Art Buchwald Leaves Hospice Because He Got Better
The humorist Art Buchwald has proved what hospice professionals will also tell you: Just because you are diagnosed with a terminal illness, it doesn't necessarily mean you are about to die. Buchwald has been in hospice for many months because it was thought his kidney ailment would end his life. Yet, even though he refused dialysis, he didn't die but got better. He is now out of hospice and writing his next book.
Buchwald reminds me of the first patient I cared for as a hospice volunteer. The first time I met Ernie, an elderly man expected to die of congestive heart failure, he fell into my arms crying, "I want to die! I want to die!" When I asked him why, he said he worried about burdening his son. About three months later, I lost Ernie, not because he died, but because he had so improved he was no longer qualified for hospice care.
And these two cases teach us an important lesson about assisted suicide. The Oregon law requires that a doctor believe that a patient will die within six months before issuing a poison prescription. (This isn't always adhered to, but that is a comment for another day.) What if Ernie had lived in Oregon when he said he wanted to die? His doctor might well have accommodated his desire not to be a burden by issuing a lethal prescription. Ernie might well have been dead before he knew he wasn't actually dying.
Barbara Coombs Lee of Hemlock Society (now renamed Compassion and Choices) likes to say that suicide by the dying isn't suicide because these people's lives are over anyway. Well tell that to Art Buchwald and Ernie. As that great philosopher Yogi Berra once said, "It ain't over 'til it's over."
posted by Wesley J. Smith @ 9:05 AM
3 Comments
3 Comments:
All our lives are over, when you get right down to it. From the instant of conception, the clock starts ticking.
I don't believe a competent doctor who is being honest will tell you that he or she knows when a person will be dead within 6 months. (Maybe the nurse who cares for the patient and has seen it all could do a better job of such predictions, but the nurse isn't usually asked.)
I agree in many cases. Unfortunately, that is the requirement for Medicare hospice coverage. It is also the requirement under Oregon's assisted suicide law. Thanks, Laura.
My understanding is that denial of nutrition and hydration come into play here in the "less than six months" prediction. Say someone has had a stroke and needs a feeding tube to get anywhere close to his needed amount of nutrition and hydration. If the intent is to send the person to hospice without a feeding tube, then he may be put NPO, in which case he will die within two weeks, or he may be given only ice chips, spoonfuls of Jell-O and such, which would make the "less than six months" prediction very plausible.
So in some cases (not all) the prediction is self-fulfilling. The doctor predicts the person will be dead in less than six months because he knows that, after he makes the prediction, the person will be put into a situation where he's guaranteed to die in less than six months!
I have discussed this problem with the legislative folks from Right to Life in my own state and have been assured that, under our state laws (MI), the prediction must be that the person will die in six months or less *regardless of what is done*. I trust that this is true as of course that requires a much stronger amount of evidence and will hopefully save some lives.
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