NYT: A desperate act, born of depression

[Deleted]

A Desperate Act, Born of Depression
By JUDITH GRAHAM
Over the last several months, two California men have watched their wives end their lives after a long, drawn-out illness. Afterward, each of these old men was placed in handcuffs by the police, led from his home and questioned extensively, and faced the possibility of being charged with assisting in a suicide.

Were the husbands’ acts informed by love or despair? Were they a reasonable response to unbearable suffering?

Alan Purdy, 88, hadn’t been willing to accept his 84-year-old wife’s hopelessness in December, when he found her sitting in the garage of their home near San Diego with a car engine running. He pulled her out and revived her. But over the next several months, as Margaret Purdy complained to her husband and her children about unbearable pain from pancreatitis and three fractured vertebrae, Mr. Purdy had a change of heart.

In March, Mr. Purdy was at his wife’s side in their living room as she swallowed 30 sleeping pills, then wrapped a plastic bag around her neck and took her last breath. “Yes, I sat beside her as she died,” he told a reporter from The Los Angeles Times. “I didn’t want her to feel abandoned.”

San Diego prosecutors considered charging Mr. Purdy but have no immediate plans to do so, a spokeswoman told The New York Times.

In July, a similar story unfolded in Palm Springs when Lynda Bentinck disconnected her oxygen supply and asked her husband of 25 years not to resuscitate her. Mrs. Bentinck, 77, had terminal emphysema and was in hospice care at the time.

“The last few weeks, it had become unbearable for her,” Bill Bentinck, 87, told The Los Angeles Times, describing his wife’s breathing problems. “She’d wake up and say to herself, ‘Oh, my God, another day to go through like yesterday, only worse.’ And she wanted to end it all.”


Mrs. Bentinck had left a copy of her “do not resuscitate” order on a bedroom mirror. But because her husband waited several hours to call her hospice and had given her several shots of vodka that morning, police were suspicious and arrested him, confining him to a jail overnight.

He was released after Riverside County prosecutors decided not to pursue the case.

No one knows how often such cases occur; national data isn’t collected, according to Donna Cohen, a professor at the University of South Florida in Tampa who is an expert on suicides and murder-suicides in the elderly. She said only one spouse had been convicted of assisted suicide in the United States: a Manhattan resident, George Delury, who in 1995 admitted to helping his wife, Myrna Lebov, ingest a lethal dose of an antidepressant and later was found guilty of second-degree manslaughter. Ms. Lebov, 52, had lived for decades with multiple sclerosis.

Typically, older adults who find themselves in these kinds of circumstances are depressed, Dr. Cohen observed. Depression is the most common underlying cause of suicide in older people, and seniors take their lives more often than people in any other age group.

For Dr. Timothy Quill, a professor of medicine and psychiatry at the University of Rochester School of Medicine, the tragedy is that many older couples shut themselves off from others when their lives begin to spiral downward.

“If people could talk about this and didn’t have to go underground, we could help,” Dr. Quill said. “We have good ways of dealing with pain and depression.” He said he evaluates a lot of people who say they are contemplating suicide, “and for the vast majority, we’re able to help them find other alternatives.”

The key is finding out what the real issue is — why older people are suffering so much — and “then we can usually intervene to make their lives better” by offering palliative care, arranging for extra support or counseling, or other means, said Dr. Daniel P. Sulmasy, professor of medicine and ethics at the University of Chicago.

Often the underlying issue is not physical agony but unexpressed, unmet psychological or spiritual needs, he noted. For instance, for some people the sense that they are a burden to those they love is intolerable. For others, dependency, the loss of control or the prospect of being abandoned is excruciating. In these cases, reassuring people that they are loved, accepted and not alone can make an enormous difference, Dr. Sulmasy suggested.

“To me, this underscores that we as a society have not figured out how to help people who feel that desperate measures are indicated at the end of their lives or other critical junctures,” said Dr. Robert Brody, chief of the pain consultation clinic at San Francisco General Hospital.

What do you think? Is being present at a spouse’s suicide an act of love or an act of despair? Is the problem not enough help for older people in decline? Or are desperate acts sometimes a rational response to extraordinarily difficult circumstances?

[heightsyankee]

I think when someone is 80+ and has lived a normal life, that if they're ready, let them be ready. I often feel that suicide is only illegal because of life insurance and that if you remove finances from it, people who want to go should be allowed to go, especially when they are suffering.

