6packofun Posted October 31, 2016 Share Posted October 31, 2016 I feel like this is a difficult area for me to have a strong stand on. When dh's grandmother was in the late stages of Alzheimer's and had a stroke, it left her unable to speak, eat, drink, get out of bed, do anything. At this point, we honored her wishes to not keep her alive artificially which she was very clear about. So, we watched her die over 9 days. We gave her morphine and I let her try to suck on wet washclothes but I'm not sure she even did. She wasn't in a vegetative state as we think of one; she could sort of look around and seemed somewhat aware. (maybe?) When I found her on that 9th day, she honestly looked very peaceful. Anyway, I hear two different things about the experience of dying from dehydration/starvation. One side--who may or may not be for assisted suicide, btw, and I don't want to get political if that's considered political--like hospice and plenty of medical professionals say that at some point there is NO hunger anymore. It's not any more cruel than making someone have a feeding tube or some other artificial means put in. The other side simply says that it's torture and makes no difference between this scenario which plays out in nursing homes and hospice care throughout this country probably on a daily basis and the purposeful conscious choice of stopping food/water, even the administration of drugs, to end a life. I just think there are nuances to this. Dh and I have been talking about end of life care, what we want for ourselves, what our parents want, etc. What are your thoughts and how did you come to your conclusions? Quote Link to comment Share on other sites More sharing options...
MooCow Posted October 31, 2016 Share Posted October 31, 2016 No. I don't. My mom had one, so did my grandma. Quote Link to comment Share on other sites More sharing options...
SproutMamaK Posted October 31, 2016 Share Posted October 31, 2016 No, I don't consider them the same. 1 Quote Link to comment Share on other sites More sharing options...
Charlie Posted October 31, 2016 Share Posted October 31, 2016 I just think there are nuances to this. Dh and I have been talking about end of life care, what we want for ourselves, what our parents want, etc. What are your thoughts and how did you come to your conclusions? We've spent the last year formalizing these things with our lawyers, and are now helping our kids do the same. The way I have it worked out is by assessing my quality of life. If there's little potential for regaining a good quality of life and there's an emotional and/or financial burden, then it's okay for my husband or my kids to let me go. I'd prefer euthanasia to dying naturally (for the reasons you list, just in case I can feel discomfort), and I'd like that conversation to be held outside the hospital room (just in case I can hear!). My husband's wishes are similar to mine, our kids' vary. But then, they're young and I think that's to be expected. 1 Quote Link to comment Share on other sites More sharing options...
Daria Posted October 31, 2016 Share Posted October 31, 2016 I am very strongly anti assistive suicide, for reasons I will not go into here, since this is not the political board. My father died at home, after a long fight with cancer, with palliative care from hospice coming in for pain relief. My arms were around him when he died. It's possible he would have lived a few days or weeks longer in the hospital, but that's not what he wanted. I have no regrets about that choice. I see it as absolutely different from withdrawing an already established form of support (e.g. removing a feeding tube). 9 Quote Link to comment Share on other sites More sharing options...
The Girls' Mom Posted October 31, 2016 Share Posted October 31, 2016 Legally and semantically it is passive euthanasia. I don't feel that it is wrong, however. One should have the right to not have their lives artificially prolonged, IMO. 2 Quote Link to comment Share on other sites More sharing options...
Lang Syne Boardie Posted October 31, 2016 Share Posted October 31, 2016 No, I absolutely do not. I was just reviewing my grandmother's wishes earlier this month, as I was helping her through an illness and injury, so the topic is fresh in my mind. I do not see the two as remotely the same. My grandmother has studied end of life care, and decided that frequently the interventions are more tortuous than allowing a 90yo person in her right mind to die comparatively peacefully of natural causes, if she'd rather. 9 Quote Link to comment Share on other sites More sharing options...
