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Hard Choice for a Comfortable Death: Sedation

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This is a very difficult subject to think about, for myself or anyone, but in reality it is something we are all usually faced with at some time in our lives. Whether it be a beloved relative, our aging parents, our spouse or even a good friend. It is as important as knowing what they or even ourselves for that matter, prefer for funeral arrangements.
My aunt, with whom I was very close, died in December of 2002. She was 79 but had been in failing health for several years with emphysema. Her mind was as sharp as ever, but according to her doctors, everything that was possible at the time had been done for her. She was sedated, but was aware of everything around her and knew what was happening but breathing easily without her oxygen. As sad and upset as I was, I was thankful that she didn’t have to suffer as could have been the case. She had made her peace, and didn’t want to be kept alive by machines. And just as in life, she waited for everyone to go home, and her son to step outside, and then she let go. This piece brought back all of those memories, and I realized that this is what I would want for myself. This article is hauntingly familiar, and raises some interesting questions. Read it and decide for yourself.
Difficult Decisions on End-of-Life Care
In almost every room people were sleeping, but not like babies. This was not the carefree sleep that would restore them to rise and shine for another day. It was the sleep before — and sometimes until — death.
In some of the rooms in the hospice unit at Franklin Hospital, in Valley Stream on Long Island, the patients were sleeping because their organs were shutting down, the natural process of death by disease. But at least one patient had been rendered unconscious by strong drugs.
The patient, Leo Oltzik, an 88-year-old man with dementia, congestive heart failure and kidney problems, was brought from home by his wife and son, who were distressed to see him agitated, jumping out of bed and ripping off his clothes. Now he was sleeping soundly with his mouth wide open.
“Obviously, he’s much different than he was when he came in,” Dr. Edward Halbridge, the hospice medical director, told Mr. Oltzik’s wife. “He’s calm, he’s quiet.”
Mr. Oltzik’s life would end not with a bang, but with the drip, drip, drip of an IV drug that put him into a slumber from which he would never awaken. That drug, lorazepam, is a strong sedative. Mr. Oltzik was also receiving morphine, to kill pain. This combination can slow breathing and heart rate, and may make it impossible for the patient to eat or drink. In so doing, it can hasten death.
Mr. Oltzik received what some doctors call palliative sedation and others less euphemistically call terminal sedation. While the national health coverage debate has been roiled by questions of whether the government should be paying for end-of-life counseling, physicians like Dr. Halbridge, in consultations with patients or their families, are routinely making tough decisions about the best way to die.
Among those choices is terminal sedation, a treatment that is already widely used, even as it vexes families and a profession whose paramount rule is to do no harm.
Read the rest of this article here

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