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Make the Argument
Most people in the country are at their limit, emotionally. It can be seen in the comments section here at Ricochet, on TV news, on campuses, and even among friends and family. The emotions include anger, fear, disgust, distrust, and doubt. These aren’t exactly the best emotions for this time of year. The Christmas season is supposed to be a time of hope and expectation, so I’d like to share a recent experience that buoys my spirit.
I’m in graduate school in DC receiving a Masters Degree in Physiology before beginning medical school next year. Occasionally, we will have speakers who discuss relevant issues in medicine, followed by small group discussions. During a discussion of end-of-life care, one student in my group of 20 made an argument in favor of physician-assisted suicide. He said that he would happily assist a patient end his own life, if he wanted to end it. The room fell silent and awkward silences make me uncomfortable, so I decided to offer a retort.
I argued that there is a great moral line that should never be crossed by physicians. The line between removing a patient from a ventilator, and letting nature take its course versus actively killing a patient. Also, as a matter of policy I believe that “Right to Die” will easily turn into “Duty to Die.” Patients feeling pressure from administrators, physicians, and family will eventually end their own lives.
As soon as the words left my mouth, the professor moderating the lecture began laughing and incredulously asked, “do you actually believe that? Come on, you can’t really believe that?” When I shot back a stone-cold stare at him, he knew I was serious. He then proposed the same question to the class who, to my professor’s astonishment, agreed with me. He decided to go around the room and asked everyone why they agreed with me and one girl’s response was representative “well, I walked in here not really thinking about it, but I kinda supported assisted suicide. I just never heard that argument before, but now I don’t think I could support physician-assisted suicide.”
I was a sophomore at this same university during Obama’s first term, and I could have taught a course in keeping one’s mouth shut and hiding one’s own views. I didn’t want to rock the boat, or be “that person” who is always disagreeing. Now that I am back in school, I have decided to change my personal policy of hiding and not engaging. The first reason is that after living in the real world, I have adopted Morgan Freeman’s attitude from the end of The Shawshank Redemption, and I don’t really care what liberal academicians have to say about politics. Most importantly though, I know that there are others out there who agree but are too scared to say anything, and a larger group that has just never heard the argument.
I don’t want this to turn into a Trump vs anti-Trump article, but I agree with David French’s piece about shifting the Overton Window. A group of future physicians were unwittingly on the slow road to accepting a progressive cause. I moved the window and totally blew up the argument. Conservatives have been playing away games for too long, but we can change that by being confident and unafraid to challenge the orthodoxy of the today’s groupthink.
Published in General
Annefy, (17), I don’t get your point. If you don’t want your mom in the ER, which I think is reasonable, can you not decline to permit such care? As to the BP meds, all changes in therapy are experiments, I don’t see anything perjorative in your mom’s doc’s attitude. If one is going to treat, treat effectively, or not at all.
It is a fascinating and very unsettling thing to deal with demented patients. Can we know their quality of life? Perhaps, like the Down’s syndrome angels, the demented may be in a different and better world than are we.
Actually, I don’t think they are. The disconnect in Alzheimer’s is to leave a blank space in their minds which trouble them. My mother would pace the floors every night, around and around the house. She would become very stressed. Finally one night I asked her, “what are you looking for mom?” And she said, “my bed, I can’t find my bed.” After that, I put her to bed every night as you would a small child, kissed her and hugged her goodnight and she never paced the floors again.
I agree completely. I have no idea what is going on in my mom’s mind and heart. But I’m fairly certain she’s happy there. She’s smiled at me more in the past year than in the previous 56. Which my siblings take as proof she has no idea who I am.
My point was that I was surprised by the aggressiveness of care. My relatives in Scotland can barely get into to see a doc – I have docs wanting to start changing my mom’s meds as her BP was a little high.
When the day in the emergency room didn’t turn up anything obvious they wanted to admit her and do more tests.
Everyone was very supportive when I declined further care, but I did have to sign an AMA.
Not complaining; just surprised.
p.s. I think I am complaining, but just a little.
I have the best of all worlds in what is a very stressful situation. I have two brothers and two sisters and all five of us are on the same page. No one is saying: something’s wrong! figure out what it is!
Instead all of us just want my mom to be comfortable.
My mom is on one medication. She probably would have lived to her current age had she been born hundreds of years ago. Not so the case with many in her care facility. Many in her current mental state are on a lot more daily meds. I’m not sure how I would feel about that were we in the same situation.
Fortunately, we’re not.
Because of this experience one sister has already told us and her kids that if she develops dementia like my mom she wants all medications cut off. Let high blood pressure or heart disease or diabetes take its natural course. I don’t disagree with her, but I wouldn’t relish that conversation with a doctor. Telling a doc you are refusing further care is very difficult.
What if it’s a tumor? One doc said to me. What if it is? I replied.
I’ve told her kids the same about me. But not MY kids for fear they’ll pull a plug the next time I can’t find my keys or call them the wrong name.
First—yes, it is a good thing to make the argument, and not allow the assumptions to stand. Keep it up.
Next—my mother has been diagnosed with ALS. The doctor said that we could go to Boston for a second opinion, maybe participate in some clinical trials…Mom just kept shaking her head. She’s not afraid of dying. She’s a little worried about what she’ll have to go through to get there.
I figure my job is to help Mom be Mom, and whatever that looks like, whatever she needs from me, I’m with her.
Now that I think of it, I might go post this on the prayer page…
In my experience, people who aren’t afraid of dying actually are afraid of it, at least a little bit. It may be that the distinction you make between the process and the end result is important, but they usually are afraid. Keep that possibility in mind as you try to help your mother.
You probably didn’t need to be told told that. Anyway, you and your mother are being prayed for.
NOT intending to make light.
Near the end, we contracted with Hospice to help with my dad. 3 days before he died he said to me:
How long are these people going to be here?
Me: We signed a 90 day contract. If you’re still around in 90 days we’ll sign another.
Dad: What? Are you telling me I’ll still be alive in 90 days?
Me: No, that’s the minimum we could sign for.
Dad: What the hell? I’d better not still be alive in 90 days.
So basically he thought he’d paid for it and needed to make it the 90 days to get his money’s worth. Scots …
My dad died 20 years ago after spending his last 17 days in the CC-ICU waiting for a heart transplant that never came. He was very happy he made it to March 2nd before he died – it meant he got an extra Social Security check for my mom.
And just so nobody gets on my case about sponging off the government, he was also sitting up in bed working on his income taxes around ten in the morning. He died that night at about 8:30 PM.
Germans…
Father Duesterhaus, said, “Many processes are initiated because they can be and no one sees the cost – both in dollars and family stress – when the best course of action would be for life to take its final bow.”
I am curious as to your religious affiliation because I haven’t ever heard anyone else with the title Father, actually attempt to consider the dollar cost in decisions regarding continuance of life. What would you say about a middle age woman that some doctor says is “terminal” as she was diagnosed with late stage cancer, and they also say approved protocols surgery, chemo, and radiation are not an option — estimated life is 2 to 4 months, should she be put down now? I mean to say money and stress?
And then, there’s is this …
Miffed White Male “My point is, it would have been easy to say that it’s not worth putting resources into keeping this old lady alive. Why spend all this money, she’s probably in her “last two months”.
But who knows?”