It is virtually impossible to escape all the death talk in the media with its focus on worst case medical scenarios and perplexing treatment options. In spite of all the hype that leads people to feel overwhelmed or frightened by medical decision-making when they or their loved ones are seriously ill or near death, not every such situation involves wrestling with difficult dilemmas. Plain old common sense (along with accurate information) may be all that is needed to make a person’s last stage of life as good as possible.
For instance, Nancy Valko, an intensive care nurse, recalls: I once cared for Mary (not her real name), an older woman who was near death with cancer. Her loving family took her to the doctor when she became confused and severely short of breath. An x-ray showed a fluid build-up near her lungs. The doctor inserted a long needle, aspirated the fluid and Mary immediately improved. Still worried, the family asked me what they should do if the fluid built up again because they were afraid that this would prolong her death. I told them that the primary question now was comfort. If, for example, fluid did slowly build up again but Mary was comfortable, it could be burdensome to aspirate the fluid. However, if Mary did develop severe breathing problems that could not be controlled by medication, they might want to consider another aspiration since the goal was to make Mary as comfortable as possible during the short time she had left. “Why, that’s just common sense!” her daughter exclaimed. Exactly!
Sometimes, because it is assumed that a person is dying, other possibilities are overlooked. For example, when an elderly person doesn’t feel well or eats very little, his doctor and family may think he is dying of old age and look no further. However, poor nutrition, depression, loneliness, and other reasons for the person’s condition should be explored. The solution can be as simple as better nutrition, antidepressants, visitors or a pet. A thorough medical examination may also reveal treatable physical problems. If the person is truly dying, he or she will die with or without interventions. But it is gratifying for all concerned when an elderly person makes a remarkable recovery after his or her true needs are identified and met.
If a time comes when it is impossible to heal or cure, we do not deliberately hasten death. We do what we can to meet the person’s physical, emotional, social and spiritual needs. We lovingly care for the terminally ill person until death comes naturally.
Patients who want potentially effective treatment should not be denied it even when there is only a faint hope of curing or extending life. Extraordinary or experimental treatments can be tried with the option of stopping them if they don’t produce the hoped for results.
A balanced view rejects intentionally causing death while it accepts the morally sound decision to stop medical interventions that are ineffective, harmful, extremely burdensome to the patient or overly zealous. It’s just common sense.
