I visited the palliative care oncologist today. I really, really liked him. He was a hospice physician for five years, and he is a man of faith—he is principled, and he is not just another rank-and -file medical moneychanger who is eager to pull the plug ASAP to keep costs down.
So I listened carefully when I asked him the truth about end-of-life care.
My husband takes a firm stand on what he earnestly believes is the highest moral ground: that I should continue to receive infusions of food and water via tube and IV when I become unable to feed myself naturally.
He believes that to withhold them is like starving the patient—an inadvertently cruel method of hastening death.
Many people believe this.
I used to, too.
But after having spoken with my hospice nurse and now this palliative care oncologist, I have learned some things that I was previously unaware of.
When a patient who is already in the process of dying loses the ability to feed himself, his body adjusts to the lack.
Administering food and water artificially actually can cause physical harm and increase discomfort.
When the hospice program admissions nurse told me that, I didn’t believe her. She seemed rather insensitive and callous in her general manner, so I instinctively didn’t trust her. Despite the fact that she worked for hospice, she seemed to have a complete tin ear when it came to empathy.
But when I spoke with the doctor today, I heard specifics of how the dying patient is put in more discomfort: the body no longer is able to process water properly, and excessive swelling can occur in the extremities (my left ankle is already prone to swelling)—plus, the lungs tend to fill with fluid.
So it is not a mercy to provide dying people with nutrients artificially.
It would definitely be inhumane to withhold food and water from a person who was healthy, or at least sick with hope of recovery; but when a person is already dying, it not only prolongs things, but makes them worse.
So I just wrote up an advanced directive.
When my husband comes home tonight I will let him know that what they say is really true—it is not just a cynical way to cycle stiffs through the system faster!
I had complete trust in the doctor today.
If my husband is still not convinced after we talk tonight, then I’ll make an appointment for him to see this doctor and ask questions.