Perhaps it is time for you to get some direct clinical experience with those who are suffering from autonomic system failure, and consequent organ shut-down.
I do not doubt that there are people dying prematurely, improperly denied hydration and nutrition, and overly medicated, as you suggest.
But, do not fall off the horse on that other side, because there are medical situations that require much less medical interference than is “present protocol”. And, many docs pursue these, for fear of legal consequences or personal gain.
General comments made in an online forum that could intimidate loving relatives trying their best to provide comfort and care for those terminally ill, making them feel guilty for not “doing everything medically possible” could be (in my layman’s opinion) at least, considered insensitive to individual situations, and might verge on what we commoners consider “verbal malpractice”.
Who knows what someone might decide to do, based on a general statement you have made over the internet? Have you considered the impact that the initials behind your screen name might have on someone who concludes you are more qualified than you are, in fact?
We do not want to devolve into a world where our loved ones, no matter what their age or circumstance, become subject for medical experimentation, when weird tests and trials are conducted in the “name of science, and the betterment of mankind”.
This has happened in the past, as I am sure you know, and it is probably happening in the present. I hope it never happens to me, or anyone I love.
In conclusion, remember that saying about words being like feathers released from a pillow?
Most doctors would not generalize on an internet site, about a patient they have not examined, or express an opinion on someone who medical history and situation they have not studied.
So, why have you?
Sorry, but I'm not going to be threatened or bullied into silence on this issue, by you or anyone else. Six years ago I had to stand by silently while they euthanized a close personal friend with Parkinson's by dehydration. His kind of case is typical of what is occurring in the hospice and palliative care field, I've personally witnessed it, and I'm not going to be silent about it.
Fr. Gerard's Story:I first met Fr. Gerard in 1998 while doing a house call for his mother. A brief initial conversation revealed that he was retired and living in a small apartment only a block from my office, and that we shared many Catholic and pro-life interests. Fr. Gerard soon became a close friend, and we met frequently for meals. I assisted him with various tasks around his apartment, and he called me often simply to talk. He got to know my wife and children well and relied on us for help, as his only sibling lived out of state. Fr. Gerard eventually developed Parkinson's disease. We offered to take him into our home, but knowing the chaos of our homeschooling household he politely declined, and entered a local nursing home. We continued to visit him often and took him out to dine at his favorite restaurants.
In late 2007 and early 2008, Fr. Gerard's health declined rapidly. He left a voice message on my cell phone late on a Wednesday in April 2008, asking me to stop and visit. By the time I was able to visit him two days later, he had been admitted to a local hospital for aspiration pneumonia, and had been diagnosed as "terminal" by the treating physician. He was transferred to the palliative care unit from the ER and the treating physician insisted that according to his Living Will, Fr. Gerard wanted no "extraordinary care" to prolong his life.
I was shocked that he was receiving no water, food or IV, only Morphine by slow IV drip. His Parkinson's was certainly advancing and the aspiration pneumonia was a serious crisis (aspiration pneumonia has a 20 to 60% mortality rate), but food and water did not constitute extraordinary care. We were permitted to wet a sponge to moisten his lips, and he would try to suck all the moisture from the sponge, but we were forbidden to give him a drink of water, because of the "risk of further aspiration pneumonia."
Fr. Gerard had shared with me his opposition to passive euthanasia in the past, and he was trying to talk to me, but he had become so dehydrated that he could not form words. When the attending physician made rounds, I told him my concern that Fr. Gerard was receiving no food or water. The physician asserted that "their hospice rules forbid IVs" as it only "prolonged the process." He then stated, "The public has a misconception that death by dehydration is torturous, but that's not true. It's the most humane way to do this, with the least discomfort. We will control any discomfort with the Morphine. That's what we're going to do."
With that the attending physician, a Catholic father of six, looked me in the eye defiantly, turned on his heels and left. I was speechless. The next day I pleaded with his sibling that Fr. Gerard would never have consented to passive euthanasia by dehydration, explaining that if he died now it would be due to dehydration, not the aspiration pneumonia or the Parkinson's, but to no avail.
I have always been pro-life. I had even attended pro-life conferences about euthanasia and had sat on the medical ethics committees of two hospitals, both in the mid 1990's. I had staff privileges at the hospital in question. But in April 2008, in Fr. Gerard's specific case, I simply did not know what to do. I called four good pro-life priests locally, begging for advice. They all agreed that something must be done but none could offer any specific advice, and because his sibling held power of attorney none could personally intervene to help their fellow priest.
Another priest I consulted recommended I request a medical ethics committee consultation. Late on a Thursday evening, eight days after Fr. Gerard had left the voice message on my cell phone, I spoke with a physician assistant who was on call for the ethics committee. I told her that he was a good priest and a faithful son of the Church who would never agree to being passively euthanized, and I discussed with her the relevant documents from the Vatican, the USCCB and the state bishops' conference. She asked me to enter these documents in Fr. Gerard's chart, and the medical ethics committee would be happy to review the case Friday morning on rounds.
Relieved that there was something I could finally do for this good priest, I went to the hospital Friday morning at 7:00am, asked the unit clerk to formally enter the documents into his chart for the ethics committee consultation, and headed down the hall to visit him.
His room was already empty. Fr. Gerard had died of dehydration several hours earlier.
I believe that the history of the "right to die" movement stems from similar situations, where everything possible was done to try to prolong life in dying people.
On both sides, there are people who advocate "all or nothing" approaches. Either they want to hasten death in every case, even where the patient is not dying, or they want to prolong life by any means possible, even when the patient is clearly about to pass. There is a large area between the extremes that is being ignored--where the decisions are made based on the condition of the patient. The middle road, of course, requires some thought and analysis, which makes it harder than taking either extreme position.