May 27, 2011

"Death from Dehydration Is Usually Serene."

An ABC News article, from 2005, back when people were agonizing over Terri Schiavo.
"The process of starving to death seems very barbaric but in actuality is very peaceful," said Dr. Fred Mirarchi, assistant clinical professor of emergency medicine at Drexel University College of Medicine in Philadelphia.

"The patient's experience is really pretty benign," said Dr. Joanne Lynn, a hospice physician associated with Americans for Better Care of the Dying, a group working for improved end-of-life care. "Overwhelmingly, what will happen is nothing."...

"Patients [become] uremic -- filled with bodily toxins -- and are unaware of their surroundings," Mirarchi said. "They develop electrolyte imbalances that eventually cause an abnormal beating of the heart."...

"The heart will then stop and the patient will die," said Mirarchi....

"Going without water makes it more gentle," Lynn said. "Allowing chemicals [in the blood] to cause arrhythmia is more merciful."
That came up first when I Googled "patients die of dehydration," which I did because I was trying to find this news article I'd read yesterday. Here it is: "Elderly patients dying of thirst: Doctors forced to prescribe drinking water to keep the old alive, reveals devastating report on hospital care." That's in the Daily Mail, reporting on the situation in the UK:
The snapshot study, triggered by a Mail campaign, found staff routinely ignored patients’ calls for help and forgot to check that they had had enough to eat and drink.

Dehydration contributes to the death of more than 800 hospital patients every year.

Another 300 die malnourished.
Am I wrong to suspect there is a form of euthanasia going on?

93 comments:

Victor Erimita said...

Why worry? It's all so "serene."

nevadabob said...

"Am I wrong to suspect there is a form of euthanasia going on?"

Yes. It's just regular old shitty government health care. Same shitty service you get from every other government program.

Welcome to your Democrat Party future.

traditionalguy said...

That evil bullshit sounds more like a disguise for poisoning of the hangers on to free up bed space. Withhold their water so their uremia condition causes hearts to flutter and fail faster. Welcome to the Obama National Health Insurance/Single-Payer Land's version of mercy.

Terrye said...

No, it is not. Death by dehydration is scary and painful.

I have seen sick people who are very dehydrated and they did not strike me as serene.

Pogo said...

Yes, "a form of euthanasia".

Malignant (rather than benign) neglect.

Workload reduction by attrition.

Survival of the fittest, hospital ward style.

John Lynch said...

No, you aren't.

People who are near death tend to be in and out of the hospital a lot. They don't realize when it's the last time.

PatHMV said...

I think you are, actually. They sound like typical National Health Service employees, treating their patients like shit, as always.

Pogo said...

"Allowing chemicals [in the blood] to cause arrhythmia is more merciful."

Bless these gubmint angels of mercy.


"Dehydration contributes to the death of more than 800 hospital patients every year."

But next year they hope to surpass that record.

shoutingthomas said...

Wrong!

One of the most common emergency calls for the EMT is the dehydrated senior living alone.

Sometimes, they just forget to drink as a result of medication.

But it's mostly this... The urge to urinate come on very quickly in the elderly and they have to get to the bathroom quickly or risk an accident. The elderly often eschew drinking fluids rather than risk the accident.

As stated, this can quickly lead to an altered mental state in which they just drift away.

crazy legs said...

Obviously people trying to sell readers on pulling the plug on Terry Schiavo were going to paint her eventual death-by-neglect as peaceful. It's not like they could win anyone to their argument if they admitted it was a horrific way to go.

As for your question, it's not that a form of euthanasia is being employed, it's whether it's intentional or due to neglect/incompetence/insufficient number of nurses.

But will Obamacare, we'll all get to experience this sort of thing, soon enough. That is, unless we have family members sneaking in food and water for us...

word verification: fulkme. Something I say every day, or whenever Obama says/does something stupid, whichever comes first.

chickenlittle said...

Am I wrong to suspect there is a form of euthanasia going on?

It could be laziness--the more you feed and water patients the more you have to "clean-up" after them.

But I'm sure such things don't happen in the UK.

Fred4Pres said...

Yeah, because when you are so weak that you can no longer cry out or move you are "serene."

Have you ever been thirsty? I mean middle of the desert, really really thirsty? There is nothing serene about it.

Carol_Herman said...

We all die.

And, it turns out a diagnosis of Alzheimer's is NOT painful TO the patient! But the brain deteriorates. And, it's the living who suffer.