Carol in Cal. Posted October 31, 2016 Share Posted October 31, 2016 Assisted suicide is someone killing themself and you help. DNR is someone dying suddenly and you don't try to bring them back. For instance, you don't do CPR on someone whose heart as stopped. To me those are very different, morally. The case that you're talking about is in between, and not really exactly one or the other. I think it is horrifying to decide that someone who is dependent on a feeding tube should suddenly not get the feeding tube filled anymore, and that it's very possible that someone like that is in a great deal of discomfort and maybe fear and horror during that process, that I wouldn't want to put them through. I've known a couple of people quite well who had feeding tubes, and I'm very uncomfortable with a random decision to stopping feeding them that way. But I think it's reasonable to say, if their heart stops we won't restart it, if that is their expressed wish, for instance. Having said that, I'd rather err on the side of life, generally. A classmate of mine was in a car accident in her first year in college, and was in a coma for 3 months. I'm really glad that she was kept alive. She regained consciousness and went on to live a normal life. Fundamentally I think people need to be kept comfortable and supported but not intentionally killed. If someone needs enough morphine to shorten their life to be able to stand or eliminate their pain, so be it, for heaven's sake give it to them. The intent is not death, it is comfort. No issue there, none whatsoever. 10 Quote Link to comment Share on other sites More sharing options...
idnib Posted October 31, 2016 Share Posted October 31, 2016 (edited) No. While I think both are valid options, euthanasia to me implies something deliberately ingested or other action taken to end life within an expected timeframe. DNR to me means not taking advantage of certain knowledge and/or technology in order to prolong a life. My dad used to teach a course on medical ethics so we've discussed this far too much over the last 30 years. :laugh: It's more nuanced than what I've mentioned here, but the gist of it is that they are not the same. One is the artificial ending of life, the other is the artificial prolongation of life. Edited October 31, 2016 by idnib 5 Quote Link to comment Share on other sites More sharing options...
mmasc Posted October 31, 2016 Share Posted October 31, 2016 No, I do not consider them the same. In the scenario you gave (which unfortunately I've lived through as well), forcing a feeding tube or food at all, or even meds, definitely went against the person's wishes. I believe in dignity in dying and do not think we should force things on people just because we *can* feed that person, or *can* extend the life through artificial means. Of course, this is why having all of these things stated in writing and known by caregivers/family is SO important before anything happens where decisions have to be made. And even if people think that dying without water or through starvation is torture, I think that person has a right to deny food is s/he chooses. 2 Quote Link to comment Share on other sites More sharing options...
Spryte Posted October 31, 2016 Share Posted October 31, 2016 No, I don't consider them the same. I have been the primary caregiver for someone who was dying, my sister-friend. She did not have a DNR, she was young, with a child, and we held out hope till the very last weekend that she would get an organ transplant. I have no regrets about it, and looking back - I would have struggled to support a DNR, so ... I understand both sides to wanting one or not wanting one, but I can't view it as suicide. Not even assisted suicide. Quote Link to comment Share on other sites More sharing options...
Seasider Posted October 31, 2016 Share Posted October 31, 2016 (edited) For an elder with already diminished quality of life? Absolutely not. You might want to read Being Mortal by Atul Gawande. A standing DNR order on an otherwise healthy young person (which is not what you are describing) would be weird. ETA the best takeaway from the Gawande book, for me, was how to have these conversations with the elders in our lives. It will give you much to think about. Also, while you are in this stage of planning, you may want to go ahead and look at Medicare, Medicaid and long term care insurance options to determine how your wishes in older age will be funded without putting your children in a tight spot (both financially and with their commitment of time to care for you). Edited October 31, 2016 by Seasider 3 Quote Link to comment Share on other sites More sharing options...
Rebel Yell Posted October 31, 2016 Share Posted October 31, 2016 I've always understood "DNR" to mean Do Not Resuscitate, as in, if the patient has a heart attack do not attempt CPR or use paddles. Basically, if the event happened when they were alone they would have died without treatment. To me that is very different from intentionally withholding food or giving a dose of something that is understood to hasten death. 6 Quote Link to comment Share on other sites More sharing options...
