This is Not the Question
|
End of Life Issues: How We Live and How We Die Opening Statement By Tom Smith, Ph.D. & Ofer Zur, Ph.D. Death makes no room for either avoidance or treatment. We all shall die and there is no cure. Most of us stay away from the dying and the specter of death until a family member, dear friend or neighbor gets sick or into an accident or some other situation that leads to death. Then there we are, usually totally unprepared the first time. As Ernest Becker and many other philosophers asserted the denial of death prevents us from living fully with meaning, connections and happiness. Medical Science can significantly prolong life and so we are faced with ethical and moral dilemmas that, heretofore, were not before us because people just died without the heroic, extreme, extraordinary measures taken to keep them alive. Terminal illness, the prolongation of life in the very old, the administration of curative, palliative and hospice care are fraught with profound and serious moral and ethical considerations, regarding, assisted suicide and euthanasia. What is "hastened death" or "assisted suicide"? What do we mean when we say the situation is "futile"? Assisted Suicide is legal in the states of Oregon, Washington and Montana. Michigan, Maine, Hawaii and Vermont have considered making assisted suicide legal. People are paying much more attention to how we die and want to have some control over how they end their life. Where and when are euthanasia and assisted suicide transformed into medical treatments?
Dr. Zur's personal contemplations: Pondering on Kilimanjaro, Death and Preciousness of Life Online Courses:
Melanie Waters, CPC-I wrote:
I work with the aging population 55-100 years of age and I have listen to several say...I am ready, I want to go today. I have heard those in a lot of pain and others who are healthier than you or I, they just want to die today, their time here is done, they have done all they have wanted to do and seen all they have wanted to see.
Even with all this in mind, I do not feel that assisting anyone to die should be an option of anyone, except the individual them self. I do not believe others should assist. If the person wants to die, I believe they have that right, but others should not assist. I just believe that dying is a spiritual process between the individual and his/her maker.
02/17/10 12:09:59
Lea Abbott, LCSW wrote:
Having worked as a medical social worker in my '40's, I became very comfortable with dying. It was a natural when I became a Buddhist. We concentrate on dying as a way of living. This has enhanced my therapeutic relationships; since I work with the elderly. The deeper any of my clients go spiritually, the more comfortable they become with dying. This applies to all ages.
02/02/10 22:18:23
Sara Alexander MFT wrote:
Two months ago a friend of 30 years, Janna Wissler, who was a therapist for decades, suicided by helium inhalation. She left behind 3 notes - for friends, for family, for clients - "explaining" her choice: unable to stop the chattering voices in her brain; defeated by her own brain chemistry (bi-polar disorder, if you want the DSM word) ; tired of battling it. She left behind truly wonderful friends, 4 siblings, their children. two cats. and at least 20 clients. Those I have spoken to, felt (mostly) very helped by her, and deeply sad to lose her. She was a beautiful, smart, deep person who loved to dance and hike and had a great grasp on living in the present moment. Oddly enough, many of us knew that she had bought helium, many months before, for the purpose of ending her own life. And I had been convinced that she no longer wanted to die, and would phone me any hour of day or night if the dark thoughts returned. But she hid her planning from me with great skill; a closer friend knew she had put the bag on a few days before; Even so, everyone (else) was surprised. I struggle with her choice; she was a woman who knew how to choose. She was determined, and brave. Maybe those summer hikes solo in the Sierras gave her the courage and independence to carry out something she really wanted to do; something else helped her hide her despair from us.
01/14/10 19:33:56
Myriam Coppens, LMFT wrote:
Thank you so much for bringing up this topic. Assisted suicide is totally different from the issue of suicide. Assisted suicide, aid-in-dying, assisted death, should be a right for the terminally ill! People requesting aid-in-dying are not suicidal! They wish to have control over their dying, as they face the end of their lives. It is a gift from families to be supportive of these wishes, to talk, to be present. If a patient requesting aid-in-dying was deeply depressed, it would need to be addressed as with any suicidal patient, encouraging that the patient see a psychiatrist. Calling aid-in-dying assisted suicide confuses this already difficult end-of- life decision for patients, families and health care professionals.
01/07/10 14:37:21
Gerald W. Vest, ACSW/LISW/LMT wrote:
I work with Wounded Warriors who have lost their brothers/sisters in combat and we discuss these losses individually, in groups, with their families and every opportunity we have. They write about them in their journals and have a special ceremony for their buddies where they can put up their picture and tell other soldiers about their loss. Saying goodbye is an important part of becoming whole again and also learning about our spirit or essence. I introduce meditation every day with our warriors and I share special quotations from our great masters to open up these opportunities to transcend and transform many of our beliefs that limit our freedom.
12/26/09 08:46:35
ugg wrote:
Yoga and religion aside, we do not think about death much as a culture except to call it a tragedy. But what sort of system has a built in tragedy? This is a mis-interpretation of the difficulty or pain that sometimes comes with death.