[emisi]

Oh, how sad. These men did what they did out of love, they shouldn't be charged for that. People should be allowed to die in these sorts of cases. It's crueler to make them wait to die naturally.

[Michelle]

Aug 4, 2012 15:00:38 GMT -5 heightsyankee said:

I think when someone is 80+ and has lived a normal life, that if they're ready, let them be ready. I often feel that suicide is only illegal because of life insurance and that if you remove finances from it, people who want to go should be allowed to go, especially when they are suffering.

Actually suicide (and euthenasia) have been historically illegal because of the faith-based influence on what the law says is ethical or moral. From a Christian perspective, suicide is considered murder - murder of the self. One of my close friends killed himself when we were 14 and I remember being scarred at his funeral when the Catholic priest shared with the whole service that we must pray for our community of youths because what Darren did is judged as murder of the self - a mortal sin that once committed you can no longer ask forgiveness for and you are damned to hell forever.

Those were surely not his exact words - it was a long time ago and i didn't exactly write it down, but that was the impression he left with me.

In Ethics in college we discussed acts such as abortion and euthenasia and the position then was the same (of course I went to a Catholic university and my ethics professor was a nun).

We discussed Oregon's position on the subject because at least then it was not illegal (or there was proposed legislation to make it legal) for someone to participate in the euthenasia of a loved one in the end stages of their terminal illness. Some of our class argued that was a good thing and the rest argued it was state-sanctioned murder. All of the latter category believed firmly in the Catholic position on the issue.

[zelda25]

Aug 5, 2012 9:56:34 GMT -5 Michelle said:

Aug 4, 2012 15:00:38 GMT -5 heightsyankee said:

I think when someone is 80+ and has lived a normal life, that if they're ready, let them be ready. I often feel that suicide is only illegal because of life insurance and that if you remove finances from it, people who want to go should be allowed to go, especially when they are suffering.

Actually suicide (and euthenasia) have been historically illegal because of the faith-based influence on what the law says is ethical or moral. From a Christian perspective, suicide is considered murder - murder of the self. One of my close friends killed himself when we were 14 and I remember being scarred at his funeral when the Catholic priest shared with the whole service that we must pray for our community of youths because what Darren did is judged as murder of the self - a mortal sin that once committed you can no longer ask forgiveness for and you are damned to hell forever.

Those were surely not his exact words - it was a long time ago and i didn't exactly write it down, but that was the impression he left with me.

In Ethics in college we discussed acts such as abortion and euthenasia and the position then was the same (of course I went to a Catholic university and my ethics professor was a nun).

We discussed Oregon's position on the subject because at least then it was not illegal (or there was proposed legislation to make it legal) for someone to participate in the euthenasia of a loved one in the end stages of their terminal illness. Some of our class argued that was a good thing and the rest argued it was state-sanctioned murder. All of the latter category believed firmly in the Catholic position on the issue.

Just to clarify on Oregon's assisted suicide law (and I believe Washington's is very similar), the only "assistance" the person gets is from the dr. writing the prescription. The patient has to be able to take the meds without any assistance.

[llama]

Aug 5, 2012 9:56:34 GMT -5 Michelle said:

Aug 4, 2012 15:00:38 GMT -5 heightsyankee said:

I think when someone is 80+ and has lived a normal life, that if they're ready, let them be ready. I often feel that suicide is only illegal because of life insurance and that if you remove finances from it, people who want to go should be allowed to go, especially when they are suffering.

Actually suicide (and euthenasia) have been historically illegal because of the faith-based influence on what the law says is ethical or moral. From a Christian perspective, suicide is considered murder - murder of the self. One of my close friends killed himself when we were 14 and I remember being scarred at his funeral when the Catholic priest shared with the whole service that we must pray for our community of youths because what Darren did is judged as murder of the self - a mortal sin that once committed you can no longer ask forgiveness for and you are damned to hell forever.

Those were surely not his exact words - it was a long time ago and i didn't exactly write it down, but that was the impression he left with me.

In Ethics in college we discussed acts such as abortion and euthenasia and the position then was the same (of course I went to a Catholic university and my ethics professor was a nun).

We discussed Oregon's position on the subject because at least then it was not illegal (or there was proposed legislation to make it legal) for someone to participate in the euthenasia of a loved one in the end stages of their terminal illness. Some of our class argued that was a good thing and the rest argued it was state-sanctioned murder. All of the latter category believed firmly in the Catholic position on the issue.