The Girls' Mom Posted October 31, 2016 Share Posted October 31, 2016 (edited) I'm smack in the middle of an Ethics class and this was one of the argument topics we had to discuss. Technically, DNR or a request to not be sustained artificially is a form of euthanasia. It is a "letting die" euthanasia vs an active "killing" euthanasia. Important distinctions, and they often get overlooked when it is being discussed. Having dealt with end-of-life situations for two parents, I think DNR requests are extremely important. It saves the surviving family a great deal of stress and grief in decision making, AND it gives the terminally ill person some control over their care at the end. Edited October 31, 2016 by The Girls' Mom Quote Link to comment Share on other sites More sharing options...
zoobie Posted October 31, 2016 Share Posted October 31, 2016 No. Not forcing IV nutrition or fluids or not resuscitating someone who has stopped breathing isn't the same as actively hastening death through chemical means. Quote Link to comment Share on other sites More sharing options...
trulycrabby Posted October 31, 2016 Share Posted October 31, 2016 No, it is an order to not administer lifesaving measures CPR/defibtillation/oxygen (ACLS) when the person has stopped breathing or does not have a pulse. To me it is an attempt to reverse a death that is in progress or has already happened. Medical staff do not resuscitate someone who is breathing. 2 Quote Link to comment Share on other sites More sharing options...
QueenCat Posted October 31, 2016 Share Posted October 31, 2016 No, not at all the same. Quote Link to comment Share on other sites More sharing options...
6packofun Posted October 31, 2016 Author Share Posted October 31, 2016 Assisted suicide is someone killing themself and you help. DNR is someone dying suddenly and you don't try to bring them back. For instance, you don't do CPR on someone whose heart as stopped. To me those are very different, morally. The case that you're talking about is in between, and not really exactly one or the other. Ahhh, yes, you're right. I wasn't sure DNR was the right term. She did not die from the stroke. I know that dh was in charge of everything for her and somehow she had made it clear in her will or other papers that she did not want to be kept alive if she lost the ability to eat, drink, breathe on her own. Is there an official term for that? Or can you just be super specific in your will? I'm not doubting we did the right thing, only that I wonder how people view it out of curiosity. Thanks for clarifying that! 1 Quote Link to comment Share on other sites More sharing options...
6packofun Posted October 31, 2016 Author Share Posted October 31, 2016 Shoot, since I worded it wrong, that may muddy the waters. In this situation, she was able to be spoon fed and helped with drinking, but after the stroke there was no hope she would regain those abilities and so we did not *start* artificial means. But in circumstances where a person had more awareness and the hope of regaining those abilities, it might be ethically wrong to withhold food/water. Quote Link to comment Share on other sites More sharing options...
trulycrabby Posted October 31, 2016 Share Posted October 31, 2016 (edited) Ahhh, yes, you're right. I wasn't sure DNR was the right term. She did not die from the stroke. I know that dh was in charge of everything for her and somehow she had made it clear in her will or other papers that she did not want to be kept alive if she lost the ability to eat, drink, breathe on her own. Is there an official term for that? Or can you just be super specific in your will? I'm not doubting we did the right thing, only that I wonder how people view it out of curiosity. Thanks for clarifying that! The official term is advance directives, and often includes the DNR form. Edited October 31, 2016 by trulycrabby 1 Quote Link to comment Share on other sites More sharing options...
Pam in CT Posted October 31, 2016 Share Posted October 31, 2016 It is a difficult area, and circumstances arise that do not fit cleanly into either/or ending life/prolonging life dichotomies... or can be forecast in advance even when families do communicate well about their wishes and do have living will type documents in place. Still, that kind of communication is the place to start. OP, if you're working through your thoughts on these issues and haven't come across it already, I would heartily second seasider's recommendation of Atul Gawande's On Being Mortal: Illness, Medicine and What Matters in the End. It helped me a great deal (and I keep dipping back to it). 1 Quote Link to comment Share on other sites More sharing options...
