Thursday, February 02, 2006
Take my breath away
"Dear Doctor, this is a life-saver and I give it to you because you save lives"... Edward
I was reading this short note on a sticker of a life-saver mint that a sick patient gave to me and other members of the team. Edward had a terminal disease in his lungs from smoking and came to the hospital having an infection, then he suddenly became very short of breath and we watched him take his last breaths, gasp for air with his face turning blue and his hands and legs shaking until he gradually stopped breathing completely and was gone. That was the first time I see someone actively dying in front of me without being able to do anything. We had all the equipment and medication which could have brought him back to breathing, at least temporarily, but we didn't interfere because Edward had asked us a few hours before that, when he was more alert and healthy, that in the case his heart and lungs stopped working to let nature take its course and not intervene to bring him back to life.
A lot of patients take these decisions, and sometimes doctors encourage them especially in terminally-ill patients who will only suffer longer if they're placed on a breathing machine. Other patients are totally healthy but are too old and they feel they had a good life and if their heart stopped they don't want anything done for it. Whatever the case is, people who make these critical decisions about their living wishes make these decisions when they are alert and conscious, and when most of them have not known what death or dying is like.
I'm wondering if Edward, while fighting death during the last seconds of his life, would have changed his mind or whether or not he have regretted his decisions and that is something we can never know. However it also wouldn't make sense to keep him on a breathing machine all his life if he is unable to wake up and breathe on his own: he would be basically turned into a "vegetable".
What confuses me, is that some people who are very healthy and have never experienced what death is like make a choice about their end of life and ethically and legally we have to follow their choices, but on the other hand whenever a dying or suffering person asks to end up his/her life that would be considered a murder. We are allowed to let people die although this can be stopped, but we are not allowed to help them die. Those technicalities can either make you a compassionate doctor or a serial killer.