Euthanasia?

[topcropper]

One of my best mates passed away last night from motor neuron disease at 51. He battled it, or suffered it really as there's not a thing can be done about it, for 2 years. He had the worst type that effects you from the top and bottom. His first symptoms was that his speech was slurred and he sounded like he was drunk when he spoke. His last days were spent fully alert, but pretty much unable to move almost anything. About 10 of his mates and I spent a few hours with him last week, and drank a few cartons of beer and told funny stories in front of him. Hard to tell if he wanted to be there but we were invited by his wife. I think he enjoyed it.

What was a relief to me though was how he was able to end things. I'm sure he would have lasted another month or two? But I'm no doctor? He knew within a few days when he was going to die. We knew he was going to hospital and it would soon be over. I'm led to believe he was just pumped with more and more morphine until it was over? He had his family with him.

The next few months if he had to live them would have been horrific. I'm told it's one of the worst things to die from?

I'd want to go at the same stage as well if I had what he had. Certainly learnt a few things about end of life care. It's better than I thought it was?

I've always been in favour of euthanasia. But I thought it didn't happen? It is used though, sensibly, and that's a good thing.


See ya's.

 

[Deena]

Terrible, horrid cruel disease.

 

[wylie]

I'm sorry for your friend topcropper. It is very hard to watch someone you love fade away. I've done it three times too many these past few years.

I have huge respect for the people who tend patients with terminal illness, especially in palliative care wards. I know I couldn't do it. I spent three months helping feed and care for my mother, every day, most of the day, and the staff looked after me and cared for me almost as much as for my mother.

I just hope that the law is changed to allow those who are suffering to choose their own time.

 

[Nemo30]

I have huge respect for the people who tend patients with terminal illness, especially in palliative care wards. I know I couldn't do it. I spent three months helping feed and care for my mother, every day, most of the day, and the staff looked after me and cared for me almost as much as for my mother.

I just hope that the law is changed to allow those who are suffering to choose their own time.

+1
I'm fully in support of euthanasia.

Sorry to hear about your friend - hard to lose a loved one, particularly at a young age.

My mum died of cancer three years ago. She talked often of euthanasia as she knew what was coming. There wasn't a time though that we were willing to give up. While I support the concept I wouldn't have been able to do it.

Her last days were horrendous, even with morphine. The staff didn't say, but I'm sure they increased her morphine levels to a lethal dose, which I'm thankful for.

Takes a special person to work in palliative care.

 

[Peter_Tersteeg]

In all honesty I can't say either way if I support or don't support euthanasia. I I support a persons right to make their own choices but there have been cases of euthanasia where the persons choice has not been followed (there have been several scandals in the Netherlands where some people have been allegedly euthanized against their will).

What is interesting is an article in The Age about a month ago. Looking for the way to go.

This article describes the choices that doctors who treat terminal people express their wishes on how they die. Many choose to refuse treatment and die sooner, rather than have treatment that extends their life, but not their quality of life.

Definitely an article worth reading and considering.

 

[Scott No Mates]

I have seen close family members go down both paths that Peter observed. Those who have endured treatment until the painful end and others who have endured the horrible side effects and said enough when it came to a decision of 6 months of reasonable health or 18 months of further treatment, poor health and quality of life with the same outcome.

When another was in hospital recently hearing their spouse say dnr for both of them struck me quite hard at first but saw it was the right decision.

 

[fernfurn]

My mother died at home from cancer with her 3 children tending her everyday. When she got very bad I worked out later on that the nurses who came every day were gradually increasing her doses of morphine until she passed. I thank them silently every day. I think it goes on a lot more than people who are not touched by death realise.

 

[topcropper]

My mother died at home from cancer with her 3 children tending her everyday. When she got very bad I worked out later on that the nurses who came every day were gradually increasing her doses of morphine until she passed. I thank them silently every day. I think it goes on a lot more than people who are not touched by death realise.

I agree. When my mate went to hospital, I was assured he was going there to die, and it would be in a few days. But I couldn't work out how they knew this, as I assumed euthanasia doesn't happen. Then I was told he was going to be given something to end it? As I said before, I'm sure he'd have gone on for many more weeks of misery, stuck in a body that didn't move?

All a bit hard to find out what happened. My mate couldn't talk since months ago and you don't feel like prying those in the know like his wife for info?

Very thankful that this goes on. Seems that it's just kept quiet about?


See ya's.

 

[The Fence]

Very thankful that this goes on. Seems that it's just kept quiet about?

