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In the last few years I have watched my Mother in Law, my Mother and, more recently, my Sister in Law suffer long drawn out and painful ends to their lives. In each case resuscitation was carried out more than once in an effort to prolong life in a bed-ridden and semi-concious state. With my Mother I had the horrible experience of her actually asking me to help her die, something I could not bring myself to do. I had a discussion with the doctors in the hospital and got an agreement that they would let her go naturally rather than try to resuscitate the next time that her heart stopped. Much as it pains to lose a loved one is it fair to keep them in a vegetative state just because we can? I'm not suggesting that we should stop all CPR as it is often able to give a prolonged useful life in many cases, but how do we set a dividing line? Too quick or not?
The option to have a "DNR" (Do Not Resuscitate) marker on your records is available to us all and is valid in cases such as you mention. However such a marker must be a personal option whilst in a fit mental state to decide; unfortunately this also is not always the case.
Although I dislike tattoos, I can see a case for one on my chest that provides my wishes for such action - the problem as always is when to get it done.
As FM has said this is not just a problem of old age but covers the whole range of health care. My wife is a neonatologist and has the same problem with premature babies. I can only imagine the stress put on a young couple on making this sort of decision and I can assure you that no decision like this is taken lightly.
When I started my NHS career I had to do law as part of my duties covered will writing in emergencies etc and I hated it. When I moved to England I had to do English Law and I still hated it. Where necessary lawyers are now brought in to do this but often it is too late. The whole area is a minefield and often the damned if you do damned if you don't is very accurate. I still believe that the doctor's roll is to "do no harm".
I recognise that it is a case of "damned if you do, damned if you don't" especially in these days of litigation at the slightest chance. Doesn't make life any better for the one being resuscitated. Perhaps the DNR tattoo isn't such a bad idea, but then who knows how you will feel when it really does get near the end.
I have had DNR in my records for a few years.
I have no wish to hang around until our Milky Way collides with Andromeda in four billion years time!
My pal (and downstairs' neighbour) John who was 93 died two weeks ago. He went into hospital as his health was failing.He knew his time had come to die and he refused to be fed and refused all of his medication...I know this because my girl-friend is a nurse who tended him.It's better to let people die peacefully when their time comes, in no pain. It's very hard on relatives.
If you had watched a few program being televised very recently (and there as been a number), you may have seen how the medical people and possibly families deal with this.
One such program was with children in a London Hospital, and the main subject was about quality of life and expense to the NHS, especially if some of the children had possibly never left hospital since their birth, perhaps 12 months or more ago.
My own mother went through a range of hospital intensive care treatments in later life, being transferred between ITU and side wards. The final crunch was visiting my mother the previous evening, when she was 'bright as a bell and ready to go home', then being informed at 8am the next morning, that she had passed away suddenly?.
Was this a blessing in disguise. I wouldn't really know, but it may have saved a lot more suffering in the forthcoming months or years?.
My father died in one of those new and very expensive care homes. that had just commenced being established many years ago. To this day, I are not sure whether he died of convenience, neglect, inexperience or whatever. The death certificates didn't state that. But it as always remained in mind as to the happenings of those final hours or minutes?.
Death can be a funny thing (not in the amusing sense although sometimes on reflection it can even be that)
I got the call one afternoon that my mother had had a bad heart attack and had been rushed into hospital. I immediately jumped into my car and drove up to Glasgow which took several hours.
When I entered the hospital I was told that they were very surprised that my mother was still alive which was a good sign. When I sat down beside her she opened her eyes and smiled at me. She then asked me if I would look after Dinky (Her budgie and best listener) and I said of course I would at which she smiled and passed away.
I often think back to that moment of her hanging on in there until I arrived so she would be sure her budgie would be looked after and I also smile.
Each time you are admitted to Hospital you are for CPR unless and until it is discussed with you ( if you are in a state of mind to do so ) that you no longer wish to be Rescuscitated.
However, if you are too ill to make that choice then your Next of Kin will be asked to do so and all these discussions will be with the Doctors and the Staff attending ( the decision is not 'taken lightly' but after careful consideration of many factors and input from these staff who have direct contact with the patient )
That said, a CPR directive can be reviewed and cancelled if a patient recovers sufficiently for the Doctors to beleive that a health improvement indicates that the patient will respond successfully to CPR if required
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