Wise to remember that if you have loving family ... the best death is "while you sleep." The most feared is so suddenly no one in the family is even prepared for it.

And, Kubler-Ross used to say that cancer had one aspect to it ... in that it was slow enough. The person who gets the diagnosis can prepare their estate well enough, that the living can cope.

What you call "dehydration," I call kidney failure. And, no. I am not a doctor.

But a family that wants to watch someone suffer is a pretty dysfunctional one. Even when they are screaming "keep the tubes in!" "Keep the machines on."

We should judge those who say it's God will to continue unmercefully keeping someone alive.

Heck, those who loves their pets, DON'T!

Too bad the republican party loves having itself labeled as the home to religious zealots!

shoutingthomas said...

In the nursing home, this syndrome is even more pronounced. Patients are supposed to be toiletted every two hours by a CNA. Staff shortages almost always make this unlikely. Four hours is more likely.

To avoid the humiliation of an accident, the patient will avoid fluids.

Sixty Grit said...

Are you wrong? No. That wonderful form of care will be here in time for your dotage.

Pogo said...

To be fair, the elderly often lose their normal thirst mechanism. In an illness, that can be deadly. Dehydration is also a bit difficult to detect in the elderly. You have to actually prompt some oldsters to drink fluids. Awake and alert younger folks don't have this problem. Easy dehydration is a sign of debility and fragility itself.

Lava said...

...unless it's you.

Michael said...

Surely no one is complaining. It is free, after all.

Pogo said...

So, fragile people in a chronically understaffed environment fare poorly.

Thankfully, the elite like the IMF and UK officials do not suffer such pedestrian indignities.

Seven Machos said...

Dehydration contributes to the death of more than 800 hospital patients every year.

Another 300 die malnourished.


But, hey, it's free. And free health care is the most vital thing.

Fred4Pres said...

And in the Muslim world young girls sometimes drown in their family pools. Insh'allah. That they happen to be sluts who dishonor the family is just a coincidence. Hundu'allah!

Coketown said...

I suspect neglect is the culprit. I remember reading about a 22 year old in England who died after a routine operation from dehydration during recovery. Let me google it. Here is it.

I can't find the original story I read, which gave more details of the inquiry. The man called nurses several times requesting water and even called 999 saying he was in the hospital and needed water. It was a really horrifying story.

Mark said...

It wasn't just religious beliefs that caused people to object to Terry Schiavo's killing. I remember reading about an activist who was protesting on behalf of Terry who was worried about the precedent this might set. Slippery slope and all that.

The activist was pretty severely disabled herself by the way.

Synova said...

Being dehydrated makes you stupid (I know this from experience) so that you aren't competent or responsible. Most people in the hospital already have an impaired ability to watch out for their own interests.

SteveR said...

Before my father died (80 yrs old) he had serious issues but ultimately he wasn't eating or drinking. Sure they could have prolonged his physical life but I always felt he knew it was time.

Not to say its the right thing in every case. It was a VA hospital BTW

Seven Machos said...

I climbed Grand Teton once and got altitude sickness. Could not make myself eat or drink. The guides were not pleased.

At one point, in my weakened condition and with my mental state being very odd, I remember thinking that I was going to have to try to make rational decisions. I tried to think about what a reasonable person would do in whatever circumstances.

When I got down to a decent altitude, I became very hungry and thirsty. That night, I bet I ate a dozen tacos from Taco Bell. And I don't even like Taco Bell.

ricpic said...

Lefties kill compassionately.

Chip S. said...

Well, sure, there's a little bit of a hydration problem in UK hospitals. How else did you bitter life-clingers think they kept their health-care expenditures under 8% of GDP? At a certain point, you've had enough life.

ricpic said...

It was beauty killed the beast and it was a chihuahua saved Seven

Paul said...

Nope Ann, that is just a hint of what will happen under socialized medical care.

Keep in mind Nazi Germany had socialized medical care and they killed off all the insane, defective, old, etc... BEFORE the start of the war.

You are just seeing the tip of the iceberg that Obamacare will bring.

Pogo said...

The answer to this, in a socialist system, is new regulations and more paperwork.

Seven Machos said...

And Godwin's Law invoked at post 30.

Lincolntf said...

Much like abortion, suicide is championed exclusively by those who've never been through it.

Chase said...