Yes be thankful and keep it hushed.


My sister was the same back in Nov.

When I said goodbye for the last time i thought she'd be alive for at least a few more months.

Nup, 3 days.

Thank God for morph.

Otherwise her lingering would have been hell.

 

[weg]

It's been normal practice for many decades. First and foremost it's about making sure the patient doesn't suffer at all in the final 'terminal' stage.

The coroner sees it this way too even if it does hasten death (the dose is not one big hit).

Many years ago I worked with a couple of doctors who disliked using any drugs that hastened death (pain control fell well short before they were expected to die too), and many of their patients clearly suffered prolonged and painful deaths.

Their actions were frowned upon by everyone even then.

 

[lizzie]

Having watched several friends and relatives go thru life ending diseases like motor neurone, brain killing strokes and incurable cancer I am very for euthanasia ... even if it is just "tipping over the edge" by doctors.

The bit I don't understand ...

My previous dog and I used to visit a dementia ward once a week for "dog therapy". I was incredibly sad to see these shells of people wandering around, completely bewildered and "lost" within themselves, often causing trouble by taking other patients' property or wandering into random rooms - or just sitting in a corner day after day staring at the wall.

The staff did the best they could to keep the place lively and engaged - with hairdressers and nail artists coming in, craft sessions, music and games.

The first day, I was warned to keep a close eye on Mushka so that she didn't pick up any medication off the floor as patients sometime drop their tablets because they don't want to take them.

My mother in law suffered dementia, and got super paranoid about everything (which is very common), so I asked the staff what happened with the medication when the patients got to that paranoia stage ... apparently they crush it up an put it in their food.

Now - the bit I don't get - why, when a person gets to the stage they are suffering dementia so badly that their lives are spent staring at a wall - why are we forcefully medicating them to extend their lives?

 

[xactly]

Top Cropper

Im sorry for your loss. I am grateful that your mate had a peaceful passing away and death without pain and suffering, just dignity and peace.

Let me see if I can help you with the terminology and the confusion that is in this thread.

I am a senior doctor, I work with the critically ill. Life support and emergency treatment of trauma, infections, cancers and chronic diseases also involves palliation and end of life care in some cases. It has been my chosen profession for the last 16 years. 8 years of advanced training. 2 specialties.

Euthanasia is the practice of intentionally ending life to end pain and suffering. The thought process is.... I see you in pain/in an unacceptable state of being ( or about to be) and to prevent that I will end your life.

This is illegal and there is much debate. I do not want to get into that here.
My aim is simply to answer your question. "I thought it didnt happen?"

It didn't. It shouldn't. It is illegal.

Your Mate sounds like he was the recipient of excellent palliative care and end of life therapy.

How is this different?
Palliative care is the response to the disease process. If the pain is increasing, it is treated, If any symptoms are affecting the quality of life of the patient. they are resolved.

Sometimes the treatments may hasten the dying process, the drugs make people pain free but stuporous. relieve anxiety but change the breathing pattern. This is accepted as a side effect because overall the therapy is helping the patient. i.e. they arent screaming and distressed in intolerable agony as the cancer eats thru nerves or as in motor neurone disease where the patient is trapped and suffocating in his own body unable to move his arms or speaking muscles properly and finally move his chest muscles...to breathe...

we may not be able to cure them but we can give them a humanitarian, dignified pathway as the disease continues.. and eventually the disease causes the patients death.

The Doctors don't chose when and likewise the families or patient does not choose the time of death. if they did it WOULD be euthanasia
Nature, the disease process combined with the responses to therapy, That is the decider.

what we can do tho is give you an estimate of the time remaining for the patient, based on our experience and practice. Like a mechanic estimating how long your car will run.

We tell the families what to expect so everyone is prepared.
"When this and this happens... then come back to hospital as the nursing care will be too heavy to cope with at home...he will have likely x time left.

I have told many families they have
... hours to days
... days to weeks
and sometimes minutes to hours left because of my clincial experience. This may have happened to your friend and his family as chronic disease has a mostly predictable course. That is how the doctors would have been able to tell him and his family how much time he had and what would happen to him as the dying process continued

Of course, some people "just know" when they are going to die and I have no scientific explanation for that. but I have met patients who have patted my hand as I have explained to them what is happening and smiled at me.

"Its OK doc. Im ready. I know."

