In the past, I've encountered occasional misconceptions where some people mistakenly view the cessation of antibiotics, IVs, and blood transfusions for terminally ill patients in hospice wards as a negative act of passive abandonment, dubbing it as cutting off water and electricity. However, it's crucial to understand that as terminal patients enter the final stage, these life-sustaining medical interventions cease to offer benefits and may even increase the patient's physical strain. Continuing them only prolongs the patient's needless suffering.
In instances where antibiotics lose their effectiveness in managing infections, they might additionally strain the liver and kidneys. Moreover, with debilitated patients whose blood vessels are as delicate as silk, administering injections often requires numerous attempts before successfully inserting the needle.
Similarly, when nutrient fluids are administered with good intentions, the terminally ill patient, due to organ failure, cannot tolerate these fluids. Consequently, excess fluid retention occurs, leading to pleural effusion and ascites, further complicating breathing! In such cases, physicians conduct a thorough evaluation of the patient's condition, provide professional guidance, and, through comprehensive explanation, discussion, and communication with both the patient and family, reach a consensus to either withhold or withdraw these life-sustaining medical interventions. They also emphasize holistic care—physical, psychological, social, and spiritual—to enhance the patient and family's well-being. This approach aims to improve their quality of life and facilitate a peaceful passing for the patient. It's indeed a highly positive and proactive medical process! It's disheartening when individuals who don't grasp the process label it as cutting off water and electricity.
Ethical Medical Decision-making
In the face of extreme suffering experienced by certain patients, I believe we all resonate deeply and earnestly consider ways to relieve the distress for these patients and their families. This is why the concept of fasting to death has sparked such widespread attention! However, it appears to have led to misunderstandings among the public, causing considerable confusion. In reality, clear explanations exist regarding the appropriate care for these patients.
If a terminal patient's condition reaches an irreversibly severe stage, even nearing death where the patient is unable to orally intake or digest food, reducing or ceasing food intake becomes a necessary intervention. As previously mentioned, the objective is to ease the patient's needless suffering, not to expedite their passing. Hence, this constitutes a natural death, not a deliberate fasting-induced death.
Even in the advanced stages of a terminal illness, if a patient can still orally consume food, efforts should be made to support their natural eating and allow for a comfortable life. If the patient wishes to cease eating as a means to expedite the end of their life, caregivers should engage with empathy and acceptance. Their focus should be on addressing the patient's physical, mental, and spiritual anguish, nurturing their inner resilience to bolster their will to continue living. It's crucial not to simplify this situation as merely assisting in a fasting-induced death to reduce their suffering.
In cases where individuals have lost the capacity for self-expression, are bedridden, and cannot orally take in food, the medical team should conduct a thorough assessment of the severity of their condition. Considering their prior intentions, empathizing with the perspectives and distress of their family members, and engaging in an ethical deliberation process, the focus should revolve around prioritizing the patient's welfare while maintaining harmony in the family. Moreover, it's crucial to adhere to existing legal frameworks to ensure the provision of suitable medical care for the patient. If discontinuing artificial feeding aligns with the patient's best interests, it constitutes a natural progression within the disease's course toward death, and not a deliberate fasting-induced death.
Physical, Mental and Spiritual Health Care
Careful evaluation of a patient's condition, adherence to medical ethics, compliance with legal norms, and the ongoing adjustment of healthcare to prioritize patient-centered care at every stage represent the core professionalism and responsibility within the realm of medicine. A dignified passing is an integral part of our valued culture, a shared aspiration for us all. Yet, achieving a peaceful end isn't effortless; it's a challenging learning journey that requires personal commitment, the backing of family, and the support of the medical team. It's hoped that through the compassionate presence of both family members and healthcare professionals, patients can find physical, mental, and spiritual solace, embracing life positively until the end, thereby finding peace in both life and death.
Hence, careful and thoughtful consideration is crucial. It's imperative not to let the public misconstrue fasting as a means to achieve a peaceful passing. To prevent any misunderstandings that could adversely impact society, it's essential to foster discussions that include diverse perspectives. Through these discussions, we aim to elucidate the true meaning of a dignified passing, ensuring clarity for all and fostering a more harmonious and fulfilled society.