:-( That is really harsh.

Morally speaking I am in favor of allowing people to choose to end their own lives in certain circumstances because the suffering aspect really bothers and upsets me. Practically speaking, even without the life insurance thing coming in to play, the medical care support system in the US would need to look very different before I would feel truly comfortable with these laws*. Think about the cost of treating terminal illness in this country and how many people go bankrupt because of it. I worry that patients would opt to commit suicide to save their families not only the burden of caring for them and watching them die, but also the cost of doing so - a cost that is devastating to many families.

*To clarify, I wouldn't vote against them or lobby against them because what other people want to do with their lives and bodies is not my business and not my choice. I just think that when choices are constrained so greatly the way they are in these cases there is another ethical dilemma to consider.

[joenali]

Aug 5, 2012 10:55:44 GMT -5 zelda25 said:

Aug 5, 2012 9:56:34 GMT -5 Michelle said:

Actually suicide (and euthenasia) have been historically illegal because of the faith-based influence on what the law says is ethical or moral. From a Christian perspective, suicide is considered murder - murder of the self. One of my close friends killed himself when we were 14 and I remember being scarred at his funeral when the Catholic priest shared with the whole service that we must pray for our community of youths because what Darren did is judged as murder of the self - a mortal sin that once committed you can no longer ask forgiveness for and you are damned to hell forever.

Those were surely not his exact words - it was a long time ago and i didn't exactly write it down, but that was the impression he left with me.

In Ethics in college we discussed acts such as abortion and euthenasia and the position then was the same (of course I went to a Catholic university and my ethics professor was a nun).

We discussed Oregon's position on the subject because at least then it was not illegal (or there was proposed legislation to make it legal) for someone to participate in the euthenasia of a loved one in the end stages of their terminal illness. Some of our class argued that was a good thing and the rest argued it was state-sanctioned murder. All of the latter category believed firmly in the Catholic position on the issue.

Just to clarify on Oregon's assisted suicide law (and I believe Washington's is very similar), the only "assistance" the person gets is from the dr. writing the prescription. The patient has to be able to take the meds without any assistance.

The person also has to be found to be coherent enough to make the decision to end their life. I also think that there needs to be two doctors that agree the patient has an illness that will eventually end their life.

There are many rule that need to be followed for the end of life to happen in these situations.

[basilosaurus]

Yep, in OR 2 docs have to agree, the person has to be competent, and has to give themselves the meds.

I know my mom struggled with whether to give herself a lethal dose of morphine and seriously considered it. She was raised Catholic, parochial school her whole life (and pre-vatican ii), so I'm sure there was a ton of guilt. She ended up deciding (erroneously IMO) that she didn't want my sister and me to know our mom died from suicide rather than from cancer.

I can tell you, from sitting with my MIL her last few days, it crossed my mind many times that giving her too much morphine would have been the more compassionate thing. I didn't, but I really really wanted to.

michelle, how awful to say at a funeral!

[bhnumbers]

these stories have me in tears. I posted awhile back (old board, I think) that my H was diagnosed with an auto-immune disease. if it progresses and if we can't find a drug to slow it, daily living could be incredibly painful for him. I can't imagine DH getting to the point where he would consider suicide at all, but I know that chronic pain can do terrible things to people. man, I wish I hadn't read this.

[Michelle]

Aug 5, 2012 11:07:25 GMT -5 llama said:

Aug 5, 2012 9:56:34 GMT -5 Michelle said:

Actually suicide (and euthenasia) have been historically illegal because of the faith-based influence on what the law says is ethical or moral. From a Christian perspective, suicide is considered murder - murder of the self. One of my close friends killed himself when we were 14 and I remember being scarred at his funeral when the Catholic priest shared with the whole service that we must pray for our community of youths because what Darren did is judged as murder of the self - a mortal sin that once committed you can no longer ask forgiveness for and you are damned to hell forever.

Those were surely not his exact words - it was a long time ago and i didn't exactly write it down, but that was the impression he left with me.

In Ethics in college we discussed acts such as abortion and euthenasia and the position then was the same (of course I went to a Catholic university and my ethics professor was a nun).

We discussed Oregon's position on the subject because at least then it was not illegal (or there was proposed legislation to make it legal) for someone to participate in the euthenasia of a loved one in the end stages of their terminal illness. Some of our class argued that was a good thing and the rest argued it was state-sanctioned murder. All of the latter category believed firmly in the Catholic position on the issue.