Palliative care has come a long way and it is a privillege to help people in their last hours to be pain free and dignified and surrounded by family who are not crying and witnessing the treatable distressing symptoms of death but holding thier loved ones hand knowing that medicine cant cure them, but it can still relieve suffering and allow them a dignified respectful end of life care.

But I have never thought to myself " you have had enough, I will end your life now"
That is illegal. That is euthanasia.

It is vastly different from good quality palliative care and end of life treatment and I think a lot of the cases that hit the papers are because they arent being treated and supported effectively, hence the euthanasia call.

I hope this helps.

Best wishes and condolences
Xactly

 

[xactly]

Now - the bit I don't get - why, when a person gets to the stage they are suffering dementia so badly that their lives are spent staring at a wall - why are we forcefully medicating them to extend their lives?

YOu may find that the drugs arent life extending but symptom controlling.
For continence, for anxiety or agitation relief.

Some dementia is hallucinogenic and can be quite frightening.

 

[Truly Exotic]

so sorry to hear that, my friends mother passed away from it a few years ago, I think she lasted 2-3 years,

very sad disease.

as for euthanasia, Im on the fence,
Im actually completely for anyone being able to take their own lives at their own will,

however, when you are in pain or in a mental unbalanced state, you often make bad decisions.........and obviously you cant press the Undo button

 

[lizzie]

YOu may find that the drugs arent life extending but symptom controlling.
For continence, for anxiety or agitation relief.

Some dementia is hallucinogenic and can be quite frightening.

I did ask and the nurse replied that most of the medication was for heart/cholesterol/diabetic etc type conditions ... and that the law is that they must medicate.

 

[weg]

Now - the bit I don't get - why, when a person gets to the stage they are suffering dementia so badly that their lives are spent staring at a wall - why are we forcefully medicating them to extend their lives?

Mostly what they are trying to get the patient to take is not life extending medication but medication to make them more comfortable, ie. anti psychotics, anti depression/anxiety and anti Parkinsons medication, apperients, etc.

Without some of these my FIL would be back to the old themes of thinking the nurses are undercover police and are planning is execution him, or that his family will be kidnapped and murdered (has 'treated' major depression, recent diagnosis of Parkinsons, dementia).

Occasionally he has his tablets crushed because without them he would go back to the tormented person that he previously was.

Oops, xactly answered this.

 

[lizzie]

Occasionally he has his tablets crushed because without them he would go back to the tormented person that he previously was.

Oops, xactly answered this.

I totally agree with that type of medication ... the nurse explained that the life extending medication laws were caused by relatives unwilling to allow, or unready for, a loved one to simply pass away.

The sad part is that we so little death in our society nowadays - all very clinical in most cases - that death in any form is no longer seen as a normal part of life.

 

[xactly]

I did ask and the nurse replied that most of the medication was for heart/cholesterol/diabetic etc type conditions ... and that the law is that they must medicate.

Hmmm. The law is that NURSES cannot withhold medication unless for a defined medical reason and certainly not cease them unless discussed with a physician. There is no law that says you MUST medicate, only that good medical practice is followed. Consistent with the standards of your respective college guidelines and peer review practice as reviewed by the medical board and regulatory affiliations.

Heart medication... It depends, some control heart rate without which uncomfortable or unpleasant palpitations happen.
End of life care again

Cholesterol. Well I agree with you there, no point in a pill that decreases your risk of stroke /heart attack over 10 years if you are 92! It's not really life prolonging merely unnessessary.

Diabetic comas are very unpleasant until you are deeply unconscious.

The point is some medications are for symptom control. Some are pills the poor dears have been taking for decades and non intervention or keeping the status quo is thought to be the best option giving the least harm.
Some are irrelevant. I always cross them off.

There are many reasons for the medications in dementia wards. It isn't just the wilfull prolongation of life... Any life... As your enquiry seemed to suggest.

Apologies if I have misunderstood you.

Cheers
Xactly

 

[xactly]

I

The sad part is that we so little death in our society nowadays - all very clinical in most cases - that death in any form is no longer seen as a normal part of life.

Agreed. Death can be a friend or simply part of the cycle. We are too compartmentalised.

Country folk understand the cycle of life more than city folk as a generalisation I find.

OR
Folks who have a close multigenerational family. They understand. It's an honour to meet such strength and caring at times like those.

 

[baby blue eyes]

Xactly

Thanks drs like you helped my dad ( cancer) my mum ( liver) and my uncle( motor neurone disease) pass with grace and dignity..... You explained the process well and kudos to you