A most uncomfortable topic

Actually, it would be more apt to see this as a lack of true compassion – ‘to suffer with’ – replaced by a utilitarian attitude toward impaired and dependent family members.

“There is one ethical guidepost for all the protocols: Terminal sedation should not become so routine that the end of life is scheduled like elective surgery, for the convenience of the doctor or the family, or because the patient’s care is no longer economically viable.

“Physicians occasionally feel pressure to turn up the medication, said Dr. Pauline Lesage, Beth Israel’s hospice medical director. The pressure may come from weary relatives, who say, in effect, “Now it’s enough; I just want him to disappear.”

There are chilling glimpses in this piece of the cultural down slope we’re on that’s gradually changing the way we think about end of life care. At least we’re still able to catch the discomfort in having these situations, and using these terms.

“Mr. Oltzik’s life would end not with a bang, but with the drip, drip, drip of an IV drug that put him into a slumber from which he would never awaken. That drug, lorazepam, is a strong sedative. Mr. Oltzik was also receiving morphine, to kill pain. This combination can slow breathing and heart rate, and may make it impossible for the patient to eat or drink. In so doing, it can hasten death.

“Mr. Oltzik received what some doctors call palliative sedation and others less euphemistically call terminal sedation.”

Thank God for good and great and ethical health care professionals like my friend Nancy Valko, who responded to the Times piece with this:

“In my experience, it’s more often the doctors and ethicists rather than the families who are ready for the patient to “disappear” and not “waste” health care resources. Terminal sedation is proving to be how so-called “assisted suicide” is flowing down to the general public. It’s no accident that terminal sedation is allegedly becoming more popular than the one-time lethal overdose in Holland. Terminal sedation accompanied by the deliberate withdrawal of food, water and basic care without a medical indication is an easier way to fool oneself-and the public. Having been a hospice nurse myself, I know the difference between making someone comfortable with sedation and pain medication versus deliberately causing or hastening death. Everyone deserves a natural lifespan.”

Well said.