That is really harsh.

Morally speaking I am in favor of allowing people to choose to end their own lives in certain circumstances because the suffering aspect really bothers and upsets me. Practically speaking, even without the life insurance thing coming in to play, the medical care support system in the US would need to look very different before I would feel truly comfortable with these laws*. Think about the cost of treating terminal illness in this country and how many people go bankrupt because of it. I worry that patients would opt to commit suicide to save their families not only the burden of caring for them and watching them die, but also the cost of doing so - a cost that is devastating to many families. *To clarify, I wouldn't vote against them or lobby against them because what other people want to do with their lives and bodies is not my business and not my choice. I just think that when choices are constrained so greatly the way they are in these cases there is another ethical dilemma to consider.

You know I think we discussed topics like that too. That class was also so long ago... I'm starting to feel old thinking about how long ago it was. Anyway yes there are other ethical challenges that make legalizing it difficult.

Zelda, thanks for clarifying the law in OR. My college ethics class was in 1995 or 1996 so the cobwebs are a pretty thick in that regard. :-)


BHNumbers, you have my sympathy. I don't really know what else to say except I hope a drug IS discovered that will help him.

[Michelle]

Aug 5, 2012 22:51:40 GMT -5 @littlemoxie said:

It boggles my mind to think that people even considered pressing charges here. Priorities, people.

Wrt the Catholic guilt trip, I don't understand the "it's up to God when you die" combined with the fact that many people in these situations have been kept alive due to medical intervention. Either playing god is wrong all the time or right all the time. You can't have it both ways. I know that's a bit off topic, but it seems somewhat related (although I know not applicable in all circumstances).

That isn't actually off-topic. That is part of the debate in terms of the ethics of euthanasia.

Vermont2B could of course speak on Catholic doctrine better than I could but I remember the issue came down to what level of medical intervention was involved as to whether it was assisting suicide vs. allowing a natural course of events play out. Removing nutrients and hydration would fall in the assisted suicide/murder category but no longer prolonging any other medical intervention would be allowing things to play out.

Hospice care, for example, where you allow the terminally ill to sign a DNR and living will that they just be made comfortable would be ethical. Purposefully administering a lethal dose of morphine would not. Unplugging a ventilator would be ethical. Removing water/feeding tubes would not.

NOT initiating the feeding tube in the first place was considered ok, but once administered not ok. I can't remember the logic behind that last one.

[basilosaurus]

Aug 5, 2012 23:17:26 GMT -5 Michelle said:

Removing nutrients and hydration would fall in the assisted suicide/murder category but no longer prolonging any other medical intervention would be allowing things to play out.

Hospice care, for example, where you allow the terminally ill to sign a DNR and living will that they just be made comfortable would be ethical. Purposefully administering a lethal dose of morphine would not. Unplugging a ventilator would be ethical. Removing water/feeding tubes would not.

I won't speak to the Catholic side of things, but hospice does actually support discontinuing feeding tubes and not forcing fluids. That's considered a supportive measure as dying bodies can't actually metabolize food, and things like iv fluids will usually just swell them as the organs (like kidneys) start slowing/shutting down.

I think if you told any hospice nurse they were assisting suicide by doing that, they'd be highly insulted.

[Michelle]

Aug 5, 2012 23:26:59 GMT -5 basilosaurus said:

Aug 5, 2012 23:17:26 GMT -5 Michelle said:

Removing nutrients and hydration would fall in the assisted suicide/murder category but no longer prolonging any other medical intervention would be allowing things to play out.

Hospice care, for example, where you allow the terminally ill to sign a DNR and living will that they just be made comfortable would be ethical. Purposefully administering a lethal dose of morphine would not. Unplugging a ventilator would be ethical. Removing water/feeding tubes would not.

I won't speak to the Catholic side of things, but hospice does actually support discontinuing feeding tubes and not forcing fluids. That's considered a supportive measure as dying bodies can't actually metabolize food, and things like iv fluids will usually just swell them as the organs (like kidneys) start slowing/shutting down.

I think if you told any hospice nurse they were assisting suicide by doing that, they'd be highly insulted.

I think hospice supports discontinuing feeding tubes when you are at end stages and can no longer metabolize food. But some people are in hospice for months because they are in end-stage of a disease like COPD where they require constant hospitalization but their bodies are still fighting. During the early months removing the food would be considered unethical because all other things considered the individual would die of starvation. If the body just cannot take food anymore because the body is shutting down, that is a different stage of death and it would then become ethical, otherwise you are further exacerbating a condition and the pain of the individual unnecessarily.

