End of life decisions

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canmark

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Last fall, the CBC did a very interesting series on people making end-of-life decisions. It was called Last Right.

Assisted suicide is illegal in Canada but public opinion is shifting. Baby boomers are aging and they are bringing their activism to the subject, intent on pushing the debate forward.

In our series 'Last Right,' Duncan McCue follows Canadians, many of them terminally ill, who have decided to end their lives and want to control the way they die.

Click through this interactive to hear their stories, along with other voices in the debate. There are also behind the scenes details from Duncan and viewer responses to the series.

Recently, this was in the news in Canada: Lawyers want Supreme Court to view man’s dying plea for assisted suicide law

The friend of a Toronto lawyer who went to Switzerland to end his life says a group of lawyers is looking at whether his dying plea for legalized assisted suicide could be part of an upcoming Supreme Court hearing on the subject.

In an open letter and video, Edward Hung, 62, explained why he opted to die with help rather than continue living with ALS — amyotrophic lateral sclerosis — an incurable and increasingly debilitating condition also known as Lou Gehrig’s disease.
 

Atsugi

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In those few places where Physician Assisted Suicide is legal, it's not easy. Sometimes there are residency requirements, and usually the patient must self-administer the drugs.
 

AfraidButNotAlone

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My EOL directives are to provide food and water, but no cardiac or vemtilator support. Still up in the air about ventilating prior to EOL time.

I'm going to talk with my priest about it all.
 

MaxEidswick

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>I'm going to talk with my priest about it all

I would sure what that goes like ... it is a very tricky question: Quality vs. Quantity. That Last Right video was very touching.
 

CGARS

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Gloria Taylor, a pals from B.C. Canada, was the only person in Canada to win in court her right to die.
She passed away in 2012 before going through with it.
 

Tx Daddy's Girl

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>I'm going to talk with my priest about it all

I would sure what that goes like ... it is a very tricky question: Quality vs. Quantity. That Last Right video was very touching.
My EOL directives are to provide food and water, but no cardiac or vemtilator support. Still up in the air about ventilating prior to EOL time.

I'm going to talk with my priest about it all.
It goes against Catholic doctrine - my dad would've done it along time ago had he not thought his soul would be in jeopardy.

We were told if we started the vent or PEG we could not then take away what was providing life so we chose to forgo both. Our priest has been very good about answering questions.
 

MaxEidswick

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>We were told if we started the vent or PEG we could not then take away what was providing life so we chose to forgo both. Our priest has been very good about answering questions.

I, also, have a similar concern and am unwilling to pass control to the medical/political institutions. FWIW, I have no real basis in fact, only fears.
 

Tx Daddy's Girl

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>We were told if we started the vent or PEG we could not then take away what was providing life so we chose to forgo both. Our priest has been very good about answering questions.

I, also, have a similar concern and am unwilling to pass control to the medical/political institutions. FWIW, I have no real basis in fact, only fears.
Same here. My dad always said if he got Alzheimer's like my grandmother he'd shoot himself. When he was diagnosed it was my biggest fear but after talking to our priest he choose the same as you. If I didn't fear for my soul I would put him out of his misery for him. It's the thing I hate the most, I want to end his pain and God isn't taking him fast enough.
 

Santa joe

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When I said my prayers at night, I would always end with "thank you Lord for giving me another day with him". I know longer say that. Watching his progression is a nightmare both for my pals and myself.

Debbie
 

Diane H

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>We were told if we started the vent or PEG we could not then take away what was providing life so we chose to forgo both. Our priest has been very good about answering questions.

I, also, have a similar concern and am unwilling to pass control to the medical/political institutions. FWIW, I have no real basis in fact, only fears.
You have been badly misinformed. In 1990 the Supreme Court ruled that any citizen has the right to order the end of any medical treatment they are receiving including ventilation, nutrition, dialysis, medications. I knew personally two PALS who made this decision and were given medication for comfort, sedation, and to relieve air hunger before the ventilator was turned off. There was no legal entanglement in the process because both people were able to make it clear that they wanted to be allowed to die.