`

"Handbook for Healthcare, Liberal Version":

1) If You need to sell rationed care, death by dehydration is serene.

2) If you need to scare people - "the GOP wants to take away your MEDICARE!" - then death by dehydration is the worst possible way to die.

It all depends on what your liberal need is - truth and facts are relative and malleable.


Next up for Obamacare: Praising the virtue of giving up and dehydrating to death on your own, You Valiant Senior!

Chip S. said...

Dehydration seems to hold a lot of promise as a treatment for Alzheimer's patients, who otherwise linger on and on, expensively.

Jim Bullock said...

If a medical policy leads to avoidable deaths of the most expensive patients, is it a death panel?

Chip S. said...

No. The death panel is the group of experts who determine the eligibility criteria for dehydration therapy.

Seven Machos said...

By the way, I don't know what the tort laws are in Great Britain, but one of the reasons this shit doesn't happen here as much is because doctors and hospitals stand to lose millions of dollars in lawsuits if they do happen.

So, thank your lucky stars for the trial lawyers and the freedom to sue, which would likely be lost in a single-payer system.

edutcher said...

All of those sophisticated, intelligent people that love ZeroCare are the same civilized monsters that made the death camps work so flawlessly.

"The process of starving to death seems very barbaric but in actuality is very peaceful," said Dr. Fred Mirarchi, assistant clinical professor of emergency medicine at Drexel University College of Medicine in Philadelphia.

I'm sure Dr Mengele felt the same way.

Catherine Drexel must be spinning.

Bender said...

Do these apologists for the culture of death really expect people to think that the walking skeletons of the Nazi concentration camps were living serene and peaceful lives?

It is one thing to forego food or even water when in extremis, that is often a natural sign that death is imminent (within a matter of days), the person simply stops taking in nourishment.

It is another thing entirely when the person is otherwise physically healthy, as was Terri Schiavo, but is thought to be an inconvenient nuisance, as was Terri Schiavo, or otherwise "lebensunwertes leben" (life unworthy of life), or simply not worth the cost. Foregoing food and water when not in extremis is an awful and tortuous experience.

Johnny C said...

Serene would definitely NOT be the word I would use to describe my mother's hospice/dehydration death. It's been close to a year and half (Jan, 2010) and my wife still gets upset thinking about it.

Seven Machos said...

Tony Soprano's death seemed very serene. Quick, too. Let's just do that.

Chip S. said...

Mengele laughs at those British weaklings and their pathetic dehydration therapy. Herr Doktor Mengele was far more creative than that:

In order to determine if eye color could be genetically altered, Mengele had dye injected into the eyes of several twin subjects. This always resulted in painful infections, and sometimes even blindness. If such twins died, Mengele would harvest their eyes and pin them to the wall of his office, much like a biologist pins insect samples to styrofoam. Young children were placed in isolation cages, and subjected to a variety of stimuli to see how they would react. Several twins were castrated or sterilized. Many twins had limbs and organs removed in macabre surgical procedures that Mengele performed without using an anesthetic. Other twins were injected with infectious agents to see how long it would take for them to succumb to various diseases.

I hate to go all thread-cop here, but there ain't many comps for Mengele.

Bender said...

And can we get over this too-clever-by-half invocation of "Godwin's law"?

It is not an inappropriate comparison when the National Socialists themselves had terms like "useless eater" and simply decided to starve and dehydrate people to death. And not merely Jews and other enemies of the state. Much of the starvation and dehydration was conducted in the hospitals, by doctors who insisted that they were acting out of "compassion," to alleviate the "suffering" of the handicapped and mental patients and give them a "merciful death" (all while also preserving much needed financial resources that were otherwise sapping the state in order to take care of such people).

The fact of the matter is that the medical community of 1930-40s Germany blazed the way for most of what the right-to-die crowd, as well as supporters of state-run medicine, advocate today.

mariner said...

I suspect your suspecting is correct.

There isn't even any wrangling about whether or not caregivers are "managing pain".

dbp said...

I obviously haven't died of dehydration, but have been fairly dehydrated a fair number of times and it was extremely unpleasant.

I do distance training and even on cool days I am feeling dry by 12 miles of running. The final 4 miles of a 19 miler are hellish.

All of this is self-inflicted, so I have no complaints about it. If someone forced me to be dehydrated (to a life threatening extent)I would easily class it as torture. And I mean torture torture, not "torture" like water boarding.

Lincolntf said...