[basilosaurus]

Are you saying it would become ethical by Catholic standards to remove at end stage, if it was the only thing prolonging life, similar to a ventilator? I know Terri Schiavo was slightly different than an end stage death, but there was a huge outcry about removing her feeding tube.

Hospice certainly supports feeding tubes if they're supportive of comfort and increase quality of life. It's a hard call when to remove it. I did a hospice rotation as a student nurse, and that was a decision we made with a couple of patients, trying to figure when it switched from being palliative to unnecessarily sustaining life.

My response was assuming you were talking about end stage, relating it to a ventilator. Sorry if I misinterpreted and unintentionally misrepresented.

[copzgirl1171]

Damn.

[Michelle]

Aug 6, 2012 0:48:15 GMT -5 basilosaurus said:

Are you saying it would become ethical by Catholic standards to remove at end stage, if it was the only thing prolonging life, similar to a ventilator? I know Terri Schiavo was slightly different than an end stage death, but there was a huge outcry about removing her feeding tube.Hospice certainly supports feeding tubes if they're supportive of comfort and increase quality of life. It's a hard call when to remove it. I did a hospice rotation as a student nurse, and that was a decision we made with a couple of patients, trying to figure when it switched from being palliative to unnecessarily sustaining life.

My response was assuming you were talking about end stage, relating it to a ventilator. Sorry if I misinterpreted and unintentionally misrepresented.

I can't speak for the whole Catholic church doctrine on the subject. However in that ethics class I do remember that being a topic of discussion. Removing medical intervention that is the only thing sustaining life is allowing the natural course of things to occur, which would be ethical, because the death would be as a result of Kidneys shutting down, heart failure - whatever the situation would be.

In the case of Terri Schiavo, she didn't require any other kind of medical intervention to keep her alive. Removing the feeding tube was, in effect, starving her to death. So following the logic, that would have been considered unethical.

As for hospice care - the nurses and other staff who work in hospice care deserve an extra special place in heaven when they die. They are walking angels on earth. I can't imagine working in that profession and helping families make the hard call because that is what is the most compassionate thing to do for the patient, even though it hurts to see them go.

[SusanBAnthony]

I don't get how anyone is bent out of shape about this. It sounds like they didn't end up charging either of the men in the story, but still!

Spouses of hospice patients frequently do things like that. Dr's frequently say things like "if you were to give your husband all this morphine at once, wink wink, it could be lethal, so Be Careful!". People ask for it all the time for their loved ones, at the end. Now that is usually a matter of days, not weeks or yrs, but still.

My grandpa was gone a feeding tube after a mjor stroke, and then the (catholic) family could not handle removing it, and he had a slow, painful decline to the end. When my grandma, his wife, was declining, everyone thankfully had realized that a feeding tube was a terrible idea. She was able to die so much more peacefully!

(my mom is a hospice nurse).

[2vermont]

Michelle, I am still working on my first cup of coffee, but it looks like you did a fine job of explaining things....you don't need me. ;-)

But I'm loling at my new sig name: Vermont2B

[2vermont]

Aug 5, 2012 9:56:34 GMT -5 Michelle said:

One of my close friends killed himself when we were 14 and I remember being scarred at his funeral when the Catholic priest shared with the whole service that we must pray for our community of youths because what Darren did is judged as murder of the self - a mortal sin that once committed you can no longer ask forgiveness for and you are damned to hell forever.

Ugggh. Even though it is grave matter, the priest does not know whether that person committed a mortal sin. For it to be a mortal sin, the person had to have full knowledge and deliberate consent. Only God knows this for sure and therefore ultimately we should not be making judgments on the state of one's soul at the time of one's death. I am sorry that that priest felt the need to say that...especially at the funeral!

Here's the Catechism with the official teaching on Euthanasia and Suicide for anyone who is interested (note the bolded re: those who commit suicide):

Euthanasia

2276 Those whose lives are diminished or weakened deserve special respect. Sick or handicapped persons should be helped to lead lives as normal as possible.

2277 Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons. It is morally unacceptable.

Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator. The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded.

2278 Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of "over-zealous" treatment. Here one does not will to cause death; one's inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.

