On DNR, from the Front Page Sections, translated…
The famous romance writer, Chun Yiao, for the sake of her severely demented husband, Ping, had spoken up and out on the matter. She’d had been insistent on not intubating her husband, described “the doctor told us about his conditions, and recommended the feeding tubes for him…”, it’d stressed her out; and the children believed, “the patients with dementia are humans too, they can’t be treated like the terminally ill, and not giving them treatments!” “What we perceive as whether or not life is still worth living is different from your and our father’s views”, this made a lot of people think.
The matter of life and death of a patient happened at home, none of us, bystanders want to see that. The American reporter, Michael Vites had been hospitalized for several months, and he’d written reports on the trials the families weathered through, choosing life of death for their loved ones, he’d won a Pulitzer Prize for his report. He said, “The I.C.U. gives the hope of a full recovery for the patients, but at the cost of leaving the world in pain, it’s a torture for everyone, to decide on when to give up”. He saw so many families staying close to their loved ones, not knowing what will happen next, and not knowing what they can do.
what quality of life do you think she has??? Photo from online…
The Boston Children’s Cancer Hospital’s Hospice Unit Manager, Joanna Wolfe told, that she’d encountered patients who are difficult to communicate with, “Asking the RIGHT questions took a very long time”. She’d found innovative methods to communicate with the patients, stressing that the purpose of communication is not just in relieving the pains, but also, taking heed of the patients’ lifestyles, and emotions, it’s most important, to fulfill the wishes of the patients at this point.
The trainings of terminal care in Taiwan started very early. But, a doctor friend who was in the terminal care department told, in Taiwan, the doctors usually need to communicate with the families, and the families decide whether or not to tell the patients. Unlike in the U.S. where the doctors just tell the patients themselves, and the patients make the final decisions.
Most of the family members in Taiwan would hope to resuscitate, that’s only normal; and so, the doctors can only do their best. My friend who’s the doctor for the terminally ill said, that he had a terminal cancer patient, who’d already signed the D.N.R.; but when the time came, as the doctors were about to follow through with the patient’s requests, the family members who were against the idea urged the doctors to save her, to not give up; and, what we’d not expected was, “Our team worked on her for two hours, and she didn’t die. And now, we saw more of her families, coming to visit her at the hospital ore, cherishing the love even more, this was, a happy ending. It’s really hard to tell the results of matters of life and death, this made me think, for a very, very long time.”
not my photograph…
There was another scenario, the families rushed back from overseas to see the patient one last time. And, although, there was nothing left to do medically, the families still didn’t want to let go, wanted to have more time to keep the individual’s company, perhaps, it’s to make up for living faraway. And, this unique kind of situation in Taiwan on family support, had made the doctors struggle really hard.
Dr. Jonah had once had a mother of a child with terminal cancer told her in private, that she’d not want her daughter to suffer in the end, asked to not do any CPR, or to intubate, but the daughter has the strong will to live, and requested for the resuscitation herself; and that, was when Dr. Jonah realized, that the doctors and the patients should have discussed this matter earlier, to NOT make the patients’ families feel, “Time is really running out, we don’t know what to do.”
The bestselling author of “Being Mortal”, Dr. Gawande said, “I can’t say, that the end of life can be controlled”, because the “doctors all believed, that people lacked the medical knowledge, but, the terminally ill patients wanted more, they’d hoped that the physicians will help them arrange the best end for them.”
As the patients are about to die, most families are too stressed to know what they’re to do, if the doctors, the patients, and the families can set up a good partnership, to help the communication means flow smoother, it can help the patients find the supports they need as they slowly reached the end.
get it filled out and signed!!! From online…
So, this, is on the matter of intubation, and, each case is still unique, and, there’s still no one-size-fit-all, because there are too many unknown factors, the families, the medical advances, the quality of life after being resuscitated, these are all, variable in the situations, and we won’t be certain of how each one of these separate variable will work out, and how they will affect each other for sure, so, it’s still, not at all easy, to decide, whether or not to intubate or do-not-resuscitate!