Everyone will die. But like many people in this age of advanced medicine, I am concerned about not being allowed to die when it’s my time. As a senior citizen, I know that more of my life is behind me than ahead of me. That’s the way of nature – the circle of life.
I also know that with COVID-19 lurking everywhere, the chance of that time coming is increased. And I can accept that (even though I am careful and religiously wear a mask when I leave home).
But when my time comes, I am concerned that medical science will try to prolong a life when the very qualities that make it ‘life’ are gone.
Home was for Living – and for Dying
It wasn’t always this way. In times past, and not all that long ago, people who weren’t killed immediately in an accident or other circumstances were taken home to die.
The person might be placed on a bed in a corner of a room, near a window. They might be propped up with pillows, a blanket to keep them warm. As their life faded, it was accompanied by the sounds of life continuing all around them.
Children played in the same room, or outside where the elder could watch through a window. Maybe she can sit up for a while, her eyes filled with the joy of continuing life, even as hers faded.
Perhaps the elder reflected on the times her own children played in a similar yard. Oh, the joy those times brought to her.
Adults – the children of the elder – attended to the elder’s needs. It was their duty, accepted without question. It was just as they had seen the elder care for her own dying mother or father.
Maybe there was an ever-present pot of soup on the stove, just in case the elder need nourishment at an unusual hour. The smells of home cooking added a comforting quality to the air.
And the adults, who had been given life by the elder, spent time at his/her bedside, holding a frail hand – comforting a waning life. Just as important, they were close by – maybe in a nearby room. They were ready to come quickly when the end was near so that the elder’s last moments would be in the presence of loved ones.
Death wasn’t something to be feared, nor something to be pitied. It was, and is, a part of life – just as birth, adolescence, and middle age are.
Medical Science Intervenes
But scientists made huge leaps in understanding the mechanics of life. And somewhere along the line, we as a people decided that we could rewrite the rules of nature.
“Life” no longer was defined as conscious awareness of one’s surroundings, one’s family. “Life” came to be defined as the mere presence of a life function – blood flow, breathing, nourishment. It was “life” even if those functions were continuing only because of machines.
Medical science had triumphed, vanquishing death itself – if only in the coarsest of terms.
As Dr. Louis M. Profeta, an emergency room physician put it in a 2016 article: “Our end-of-life psyche has slowly devolved and shifted and a few generations have passed since the onset of the Industrial Revolution of medicine. Now we are trapped.
“We have accumulated so many options, drugs, stents, tubes, FDA-approved snake oils and procedures that there is no way we can throw a blanket over all our elderly and come to a consensus as to what constitutes inappropriate and excessive care. We cannot separate out those things meant to simply prolong life from those meant to prolong quality life.”
What About Me?
And what of the elder – what does this do for them? Instead of the familiar surroundings of home – theirs or a child’s that they have visited many times in the past – they are surrounded by sterile white walls. White walls devoid of photos of familiar objects and places.
Tubes and monitor cables snake out from frail arms and hands. Instead of drifting off to sleep to the sounds of children, they listen to the incessant beep of a heart monitor.
Instead of taking in the smells of their adult child cooking dinner in an adjacent room, their noses are invaded by the smell of antiseptics and latex.
Contact with family is limited to short ‘visiting hours.’ Time with the elder must be planned – get everyone together, drive to the hospital, keep an eye on the clock to get back to the daily routine.
People crowd around a small room, making small talk that passes for ‘quality time’ with the elder. There will be no children running by, brushing the elder’s hand as they streak past. Everyone must be on their best behavior in the sacred halls of the hospital.
It’s hard for the elder to think back on all the good memories of a life well-lived when he lies alone – ‘protected’ by shiny chrome bedrails until the next scheduled check by the nurse.
And when life drains away, it is as likely as not that medical staff will be the only people in attendance. The elder’s last vision may be a glaring fluorescent light above his bed rather than the fading images of home and loved ones.
Fortunately, the trend is changing. In the 1980s, more than 50% of U.S. deaths occurred in hospitals. But by 2003, that percentage decreased to 40%. At the same time, 24% of deaths occurred in nursing homes.
By 2017, hospital deaths had fallen to 30% and nursing home deaths accounted for 21% of the total. There is also good news, at least for those who believe that being surrounded by family in a home atmosphere is best. By 2107, deaths at home had risen from 24% to 31%1.
Of course, these numbers precede COVID-19, which has seen an understandable rise in deaths in hospitals and nursing homes. But we can hope that the previous trend will return once the pandemic passes.
Thankful, But There’s Also a Time to Die
No, this is not the kind of end that I want. I often make a gesture to my wife when this subject comes up – a flick of my finger indicating “turn off the switch.”
A living will memorializes my wishes. I do not want my last wish to be overridden by medical personnel whose idea of ‘life’ differs markedly from mine.
I certainly appreciate the advances in medicine and medical treatment. I’ve been fortunate not to have needed much in the way of medical treatment over the years. And my current life is better than it might have been. Advances in medicine make healing treatment possible when I have needed it.
But I’m also cognizant that there will be a time in my future when “keeping the patient alive” won’t be the choice I want. And I make sure my family knows that.
When my time comes, I have one wish: “Family, I know you love me as I love you. Now let me die.”
What are your thoughts on this subject?
Let us know in the comments below.
- “Homes, Not Hospitals, Now Host Most US Deaths.” Nature News, Nature Publishing Group, 11 Dec. 2019, www.nature.com/articles/d41586-019-03805-9. Accessed October 21, 2020.