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DEATH BE NOT PROUD
1 February 2006
I saw a couple of things on Sunday that set me to thinking about how our ideas about things are so screwed.
First, there was the 60 Minutes report on the man who is serving twenty-five years in prison for "drug trafficking." His crime is in using what the law has determined is too many prescriptions, filling prescriptions his doctor now denies writing, and all because he suffers from chronic pain, which he describes as feeling like his legs are sticking in a barrel full of flames, pain so severe that it has driven him to attempt suicide.
Doctors, the report goes on to state, tend to under-prescribe for patients with chronic pain because they fear that they will be charged with contributing to a drug addiction, when in fact, the drugs are simply to relieve the pain.
I am reminded of a time when I worked for a psychiatrist (not "the" psychiatrist) whose job was to do mental health evaluations for Workers Comp evaluations. I worked in his office and it was next door to an orthopedist's office. I left our office one day and there was a patient sitting on the patio, tears streaming down his face. He suffered from unremitting pain, but neither the orthopedist nor the psychiatsit would help him because he had used up his number of referrals and the doctors would not be paid to see him. So the man sat there pleading for relief and nobody would lift a finger for him. I have often wondered what happened to him.
The "perfect squelch" to the 60 Minutes story is that now that the man is incarcerated on a 25 year sentence, the government has taken over his medication and are giving him morphine, stronger medication than what he was convicted of taking.
I contrast this to the story recently of the judge who sentenced a man convicted on two counts of child molestation to two years in prison (public outcry convinced the judge to up the sentence, but initially it amounted to a slap on a wrist--for child molestation, while the man trying to relieve his own pain is sentenced to 25 years behind bars, while the government supplies his drugs).
Later Sunday night I was watching Grey's Anatomy. One of the story lines concerned an old woman, who was resigned to and looking forward to her impending death, hoping to be reunited with her deceased husband in the afterlife, but she was accidentally intubated when the intern forgot to read the DNR order ("do not resuscitate") in her file. The law demands that once a patient has been connected to any life-saving apparatus, whether there is a DNR or not and whether the life-saving has been made by mistake or not, the medical personnel are not allowed to remove that life support without orders from someone who has a medical power of attorney.
I attended a seminar on death and dying at Stanford with Steve a few years back and heard horror stories of people who had gone out of their way to make certain that their wishes were respected, only to have paramedics, unaware of the standing orders, put them on life support, which the hospital was then legally bound to keep in place. One woman went so far as to keep her DNR on her body, but, fearful of a lawsuit, the paramedics put her on life support anyway.
In the Grey's Anatomy story line, the woman's daughter had to make a special trip in to sign papers which would permit the doctor to remove her mother from life support. It then took several hours for the woman to die, during which time she was surrounded by the people who loved her, who touched her and wished her well on her journey.
It made me think of putting our dogs to sleep. Seeing that they were suffering in intense pain and no longer wanted to live, taking them to the vet's office, holding them while the vet gave them a tranquilizer to calm them down, and then holding them in my arms while the doctor injected the drugs that would end their suffering--and their life.
As emotionally painful as it was for me, it made me feel good knowing that the dog I loved was no longer in physical pain.
It also made me angry, every time, to realize that at the end of life, we treat our animals better than we treat our human beings.
Human beings in intense physical suffering are denied the relief they need on the theory that it might cause drug addiction (when most doctors will tell you that drugs which are take for pain usually act differently on patients than those which are taken to get high. There are instances where terminal patients, where it is agreed that they have only "days" to live, are denied enough drugs because they might become addicted!) So instead of helping them deal with the pain, we put them in prison, away from their loved ones--because they dared to try to find their own relief from the physical pain.
When it comes to death, we will go to any extremes to keep a body alive, no matter how much the person is in pain, now matter how much the person has made his or her peace with the end of life and is ready to pass on to whatever is ahead of us, no matter how much the patient begs to be allowed to die.
Dr. Kevorkian sits in prison because he felt (rightfully so, I believe) that people had the right to make the decision about where and when to end their own suffering.
Our new Supreme Court Justice voted in support of the challenge to Oregon's Right to Die law.
We can relieve the suffering of the family dog, but not Grandma.
The only time it seems when ending a life is OK in this country is when we are taking an eye for an eye. We can't choose the less costly alternative, locking a person in prison for the rest of his or her life, without hope of ever being released on parole. Instead we give them a lethal injection and watch them die and we say that this is a good thing.
But if Grandma is suffering intense pain and wants to die, we tell her she has to tough it out because she has no right to choose when and where she should die.
I don't know. There is just something so "off" in the priorities in this country.
Complementary to this entry is Zon's entry from yesterday. I urge you
to read it.
PHOTO OF THE DAY
I just loved this photo--