TranquilMind Posted October 31, 2016 Share Posted October 31, 2016 I feel like this is a difficult area for me to have a strong stand on. When dh's grandmother was in the late stages of Alzheimer's and had a stroke, it left her unable to speak, eat, drink, get out of bed, do anything. At this point, we honored her wishes to not keep her alive artificially which she was very clear about. So, we watched her die over 9 days. We gave her morphine and I let her try to suck on wet washclothes but I'm not sure she even did. She wasn't in a vegetative state as we think of one; she could sort of look around and seemed somewhat aware. (maybe?) When I found her on that 9th day, she honestly looked very peaceful. Anyway, I hear two different things about the experience of dying from dehydration/starvation. One side--who may or may not be for assisted suicide, btw, and I don't want to get political if that's considered political--like hospice and plenty of medical professionals say that at some point there is NO hunger anymore. It's not any more cruel than making someone have a feeding tube or some other artificial means put in. The other side simply says that it's torture and makes no difference between this scenario which plays out in nursing homes and hospice care throughout this country probably on a daily basis and the purposeful conscious choice of stopping food/water, even the administration of drugs, to end a life. I just think there are nuances to this. Dh and I have been talking about end of life care, what we want for ourselves, what our parents want, etc. What are your thoughts and how did you come to your conclusions? No, not at all. A DNR simply means that the person desires that extraordinary measures not be taken after a certain point and makes those wishes known via an advanced directive. It isn't the same as assisting in someone's death intentionally. Are you talking about removing hydration and nutrition? That's not customarily in the DNR, as I recall it, but a DNR usually involves comfort measures. I am sure that there is little hunger but I couldn't withhold water from someone. I've had a few family members with them. Quote Link to comment Share on other sites More sharing options...
StephanieZ Posted October 31, 2016 Share Posted October 31, 2016 Nope, it's not the same. At all. I wish it were legal to actively assist with death when it is imminent and no decent quality of life is achievable, but in general, it isn't, so withdrawal of drugs/nourishment is one option to leave suffering behind. Each of my parents died after "withdrawal" of life supports/etc. In each case, their death was imminent. If I could have given them a nice injection and allow them to go to sleep instead of risking suffering, I would have done that. But, apparently we understand that for dogs, it is more humane to hasten death than it is to allow additional hours or days of suffering, but for people, we don't worry about that humane thing. My dad's death (in ICU, respiratory failure, multi-system failure, all secondary to a stroke and a hospital-caused accident) was ugly and distressing and I will never forget it (16 years later). My mom's death (also respiratory failure, but at home, with hospice, also secondary to a stroke and Alzheimer's) was not ugly or disturbing, probably because it was mediated by the hospice prescribed morphine and anti-anxietry drugs, etc. In both cases, I'd have much preferred providing anesthesia before they were allowed to die from respiratory failure. It would be more humane for everyone, families included. At least for Mom, she had lots of good drugs on board, so I don't think she suffered. My dad suffered a lot, but we didn't know better back then to have demanded hospice/etc before allowing removal of life support. Personally, dh and I have living wills and would order/allow/instruct as active assistance in dying as is legal. Once I'm on my way out, the last thing I'd want to do is to put my family through what I went through with my Dad. I'd MUCH prefer to throw myself out a window, but by the time it comes to that, we usually don't have our wits about us. 7 Quote Link to comment Share on other sites More sharing options...
regentrude Posted October 31, 2016 Share Posted October 31, 2016 (edited) No, a DNR is not assisted suicide. The family/provider do not take any active action in causing the death; the merely refrain from taking action that would postpone the death/prolong the dying process. Very different. Edited October 31, 2016 by regentrude 2 Quote Link to comment Share on other sites More sharing options...
bettyandbob Posted October 31, 2016 Share Posted October 31, 2016 Absolutely not. 1 Quote Link to comment Share on other sites More sharing options...
