Sometimes I disagree with what we do; I think that as a culture we cling desperately to the last shreds of life at whatever cost. It doesn’t mean I don’t do my job, I do my job to the best of my abilities, but sometimes I disagree with what I’m asked to do.
We, being a Care of the Older Person ward have a lot of people who’s quality of life is pretty poor. Bedbound and incontinent, with dementia; many of our patients don’t, or won’t eat; don’t or can’t walk, and I wonder how much awareness of the world they truly have anymore.
Certainly their personality seems largely gone (or changed beyond recognition); but we fight for their lives, with interventions that are painful, strip them of their dignity, and just seem… wrong, to me.
But – where a patient’s not stated beforehand that they don’t want these moderately extreme interventions – like for example – surgery to put a feeding tube into their stomach – so we can safely feed them when they’ve lost their swallow/gag reflexes. Well, then we tend to go ahead and do it. And I wondered, last night, as I put a feeding tube into a patient who’s confused (dementia) and immobile whether it was really the right thing to do. I know it’s what the *family* want, but is it what he’d’ve wanted?
I can’t say, except for myself, and y’know what, I don’t want heroic interventions to keep me alive. If I’ll recover, and be independent (at least largely) – or if that is a high probability (like 80%), then sure, heroic me all you want. But if my heart stops, it stays stopped (thanks all the same) and if my life will consist of nothing more than laying in a bed, then no; thank you. It’s not what I want.
