Each of us dies only once.
So it might not be enough to be counseled about
It might be wise for us to put ourselves under the care of a team of
who have helped many patients in their last days of life.
Some systems of safeguards for life-ending decisions
require that a palliative
care specialist be consulted.
All doctors know something about taking care of the human body
when it is beginning to shut down.
But since most of medicine is devoted to curing diseases
and repairing physical
problems that have emerged,
only a few specialists have carefully considered
how best to take care of people who have no other wish
than to have a pain-free and
Palliative care can be offered in many different
such as nursing homes, hospitals, or hospices.
And depending on the specific problems at the end of the patient's life,
one of these might be more appropriate than the others.
Many people who oppose the right-to-die
say that adequate palliative care will end the desire for death.
And open-minded people of any persuasion
should be willing to give this claim a fair test
for each person who is drawing life to a close.
week in a hospice or other care setting
where 24-hours-a-day palliative care is being given
would be a fair test to see if this particular patient
wants to continue to receive this kind of comfort-care
or still wants to exercise his or her right-to-die.
care trial is a time-limited experiment
not a mandatory alternative to the chosen death.
If palliative care does not
work satisfactorily for this patient,
various forms of chosen death should remain open.
A few days of good palliative care
will empower everyone to make wiser end-of-life choices.
They can all carefully consider when and how
would be the ideal way for
this patient to meet death.
When a meaningful period of palliative care has
actually been tried,
then there will be medical records showing
just what kinds of symptom-control were used.
Such medical records should not be made
But the fact of a palliative
care trial can be used as good evidence
that all appropriate alternatives to immediate death were explored.
HOW A TRIAL OF PALLIATIVE CARE
COULD DISCOURAGE IRRATIONAL SUICIDE
AND OTHER FORMS OF PREMATURE DEATH
Sometimes physical or psychological suffering
is the main push toward irrational suicide.
When all forms of suffering are treated by comfort-care
this should discourage formerly-frantic patients
from asking for death before it is absolutely
Likewise, the proxies who were thinking
that some form of chosen death would be the best answer
might discover that many of the physical and psychological problems
that were leading them to choose death
have been adequately dealt with by the comfort-care now being used.
Sometimes the patient and/or the proxies
have an imperfect grasp of the disease or condition
that is leading them to consider choosing death.
So when they put the patient into a palliative care trial,
this will be another opportunity to discover the real medical condition.
For example, if the pain they thought was caused by an incurable cancer
actually has some other causes, which can be treated,
then they can avoid the mistake of choosing death too soon.
Or if the trauma of terminal illness was leading
a premature death,
the breathing-space provided by good palliative care
can allow all concerned to reconsider any decision for death.
Emotional as well as physical problems should be addressed.
And when everyone involved feels better about the approaching death,
they can make wiser decisions.
If the patient can be made comfortable
even tho death is not going to be avoided,
the last days can be meaningful for all involved.
And thus the palliative care did actually avoid a premature death.
Dying before it was absolutely necessary can be avoided
if the patient receives all appropriate physical and
And if all palliative-care measures do not bring
then all concerned can follow the other pathway towards death
they have been keeping in reserve
just in case the palliative care did not prove satisfactory.
If the advocates of palliative care as an
alternative to choosing death
prove to be correct in this case, then the patient and his or her
will be thankful for
the additional days
even just hours—that
created February 1,
2007; revised 3-15-2008; 4-10-2008; 2-6-2010; 5-20-2010; 5-27-2011;
1-29-2012; 3-23-2012; 8-1-2012; 8-22-2012; 11-6-2012; 5-22-2013