I'm pretty sure I had a goal somewhere on here to write more often...and of course it's been one month since my last post. Maybe I should reward myself with chocolate for every post...
I saw The Descendants today, and loved it. (I won't give anything away, the previews pretty much cover it). The movie was great, but honestly what I loved most was the depiction of George Clooney and his family respecting the wishes of his comatose wife. As a nurse, I see daily the progression of healthcare to keep the human body alive and functioning. It truly is amazing the ability we have to heal, and there is no better feeling than having a patient make it against the odds. The downside to all this technology, however, is just that: we are keeping people alive, longer. What non-medical people fail to understand sometimes is that just because the patient still has a heartbeat doesn't necessarily mean they are "alive" in the sense you probably want them to be. I remember the outrage in the media over Terri Schiavo (sp?) and how people were claiming her husband was essentially murdering her in the cruelest way (starvation/dehydration). I have withheld oxygen, lifesaving medication, food, and water from patients, and I have never felt cruel. What I view as cruel, to myself as a nurse and to the patient, is keeping someone alive who does not have any quality of life. When this topic comes up, I have never heard anyone say "Yes, please keep my body alive, connected to a ventilator and being fed through tubes". So why the discrepancy? For one thing, most people never have this conversation with their loved ones; it's usually considered too morbid. The family is then left to make the decision, and it is not an easy thing to be the one to say "enough", and take away life supporting care.
Sometimes, even when the person has made their wishes known, if it is not expressly written and notarized, it gets overlooked. Well meaning family members want everything to be done, and then if they die it was meant to be. The problem is that nowadays, we can keep someone alive indefinitely, and usually it is a complication from being bedridden (infection, pneumonia, etc) that ends up ending their life. You are left with a shell of a person, unable to communicate, unable to feed themselves or even move when they feel uncomfortable. I have seen someone with cancer in almost every organ system, including the bones, in excruciating pain die a very long and drawn out death due to the family's insistence we do everything possible. I am not saying we give up hope, quite the opposite, actually. I have seen miracles in the course of my work. People who should not have made it walking back into the hospital to thank us. The problem comes when it is a chronic issue, and there really is no new treatment to give the patient. Nothing helps. We are just keeping the patient in a suspended state of misery until their body gives up. This is what I am against, and why I was so happy to see a movie in which this issue is addressed, albeit briefly. I don't mean to sound callous, but keeping patients alive with expensive procedures that will not change the prognosis weighs on all of us as well. It costs millions to keep a patient alive in the ICU; ventilators, chest X-rays, dialysis. artificial nutrition, life-sustaining medications to maintain blood pressure and heart rates. Modern medicine is wonderful, and I am grateful for all that the new technology allows us to do, but it should be used meaningfully, keeping in mind that just because you can do it all, doesn't mean you should.
*End rant*
