Patients and/or their proxies
who are seriously considering voluntary
death
or merciful
death
need as much information as possible about the alternatives.
Choosing immediate death might not be the best pathway.
Pain
control is an option appropriate
for almost any patient.
The doctors can explain the various means of controlling symptoms
that might improve the patient's quality of life.
Sometimes uncontrolled pain is driving the patient toward an early
death.
In fact, untreated pain might lead to irrational
suicide.
Nursing
home care or some other assisted-living arrangement
might be worth exploring if the patient knows
that he or she cannot continue to live at home
because that has become too difficult for other members of the
family
or because it is no longer possible to live alone.
Some specific nursing homes might be visited
to see which might be good alternatives to choosing death now.
Bad nursing homes are
all too common.
But there are some good
nursing homes.
The patient and/or family should not make any life-ending decisions
based on incomplete
information about nursing homes.
Hospice
care is also a valid alternative to
immediate death.
The patient might not like the idea right away.
But some printed information about hospice philosophy and practice,
a visit with a representative of a hospice program,
and/or a visit to a residential hospice
might offer some new perspectives on the hospice option.
Often patients are poorly informed about palliative
care.
They might associate hospice-care
too closely
with the hospital treatments
they have experienced.
And they want no more invasive medical
procedures.
But the comfort care
offered by a hospice program
is not nearly as
burdensome as the endless round
of tests and procedures performed in the hospital.
When the patient understands all of the benefits of palliative care,
he or she might agree to give hospice-care an honest try.
(A trial
period of actually receiving palliative care is another
safeguard.)
HOW INFORMATION ABOUT PALLIATIVE CARE
AND OTHER ALTERNATIVES TO IMMEDIATE DEATH
CAN DISCOURAGE IRRATIONAL SUICIDE
AND OTHER FORMS OF PREMATURE DEATH
Persons who are feeling desperate because their
lives are ending
are sometimes tempted to commit irrational suicide
because they have incomplete or inaccurate ideas
about the process of
dying.
If they can be calm enough to listen to
a presentation of the alternatives to hasty death,
they might decide that killing themselves immediately
is not their best pathway towards death after all.
Both patients and their proxies
sometimes attempt to make end-of-life decisions
overshadowed by particularly
terrible
deaths they have witnessed.
If they believe that this patient will have a horrible death,
they might be tending toward choosing death prematurely.
However, the case of this particular patient
might be different enough
from the terrible death they want to avoid
that none of the suffering they fear
need necessarily be a part of this patient's pathway towards death.
Fears about repeating terrible deaths can be used
constructively.
Instead of committing irrational suicide to avoid a similar fate,
the patient and family can carefully consider alternative pathways.
Actually trying some alternative living arrangements
will be better than just thinking abstractly about other places to
live.
If the patient actually tries adjusting to a nursing home,
everyone might be pleasantly surprised that it works well.
And when that way of life is no longer meaningful
or if other circumstances make life worse,
then the patient and/or the proxies can choose death at that time.
What further life-meanings does the patient want to
realize?
What additional experiences would be enriching?
Does the patient wish to distribute any assets or possessions before
death?
Would it be wise to begin clearing out the patient's home before death?
This might result in more meaningful ways
of disposing of everything that will remain after the patient's death.
Carefully considering some good alternatives to
dying-right-away
can help some patients and their families
to choose a meaningful, positive pathway towards death
that is definitely better for everyone than choosing immediate death.
Created March 1,
2007; revised 8-26-2008; 9-10-2008;
9-17-2008;
2-12-2010; 5-19-2010;
5-21-2011; 12-31-2011;
2-3-2012; 2-11-2012; 2-12-2012; 2-23-2012;
3-24-2012; 8-3-2012; 8-23-2012;
3-5-2013; 6-28-2013; 2-19-2015; 1-13-2016; 2-9-2018; 5-21-2020;