Thursday, February 4, 2010

REFUSING TREATMENT

A friend undergoing cancer treatment told me, “You know, this is pretty rough. In fact, it seems primitive to kill my cancer by almost killing me. I understand my doctors have my best interests at heart, but a hundred years from now today’s treatment will be considered really crude.” She went on to discuss the balance between the quality of her life and its abrasion by her treatment. “At some point,” she said, “I might just decide to stop my treatment.”

A few weeks ago, another friend with advanced cancer did exactly that. In our final conversation, while she was under intense treatment in the hospital, she said to me, “What would do me the most good now is just to go home.” She did, and died two days later with her family at her bedside.

I met another woman with stage 3 breast cancer about ten years ago, when she was just beginning her chemotherapy. After a single intravenous dose, she declared, “Wow, this definitely isn’t for me.” Her doctor encouraged her to at least get radiation. She tried that once, and pronounced the same verdict. I knew her over the next five or six years, as she led her life with no treatment at all. She did fine, as a matter of fact. I’ve lost track of her since.

What these people have in common, the issue of halting treatment, will arise in almost everyone who bears a life-threatening illness. Most don’t consider it until they realize, far down the road, that their life has gradually contracted down to numerous medical appointments and the tribulations of side effects. They begin to ask, “Am I really prolonging my life or simply prolonging my suffering?”

Common though this issue is, we don’t even have a name for it because it’s still semi-taboo. After all, who in their right mind wouldn’t keep treating their serious illness? Isn’t that giving up? A kind of suicide? A slap at one’s family?

Even given those criticisms, the issue persists. Like one man said, “I have to look at this. This is me we’re talking about.” Once we realize we’re in this situation, we recognize that we’re the only one who can resolve it. What makes it difficult is the wide panorama of advice from those around us, including practitioners and, most compellingly, relatives. 

If we decide summarily to forego treatment, our doctors might feel like they’ve failed (don’t kid yourself: this is not uncommon among doctors). And relatives might feel we’re self-centeredly abandoning them. If this issue concerns me and I want to avoid unnecessary grief, then, I’d better have a thorough conversation with all involved.

1 comment:

  1. Jeff, just catching up on all your postings. Very timely, thought-provoking and important. Thanks for this. Hope it gets out to the world.

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