Modern medicine can keep people alive – but is that the same as really living?
I asked myself that question when my dear old Gran was dying a few years ago. She was aged in her 90s, and in her last few years earth-side she was virtually blind, 90% deaf, and suffering from dementia.
It was an awful, confusing, undignified way to go.
I ask myself that question again now, as I watch my dad go downhill. A four-year battle with cancer has him now bed-bound, unable to perform any functions for himself. He’s fed, he’s cleaned, he’s dressed, he’s shaved. He has an army of competent carers who tend to his needs around the clock.
And he has an army of health professionals topping up his painkillers, managing his discomfort as best as possible. He’s still with us right now, thanks to modern medicine.
But I wonder… Is that a good thing? At what point does quality of life and dignity take a backseat to simply drawing breath?
In this heart-wrenching article in the New York Times, doctor Sara Manning Peskin describes the agony that families go through when their loves ones are technically gone, though physically alive.
She describes a family’s agonising decision over whether to proceed or not with treatment, for their chronically ill mother.
“The immediate fear of watching her die outweighed the unfamiliar pain of sustaining her on machines and watching her disappear in a long-term care facility,” she says of their decision to keep their mum alive.
In these instances, “sparse cases of recoveries” occur, but the overwhelming majority of patients experience “painful, expensive, drawn-out deaths – ones we would never wish for ourselves or our own families”, she shares.
“When it comes to end-of-life decisions, doctors are terrified of violating patient autonomy. We are scared of our own medical opinions,” Dr Manning Peskin says.
“So instead of saying, ‘I recommend…’, we often offer a platter of life-prolonging measures, most of which are unlikely to improve a patient’s quality of life, but which offer the possibility of hope. The patient’s heart will still beat. Her personality will be gone, but her chest will still rise and collapse. Families see an opportunity for loss to be delayed, perhaps even dodged. Then we are surprised when they take us up on the offer to prolong dying.”
As medicine continues to get smarter – the US has just approved a digital pill that tracks when you take it – the number of people who are alive, without living, is only going to grow.
But I’m not sure whether we should be celebrating?