Creepy factoid:
I lived in a barracks building (Idar-Oberstein, Strassburg Kaserne) where Josef Mengele was reported/widely believed to have hidden directly after the War. All I'll say is that when we finally wangled the keys to the under-stories, we found enough room to hide a battalion.

Seven Machos said...

Bender -- When you invoke Nazis because some people are dying in terrible conditions in British hospitals, you sound shrill. And also stupid, because you obviously can't argue with any nuance or substance. All you can do is go right to the very end of the slippery slope and yell Hitler!

You are unlikely to win any fence sitters with such crude propaganda. Up your game.

holdfast said...
This comment has been removed by the author.
HT said...

I'm so glad you published this Ann. It's just one of the biggest no brainers there is in nursing homes, and something that all people looking after their elders will be dealing with and trying to remember and nag about eventually.

Big Mike said...

Am I wrong to suspect there is a form of euthanasia going on?

Almost certainly not.

Fred Drinkwater said...

I want to reiterate the points that Bender made above.
Many of us have experienced the irrationality, disorientation, cramps, and pain associated with dehydration. (Heck, just last year I was given 4 liters of saline in an ER due to food-poisoning related dehydration.) I do not think anyone who, while otherwise more or less healthy, goes through this process, could call it serene or painless.

That said, last January I sat by my 83-year old mother's deathbed while she expired from complications of ovarian cancer. She had been in Hospice care at her apartment in an "assisted living facility" for 3 months, and had been well taken care of, within the bounds of the palliative care that Hospice provides (and that she had selected for herself while still completely lucid.)
She died of multiple organ failure due to complication of insufficient nutrition and insufficient hydration.
Her last few days were about as peaceful as I can imagine such a sequence being. A couple of her kids were with her pretty much continuously for the last week. She was in no apparent pain, and was on a minimal dose of oxycodone more or less "just in case" she could not communicate with us about pain.

I'm not sure if this anecdote contributes anything substantial to a policy discussion, but there it is.

DADvocate said...

As someone with an arrhythmia, I can feel the abnormal heartbeats. My cardiologists tell me my arrhythmia is quite benign. Which seems true as I can exert myself physically quite heavily, but I never thought of it as a serene way to die, quite the opposite.

The nursing home I worked in refused to allow people to be allowed to die of starvation, dehydration or any other method that sped up or aided the process. The elderly patients would have to be reminded to drink enough. Apparently, they aren't as aware of being thirsty.

I was told at the nursing home that dying of starvation was quite painful.

Carol_Herman said...

Someone who vomits, and has diarrhea is not experiencing the dehydration of dying!

And, we all die!

I still think Alzheimer's is the worst way for a person to go. And, yet, to the person? It's quite painless.

To the families, however, it is painfully sad.

One way to test yourself is to ask, if you own a beloved cat or dog; if you'd let them suffer unnecessarily ... or if you would look to end it?

I always thought the kindest doctors used morphine.

And, then you hear the horros stories that "because a doctor can be sued for addicting you to narcotics," morphine in sufficient quantity to alleviate pain, is withheld.

Religous nutters get themselves all twisted up, when they hear hypotheticals. And, what they push is their "agenda."

Bender said...

Sorry Seven, I am not going to impose a comparison-free zone around the evils of 1930-40s Germany, National Socialist or otherwise.

What the hell do you think that "never again" means? It is when fools purposely blind themselves to the obvious parallels that "never again" becomes "once again" and again and again and again.

That is not to say one should cry "wolf" in each and every dispute, but when the wolf is rampaging and has already killed many times over, the real stupid thing to do is to bitch about "Godwin's law" when someone points out, "hey, there's a wolf over there."

DADvocate said...

Seven Machos - I think Bender has a point - "Hundreds of the prisoners died from starvation, dehydration or suffocation..." The loss of human values and sensibilities comes in small steps until you reach a point you no longer recognize.

It's a slippery slope argument, but the process is called systematic desensitization and is used by mental health professionals all the time, but it can be used for bad as well. I agree you need to do more than scream "Nazis" and "Hitler" but that's not always verboten.

Coketown said...

Those religious nutters need to stop shaping public policy. They caused enough problems abolishing slavery. Those jerks. <3 carol

Michelle Dulak Thomson said...

Carol_Herman,

I still think Alzheimer's is the worst way for a person to go. And, yet, to the person? It's quite painless.

To the families, however, it is painfully sad.

