Tue, May 14, 2019 - Page 8 News List

Respecting the right to die without stigma, fear

By Jung Tsai 蔡榮聰

The late British physicist Stephen Hawking once said: “I have noticed that even people who claim everything is predetermined and we can do nothing to change it, look before they cross the road.”

Humans cannot overpower the heavens, but every scientific development and medical advance gives us more choices.

As doctors pledge primum non nocere (first do no harm), I was for many years against physician-assisted suicide, but a few patient experiences have led me to think differently.

An 80-year-old woman with newly discovered lung cancer was advised surgery, chemotherapy and radiotherapy by her oncologist.

She refused, but came to ask my opinion. I found her to be depressed; she had lost her passion, enthusiasm and positive outlook. The patient did not think she had depression, but started anti-anxiety medication, and she came back feeling much better and thinking that life was more meaningful.

Her life was better after being treated by psychiatry and she came to see me to let me know that her diagnosis helped her, but when I asked her about her cancer therapy, she said she did not want it, fearing that the treatment would bring painful consequences.

Clearly, people with an illness have the right to decide their fate, to live or die.

Another patient, a 60-year-old man with colon cancer, came to see me and while I was preparing him for surgery, he suddenly told me: “If my heart stops during surgery, please do not resuscitate me — let me go.”

He saw my surprise and continued: “There are some things more terrible than death.”

With advances in medicine, death is no longer a moment in which to “die,” but a process of “dying.” Life can be more terrifying than death.

A 96-year-old patient was brought into the emergency room with a perforated stomach and surgery was not an option. He was still conscious and suffering a great deal of pain and discomfort because of peritonitis.

The medical staff decided to make him comfortable with morphine. For three days, he was still breathing. Finally, he received an anesthetic agent and his breathing stopped. His suffering was no more.

No wonder the “right to die” movement has reached a new milestone. Advances in medicine make it almost impossible to die. Dialysis, feeding tubes, ventilators, antibiotics and pressors keep the body going.

When we prolong the process of dying, is that not also harming our patients? New Jersey has recently become the eighth US state to legalize assisted suicide.

Some people think that this law would target poor, non-insured, disabled groups, but in Oregon, most people looking for assisted suicide are Caucasian, educated and upper-middle class. Among those who requested assisted suicide, 35 percent bought the medication, but did not use it. When asked why they did not use it, they said they just wanted to have the option.

Some think that doctors and nurses would not spend time with a patient who is dying. The reality is that more physicians and nurses are opting to work in the fields of hospice and palliative care, because they realize how important the end of life is. High-quality palliative care in a hospital setting is the way I would want to go.

French writer Victor Hugo said: “I am no longer afraid of death, because I am more worried about living.”

Waiting to die, deciding to die and dying are difficult enough. Let us help one another embrace death when the time comes — without stigma, without fear.

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