The columnist’s father suffers a broken hip, renewing questions about declining health, medical care and euthanasia.
Steve Lopez
Last time I wrote about my dad, he’d taken a fall in his bedroom, couldn’t get up, but didn’t want yet another ride in an ambulance. So my mother got down on the floor with him, pulled up a blanket and they went to sleep.
This time they went down together, falling in the street outside a Burger King in the Bay Area town of Pittsburg. He was using a walker with my mom assisting, but he lost his balance and dragged my mother down with him.
She was OK, but my dad was hurting. An ambulance happened to be going by, scooped him up and the verdict in the emergency room was a broken hip.
For a senior, those two dreaded words — “broken hip” — are often the beginning of the end. Doctors said that without surgery, my father would probably die within three months. But surgery itself could kill him, given his weak heart.
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h/t Michael Fugate
Four weeks ago as of today, my father died. He was aged 83. Up until about 4 months ago he appeared to be in reasonable health. If I’d been asked how he was after my last proper visit (he and my mother had retired to the Gascony region of France; I live in the U.K., as does my older brother and two of my sisters along with their respective families; my third sister lives in Canada, along with her husband) I would have said that he looked good for another 5 years, though probably not 10.
It was just about four months ago that the first signs appeared. He had gone to the doctor with a spot on his brow that proved to be cancerous. This was treated, but he was soon diagnosed with a prostate condition and an x-ray scan revealed a mass on one of his kidneys. He also developed severe back pain which progressively restricted his mobiltity. A biopsy for his kidney was scheduled (by now it was clear that he had entered into significant cancer territory), but in the end never took place. He was finding eating difficult and was growing weaker. Just before the kidney biopsy was due to take place, he was hopitalised from a mild heart attack and further tests revealed that his back pain was from the cancer metastasising to his spine. He was by now too weak for either surgery or chemotherapy and was allowed to go home; we were told to say nothing about it, but basically it was just to await the inevitable.
My youngest sister Debbie (the one who lives in Canada) was over for a visit as this was happening; my first sister also managed to get out to France for a while. Together with my second sister, I was able to get out to see my mother and father for a week at the beginning of October (we crossed paths very briefly – the taxi that brought Fiona and myself to my parent’s house took Laura away on the first stage of her return journey). By this time my father was not in good shape at all. He was completely bedridden and growing steadily weaker as he was hardly able to eat anything at all – with hindsight he may eveh have been actively starving himself. He spent quite a lot of his time dozing, though he was still quite alert and lucid when awake. Even so, the way he was during this time is not the way I choose to remember him. My brother Robert was also able to visit for a couple of days soon after Fiona and I had left, but by now he had deteriorated even further. Finally at about 10 to 7 in the morning of the 20th Robert called to break the news that I had been expecting – our had called him to let him know our father had died during the night.
From some things my mother said a few days later, I think she would have liked the option of easing his passage to have been available. Ever since I saw Terry Pratchett’s (I think it was actually the BBC’s Richard Dimbleby lecture, come to think of it) presentation on Assisted Dying, I have been coming round to favouring this position. My father’s experience has confirmed my position – if and when I am ever in a similar position I want the option of checking out in my own time rather than waiting to be evicted.
This particular issue is becoming more and more evident as time goes on, as medicines get better, and people’s lives become longer and longer.
Somehow where the Hippocratic oath states “do no harm” has been translated to “prolong life as long as medically possible”.
Somewhere the idea of quality of life has been lost.
While medical technology surges ahead with what is possible, as a society we need to ask ourselves what is the best course for each individual patient taking into account their quality of life and their wishes, and change the law accordingly.
Indeed. In the Medical Ethics course that I teach in the local Institute for Lifelong Learning here, under the aegis of Bucknell University, in the first session – “Primum Non Nocere?” – I deal with aspects of this issue at some length. It is a fact that medical practitioners at all levels of care-giving are focused on the necessity of going all-out to preserve life, regardless. The baleful consequences of ‘doing good’ are universally overlooked, much to the disfavor of those who simply want to stop their own pain and suffering. I have many such episodes in my memory banks from 40 years of clinical neurosurgery, and I regret my part in very many of them. Sometimes, compassion for the humanity of suffering and dying patients takes years to develop, and among doctors, often it never does – for some, safely hidden amongst dogma.
I thought I had posted a response to this, but clearly did not push the “Post Comment” button, and it simply disappeared! However, to start with Dactylos — sorry about your Dad — know what you mean by the thought that your mother “would have liked the option of easing his passage to have been available.” While I have not likely seen as many people die as Loren, there is scarcely a person whom I have seen dying where I did not think to myself what a blessing it would have been if someone could have gently eased his or her passage. “First, do no harm,” is a good principle to start with, but it is not enough to be going on with. Indeed, it might be fairly said that to stand by while things go very badly indeed is to do harm, for not doing something, when you could, is doing the opposite of what you could have done. So, not only is prolonging life for the sheer purpose of simply more hours wrong — the death cult at work, because it prolongs the act of dying in order to oppose the death that comes at the end of it — and thus a positive harm; not permittiing the shortening of the misery is also a positive harm, if the person suffering wishes it (or would have wished it).
And — to add another point — the idea that the suffering should pay with their suffering, to protect others from the possible abuse of any law which would legalise assisted dying, is perhaps the most cynical idea about death and dying, and yet it is appealed to again and again.