Dying with Dignity? Can't Everyone Die with Dignity?
Recent news has focused on the news that a terminally ill patient ended her own life rather than let an aggressive brain tumor end it for her. Many praise this as a death with dignity but as nurses, let's make sure everyone dies with dignity by providing end of life care. Hospice and palliative care offer death with dignity every day for patients.
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There is huge support for the recent case in the news about Brittany Maynard who recently took her own life rather than letting cancer take it from her in its own time. While many people believe that what Brittany did was a good and decent thing, a question remains: If the only way to die with dignity is to take your own life, what does it mean if you don't?
As a hospice nurse, I believe all of my patients die with dignity. They die with dignity because they are human persons, with the dignity and worth all human persons deserve. I certainly can speak for the fact that they suffer, that they decline, that they need help and support of others, but that does not exclude the fact that they have dignity. Nor does it diminish their honor that they choose to let nature take its course rather than letting a pharmaceutical cocktail end it for them.
It is my hope that no one believes that there is nothing to live for if you have a terminal disease. I hope all my patients know that. Life isn't always about being a perfect person, without sickness or debility. Steven Hawkings is an excellent example of this, although severely debilitated, and having a terminal illness, he continues to contribute greatly to knowledge, to science, and to many people who care deeply for him as a person.
Being sick or being terminal doesn't have to mean you have no quality of life. Not knowing what Brittany Maynard was told about her condition, I can only hope that she was given the choice to continue life with hospice or palliative care. Such care can give patients quality of life they did not know they could achieve with a terminal or severe illness.
Further, although a person may feel they don't want to live with sickness or debility, what they really may be feeling is that there is no hope, which is never true for anyone. They also may not understand or be informed that the things they fear may not happen at all. Often, health professionals opt to be totally honest with patients and let them know "worst case scenario" and while honesty is generally the best policy, sometimes too much information does a disservice to a vulnerable person. All of us know what happens when we look up diseases or illness on the internet: we learn things we never wanted to know or we learn things that aren't even close to accurate. Someone who has just learned they are terminally ill is someone who needs information but they also need support and at the end of life, one of the best supports is knowing that there is help no matter how dismal things seem.
With hospice or palliative care, many patients realize that their symptoms can be controlled and managed and they can go on living and enjoying each day. It is beyond doubt that most people given a terminal diagnosis fear not only death, but being a burden on others. With supportive care from hospice many of these concerns are ameliorated but a patient doesn't know that if no one tells them.
So before we start to think that the only way to die with dignity is to end a life, let's make sure we offer our patients every option for end of life care we can. Hospice and palliative care can make so much difference and give hope to those who may feel that they have no choices left. Let's make sure that every patient dies with the dignity of end of life care, given by health workers who believe that no one death is less dignified than others.