This is not assisted suicide. In legal terms, assisted suicide is administering drugs or other methods of ending the life of another person who wishes to die BUT is not receiving any treatment that is keeping him alive. That treatment can be legally withdrawn allowing the person to die. Assisted suicide requires a step to cause death in someone not depending on treatment or equipment to stay alive.

Seeking legal advice from a priest, pastor, etc. is going to get religious views instead. If that is what you are seeking, fine, but recognize that it isn't legal information.

The one thing I find most emotionally comforting about being on a ventilator is that I am in control. If at any point I decide that I want to end my life comfortably, legally, and without putting anyone else in legal jeopardy, I can do so. My only fear is that that right to self determination may be taken away by right wing nut jobs who want to enforce their religious beliefs on everyone else.
 

lgelb

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The statement that a Catholic PALS can't or shouldn't get a feeding tube because it "can't be taken away" (which is not the course that most PALS w/ tubes take anyway) is at odds with both current practice (hopefully some Catholic PALS can chime in here) and the Bishops' directives. From Ethical and Religious Directives for Catholic Health Care Services, 5th ed., US Conference of Catholic Bishops:

We have a duty to preserve our life and to use it for the glory of God,
but the duty to preserve life is not absolute, for we may reject life-prolonging procedures that are
insufficiently beneficial or excessively burdensome. (p. 29)

Medically assisted nutrition and hydration become morally optional when they cannot
reasonably be expected to prolong life or when they would be “excessively burdensome for the
patient or [would] cause significant physical discomfort, for example resulting from
complications in the use of the means employed.” For instance, as a patient draws close to
inevitable death from an underlying progressive and fatal condition, certain measures to provide
nutrition and hydration may become excessively burdensome and therefore not obligatory in
light of their very limited ability to prolong life or provide comfort. (p. 31, section 58)

And in a similar spirit:
Medicines capable of alleviating or suppressing pain may be given
to a dying person, even if this therapy may indirectly shorten the person’s life so long as the
intent is not to hasten death. (p. 32, section 61)

and:
The free and informed judgment made by a competent adult patient concerning
the use or withdrawal of life-sustaining procedures should always be respected and normally
complied with, unless it is contrary to Catholic moral teaching. (p. 31, section 59)

Your priest may be referring to a well-publicized edict from the last Pope that feeding tubes should not be withdrawn from pts in a persistent vegetative state, which was sparked by a couple of high-profile cases in the States. As seen from the above, ALS as an invariably terminal condition (which PVS is not) as well as a potentially painful and distressing one due to air hunger, etc., would not apply to that particular edict.
 

affected

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Such a difficult discussion, and so many views that all have merit.

Diane, thanks for making those distinctions clear, they are truly important ones.

I wondered often at the time and since, if my husband somehow chose the Easter weekend so that we would truly be alone with no services available or booked to be intruding on his end of life.

In Australia, the palliative care approach is very humane. We had discussions in the last month or so with both our doctors (physician and GP) and the community palliative care team about what he wanted the end to 'look like'.

So there was just Chris and I at home alone, I spoke twice a day with palliative care on their support phone line, and they just gently encouraged me that I was doing perfect and how to increase his doses or frequency and kept saying - comfort is the only important thing now.

Did I end up giving him a dose the stopped his breathing? I ask that here in response, but I can assure you all I don't walk about now wondering that. He was ready to go and he let go.

In Australia, if you are registered with palliative care, when your PALS passes, all you need to do is phone the funeral director when you are ready. You can phone immediately or you can invite all your family to come over or do anything you like, there is no time frame.

The funeral director as part of their fee then have your doctor do the death certificate and that's it.

It's not quite the same as assisted suicide, but then it is - if you as a PALS decided to refuse nutrition and fluids and assistance, you would quickly be in an EOL situation. I HATE the word suicide attached to these situations, I wish there was a new word that didn't have the stigma of suicide attached to it.
 

MaxEidswick

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>I HATE the word suicide attached to these situations, I wish there was a new word that didn't have the stigma of suicide attached to it.

me too -- is there one?
 

dalvin

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Not a word but a concept for those who are believers, turning things completely over to God and allowing him to say when
 

Bad Balance

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I considered a body bag, two large zip-lok bags and a 45cal pistol, but realized that I wouldn't be able to work a zipper or lift a gun
 
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