“Can’t you give me a pill and let me end it?”
The questioner, a 76-year-old man whose wife had died eight years earlier, was now battling the demons of alcohol and prostate cancer.
“So I asked him, ‘Do you own a gun?’” said Dr. Forrest Beaty.
“I used to, but I gave it away," the man said. "I was afraid after my wife died I might do something drastic.”
“Wait a minute,” the doctor replied. “You had the means to do it yourself, but you gave the gun away. Now you want me to give you a pill. It seems we have a contradiction.”
Dr. Beaty mentioned this case in answering a workshop question about his profession’s views on assisted suicide. The American Medical Association opposes it, but, generally speaking, physicians assist the terminally ill patient with a more comfortable death, he said. Dr. Kevorkian’s well-publicized assistance in Michigan made the issue a “tempest in a teapot,” said Dr. Beaty, a man who quickly won the audience’s respect when introduced as a doctor who makes house calls.
He emphasized that he was not advocating suicide and with equal emphasis advised seniors to fill out durable powers of attorney that spell it out if they do not want heroic measures taken in the final stages. Copies should go to the doctor, the executor, the attorney and anyone else who might be calling the shots when you can’t. “Get it in writing while you’re still in a sound mind,” he added.
Dr. Beaty noted that physicians sometimes get carried away with their own jargon. They like being in charge. In an emergency room study, doctors tuned in for the comments and complaints of patients for about 20 seconds, then the doctors took control. This suggests, said Dr. Beaty, that you take steps to ensure that your doctor listens when you visit. “Make a list and separate the objective points from the subjective, or emotional, points,” he said.
Develop your own organized agenda, listing what’s important to you. Include a rundown of your prescriptions, mention that you smoke or drink. In addition to describing your chest pains, tell the doctor if your brother just died, because that just may influence what you’re feeling.
Tell your doctor in advance what you want to know about her or his prognosis. In other words, if you have six months to go, do you want to know? And if the outlook is bleak, remember it’s just one person’s opinion. An illness may run its course in a predictable amount of time, “but a vast number are unpredictable,” said Dr. Beaty.
“Doctors should have a game plan,” he said. That includes prescription management and social issues that may affect you. And to spend quality time with your physician, “Try to get the doctor’s last appointment for the day.” The pressure’s off, the end’s in sight and chances are you’ll get more than ten minutes.
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