One way to test yourself is to ask, if you own a beloved cat or dog; if you'd let them suffer unnecessarily ... or if you would look to end it?


No, no. Not analogous at all.

One way to test yourself is to ask what you'd do if your beloved cat or dog had an entirely painless but debilitating ailment. What exactly would you be "looking to end" if you "looked to end it"? Your pet's suffering, which, by hypothesis, doesn't exist? Or your own?

That's the analogous case. If you're the sort of person who thinks doddering elderly relatives would benefit greatly from (say) a quiet pillow over the face, even when they aren't themselves in pain, you'd also "put down" an animal, not because it was suffering, but because you were, just having to look at it and be around it.

Admittedly there are complications with human beings (who can communicate their wishes before the fact in living wills and such) that aren't applicable to pets. All the more reason to make damned sure a pet is suffering, rather than (say) aesthetically unpleasing or expensive to care for, before we decide that it's in its best interests to be dead.

Michelle Dulak Thomson said...

To echo Frank Drinkwater (if that's not your actual name, or even if it is, I salute you!), dehydration sucks.

I also ended up in the ER with several liters of saline being pumped into me after a bout of illness during which I couldn't seem to keep anything down for a few days.

I thought things were improving -- got some liquid to stay down, and a piece of fruit or so -- and as I had a concert I was previously scheduled to review, involving a bus trip and then about a mile walk on a hot day, set off for it. I got there a good half hour ahead of time, sat down, decided a little later that I ought to go to the water fountain -- and found I couldn't stand up without falling down again. Tried again five minutes later: same result. At which point the concert hall's management was thinking "liability risk" and called 911.

I was sufficiently out of it when I got to hospital that I didn't have a clue where I was, and when they fished my cel out to call my husband, and he asked "where are you?" I couldn't answer w/o assistance.

Let's just say that "serenity" is a poor synonym for "panic fear, combined with such befuddlement that you can't express it."

Rabel said...

Dr. Lynn agrees. “We need to build a social consensus drawing on a new paradigm that tailors care to the new reality of dying—which is after a long, chronic illness. Not only is it the right thing to do, it makes good business sense.”

Oh my.

Martha said...

NO--dying of dehydration is not serene.

When my father was dying (metastatic lung cancer), I was told there was nothing more that could be done for him in the hospital and that we had to move him to hospice care immediately. But he was unable to take fluids by mouth and was getting all hydration intravenously.

I refused to allow the hospital to discharge him and fortunately a nephrologist on staff agreed with me BECAUSE DEATH BY DEHYDRATION IS ALWAYS INHUMANE.

My father died within 48 hours but he died due to metastatic lung cancer that was not treatable--not dehydration which is eminently treatable in any civilized society.

george said...

I hear hanging is a pretty serene way to go... if you can get past the first couple of minutes of it. The same goes for crucifixion, although that can take just a wee bit longer.

Michelle Dulak Thomson said...

Technically, george, there wouldn't be any "first couple minutes," because a hangman who knew what he was doing when he set up the gallows would be sure to break your neck at the drop.

DIY ... well, there you're likely to screw it up, and asphyxiate yourself, or so I understand. Not fun, so I also understand.

I've seen it suggested many times now that if you breathe in pure nitrogen, and are allowed to breathe out (e.g., if you are in a sizable chamber full of nitrogen), you pass out from oxygen deprivation, but don't feel suffocated (which has to do with too much CO2 rather than not enough O2). Frankly, I'd take that over this "Well, we're not harming the patients; they just aren't being given food and water" BS. For one thing, it'd mean some folks either acknowledging or denying that they wanted their patients dead.

If it is not euthanasia, it's neglect and/or malfeasance.

wv: gypromni. Every possible use of that word is un-PC in some direction or other.

Fen said...

"Death from Dehydration Is Usually Serene."

You first.

bagoh20 said...

"I always thought the kindest doctors used morphine."

The problem there is that without the morphine, I would be ready to die. With narcotics, I'd want to live, assuming I had access to the internet with it's endless history, literature, music, video, and the entire world to explore in my final days. I'd never want to die.

Suffering and pain may just be God's way of getting your agreement on the matter so he won't feel guilty about offing you.

Michelle Dulak Thomson said...

Fen for the win.

Michelle Dulak Thomson said...

bagoh20,

Rather depends on the quantity of morphine, yes? Enough, and I bet you will lose absolutely all interest in the Internet. And anything else.

ironrailsironweights said...

