Five Medical Methods of Managing Dying
James Leonard Park
If we will die under medical care,
our deaths will be
using some combination of the following
methods of managing dying.
If our deaths
are not thoughtfully managed,
we might be 'treated-to-death'.
Perhaps 20% of deaths under medical care
occur while maximum
are still being applied.
Dying in the
intensive care unit (ICU)
would be the most obvious example
The doctors and nurses do not give
until we die despite their best efforts.
However, if we die from chronic illnesses,
our doctors will
recommend some combination
of these medical methods of managing
(1) comfort care only,
(2) beginning terminal
(3) ending curative treatments and withdrawing life-supports,
(4) giving up water, &
receiving gentle poison.
poison is a medical option
only in some locations at present,
but new right-to-die laws in many states and countries
extended this quickest method of dying
to more locations where
modern medicine is practiced.
includes using drugs to control any suffering
we might be experiencing at the end of our lives.
specific medical problems
that are bringing our lives to an end
will shape which drugs should be used.
And our doctors are
to increase these drugs already in use
level provides the relief we desire.
we are clearly dying,
there is no further reason to worry about
'drug addiction' or 'drug dependence'.
And usually we will
not worry about the possibility
that the palliative-care drugs
might shorten the process of dying.
is a step beyond comfort care.
If our suffering is so intense
that it cannot be
controlled by any pain-meds,
then our doctors might manage our
by recommending that we be kept
for the rest of the process of dying.
We should say our good-byes
before terminal sedation begins,
because we will never again
have any interaction with other
Terminal sedation will guarantee
that we will 'die in
The drugs used to keep us permanently asleep
be adjusted from time to time
if ever there is any sign of
Terminal sedation as a medical
method of managing dying
might also shorten the process of dying,
but in most cases, this is not a problem.
Everyone knows that
death is coming.
And this method assures everyone
dying patient will never suffer anything.
means giving up all of the medical
that have already been tried to save us from death.
Medical science has already done its best.
And our doctors
explain that these methods
could not save us from death.
There will be no more surgeries,
no more chemotherapy,
more drugs to fight off the disease.
curative treatments are ended,
we might be moved to a different
perhaps into some sort of hospice care.
Supportive and comfort-care replace
all of the acute medical
that have now failed to save us from death.
will probably also take place
curative treatments are ended.
All of the 'tubes and machines'
that were being used to keep us alive
can now be switched off
This medical method of
managing our dying
will also include deciding not
forms of life-support that might
have been tried.
if we are dying from lung cancer,
what is the point of using a
respirator at the end?
Such ways of helping us to breathe
ease the distress of not getting enough oxygen,
breathing-assistance will cure the cancer.
When disconnecting (or declining) life-supports
our doctors can
methods of reducing the likely distress.
can tell us how long we can expect to live
without the mechanical
is usually also recommended
other forms of life-support are being abandoned.
and hydration were being provided by tubes,
this medical method
of managing dying
will be noted as part of disconnecting
Perhaps we have already stopped ingesting anything
because we are dying from a medical
that prevents us from benefiting from more food and water.
Or our doctors might recommend giving up water
if there is no further benefit.
And when all fluids are abandoned,
the duration of
natural dying can be predicted
to be just a few days,
on how much water we have stored in our bodies.
Even if we are not actively dying from one specific disease,
might still decide that our meaningful lives are over
this method of managing our dying process
would be better than
continuing all supportive care
until we die from natural causes.
will make the process of dying even shorter.
medical method of managing dying
has only been authorized in a
few places in the world.
But if the other medical methods of
have been found unsatisfactory for any reasons,
then the doctors can recommend a gentle poison
bring a quick and painless death.
Netherlands, this medical method of choosing death
the form of a lethal injection given by the doctor.
doctors can also prescribe death pills,
which are taken by the
patient himself or herself.
In Canada, dying patients are also selecting lethal injection
as their preferred medical assistance in dying (MAiD).
choosing any of these five
medical methods of managing dying,
most careful safeguards
should be fulfilled for each decision.
We know that any of these methods
(or any combination of
will inevitably lead to our deaths.
Thus before we select the best methods of dying,
we should settle
any uncertainty about the wisdom
at this time
rather than dying
at some later time.
Is our medical condition clearly terminal?
Have we exhausted all possible medical care?
Are we ready
for death to come?
Are others at the bedside ready for us to die?
If and when we are ready to die,
can end the medical battle to save us from death
and surrender to
What combination of these
five medical methods
of managing dying
would be best for us
and for the people
around us as we die?
January 20, 2016; Revised 1-21-2016; 2-9-2016; 5-1-2016;
5-5-2017; r 6-14-2017; 8-25-2017; 3-29-2018; 7-5-2018;
This opinion article includes the following links
explanations of each
method of managing dying
Here they are again:
Comfort Care Only:
Easing the Passage into Death
Dying in Your Sleep---Guaranteed
Pulling the Plug:
A Paradigm for Life-Ending Decisions
Why Giving Up Water is Better than
other Means of Voluntary Death
Death by Dehydration:
Safeguards to Make Sure it is a Wise Choice
The Demand for Quick Death
These Medical Methods of Managing Dying (MMMD)
are also discussed
in the context of a hospice service
that embraces all legal,
doctor-approved methods of dying:
in a Right-to-Die Hospice
The safeguards for making end-of-life medical decisions
merely mentioned at the end of this article.
But here is a book
of over 600 pages that
explores each of 26 safeguards for
How to Die:
Safeguards for Life-Ending Decisions
Historical note about
Originally this essay was called "Six Medical Methods of Managing
What is now number 3:
—ending curative treatments and
was originally listed as two separate methods.
But it is more common in medical ethics
to list these methods together, under such expressions as:
"ending life-sustaining medical treatments".
Thus, even tho these methods get separate paragraphs above,
they are numbered as one medical method of managing dying.
Here is a chapter about giving up medical treatments and life-supports:
SHOULD INCLUDE METHODS OF DYING
modern medical care acknowledges more clearly than ever before
we are using these medical methods of managing dying,
of death might be expanded to include a new line for
methods of managing