Conference turris::womannotes-v1

    
    	Part of "western world thinking" is that we can *force* the
    outcome of a situation to be what *we* think is "right". What the
    mindset cannot cope with is where to draw the line; breathing stops
    hook up the respirator, heart stops - hook up the heart machine,
    kidneys stop - hook up the kidney machine and on and on. The "wolves"
    are waiting in the wings, should "every effort" not be made or perhaps
    a "mistake" came about - also a part of "western world thinking".
    
    	Joe Jas
    

    
    	 Good topic, one which raises alot of emotion, but one that
    	should be thought about. For myself, being thru several major
    	operations, I now carry a "living will" along with my medical
    	ID cards that give instructions that under no conditions do
    	I grant permission to use any mechical device to keep me alive.
    	Sometimes the cure IS worse than letting nature run it's course.
    	My only reget is not knowing this early enough, had I known
    	then what I do now I'd never had any of them. Why go through
    	all that only to live some sort of freakish existance afterwards?
    	The only benifit I can see is for the Doctor (BIG BUCKS!!).
    	In my case it would have been kinder by everyone involved just
    	to have let me go one of the many times my body wanted.

    I too have a living will.  Part of my value system is that I value
    the QUALITY OF LIFE, but place a much lower value on
    life-without-quality.  I have no desire to continue breathing if
    I cannot do it with dignity and freedom.  If I were in a situation
    like Debbie's, I would hope that some brave, caring doctor would
    do for me what that doctor did for Debbie, though I could not ASK
    someone to jeapordize his/her own life and career that way.
    
    My feelings on this are like my feelings about abortion.  The
    sentiments I've expressed in the above paragraph apply ONLY to me.
    I cannot say I would impose those values on someone else, even
    if it was a loved one.  I can't think of a more personal decision
    than the disposition of one's own life, and I could not presume
    to make that decision for someone else.
    
    							Pat

    It's only with a good deal of difficulty that I post these
    thoughts.  Having twice given an order to remove life support,
    it's not an easy thing to think about.
    
    It occurs to me that Joe's reply (.1) points to a major
    difficulty when he says:
    
        "Part of "western world thinking" is that we can *force* the
    outcome of a situation to be what *we* think is "right"."
    
    I believe the problem lies in the fact that, to a significant
    extent, that thinking has proved correct.  People *have* been
    resuscitated when the heartbeat has stopped; people *have*
    hooked up the heart machine, the respirator, the kidney machine,
    etc. and patients *have* gone on to live fulfilling lives.  Who
    then, as a doctor, will be quick to say "This is a hopeless case"?
    I remember in my childhood (not *that* long ago) that polio was
    cause for significant terror and a heart attack was nearly synonymous
    with death.
    
    Do I, as a patient (and possibly one who understands only a very
    little about my condition), have a "right" to check out?  What
    is the "right" thing for my doctor to do, who may or may not have 
    a good deal more information about my condition?  Suppose I want
    to die, my doctor thinks I may be able to be kept alive, and my
    family wants me to live.  If I'm allowed to die, can my family
    sue?  And what if my condition is terminal - beyond the help
    of known current medicine; does that change the picture?  And
    what if the outcome is just unknown (i.e. coma)?
    
    One thing seems certain:  the direction of technology is towards
    immortality.  As a number of writers have been suggesting, the 
    moral/ethical implications of our directions need examination 
    now; what will we do if one of the "only two certain things"
    becomes optional? 
    
    Aside:  "funny" to think that, at this stage of the game, "ending" 
    death seems less sci-fi than ending taxes. . .)
    
    It's indeed a difficult question, Martin but one that I think we'll
    all be increasingly forced to answer.  For my own part, I feel an
    individual should retain some right to choose death (without legal
    punishment, but I'm at a loss to say how I would try and codify
    that thought for any society at large.
    
    Steve
    

    How does a living will differ from the usual will?
    