At least we don't have to worry about such "stealth euthanasia" in America. No sirree, if you're a hopelessly senile, double incontinent 95-year-old, we'll happily spend $100K on heroic treatments that might extend your existence ("life" is hardly the word) for another week or two.

Peter

Michael K said...

"Am I wrong to suspect there is a form of euthanasia going on?"

Yes. It's just regular old shitty government health care. Same shitty service you get from every other government program.


No, this is a policy. Some years ago, it was before I retired so it must have been 20+, the Wall Street Journal had an article on euthanasia in Europe. It interviewed a couple of Dutch ER docs. They told the reporters that, if they admitted an emphysema patient in respiratory failure, they would lose their jobs. There would be no hearing or publicity; they would just be let go.

The family was not consulted; the pat8ent was not consulted. The emphysema patient who came to the ER with respiratory failure was not intubated or put on a respirator. He was just given a lethal injection of morphine.

In Britain, they passed one of those bureaucrat regulations that said a patient could not be kept in the ER more than 12 hours. Maybe it was less; I don't remember. Anyway, the NHS solved it by not allowing ambulances to enter the ER unloading area if the wait was over 12 hours for admission. They stayed in the parking lot.

Lots of reports about those cases lately.

Over at Wash Monthly, they acknowledge that overt rationing is the Democrats' plan to deal with Medicare insolvency. No problem.

Michael K said...

I should add that death from dehydration is easy but the patient has to consent. I have done this many times but always with everyone knowing and consenting. I've also been outvoted by a family 5 to 4 to continue to do everything. It is rarely, very, vary rarely, the doctor who insists on futile care.

William said...

The thing that troubles me about liberals is that they think Britain National Health Service is an ideal to be realized and not a horror to be avoided. Comparisons with Nazi Germany are not apt. Better perhaps would be the Soviet Union and their various lunatic schemes which the left applauded. Take the Moscow subway system. It was always given as an example what could be done if the interests of the working class were paramount. Yeah, right. The Soviet Union devoted more than 25% of their budget to its completion. It was built at the expense of a lot of malnourished and starved agricultural workers. Unlike the working class, they were not the vanguard of the revolution, so fuck them.....When we look at the needs of our health care system, I think that we can all agree that crack babies, HIV patients, and breast cancer sufferers are the most worthy. More of our resources should be devoted to their care and a search for the cure. Old people look really hideous. With the exception of lung cancer patients who got their disease from smoking (probably in public places) they are most deserving of death in order to free up the health care system for the more attractive sick people.

Ricardo said...

"Through early morning fog I see
visions of the things to be
the pains that are withheld for me
I realize and I can see..."

"That suicide is painless
It brings on many changes
and I can take or leave it if I please."

Cedarford said...

crazy legs said...
Obviously people trying to sell readers on pulling the plug on Terry Schiavo were going to paint her eventual death-by-neglect as peaceful. It's not like they could win anyone to their argument if they admitted it was a horrific way to go.

It wasn't for Schiavo. She was a rutabaga, as doctors knew and autopsy proved. NO suffering for her and the other vegetatives. No more than an oyster on ice lasts 6 days while "suffering deeply, freezing and hungr and suffocating, in a way Jesus never intended for little oysters".
But that is the "path" the Mighty Courts want us on. Death from benign neglect. Not euthenasia.

And that leaves some elderly, terminal patients still doing dehydration, self starvation to go faster. If they want. Or straight out suicide.

Good enough for dogs, the euthenasia option should be there for self-aware people and guardian of certified veggies.

HT said...

Damnit. Now I wanna watch MASH with Trapper John.

Michelle Dulak Thomson said...

ironrailsironweights,

At least we don't have to worry about such "stealth euthanasia" in America. No sirree, if you're a hopelessly senile, double incontinent 95-year-old, we'll happily spend $100K on heroic treatments that might extend your existence ("life" is hardly the word) for another week or two.

Indeed. Obviously, from your standpoint, lethal injection (or "serene" "just make sure they don't get any food or water") is better, yes? But what if s/he's merely singly incontinent and intermittently coherent and only 80? Or 75, sharp as a tack, but very frail and likely to cost a lot? Or even mentally retarded and 60, with minor, easily treatable physical health issues? Or, for that matter, newborn and mentally retarded, with your usual Down Syndrome heart and/or tracheal defects?

