A " Graceful " Death !

Geriatric medicine has come under the spotlight with many surgeons appalled that surgery and various procedures are being carried out on patients who are termed "living corpses "!  Often there is pressure from relatives and loved ones to do impractical things as "a last roll of the dice "  in the hope of attaining a last few months - and sometimes just weeks - of living.

Not only is this imposing financial strain on the hospital system it ignores the fact that we humans each have a natural life term and when this is artificially extended it comes at the expense of what we term our "quality of life " !

In particular, many question the worth of transplant surgery for those of advanced years.  We are desperately short of donor organs and the idea of putting a donated kidney into the body of a geriatric patient when others with a full life ahead of them may simply die on the waiting list seems a complete waste of resources.

The continuation of dialysis when an organ has failed means that the patient is being kept artificially alive.  That has practical value if there is the prospect of an organ replacement restoring full mobility to a younger person, but it limits the availability of scarce equipment to others.

Death is an emotive subject that we all must eventually face, whether it relates to loved ones or our own time on planet Earth.   Many people fear death and as a consequence they cling to life and make impossible requests to both doctors and loved ones.   That raises questions that the churches and the medical profession find hard to answer - and often the person concerned is a patient waiting death in a public hospital.

In recent times this matter of death with dignity has been grasped in the public arena.   Many hospitals have established a hospice as an adjunct to their function of saving lives.  These free up desperately needed hospital beds by moving the patient to a facility where every effort will be made to keep them free of pain and where visiting hours are unlimited.   For those on the cusp of death an effort is made to provide both people and surroundings that provide comfort as they slip away from living.

The Hippocratic oath required of all medical people contains a promise to "do no harm "!  Some people contend that artificially extending life by procedures that merely extend the suffering is a breach of that oath while others condone keeping suffering people alive until the last possible moment as the ultimate requirement of a medico.  For many, religion has a bearing on the point of view concerning death.

The law treats this with timidity.  It is an offence to assist a person to die but many doctors withhold treatment to allow suffering to cease and death to reach it's natural conclusion, and this is rarely questioned.   Often, it is done with the concurrence of loved ones.  A compassionate doctor will balance pain relief in the sure knowledge that the doses required will inevitably shorten remaining life but that this tradeoff will enhance that life quality.

This raises the question of whether the aged should be allowed to determine their own demise  at a time of their choosing.   That is already happening and in some countries it has passed the legal boundaries.   It is something the living would do well to give prior consideration - and make their views known to loved ones !