Palliative Care, in this morning's NYTimes

[Grits]

This morning's most widely read story at the Times has much to do with the cost of healthcare. The great cost of terminal illness; its toll on those ill, as well as their loved ones.

On Palliative care:

http://www.nytimes.com/2009/12/27/health/27sedation.html?em

We easily say what we will or will not do, or allow, when we or our family members are well. The article looks at how our feelings may change when faced with the reality of constant pain, and death.

[WinterTriangle]

There are a lot of beliefs held by people and it all plays a part in end of life scenarios.

I can only speak from my experience working in a transplant/trauma dept. of large famous teaching hospital.....there's a actually not a huge % of people who are willing to donate organs to those waiting, and what a tough touchy conversation it is to have with newly grieving loved ones of some young kid who is newly brain-dead from a motorcycle accident.

But there are lots of people who just don't want their loved ones carved open even after they are deceased, and one has to respect they have their reasons.

While I respect people's beliefs and wishes, I am still a big supporter of organ donations, eyes, heart, etc. and always encourage people to make arrangements for that to happen if they can find it within their belief-system....what a wonderful gift to give someone who will live, or have vision, because you gave.

It's pretty amazing, surgical teams have you on the operating table, taking out your bad organ while the other one is en-route via jet plane from across the country somewhere......and usually another team takes over the transplantation from there.......and so many people on these teams getting up in the middle of the night to operate, and assist, with practically no notice at all except a call on their beeper. It was the most amazing experience I've ever witnessed.

As for end of life hospice palliative care, philosophically and spiritually, it depends on whether you believe that we all have a time to go. With modern science, it seems that we can extend that, and even interfere with it, for long periods of time. For myself, I have a DNR. I only want to be "interferred with" when there is very compelling evidence that I will rise and shine and go on to live a "productive" life. When it's my time to go, and my brain and body can't do the work they do, or cannot be expected to recuperate enough to do that, then I'm ready to let go. I am one who has fully accepted that I will not live forever, and I have worked on myself spiritually to deal with the eventual outcome of my life, which is that I will die.

I have sat with dying people a few times, who were indeed kept comfortable with morophine, which will eventually kill you, but lived out their last days in a sort of "dream-like" state.........comfortable, but not fully conscious. But I can't imagine any other way because it would be worse to expose them to great suffering when we have the technology to alleviate that. I guess I agree with Thomas Aquinas as qutoed in the article.

There are cultures that are more accepting of "death being part of life", but I'm pretty sure that we are not in that place. Many cultures also are used to dealing more closely with their own deaths...i.e., washing and dressing and such------ we seem to want to be as far-removed from that whole process as possible.

It's a very personal thing. I don't envy the ethical decisions these doctors face, I can't imagine doing that job.
I do suggest, no matter how young you are, to make sure you have a living will of sorts, in which your wishes are clearly outlined. It would certainly alleviate much pain on the part of your loved ones and care givers if they KNOW what you want!!! I would not want to be making those decisions for anyone.