gardenmom5 Posted October 31, 2016 Share Posted October 31, 2016 I do not think they are the same thing. you have someone who is already far along in the process of dying - and you are not giving treatment which will have to be permanently continued for them to maintain life. the illness/injury takes its normal course. a course that would have happened 100 years ago before modern medical care. (a.s. is giving a cocktail of drugs to cause death.) My mother was at her nursing home, unattended for 10 minutes and had no pulse when the attendant returned. they called 911. at the hospital - she was on full life-support. she had catastrophic brain damage from oxygen deprivation. the likelihood of her ever regaining consciousness was closer to none - and I could have punched the dr who wanted to "let the family down easily" by not being upfront about her actual condition. my sister grabbed at them - it made it much harder for her. (mother was NOT "in good health". she had a host of serious illnesses. including tias with increasing long-term damage.). the type of convulsions she was having were very serious and typical of anoxic brain injury that would lead to death within days - even on life-support. two cases I found that survived were both vegetables. the medication she was given to control the strong convulsions did not work. we removed her from life-support, and she died within minutes. My grandmother was in pretty-much a vegetative state due to a series of tias, and my mother had her feeding tube was removed. she wouldn't have even been able to suck on a wet washcloth. it did take her several days to die. Quote Link to comment Share on other sites More sharing options...
East Coast Sue Posted October 31, 2016 Share Posted October 31, 2016 (edited) No, DNR is not the same as assisted suicide. My mom just died and this is all so very much on my mind too. My mom had terminal lung cancer but she had been responding well to a few different treatments when her health suddenly declined. I believe her doctor was just about to initiate hospice care. I received a phone call on Friday evening asking me to accompany my parents to an appointment on Monday morning, but she died just hours before the doctor's appointment. In my mom's case, she had a DNR order on file with an attorney and at home (buried in a desk drawer). When she suddenly stopped breathing (likely from a blood clot based on my observations), my dad called EMS. I begged them not to do CPR and other life saving measures. It was emotionally devastating to lose my mom (somewhat suddenly) and yet beg for her to be allowed to die as peacefully as possible. In that moment I really wanted my mom back just to hear her voice and tell her that I loved her one more time. I remember though my grandmother and grandfather suffering quite a bit at the end of their life with artificial intervention of various forms and I knew that my mom did not want to suffer like that for even a moment. It is such an important decision for loved ones to make and share with their family members. The EMS was able to locate an online DNR directive and confirmed with her doctor so they respected my mom's wishes. Still, this is so fresh and painful for me but it could have been so much more devastating to have watched them do CPR on my mom. I believe hospice would have helped us prepare and handle my mom's death but we didn't get that help in time. Edited October 31, 2016 by Sue in TX Quote Link to comment Share on other sites More sharing options...
luuknam Posted October 31, 2016 Share Posted October 31, 2016 I feel like this is a difficult area for me to have a strong stand on. When dh's grandmother was in the late stages of Alzheimer's and had a stroke, it left her unable to speak, eat, drink, get out of bed, do anything. At this point, we honored her wishes to not keep her alive artificially which she was very clear about. So, we watched her die over 9 days. We gave her morphine and I let her try to suck on wet washclothes but I'm not sure she even did. She wasn't in a vegetative state as we think of one; she could sort of look around and seemed somewhat aware. (maybe?) When I found her on that 9th day, she honestly looked very peaceful. Anyway, I hear two different things about the experience of dying from dehydration/starvation. One side--who may or may not be for assisted suicide, btw, and I don't want to get political if that's considered political--like hospice and plenty of medical professionals say that at some point there is NO hunger anymore. It's not any more cruel than making someone have a feeding tube or some other artificial means put in. The other side simply says that it's torture and makes no difference between this scenario which plays out in nursing homes and hospice care throughout this country probably on a daily basis and the purposeful conscious choice of stopping food/water, even the administration of drugs, to end a life. I just think there are nuances to this. Dh and I have been talking about end of life care, what we want for ourselves, what our parents want, etc. What are your thoughts and how did you come to your conclusions? My grandfather stopped eating/drinking at some point a few years ago. From what I've heard, dehydration is a very painful way to die, as you're basically poisoning yourself by making it impossible for your kidneys to filter out all the toxic substances that build up that are normally washed out when you pee. BUT, his doctor did give him morphine. He died of dehydration a few days later, in NL, where euthanasia is legal, but the hoops to jump through are so much that it was easier to just stop eating/drinking and get morphine for the pain. Anyway, I don't think it's the same as euthanasia. If you *choose* to stop eating/drinking, then it's suicide, but not euthanasia (use of painkillers to not feel pain still does not make it euthanasia, imo, whereas a doctor-prescribed overdose of painkillers would make it euthanasia (or homicide, if against the patient's wishes)). If you have a DNR, it's simply not taking medical action to keep someone alive who'd die without medicine. Quote Link to comment Share on other sites More sharing options...
