It's been 12 hours since you posted, so probably the decisions have already been made, but I'll say this, anyway.
A few facts:
- In Florida, a patient (or surrogate) can refuse treatment or withdraw treatment that has already been given.
- In doctor/nurse world, almost no one will allow a patient to die during their work shift, regardless of DNR status.
- Naturally, every human being will fight desperately for every breath.
- Morphine eliminates the pain and panic, so a person doesn't care that they're unable to breathe.
- You can find the best "Advanced Directives" by googling "Five Wishes." Easy, specific and thorough.
Now here's the part of my answer that is sure to anger just about everyone:
- In reality, if the hospital feels there's no argument from other family members, they'll help you become a surrogate and then they'll do what you say. The paperwork is incredibly simple.
- Like everything else in life, the most confident "salesman" gets his way. If they think you're not the one in charge, they'll ignore you.
- My 50-year-old PALS says she's led a wonderfully full life, and doesn't want to live with tubes. She is, believe it or not, a medical doctor. Her highest priority, to the exclusion of her own life, is her family. She wants to ensure we are happy and our kids live a good life. She also knows that she will beg for air when the time comes. So she has made all the arrangements to die as peacefully as possible. We've ensured that the EMTs, ER nurses, our doctors, and the hospital records are all in accord with "just let me go."
My Dad's Story
- My dad lived--mostly non-communicative--for 5 years in a dementia clinic. He got pneumonia and fought for air. So they took him to the ICU where everyone kept him alive, day by day, until I found a doctor who would release him back to the dementia ward.
- A few days later, his nurse called me to say he died quietly and with a smile at 7 AM.
- I was at his side before 7:15--he was still warm. The nurse said that, just a few hours earlier, he seemed to need a little extra morphine.
- I am convinced to this day that the nurse, who had come to know my father and our family very well, simply decided that the dying process needed to stop, and the death needed to finally happen, so she gave him morphine knowing it would stop his breathing and let him die without further agony.
You see, it's not just doctors who make life-and-death decisions. Military commanders, policemen,nurses, and wives of little old men in nursing homes have to make the "live/don't live" decision. Many of us here on this board will have to make that decision, too.
You are at the moment of truth that will face us all. We're all scared of this moment and we all hope to do the right thing. Please let us know how it went. God be with you. --Mike