End of life management

By September 13, 2021Andromeda's Vortex

By Atty. Farah Decano


SIX years ago, a nurse from an elderly home abroad came to my office and talked about the administration of painkillers to those who are already in the twilight of their lives.  He contended that those who were already advanced in age would be vulnerable to infections and degenerative diseases.  He explained that giving analgesic to our aging beloved was a humane way of letting go.  “Since death is inevitable anyway, why resist and let them suffer more pain?,” he asked, albeit, rhetorically.

I squirmed as I listened to him. I could barely sit my butt on the chair and would have wanted to cover my ears.  He saw my discomfort and said, “[y]ou’d remember these medicines, Attorney, if or when your parents experience frequent pain in their advanced age.”

“Not without a fight,” I disagreed with him.

Thoughts flooded my mind after he left.  Must we easily yield our elderlies to death just because of its certainty?  Must we give up on a parent just because he/she may no longer have any economic value, or worse, has become a money pit?

The nurse’s explanation echoed, “compassion  is the driving force behind the quiet surrender of our  oldies to  St. Peter.”    Really? Or is it inconvenience? I was of the opinion that one must first exhaust all medical interventions before resorting to mere pain management.

When Papa underwent his final crisis at the age of 85, I knew that he wanted to fight for his life.  He once relayed to me that he wanted to outlive his mother who was 91 years old when she had passed. With that in mind, we struggled with him as he battled for survival despite the consequent emotional and financial distress in the family.   We showered him with our love even if it meant leaving our comfort zones and reducing our future funds.  We later learned, however, that life is not really dependent on sheer will to live or availability of resources.  We lost Papa after 72 days in the hospital.  We are consoled nevertheless that we made him feel that we did not give up on him.

Whose decision is it for a patient to continue hanging on for dear life in times like these? Is it the patient or the family?   Should the family persist in providing medical attention even if the sick is no longer willing?  What if the patient insists on living but the complete treatment may mean the depletion of resources resulting to the jeopardy of other members’ future?

These questions are relevant nowadays. The current pandemic has resulted in numerous deaths. It has also forced some families into poverty.  It is not unknown to many that the treatment of Covid may entail very prohibitive expenses.  In fact, we have heard of a former senator whose medical bills reached to up to eight million pesos.   Because of several news about families whose resources are exhausted due to the affliction of covid of one or members of the family, I am inclined to reconsider my opinion.   The surrender of the life of members is not merely spurred by inconvenience.  It is also about consideration of other family members.

It is sad that many afflicted families have become unable to cope with the COVID expenses.  They have been thrown into destitution because they didn’t know how to deal with their dying member. Are they merely afraid to read the bold writing on the wall?  God’s will?

There are many possible scenarios.  I have no wish to engage in a discussion between pragmatism and morality. But in the event that I should be the one dying, I shall ensure that I have an advance medical directive in consultation with my spiritual director. I have no wish to bring my entire family to the pits with me.

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