‘Time for Dad to die’
December 3rd, 2008Author Diana Wagman writes in the Los Angeles Times that her 90-year-old father remains alive after a massive stroke, but she wishes he would die. She says he has access to the latest medical care and is not in a coma or in pain, but he is only occasionally responsive and relies on a feeding tube for survival.
Her father is an atheist who made clear in an advance medical directive that he did not want to be kept alive by extraordinary measures.
An excerpt:
… My husband thinks we have not respected my father’s wishes and that we are failing him by keeping him alive. One of my sisters agrees.
I know she’s right … Still, two months ago he was laughing at our president – although he couldn’t remember his name and called him simply “that joker.” He was able to hold his newest grandchild. He had moments of joy. The question becomes: “How many moments are enough to justify a life?”
On a recent visit with her father at the hospital, Wagman says she leaned in and whispered to him “that it was OK to stop fighting. I told him we all loved him and we would never forget him. I said it was time to die. It was not easy, and I cried. ” After leaving for the airport the next morning she reflected, “I don’t want to be the one to remove the feeding tube, but I am not sorry I said what I did. It is time for him to go.”
Our RSS Feed
December 8th, 2008 at 12:36 pm
Agreement is not a prerequisite for empathy. Sympathy for an ailing individual does not exclude sympathy for his family for the issues they experience related to that ailment, including their concern for their loved one’s wishes. I do not know what Ms. Wagman “needs” in terms of sympathy, but I empathize with this family in crisis, perhaps more acutely due to the fairly recent loss in my family. I feel sympathy for Ms. Wagman as I did for my mother when my grandmother was ailing. Phrasing her concerns as an unfeeling issue of convenience rather than concern for her loved one does her an injustice, regardless of one’s feelings and beliefs on the underlying issue.
My grandmother didn’t just want “no more” surgery. She wanted “no more” (period). She did not want any more blood tests, needles, anything. She was very clear about this while she was still lucid. She’d been in the hospital or rehab for months, and in those last days she wanted to be left alone. When her vein blew and they redid her IV, she protested, and her children asked that she be left alone. Not because they needed to get back to watch a football game or something similarly shallow, but because they were concerned about what Grandmom wanted in those last days. Many would consider an IV — such a little thing — to “not count” as something invasive or unnatural. And in most cases it doesn’t. But in my Grandmother’s case it was not only an invasion on her personal sense of dignity but an invasion into a natural process. (The hospital put the IV in anyway.)
I believe in medical science and extraordinary measures when appropriate. I am thankful for the many years medical science added to my grandmother’s life so that she could know her great-grandchildren and so that we could spend time with her. I saw her a lot since she lived with my parents around the corner from me. We went to movies together and shared books. She loved to hear about advocacy efforts and was Gabby’s biggest cheerleader. Additionally, my daughter would not be alive without the benefit of invasive surgery. If she’d needed a feeding tube, she would have had it.
But issues in the sunset of life that focus around how someone wants to be treated are very complex, and regardless of what one feels philosophically, religiously, or ethically as a “black and white” rule, there is a vast amount of nuance, and the emotions of families can be very complex as they struggle to do what is best for their loved ones. Again, I feel great empathy for this family.
I also agree that giving a person “permission to die” is illogical. But when all you hear are soft moans from a person who has not woken up for 2 days, logic sometimes fades.
December 5th, 2008 at 6:37 pm
Why is it Ms Wagman who is in need of sympathy? Her father is the one whose life is at issue here.
I can understand not wanting to put a person in his condition (and at his age) on a ventilator.I can understand not putting them through painful surgery that would not benefit them. I can understand instructing the medical staff to not do a code if her father’s heart should stop beating, or if he should stop breathing. But there is a difference between pulling out all of the stops and preserving the life of someone who is terminally ill and in pain-and this situation. Basically, he is just taking too long to die, so the family wants to help him along by starving him. I guess I don’t understand why she deserves my sympathy for that? I don’t agree with her point of view, so why should I pretend to?
I also think that they whole concept of giving someone ‘permission to die’ is illogical. If humans have that ‘power’(to decide when they are going to die) then why couldn’t they just decide to NOT to die as well? Doesn’t quite work like that.
A big danger of a mindset like this (giving people ‘permission to die’ in situations like this) is that pretty soon, it will not be ‘permission’, but an ‘obligation’ for people to die if others deem it ‘their time to go’.
December 5th, 2008 at 11:25 am
I am shocked at the lack of sympathy for Ms. Wagman and her situation. She bares her soul to reveal the dilemma she and her family are facing trying to balance what her father would have wanted and the conflicting emotions in end-of-life situations. Her father is 90 years old, clearly at the end of a very fulfilling life. He did not WANT to be kept alive by extraordinary measures, but this family is having difficulty figuring out whether the definition of that phrase (depending on who is defining the phrase) truly comports with his wishes in this situation. How painful for that family.
A year ago, we said goodbye to my grandmother. We were told she had days to live, and fortunately she was awake and alert as she was visited by her five children and their spouses, many of her 18 grandchildren and their spouses, and many of her over 25 great-grandchildren. This bright, alert, political fan of literature, movies, and disability causes (being herself the daughter, sister-in-law, mother, and great-grandmother of people with disabilities) was able to be herself in the days prior to her death, but in those last days I too whispered to her as I stroked her hair that it was OK to die.
In those last 2 days, we heard only ocassional moans when she was (by the rules of the facility) turned every so often. Her “self” became just a pulse. Four and five days before her death, she was able to hug and kiss her loved ones, saying her goodbyes and receiving all of the adoration our favorite relative deserved. But in the last day or so, she checked out of her dying body, unable to truly communicate or understand while her children maintained vigil at her side.
The doctors had suggested the possibility of surgery, but my grandmother adamantly refused while she was still lucid, clearly stating, “no more.” I was angry when the hospice staff did their regular turns. Though it seems minimal, when I heard the moans of my grandmother as her body was turned, in my head I heard my grandmother’s voice, “no more.”
This family seems to be experiencing the same issues of both the gradual loss of their loved one and the pain of worrying that this is not how he wanted his life to end. It’s just that their dilemma is spread out over months, not days.
I have the greatest empathy for this family.
December 4th, 2008 at 3:39 pm
I agree with ‘rickismom’…sounds to me like Ms Wagman wants to put her dad our of ‘her’ misery..his staying alive appears to be more of a burden to her than it is to him.
Since every single person living would die if they didn’t have some sort of food, giving someone nourishment through a tube is not an ‘extraordinary measure’…it may be an inconvenience, but it is not extraordinary, and, in fact, is a pretty simple procedure. Death by dehydration/starvation is not a pleasant experience, so I can’t understand why anyone would be willing to put a loved one through it.
December 4th, 2008 at 5:16 am
He’s not in a coma, not in pain. So what is so terrible about him living to see his grandkids? Maybe he would enjoy his grandkids even more if he was told that he was loved, wanted, his opinion valued.
It is beyond me why a child would tell a parent not in pain that they want him to die.