    Holly

    a "living will" is a request not to use artificial or extraordinary
    means to keep someone alive. i have one form which says in part:

    "If at any time I should have an incurable injury, disease, or illness
    certified to be a terminal condition by two physicians who have
    personally examined me, ... and the physicians have determined that
    my death is imminent and will occur whether or not life-sustaining
    procedures are utilized, and where the application of such procedures
    would serve only to prolong artificially the dying process, I direct
    that such procedures be withheld or withdrawn, and that I be permitted
    to die naturally with only the administration of medication, the
    administration of food and water, and the performance of any medical
    procedure that is necessary to provide comfort care or alleviate
    pain..." 
    
    I'm not sure how legally binding this document is (I need to talk
    to my lawyer about it). I know there have been court fights about
    these types of wishes. I also know that some hospitals and doctors
    are more amenable to honoring these types of wishes than others.
    
    e

    
    	re .4,
    
    	I guess the "blindness" I was trying to portray in my "WWT"
    statement is in the righteousness of forcing this poor dieing person
    to live for as long as possible, without regard to their life_condition.
    Society, right now, cannot handle "euthanasia", much in the same
    way as it cannot handle the concept of "prostitution". As in "You
    *cant* do that, we assume to know what's best for all cases, period..."
    
    	Certainly, if I was the one dying, I'd like every effort to be made
    to save my life. Perhaps I wouldnt feel the same way, if, BTW, there
    would only be so much *left* of me that was living. Apparently,
    We are not responsible enough to be allowed a choice in the matter.
    I understand that an intelligent choice may not be possible when
    one is in a state of shock or otherwise incapacitated. Exceptions
    will occur, however, as the story in .0 illustrates. Somehow, I'm
    *sure* the inquisitive lawyer's main interest was in securing
    compensation for the time in suffering that the patient went through. 
    Right -
      
    	Joe Jas

    
    	This has always been one area that I can't find any logical
    	reasoning by the law in. I mean they don't think twice to
    	snd someone to anther land to lay down their life for, yet
    	if that person is only going to be half a person, they won't
    	stand to let that person make thir choice if thy want to
    	be kept alive(?) like that.
    
    	The living will I carry may not hold up in court, but atleast
    	thy know my wishes. I may never get anyone to follow them, but
    	they are known. I'm hoping that because I am single and don't
    	have anyone that would be able to make a decission for me that
    	they will abide by it. I know I won't sign any blanket forms
    	of consent. This drives them crazy!!!!!  :^)

    Is this topic discussed in any other notesfile?
    
    This is not a suggestion to move it, just a question!
    
    Holly

    The legality is a state-by-state issue.  My living will was done by an
    attorney in North Carolina, where it is legal. I haven't checked now
    that I'm living in Texas -- that's on my list of "things to do in my
    spare time between 3 and 5 A.M."  (^; 
    
    						Pat

    This whole situation makes me want to be sure that if I have a terminal
    illness I stay as far AWAY from hospitals as I can. Keeping people
    who do NOT want it on life-support is....(many adjectives come
    to mind, here)...bizarre at best. I think it partly comes from
    a particularly Western problem dealing with death, but regardless
    of where we got it, we really need to lose it.
    
    I see no point in this "extreme measures" stuff (for someone who
    doesn't want it) but, as someone else said, more money for the
    mainline medical establishment types. 
    
    My mother had a "living will" - and a wonderful doctor and nurses.
    Still, while she was dying, and in a LOT of pain, they kept alternating
    between intravenous demerol and intravenous morphine. They gave
    morphine until it began to depress the breathing, then they had
    to give demerol. They gave demerol til it <did whatever *that* did
    to the body>. Back to morphine. Back...etc. She was in a lot of
    pain and under these drugs for 3 days, while I alternated between
    a motel room and the hospital waiting for her to die. I told the
    nurse to do whatever was necessary to keep her out of pain.
    
    Enough is enough, you know?
    
    --DE
    

    
    I recently took a class on Death and Mourning (taught by Jo Dorr
    at BU.  I highly recommend the class), and one of the things
    that the instructor, a supervisor of nursing at the VA Hospital,
    suggested was that hospitals and doctors generally follow the
    wishes of the patient.  Problems arise when the patient becomes
    somehow incapacitated without making his or her wishes *Officially*
    known.  
    
    Many courts might not uphold a living will, if challenged, but
    the general concensus is that if you have a living will, the issue
    of how to treat you in the case of a serious illness is much less
    likely to be taken to court.  
    
    Justine