2279 Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable Palliative care is a special form of disinterested charity. As such it should be encouraged.

Suicide

2280 Everyone is responsible for his life before God who has given it to him. It is God who remains the sovereign Master of life. We are obliged to accept life gratefully and preserve it for his honor and the salvation of our souls. We are stewards, not owners, of the life God has entrusted to us. It is not ours to dispose of.

2281 Suicide contradicts the natural inclination of the human being to preserve and perpetuate his life. It is gravely contrary to the just love of self. It likewise offends love of neighbor because it unjustly breaks the ties of solidarity with family, nation, and other human societies to which we continue to have obligations. Suicide is contrary to love for the living God.

2282 If suicide is committed with the intention of setting an example, especially to the young, it also takes on the gravity of scandal. Voluntary co-operation in suicide is contrary to the moral law. Grave psychological disturbances, anguish, or grave fear of hardship, suffering, or torture can diminish the responsibility of the one committing suicide.

[basilosaurus]

Aug 6, 2012 8:36:21 GMT -5 Michelle said:

As for hospice care - the nurses and other staff who work in hospice care deserve an extra special place in heaven when they die. They are walking angels on earth. I can't imagine working in that profession and helping families make the hard call because that is what is the most compassionate thing to do for the patient, even though it hurts to see them go.

I can only speak for myself, not the other nurses and chaplains who mentored me (yes, as an atheist, chaplains can still offer help). But, in a way, helping patients through that end of life without such intervention is so much more positive, satisfying, than seeing them trying every damn measure in an ICU. In school, it was interesting that those of us who loved ICU also loved hospice. Like 2 sides of the same coin.

Maybe it's my background with a very young mom who died of cancer (age 40, of an old person cancer, who had hospice care), but it hurts me more to see someone needlessly suffer from so many interventions rather than accept death. And I say that as an atheist who thinks death is the end. Not that I'd share that with patients. I think my MIL waited way too long, and her death was that much harder on all of us (if some of you will remember my distraught posts) because she didn't accept that kind of hospice help until literally the last 4 days.

I guess I share that with you, michelle, knowing you work in healthcare, to show how it may, in a way, be an easier job. I can't put it into good internet words with no tone. I can only hope that others I've shared with on this board know that a frank discussion and acceptance of death is sometimes more compassionate than seeing suffering in a terminal situation, as hard as it overall may be, and I hope I've helped them see that, too. Maybe it's egotistical to think I've done that, but I'm optimistic.

I know I can wax morbidly poetic on the topic, but I think there is such a thing as a happy death. I think it hurts a hospice nurse to see someone taken in for yet another code. To see someone pursue that last miraculous chemo, despite what it does to their body, their quality of life.

That's not to say it isn't hard. I know after my mom died some of our in home hospice some nurses quit and moved to a different specialty. I may have only been 6, but I remember there was Cathy 1,2,3. (Kathy 2 was with a K). There were others, but those are who I remember. 2 of the K/Cathy's quit and move to non-hospice care because they never expected to deal with young children (apparently thy weren't the only ones to quit after dealing with our young family). I 100% respect that. Cathy 3 (With a C) rode with my mom to the hospital in the ambulance because they only allowed one person, and it wasn't my dad. Yay for the 80s! Back then, they also didn't allow in home morphine without a lot of hurdles. Now WHO standards make it easier.

But I also wish Kathy 2 knew how I remembered that she would color with us, work on kindergarten homework, and in general be a good compassionate nurse. 25 years later she's still made an impression on me. I've shared this with every nurse who mentored me.

I think it's important that the nurses feel appreciated even without immediate feedback, but also that other people don't think of them as angels. It's a strange dichotomy. I've probably written too much, so I'll stop, but I obviously feel passionate on this situation.

[ringstrue]

I can't help but wonder if this happens aaall the time but that there are *better* ways to do it than others. Like she took a bunch of sleeping pills and it would have been deemed a suicide, but the plastic bag made it obvious that it was assisted, kwim?

I also wonder if there are plenty of old people who commit suicide and maybe the one kid who cared from them was told by the nurses but they didn't tell anyone else in the family. I mean, when a 15 year old up and dies you ask questions, but when an 85 year old dies? 95 year old dies? You can get away with a lot more excuses if you want to spare your parent's memory.

[copzgirl1171]

I hope I am never put in this position.

