Our dad has just told us he’s been diagnosed with Alzheimer’s and he doesn’t want anything ‘artificial’ to prolong keeping him alive. What is really considered Artificial Life Support?
There’s no doubt Alzheimer’s can be a miserable disease for both patient and family; and some patients have written in their Advance Directive (Living Will) that they do not want anything ‘artificial’ which might prolong their suffering. However, what’s artificial depends on who you ask!
These five are usually accepted as artificial:
- CPR (Cardio-Pulmonary Resuscitation);
- feeding tubes;
- ventilator support;
- IV fluids;
- kidney dialysis.
If we define artificial as anything other than ‘food’ or ‘natural’, would the following ‘minor’ items also be artificial: insulin; antibiotics; surgery of any kind; blood pressure pills; etc?
Obviously, there’s room for debate. So to help make decisions, an important question is “what’s his goal”? Realizing he has an incurable, terminal disease, he seems to be asking only to be kept comfortable, to live without suffering or being a burden (from his perspective)? Could he be worried his family would keep him kept alive in spite of suffering?
He does need to know that occasionally some of these minor artificial treatments can actually help him stay comfortable. With a goal of “comfort only”, he needs to look at each available treatment for a particular symptom and consider trying it.
Unfortunately, due to modern medicine’s focus on fixing individual organs or health problems, rather than looking at what’s best for the whole person, we may unintentionally cause suffering. For example, treating pneumonia with only comfort-focused narcotics and breathing treatments, and avoiding antibiotics, may allow pneumonia (or any infection) to be his “best friend”: because dementia usually worsens with every major illness, dying from pneumonia may be his escape from what will eventually progress to a state of bed-bound agitation.
By not interfering in a natural process and focusing only on comfort, we leave it to a greater power to determine what’s best. Our obligation is to relieve and prevent suffering. You need to support him in his right to choose.