HS Mom in NC Posted October 31, 2016 Share Posted October 31, 2016 For an elder with already diminished quality of life? Absolutely not. You might want to read Being Mortal by Atul Gawande. Anyone who expects to die some day and anyone who thinks they might have to care for an elderly relative should read that book. It's really well done. My take away was that the decisions a person make for themselves at 50, 60 and early 70s isn't necessarily the same decisions they would make for themselves at late 70s, 80s and 90s. It's quite an eye opener. No, I don't consider advanced directives the same as assisted suicide, but I do think that they can be too categorical for the range of possibilities and people aren't going into them with a lot of understanding. Take my husband's grandmother for example. She had Alzheimer's and got to where she couldn't remember to swallow on her own, but was otherwise healthy for someone with serious memory loss. That's not usually the scenario people have in mind when they say they don't want a feeding tube. The way the document was worded, it could've been interpreted either way. People need a better idea of the full range of possibilities, not just the most extreme ones when they sign those documents. I'm not for assisted suicide, but I understand the line between comfort measure and assisted suicide can blur in some situations. Administering regular high doses of pain meds to patients with severe pain is the right thing to do, but if so much is required that it causes an overdose, I don't have a problem with that. 7 Quote Link to comment Share on other sites More sharing options...
Ali in OR Posted October 31, 2016 Share Posted October 31, 2016 Living in a state where assisted suicide has been legal for many years, it is quite easy to say that it is a very different thing from a DNR or what you went through. In those cases, terminal patients who are not yet on death's doorstep go to a doctor (I think possibly they have to go more than once) and get a prescription that will end their life. They then decide when to do that act. I hear that more often than not, the patient gets the prescription filled but doesn't use it. Having it gives them some sense of control that if things get really bad, they can use it. In the cases I have heard of, they are still mentally and physically with it enough to complete the act on their own--the "assisted" part comes in getting the prescription in the first place. I will second or third the recommendations to read Being Mortal. If you have any doubts or hesitations about not intervening medically in such difficult situations, Gawande's descriptions of how that intervention can destroy a natural, peaceful ending and ruin the quality of whatever life is remaining should put you at ease. And I hope no one would judge any child or grandchild who has had to walk this path and make these difficult decisions. 1 Quote Link to comment Share on other sites More sharing options...
BigMamaBird Posted October 31, 2016 Share Posted October 31, 2016 No, I do not consider it either. A DNR basically says "please don't stop me from dying." Whereas euthanasia/assisted suicide takes actions that cause death. I see them as two completely separate things. 4 Quote Link to comment Share on other sites More sharing options...
Slartibartfast Posted October 31, 2016 Share Posted October 31, 2016 No but I am not opposed to either. 1 Quote Link to comment Share on other sites More sharing options...
TeenagerMom Posted October 31, 2016 Share Posted October 31, 2016 Having worked in acute care Geriatrics for 4 years, I fully believe older people with medical conditions, Alzheimer's, etc stop eating or drinking as a function to the biological process of death. It's extremely natural and I watched it over and over with end stage patients. To ME, providing hydration/nutrition is almost cruel when a person is end stage because you are prolonging any suffering they may have in the process of dying. Very rarely does it do any good also. It makes me sad that we can euthanize an animal to end it's suffering, but it is almost viewed as you must prolong a human's life no matter the cost to the patient. So no, I don't consider a DNR to be assisted suicide. It's allowing death to happen when it is supposed to happen. 4 Quote Link to comment Share on other sites More sharing options...
redsquirrel Posted October 31, 2016 Share Posted October 31, 2016 I consider them on the same spectrum but I don't have a problem with any of them, if they are what the person wants. Quote Link to comment Share on other sites More sharing options...