[basilosaurus]

And let me pre-empt, that was not a call for sympathy in the least. It was to let michelle and others in healthcare know the incredibly strong impact that hospice can have on people. Another friend of mine was 6 when her brother died, and she shares my same hospice memories. It's an incredible organization.

Despite that, I think they'd be uncomfortable being lauded as anything better than regular nurses. Different roles, different jobs. Not anything more special than the person making sure your morphine is not lapsed while you're in for basic surgery.

[karinothing]

Aug 9, 2012 7:49:06 GMT -5 2vermont said:

Aug 5, 2012 9:56:34 GMT -5 Michelle said:

One of my close friends killed himself when we were 14 and I remember being scarred at his funeral when the Catholic priest shared with the whole service that we must pray for our community of youths because what Darren did is judged as murder of the self - a mortal sin that once committed you can no longer ask forgiveness for and you are damned to hell forever.

Ugggh. Even though it is grave matter, the priest does not know whether that person committed a mortal sin. For it to be a mortal sin, the person had to have full knowledge and deliberate consent. Only God knows this for sure and therefore ultimately we should not be making judgments on the state of one's soul at the time of one's death. I am sorry that that priest felt the need to say that...especially at the funeral!

Here's the Catechism with the official teaching on Euthanasia and Suicide for anyone who is interested (note the bolded re: those who commit suicide):

Euthanasia

2276 Those whose lives are diminished or weakened deserve special respect. Sick or handicapped persons should be helped to lead lives as normal as possible.

2277 Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons. It is morally unacceptable.

Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator. The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded.

2278 Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of "over-zealous" treatment. Here one does not will to cause death; one's inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.

2279 Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable Palliative care is a special form of disinterested charity. As such it should be encouraged.

Suicide

2280 Everyone is responsible for his life before God who has given it to him. It is God who remains the sovereign Master of life. We are obliged to accept life gratefully and preserve it for his honor and the salvation of our souls. We are stewards, not owners, of the life God has entrusted to us. It is not ours to dispose of.

2281 Suicide contradicts the natural inclination of the human being to preserve and perpetuate his life. It is gravely contrary to the just love of self. It likewise offends love of neighbor because it unjustly breaks the ties of solidarity with family, nation, and other human societies to which we continue to have obligations. Suicide is contrary to love for the living God.

2282 If suicide is committed with the intention of setting an example, especially to the young, it also takes on the gravity of scandal. Voluntary co-operation in suicide is contrary to the moral law. Grave psychological disturbances, anguish, or grave fear of hardship, suffering, or torture can diminish the responsibility of the one committing suicide.

I will ditto all of this (even though I know this is not what this discussion is really about). My ex committed suicide 4 years ago now (it was not the result of a terminal illness) I called my priest in tears and he was amazingly comforting. He basically told me that his young mind was tortured and that God was so loving and full of compassion that he would accept him warmly giving him the peace he never had on earth.

[SusanBAnthony]

Aug 9, 2012 7:57:01 GMT -5 ringstrue said:

I can't help but wonder if this happens aaall the time but that there are *better* ways to do it than others. Like she took a bunch of sleeping pills and it would have been deemed a suicide, but the plastic bag made it obvious that it was assisted, kwim?

I also wonder if there are plenty of old people who commit suicide and maybe the one kid who cared from them was told by the nurses but they didn't tell anyone else in the family. I mean, when a 15 year old up and dies you ask questions, but when an 85 year old dies? 95 year old dies? You can get away with a lot more excuses if you want to spare your parent's memory.

It does happen all the time. No one (except my crazy family) talks about it.

[ering1115]

sibil- you honestly made me teary at work.

Both of my grandparents died a happy death. They both had lung cancer and knew it was the end. We signed the paper work and brought them home with hospice care. It was only a matter of days for both of them but the whole family was there the entire time, we all got to spend time together and say our goodbyes. They died peacefully, surrounded by the people the loved most. Even my H, who is squicky with death, said it was kind of nice to see everyone rally like that. He had never been exposed to hospice before.

It was an emotional experience for me to care for my grandmother at the end. She had cared for me for years, to be able to give that back to her and provide her a level of comfort was one of the best and most difficult experiences of my life.

We were able to donate their meds to a catholic nun hospice near our house and make donations to a group called the Hutch Project for pallitative and hospice care.

To make my respect of all things hospice CEP, I have told DH if he ever runs for office I will make hospice and local produce for the poor my pet projects. His comment was that it will look like I am pro-death panel and an elitist that only eats organic.