the least amongst us.
Gunta
Oregon has a “right to die” or “death with dignity” law on the books. It was first passed by referendum in ’94, but then had to fight a series of challenges, including from the Bush administration, but was FINALLY enacted in 2006. I believe we’re the only state with that provision.
http://en.wikipedia.org/wiki/Oregon_Ballot_Measure_16_(1994)
lbwoodgate
Washington State I believe passed legislation in 2008 that allows for doctor assisted suicide and I believe Michigan and Montana are trying to get something passed along these lines too.
You are fortunate to live in a state that seems to have a clue about right to die issues.
Gunta
Well, it sounds like we may have started the ball rolling for other states to follow?
Sherry
crap, I wrote a whole piece on this and now I have to apologize. Sigh….still, I think the refusal on the part of the company as “policy” is wrong. And why didn’t the nurse inform the 911 operator that there was a DNR on file? I guess I feel mislead by the media, and unsure of what really happened here. Apparently I am wrong in my assumptions. mea culpa.
lbwoodgate
Sherry, I think your reaction was quite normal under the circumstances. I think in a rush to get this information out the media failed once again to get all of the details. The surface information we did get does make for good copy and of course “if it bleeds, it leads” still carries a lot of leeway with most of these people.
“And why didn’t the nurse inform the 911 operator that there was a DNR on file?”
That is a curious part of what was put out there for our consumption. And yesterday I wouldn’t have been surprised to find out that the lady was really not a licensed nurse but simply a caretaker with certain skills that qualifies her to work at such a facility.
But now I discover that the same newspaper I provided a link for in my post is now saying that there was no Do Not Resuscitate form on file for Ms. Bayless.
What’s being reported by this paper and a local NBC affiliate is that the “nurse” talking with the 911 dispatcher was hired and operating in the capacity of a Resident Services Director, not a nurse, and that is the capacity in which she was serving in according to a spokesman for the retirement home.
It also appears the daughter is now saying she never suggested she was satisfied with the care there. “I never said I was fine with that,” daughter Pamela Bayless told CNN Monday before hanging up the phone. “That was completely taken out of context, and I have no further comment.”
But even with all of this confusion I think my point is still relevant. The automatic assumption that every means should be taken to save this lady’s life may have overlooked her own desire to not take necessary action in such an event.
Of course if a thorough investigation reveals further conflicting views about all of this then we do in deed need to take a look at policies that exist like that in California and see if they are designed with the patient’s interests and full knowledge of them.
T E Stazyk
Very interesting to link the Bayless case to the overall issue of death with dignity. I found this essay by a guy who hosts a TV talk show down here very enlightening. I especially like his comparison between the way we treat people and dogs.
lbwoodgate
That link didn’t come through T. E. Could you try again?
T E Stazyk
Sorry about that, hope this works:
http://www.cheer.org.nz/ves061103.pdf
lbwoodgate
Thanks T.E. for that commentary by Noel Cheers. His approach to such things reminds me of another theologian I admire – John Shelby Spong.
I took the quote from the tombstone near the Welsh border in Cheer’s essay and added it to the end of my post above.
T E Stazyk
Glad you found it useful! He’s just so .. . . . reasonable.
Snoring Dog Studio
This is the year in which the idea of being allowed to pass on without heroic effort has become more meaningful than ever. My father died at home on January 5. He was surrounded by some of his family, and, his loving wife. He was able to give her a last smile, which she remembers, though she remembers little else of that time. My mother, with the effort and full support of her children, will die at my home. Though the thought of her leaving is excruciating, I would never let her pass among strangers.
lbwoodgate
My thoughts will be with you on this Jean. I went through this in 2007 when we finally moved my ailing Mom in with us. 2 months later she passed on.
I think she allowed herself to die because living on her own (even though she was just a half mile up the road from me and got daily visits) there was always the concern about what do do with her equally ailing dog – who outlived here 9 more months with us.
She had some personal items that she cherished and was concerned about how to distribute all of those. Once we got that settled and moved her in with us it’s like she had no more earthly concerns to keep her here. Her second husband, her Mom and two of her siblings had already preceded her and I think she was ready to join them.
Snoring Dog Studio
that’s a comforting account to hear, Larry. For now, my Mom appears to be enjoying her life without the stress of her own home by herself. It is so good to see her laugh a lot these days.
Ron Byrnes
Interesting how the right thinks it represents freedom, from “big government” and taxes, but not on how and when to die. We’re all inconsistent at times, but I find this paradox puzzling. In Washington State you can smoke dope and then decide when to check out. Both of those rights are only fair given our weather.
lbwoodgate
The weather must indeed be a factor Ron because down here we grow ‘em ignorant and anal retentive.