Melissa in Australia Posted October 31, 2016 Share Posted October 31, 2016 My great grandfather had a refusal of treatment. For him this meant that he refused antibiotics when he go pneumonia at the age of 97. He and many old people I have met call pneumonia the ancient person's friend. I do not believe this is assisted suicide 1 Quote Link to comment Share on other sites More sharing options...
ErinE Posted October 31, 2016 Share Posted October 31, 2016 No, DNR is not the same as assisted suicide. My mom just died My thoughts and prayers are with you :grouphug: Quote Link to comment Share on other sites More sharing options...
prairiewindmomma Posted October 31, 2016 Share Posted October 31, 2016 What you describe with your grandmother sounds like the normal dying process from end stage diseases like cancer. Thirst and hunger stop, the organs begin to shut down, and the body and mind move into a twilight state of varying states of consciousness. There are a variety of signs that death is coming, and generally the body shutting down in and of itself is a fairly peaceful process. Euthanasia is not that. 2 Quote Link to comment Share on other sites More sharing options...
prairiewindmomma Posted October 31, 2016 Share Posted October 31, 2016 As far as end of life care goes, for me: Comfort meds, including morphine if I have air hunger No g-tube, j-tube or artificial nutrition if I am actively dying DNR once my kids are raised (I will be old) Supplemental oxygen but not a ventilator unless the vent was needed immediately post-op. If I am brain dead, take me off the vent. I have more specifics, but they are nuanced. I am not afraid of death, but I am not wild about hanging about in a nursing home or hospital in a type of half-life. Quality of life is important to me. 1 Quote Link to comment Share on other sites More sharing options...
MedicMom Posted October 31, 2016 Share Posted October 31, 2016 No, it is an order to not administer lifesaving measures CPR/defibtillation/oxygen (ACLS) when the person has stopped breathing or does not have a pulse. To me it is an attempt to reverse a death that is in progress or has already happened. Medical staff do not resuscitate someone who is breathing. A DNR is simply do not resuscitate--the person is dead and does not want CPR or intubation to be attempted. Frankly, cpr is violent and rarely effective. I am 35 and want a DNR. I think you may be thinking of a MOLST or advanced directives, where the person has put limits on what medical interventions they want. I don't consider it euthanasia; it is simply allowing natural death to occur. 3 Quote Link to comment Share on other sites More sharing options...
HS Mom in NC Posted October 31, 2016 Share Posted October 31, 2016 (edited) Being Mortal also looks at a wide range of nursing home and assisted living facility options that many people aren't familiar with. It discusses the high quality of life in low and the low quality in others. Seriously, if you only have one type of facility in mind, you should familiarize yourself with the new innovations made that can create a thriving elder environment. https://www.amazon.com/Being-Mortal-Medicine-What-Matters/dp/0805095152/ref=zg_bs_227562_1 Edited October 31, 2016 by Homeschool Mom in AZ 1 Quote Link to comment Share on other sites More sharing options...
SparklyUnicorn Posted October 31, 2016 Share Posted October 31, 2016 No, not the same. I guess the one somewhat gray area was I was once told that even if, for example, a patient in the nursing home I worked at was choking at dinner time, if they had a DNR nobody was to assist. That seemed like a bit much. 1 Quote Link to comment Share on other sites More sharing options...
nd293 Posted October 31, 2016 Share Posted October 31, 2016 Not the same in any way. Euthanasia / assisted suicide is an active intervention. DNR (or withdrawing support) is simply not intervening in the dying process. I'm in favour of both, but they're not the same from either a legal or philosophical standpoint. Quote Link to comment Share on other sites More sharing options...
FaithManor Posted October 31, 2016 Share Posted October 31, 2016 I do not consider it either of those two. Death is inevitable. At some point the best thing to do is realistic. Dh's dad died by inches over a long period due to intervention when his body was destroyed by cancer. I do not wish it any person or his/her family. Dh and I have advance directives to prevent that from happening to us. Quote Link to comment Share on other sites More sharing options...
