Life And Death

My wife and I are friends with a couple who earlier in the week needed to put one of their three dogs to sleep. The dog was old and was having health problems and it certainly was the best thing and yet, of course, it is never easy.

As luck would have it, my son and I were over there this past weekend and we both had a chance to play with all the dogs. We did not know at the time this was going to be the last time we could play with Bear but I did know he was heading to the vet come the beginning of the week and certainly had my suspicions (I am sure they did to).

After they put the dog down, my wife told my son and she asked him if he understood what that met. He said he did. Later he asked me if they can do that, or actually do that, with human beings. Now I was left with the challenge of explaining euthanasia to a nine year old. The topic is certainly controversial and perplexing enough for a 40 something year old.

I explained to him that sometimes people as they get old indicate that if certain things happen, they do not want to be treated for the illness. I did not get into the idea of mercy killings and things of that nature. Even the idea of refusing treatment, in the best of circumstances, can be confusing and murky, especially in terms of parenting our parents.

I thought about my own father who indicated he would never want to be kept alive on a respirator, if there was no chance of survival and if he would have no memory of anything. I remember when he was taken to the hospital and I, as his proxy, four hundred miles away, needed to make a decision about whether or not to intubate. This was actually something he and I had never discussed and only after deciding to do it, do my brother, my sister and I come across a living will that stated he was adamant about no intubations and no restraints, something else that was done to keep him from pulling the tube out of his neck.

The problem was his living will further went on to talk about what to do and not do if there was no chance of coming out of things (as determined by two doctors). All the information the family had indicated that the doctor’s expected the intubation to be a temporary measure to get him back on track. As a result, he actually did send mixed messages as the belief among the family was he was referring to these measures when there was no real chance of coming out of it and that was never the indication we got from the medical staff.

There were many other issues that also became a reality, perhaps for another post but the bottom line is, the idea of ‘putting a human to sleep’ is certainly complex and has many intricacies and is a very real issue at times when children are treating parents. Ultimately in the case of my father, the doctors indicated he was not responding the way they had expected (or hoped) and it was just a matter of time. With my father’s approval and knowledge (again, a post for another time), we did end up removing the tube.

So, for those of you treating parents, please make sure you actually have an in-depth discussion about the parent’s wishes. It is not as simple as it might first seem.