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Attending Death With Dignity
PREFACE: At the end of an illness or in old age, dying without pain at a time of our choosing seems like an entitlement to many of us, especially baby boomers used to controlling key aspects of our lives. Health directives, living wills, and medical ethicists to help mediate between patients’ needs and institutional exigencies are mechanisms at our disposal to help ensure that we die a "good" death when the time comes. Yet such deaths are by no means guaranteed. It is not unusual for institutions and providers to lack the skills, systemic support, and comfort level—even when legal backup exists—needed to deliver the kind of end-of-life care many of us say we will want. Sharon LaDuke, a nurse who in the 1990s administered pain relief conforming to a patient’s and family’s wishes, recounts the trauma of facing criminal charges for what she believes was appropriate care delivery. Physician Neil Calman encountered what he found to be a moral dilemma: wanting to respond to an elderly woman requesting that he help her die but being legally constrained from acceding to her wishes. Despite the increase in pain management and end-of-life training in nursing and medical schools, these two stories show the difficulty providers and patients can still find when dealing with terminal events.
Her name was Willie D. Obisky. The widowed matriarch of a community-oriented family, she had been a wife, mother, Sunday school teacher, volunteer, and neighbor. For many years she and her husband had owned and operated The Surprise, a department store in our small rural town. As a child, I had been fascinated by the pneumatic tubes that whisked messages from one part of the large store to the other.
Willie once had been beautiful. Now in her eighties, her face reshaped by years of steroid use to control her emphysema, she was "dying by inches," as her son put
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