My point is that would be very easy to starve or dehydrate almost all of these people to death if their families didn't object, and the doctors around them figured their patients would be better off dead. I do not want doctors or anyone else around me deciding that I'd be better off dead unless I've told them so myself, or given an advance directive.

ironrails, I've never been able to get over the plain facts of the first "Baby Doe" case:

The first set of Baby Doe rules was based on section 504 of the Rehabilitation Act of 1973.6,7 The Reagan Administration was responding to the death of an infant called Baby Doe, with a tracheoesophageal fistula, trisomy 21, and other problems; the parents, under the advice of some physicians, had decided not to repair the fistula. The Indiana courts supported the family’s decision, but while an appeal was being made to the US Supreme Court, the infant died. The legal theory behind the first set of Baby Doe rules was that nontreatment could only be justified if 1 of 3 stated exceptions existed; otherwise, nontreatment was discriminatory and violated the infant’s civil rights. (Baby Doe died in 1982; as more has been learned about trisomy 21, there has been greater agreement about the duty to provide life-saving treatments for infants with this condition.)

To translate: "tracheoesophageal fistula" = a blockage in the throat/esophagus that made it impossible for the child to take in food; "trisomy 21" = Down Syndrome. What happened here is that the parents declined surgery that would make it possible for their baby not to starve to death (IIRC, even when surgeons volunteered their services), and also adoption offers, because then they'd be the parents of a live retarded baby. And, I mean, a dead retarded baby is obviously preferable, yes?

Any guesses as to whether they'd've ordered the surgery absent the trisomy 21?

Michelle Dulak Thomson said...

Cedarford,

Good enough for dogs, the euth[a]nasia option should be there for self-aware people and guardian[s?] of certified veggies.

"Good enough for dogs"? What in tarnation do you mean by "good enough"?

If an animal is in great and irreparable pain, there may be a case for euthanasia, but if the animal is not in pain, only benumbed or expensive to care for or disturbing to look at, the only pain you're relieving is your own. That's not euthanasia; that's getting rid of an unpleasant reminder that your pet isn't the perfect pet it used to be. Or that suddenly its care costs have outrun its value to you.

Which IMO would make you many things I don't like to say of others when sitting next to my own cat; claws tend to come out on these occasions, and they aren't indiscriminately employed.

The exact analogue to how Americans in general treat sick or elderly animals, as applied to their immediate human family, would be "oh, have Grandma put down. It'd be a kindness." Sure: a kindness to yourself. The house would be, after all, more pleasant absent Grandma. Think of all the worries you'd no longer have.

Fen said...

the euthenasia option should be there for self-aware people and guardian of certified veggies.

I don't agree with your last - too many "guardians" have base motives.

But I do believe that you should be allowed to end your own life. My father died of cancer. We were "fortunate" in that he lived just long enough to put up a good fight, but not so long that he suffered in pain.

A year later, his best friend (and a great attorney) was diagnosed with cancer. Just before it got bad, he took a shotgun and blew his brains out. Both of us had seen what his path would have been, and I can't say I blame him.

Lynne said...

My father, dying of lung cancer, didn't eat for over a week before he died and refused any liquids for the last four days. It was everything we could do to drop even a straw full of water into his mouth. His body slowly shut down and then he died. The hospice nurses said this refusal of food or water was extremely common.

SCOTTtheBADGER said...

Those who think death by dehydration is peaceful should read accounts of survivors of torpedoings during WWII. The story of the USS INDIANAPOLIS is particularly well documented, and not very pleasant. Those Dr.s are lying.

Freder Frederson said...

It's just regular old shitty government health care. Same shitty service you get from every other government program.

Can you tell us what your particular experience with the NHS is that makes you an expert. How long have you lived in England? I doubt you have even been there.

Do you realize that the UK spends about a third of what the US does on health care (about 6% of GDP compared to the US's 17%) yet manages to deliver free healthcare to all its residents with no worse results than the US. And no one in the UK is financially ruined by medical bills.

DaveW said...

So how many people do you think believe this snot about dying from starvation or dehydration being serene and peaceful?

ironrailsironweights said...

Do you realize that the UK spends about a third of what the US does on health care (about 6% of GDP compared to the US's 17%) yet manages to deliver free healthcare to all its residents with no worse results than the US.

Aware of the UK's much lower level of health care spending, when I traveled to London a few years ago I was fully prepared to see the landscape littered with the rotting corpses of people who had died from the lack of medical care. To my surprise I didn't see any.