12/25/09 20:38:39
May E. Weatherwax, M.A. wrote:
I live in the US, and was faced recently with caring for my brother-in-law who had been a drug addict all his life. His addiction didn't stop when he was diagnosed with cancer, but his primary phsyician limited his access to painkillers due to his habits. So, he would use all his pain meds, then resort to alcohol for pain relief until the next month. Hospice was our saviour, and allowed his last two months to be a blessing to all of us. They provided him with the appropriate medication, which we administered, and services from a nurse and an assistant three times a week. He died September 11, 2009 at home with his best friend by his side. We arrived shortly after, and celebrated his life around him until the coroner arrived. Hospice allowed our family to progress into a healthy end-of-life situation, and we are grateful.
10/21/09 05:03:40
Jean Epstein, MSW, LCSW, BCD wrote:
I am a therapist with 14 &1/2 years of experience however also a former medical social worker of 17 years in the specialities of oncology (3 yrs.), trauma (5 yrs.) and hospice (9 yrs.) I am very aware my professional experience and the fact I was forced to deal with death of a brother at age 18 and my father before I turned 29 gives me a unique perspective. The professional in me has walked beside to many individuals and/or their familes not to feel strongly we need to start open honest dialogue on this sensitive subject before it is forced upon us. As Dr. Smiith/Dr. Zur write in there opening statement this is not a subject we can avoid. I encourage persons to start this discussion sooner, rather than later. Life is to precious not to discuss death, rather it be our own wishes or knowing the wishes of those near and dear to us. I have seen to many individuals and/or families in conflcit (practically and/or emotionally)when someone is dying to say "good-bye" no matter relationship dynamics. Yes, finally I practice my belief, I and my siblings all know each other's wishes and have put them in writing though fortunately we all all agree quality of life is more important than quantity.
09/21/09 17:44:20
Michael Brickey, Ph.D. wrote:
One of my favorite movie scenes is from Little Big Man in which the chief announces "It is a good day to die" and walks off into the woods. We are stuck with a medical practice imperative to do everything possible to keep people alive. Family often feel oblidged to do the same. The hospice movement was a breakthrough. The solution can't come from the government--the ethcial problems would be to great. One day we will probably see a celebrity or celebrities get a lot of publicity for deciding life had reached a point where it no longer makes sense and choosing to die. That will help legitimize such choices in the mind of the public. It is a slippery slope that needs to be a choice but not an obligation.
Michael, Brickey, Ph.D. Ageless Lifestyles® http://agelesslifestyles.com/
09/19/09 19:58:16
Marty Saeman, Managing Editor wrote:
A recent "Viewpoint" article in the July/August issue of The National Psychologist written by Jerry Dincin, Ph.D., a retired psychologist and current president of the Final Exit Network decsribes the "right to die" as an ethical issue for psychologists. He says, "I believe that individuals have the human right to hasten the end of their life, with such assistance as they deem necessary, without restriction by government, courts, religion or other well-intentioned persons when that person has a fatal illness that will cause death in six months, has a long-term, irreversible disease with no hope of recovery or is in continuing, unbearable and untreatable pain."
I say this as a psychologist for more than 30 years and as a professional in the mental illness field for more than 42 years. He differentiates between "suicide" and "hastened death." It is an interesting article. Marty Saeman, Managing Editor The National Psychologist http://www.nationalpsycholo...
09/08/09 09:01:38
Jennifer A. Jilks, B. A., B.Ed., M.Ed. wrote:
I helped my parent die. My issue is with the Primary care staff (physicians and nurses), who deny that end-of-life is near and deny pain killers. This has an impact on caregivers. I ended up moving, leaving behind family & friends, quitting work, and facing depression, due to the complications of caregiving. One in five women in Canada provide care for frail dependents. I wrote about my journey in Living and Dying With Dignity: A daughter's journey through long-term care. My mother died at home and my father in long-term care. My blog is at http://ontarioseniors.blogs... .
09/06/09 13:28:32
Azzia Zur, B.A. Philosophy wrote:
I'd like to say I want a natural death, without all sorts of surgeries at the end of the line which are expensive, invasive and traumatizing. But, I also know that the urge to stay alive is deeply ingrained in us. Indeed, it keeps us from getting run over by buses, eaten by bears, etc.
The trick is in preparing for death all through life. Yoga classes end with savasana, or corpse pose. This is integration time for the preceding poses, and also practice for death (the ultimate integration). In fact, some yoga classes begin with child's pose and end with savasana to drive the point home. Yoga and religion aside, we do not think about death much as a culture except to call it a tragedy. But what sort of system has a built in tragedy? This is a mis-interpretation of the difficulty or pain that sometimes comes with death. I think the best practice for dying gracefully is learning to let go. Because eventually, we need to let go of our bodies, ourselves, and the family we know here, in order to move to _______________.
08/31/09 22:46:31
|
