I’ve had to watch several of my family members (grandparents and elderly aunts) work their slow but meandering way toward the end of life. The thing that struck me in all those cases is that often the desires of the patient for release from suffering is in direct contradiction to the doctor’s desire to keep trying. I understand this urge, because I go through it myself, though I’m usually working on a computer and not something as messy and complicated as a human being.
I have lost count of the times that I have spent more hours than I ever had hope of getting paid for trying to remove a virus or diagnose a hardware problem. There comes a point when it doesn’t matter that I’m losing money on the project, I just want to beat the problem. I think doctors must have that exact same impulse. It doesn’t matter how much agony the patient has to go through, they want to beat the disease. I think there needs to be some consideration given to people having more control of their own lives when they know they are reaching the end. I just read an article about an organization called Advanced Care Planning Decisions. One of the neat ideas I thought really simplified the whole thing was the idea of discussing comfort as an equal consideration in deciding what to do in the process of dealing with disease, terminal or otherwise. How much medical care gets inflicted on patients because they don’t know that they have a choice?
I’m not suggesting that we legalize euthanasia or start sending terminal people off to the Soylent Green factory (Soylent Green is People! for any young people who might be reading this, young in my mind being anyone south of 30) or setting up a board to decide whether someone should receive care to stay alive. I do believe people need to be given the ability to choose between quality of life and quantity of life. Given the choice of staying alive for 1o years in excruciating pain and 2 years with no pain at all, I think a lot of people would choose the latter, myself included.
I suspect the reason people don’t make that choice or even ask to make it is that humans are by and large a hopeful lot. We have been given the ability to imagine things getting better, even in the face of overwhelming evidence that there is no hope. I think what keeps people trying is that there might be the smallest chance of getting better. I wonder if I wouldn’t keep trying just because I’d be afraid of someone finding a cure for whatever ails me the day after I kicked off. I have that kind of luck.