Peter

Michelle Dulak Thomson said...

ironrailsironweights,

Well, of course you didn't. Desperately ill people aren't walking about, you know; you won't encounter them on the streets at all unless they're homeless. (Speaking of whom, did you ever by chance visit Embankment Tube station? Or walk across Waterloo Bridge to the Southbank Centre?)

tom faranda said...

No AA, you are right.

Fen said...

UK.. manages to deliver free healthcare to all its residents with no worse results than the US

*snicker*

Love the qualifier. Even you don't believe that bullshit.

Amy said...

Am I wrong to suspect there is a form of euthanasia going on?

No. It's not a bug, it's a feature. The hundreds who die from malnutrition/dehydration are hundreds fewer the NHS has to worry about paying for.

I mean, a UK politician said the elderly suffering with dementia had an obligation to die: http://tinyurl.com/42wquj. So why should we limit it to elderly with dementia? Why not elderly in general? They don't work and pay taxes anymore and are just leeching off the system. (I'm being sarcastic, but the sad reality is people think this way).

Coming soon to a USA hospital near you...

Fred Drinkwater said...

M D Thomson:
Although my name is not Frank, "Fred" Drinkwater is indeed my real name. I gave up on internet anonymity back in '95 or thereabouts.
Re: your remarks on breathing nitrogen. My father spent more than 30 years as a NASA pilot. He participated in regular studies on health effects of piloting, at (IIRC) Lovelace Clinic in Albuquerque NM. Among other things, they were tested for tolerance of low-oxygen conditions. This involved wearing a flight oxygen mask, performing a simple task like repeatedly signing one's name, while the oxygen percentage in the air mix was reduced.
According to my father, the typical result was that the testee passed out and upon recovery, had absolutely no memory of losing task ability prior to passing out. (This fact has obvious implications for flight crew procedures.)

I SWEAR this is the real WV for this post: kille

Mickey said...

Yes, I think you would be wrong to suspect that.

Considering that there are hundreds of thousands of people in hospice, and that hospice workers are in short supply and not paid/treated well anyways (I had one for a mother), a number measuring in the hundreds for these sorts of deaths seems low.

Not that I'm an expert, but euthanasia? No.

Michelle Dulak Thomson said...

Fred Drinkwater,

My apologies! I don't know where the "Frank" came from.

Mickey,

Considering that there are hundreds of thousands of people in hospice, and that hospice workers are in short supply and not paid/treated well anyways (I had one for a mother), a number measuring in the hundreds for these sorts of deaths seems low.

But Ann wasn't writing about hospice care; she was writing about the NHS in the UK. See the long blue link in the fifth graf down in the original post.

She quoted people associated with US hospices, but the subject was this, from the Daily Mail:

The snapshot study, triggered by a Mail campaign, found staff routinely ignored patients’ calls for help and forgot to check that they had had enough to eat and drink.

This is not in a hospice, but in an ordinary hospital, run along lines that many want to see followed here.

wv: rocato. Damn, 40 years as a violinist, and there's still a bowstroke I've never heard of.

amba said...

As terrible as that "form of euthanasia" is, it is just as cruel to keep someone who is ready to die, and has expressed that by refusing to eat or drink, alive by artificial hydration and nutrition.

Michelle Dulak Thomson said...

amba,

As terrible as that "form of euthanasia" is, it is just as cruel to keep someone who is ready to die, and has expressed that by refusing to eat or drink, alive by artificial hydration and nutrition.

No, it isn't. The linked article says that patients who want and need water aren't getting it so often that physicians are actually prescribing water to ensure that it's provided. Read Coketown's link above, about a young man in hospital who was so desperate for water that he called the UK equivalent of 911. He died of dehydration. Google "Kane Gorny."

If you're trying to tell me that IV hydration of an unconscious dehydrated patient, or intubation of an unconscious patient, is as cruel as accidentally allowing a bedridden man to die of thirst, you're nuts.

If you mean forcing food and water on someone who is conscious and states that s/he doesn't want either, you're at least reasonable. Except that I don't know of that happening anywhere.

wv: secakiqu, which sounds rather like a name Robert Heinlein would give to a Martian.

T. D. said...

Euthanasia--or torture.

Hmm. What if instead of waterboarding a few key detainees, we just subjected them to the "serene" technique of withholding food and water.

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