Letters: Hurdles to dying with dignity
Dr. D. Bruce Foster's sensitive and thoughtful piece will help many to better understand and cope with the stress of watching a loved one who is approaching death. My own experience with dying patients is in full accord with Foster's. Too often, a patient loses control over choice about how to die, and the family feels powerless to challenge the "technologic imperative" that impels physicians and hospitals to keep the patient alive for a few extra days, weeks or months -- no matter the cost in pain and suffering, in resources and dollars.
The decision about when to let go as life starts to ebb should belong to the patient. Near the end of life, many of us will lose the capacity to make such a decision, so it is crucial that we grant authority through an advance directive (a health care proxy) to a trusted family member or friend who can act on our behalf, should that become necessary.
Unless we, as health care proxies, understand the issues and are willing to challenge the technological imperative, patients will continue to suffer prolonged agony in dying under the guise of prolonging life.
Dr. Peter Rogatz, Port Washington
Editor's note: The writer is vice president of Compassion & Choices New York, a non-profit organization that is working to improve end-of-life care and options, to ensure a humane and peaceful death with dignity.
I write this from my father's hospice room. While I agree with much of the sentiment expressed in Foster's op-ed, I must disagree with some points.
When I sought help to place my father in a hospice facility, I was constantly refused due to Medicare "guidelines." That is, Dad and I were denied in our quest to provide him his due -- dignity in his dying -- until this past week, when a crisis occurred while I was alone with him at night, after the paid aide had left.
The hospice network he was in had instructed me to call its office before we were allowed to ask the police or the fire department to intervene. Due to this "rule," I had to let Dad writhe in pain for several hours. By the time he arrived at Huntington Hospital, where he received excellent care, he was in unbearable pain.
Hospice care is a wonderful concept, but there are too few beds and far too much need. Dad and I discussed hospice before agreeing that it was time. Yet both of us feel incredibly let down by the system, which is overly bureaucratic and overburdened. The result leaves the critically ill floundering and wholly dependent on their family caregivers, who lack the skills to cope with complex medical issues at home.
Foster mentioned the need for "major tort reform." As an attorney and caregiver, I believe that if doctors want to point fingers, they would be better off with an honest assessment of both the insurance and pharmaceutical lobbies. We are shackled to the private agendas of these two industrial giants, who spent millions of dollars lobbying against the attorney-as-bogeyman rather than paying claims in a timely and efficient manner or manufacturing new drugs to treat difficult and rare medical conditions.
Judith Rosen Lipner, Dix Hills
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