Bluegoat Posted October 31, 2016 Share Posted October 31, 2016 No, not at all. I'm not generally a supporter either of euthaniasia or assisted suiside, but I do not consider refusal of treatment to be the same thing. (I should say - it could be, for a particular person, a way to achieve a suicide but I don't think that is a very clear-cut kind of scenario and likely isn't common.) Interventions into the process of illness and death are not always appropriate, and can be profoundly disrespectful to the body, or even cruel. I think they can also at times come out of fear of death or inability to accept it as inevitable, and I don't think that is a very healthy thing, and it can really be a barrier for some people who are actually in need of coming to terms with mortality sooner rather than later. 1 Quote Link to comment Share on other sites More sharing options...
FaithManor Posted October 31, 2016 Share Posted October 31, 2016 And as one who has a father who is terminally ill with cancer and refuses to make a plan, I can tell you it is going to get rough here. My mom is not capable of making the decision, but if he incapacitated, in the absence of directives, they will expect her too. My sister lives in France, working on her doctorate,and recently married. I know my mom would expect her to come and stay for the whole, protracted time that this could go on. Sigh... Please talk about this with your s/o, spouses, kids. It is important to get things in writing now that medical technology is so advanced. Quote Link to comment Share on other sites More sharing options...
TechWife Posted October 31, 2016 Share Posted October 31, 2016 They are not at all the same. One is intentionally ending a life, the other is not extending a life that would naturally end. A DNR means there should be no extraordinary measures to preserve life. No CPR, no intubation, etc.. DNR does not mean do not treat. That is a separate decision. A person with multiple dx can be treated for some dx but not others. Treatment for each dx is a separate decision. DNR does not mean no nutrition. That is a separate decision. DNR does not mean no hydration. That is a separate decision. 3 Quote Link to comment Share on other sites More sharing options...
TechWife Posted October 31, 2016 Share Posted October 31, 2016 DNR (or withdrawing support) is simply not intervening in the dying process. Just to be clear, a DNR and withdrawing support are not the same thing. Just because someone has a DNR does not mean that medical treatment is stopped. 2 Quote Link to comment Share on other sites More sharing options...
Bluegoat Posted October 31, 2016 Share Posted October 31, 2016 Shoot, since I worded it wrong, that may muddy the waters. In this situation, she was able to be spoon fed and helped with drinking, but after the stroke there was no hope she would regain those abilities and so we did not *start* artificial means. But in circumstances where a person had more awareness and the hope of regaining those abilities, it might be ethically wrong to withhold food/water. Yes, I would see those situations as different. To me, putting a feeding tube in someone who is dying or very frail brings up ethical questions - it is invasive, it isn't the same as spoon feeding. On someone who will recover in some way, have more quality time, all kinds of interventions make sense. When the person will not recover, the situation is different. I had no trouble giving antibiotics to my 7 year old with pneumonia. When my dh's grandmother who was frail and miserable and had a failing heart was given antibiotics for pneumonia, I thought it was probably a bad idea. And then with someone fairly close to death it won't do any good in any case and could case discomfort - though I have heard of people objecting to removing food and water even then. Quote Link to comment Share on other sites More sharing options...
nd293 Posted October 31, 2016 Share Posted October 31, 2016 Just to be clear, a DNR and withdrawing support are not the same thing. Just because someone has a DNR does not mean that medical treatment is stopped. Absolutely. I should have phrased it better to be clear that I put withdrawing support on the side of DNR rather than on the side of euthanasia and assisted suicide in terms of this discussion. Quote Link to comment Share on other sites More sharing options...
Guest Posted October 31, 2016 Share Posted October 31, 2016 I am very strongly anti assistive suicide, for reasons I will not go into here, since this is not the political board. My father died at home, after a long fight with cancer, with palliative care from hospice coming in for pain relief. My arms were around him when he died. It's possible he would have lived a few days or weeks longer in the hospital, but that's not what he wanted. I have no regrets about that choice. I see it as absolutely different from withdrawing an already established form of support (e.g. removing a feeding tube). Agreed. Someone who is already dying and just not being resuscitated is entirely different than actively starving someone or administering an injection. Quote Link to comment Share on other sites More sharing options...
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