I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: Rerun on August 19, 2006, 10:57:29 PM
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This topic has been split from the "considering giving up dialysis treatment". Rerun Moderator
Sandsman, the only thing that offended me about your most recent post is you referring to stopping dialysis as "suicide." It is NOT suicide to stop life support. It is legal and it is our last "right." If I decide not to put myself through the torture anymore than I have the right to stop dialysis. Don't taint that with the word "suicide" as if I'm killing myself for no good reason.
EDITED: Tried Fixed spelling in original title-kitkatz-Moderator
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Sandsman, the only thing that offended me about your most recent post is you referring to stopping dialysis as "suicide." It is NOT suicide to stop life support. It is legal and it is our last "right." If I decide not to put myself through the torture anymore than I have the right to stop dialysis. Don't taint that with the word "suicide" as if I'm killing myself for no good reason.
Rerun, what is the definition of suicide (http://dictionary.reference.com/browse/suicide)? I am quoting this from dictionary.com.
The act or an instance of intentionally killing oneself
Terminating ones own life support voluntarily, and for no reason other then "I can't take this life anymore" is by all means, killing yourself and there for, is suicide. I don't care how much you sugar coat it. And for your information, it is legal to deny resuscitation ( in most states ) and it is also legal to deny medical treatment IF, it is not a threat to your life or anyone else's or if you simply can not be helped. Where I can agree with you on one point, it is your god given right to do with your life, as you see fit but what you seem to not understand is that it is not your legal right to commit self termination simply because you don't want to live any more. If it were, millions of people would be getting high dollar life insurance plans and killing themselves so their loved ones would reap the benefits.
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The difference is we would have died from natural causes (ESRD). We have signed up to live "extra" with dialysis. Is a person committing suicide when they have been diagnosed with terminal cancer and deny chemotherapy? Is a person committing suicide when they have a DNR (do not resuscitate) order? NO~!
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I hate to say it but Sandman, Rerun is right. If any of us on Dialysis stop dialysis it is NOT suicide because dialysis IS life-support. Our kidneys have stopped working and even my disability has me listed as "dependent on life-sustaining therapy" (yes, that is an exact quote). I don't think you realize that. Yes, I see your point, but it is just the facts. You have only seen a taste of the complications of a dialysis patients life, but there is still so much for you to see. Keep in mind that our experiences give us a unique view point which you understandably would have a hard time understanding. It is so easy to get down and just want to give up. Only when you see us being strong is it that you forget the hard times we go through on a day to day process.
If we choose to stop "life sustaining therapy" it is not suicide at all! Instead it is putting our life into God's hands.
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Terminating ones own life support voluntarily, and for no reason other then "I can't take this life anymore" is by all means, killing yourself and there for, is suicide. I don't care how much you sugar coat it. And for your information, it is legal to deny resuscitation ( in most states ) and it is also legal to deny medical treatment IF, it is not a threat to your life or anyone else's or if you simply can not be helped. Where I can agree with you on one point, it is your god given right to do with your life, as you see fit but what you seem to not understand is that it is not your legal right to commit self termination simply because you don't want to live any more. If it were, millions of people would be getting high dollar life insurance plans and killing themselves so their loved ones would reap the benefits.
BS Someone quitting dialysis has nothing to do with suicide or self termination. It's called letting nature take its course.
Also it is the medical profession that cannot deny treatment if there is a threat to ones life. It has nothing to do with patients refusing medical treatment on their own. Any person who is of sound mind and age of consent can REFUSE ANY MEDICAL TREATMENT AT ANYTIME no matter what the end result may be.
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Dialysis is a gift of life. ;)
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To me quiting dialysis is Suicide. And it has nothing to do with death can then take it's natural course so it's not suicide. That kind of thinking is just to make them feel better while there doing in reality they have the same thoughts as someone putting a rope around there neck. Well that's what I think anyways. I don't no yet through I have never thought of giving up because so far no matter how much they throw at me I'm still wanna enjoy every possible moment I can get where life flows through my veins.
What I would really like to know is what makes something natural and what makes it"unnatural"! Just because its manmade doesn't make it unnatural because guess what we are also part of nature, so in the end what we think of and build is just as natural as a beaver building it's house on a river. And we humans if u like it are not built a dialyzed machine because we want to help others which is natural.
So take the help that humans have are step on in to the other side.
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For me Yes it would be suicide. In 1977 the Doctors had a meeting about me going onto dialysis, I only just got to go on Haemo. The Doctors were not sure how I would cope with the needles. I never did, if it had been up to me then I would not have been on haemo. The nightmare that was those four years. I refused to go on haemo in early 1987 at the end of my transplant. 1988 i had no choice but to have one haemo session, can not remember it. I was out of it, had left it too long. Was waiting for a place on CAPD. Which I got May 26th 1988. That was until September 30th 2000 when once again I had not choice but to go back on haemo. I have refused haemo a couple of times, just got out of the chair and walked off the unit, come of the machine after a hour or so. But now that the Nurses have (for now) given up to the needles. I am stopping on the machine for the time I am allotted. My only good lab result was my HB for some reason always high, so never had much Epo only ever after big operations. Not had Epo since March 2005. Do not think I have it in me to stop treatment altogether. I have thought about it, but I think that most renal patients think about giving up. In all my time on dialysis I have only ever known three patients who have refused treatment. But they had much more wrong with them than just kidney failure. They saw no hope in their future, plus they had no hope of surviving. So why prolong their life :-\ as I was told by one :'(
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Just my opinion-- but to me...........Quiting Dialysis is NOT suicide. I'm not saying in any way that anyone should quit but actually it would be brave if it was the choice of the dialysisee to do so.............AND a shows a GREAT faith in Jesus Christ. After all, if I chose to quit dialysis it would be because of my faith in Jesus. Because I would know my soul would not die. I think it is sad when I see VERY elderly people holding on to life....barely making it in and out of the dialysis center..........skin and bone. My choice would be to let go and go see my Lord and Savior. Now my father does not feel the same way and rolls his eyes at me when I say this.
Fixed italicises - Rerun - Moderator
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Doing anything that is going to produce sure death technically is suicide. Usually people stop dialysis for different reasons than those most people would commit classic suicide for. Stopping dialysis is more about just getting some peace after suffering with kidney and often other life threatening problems for a long period. Often it is older patients who have been on dialysis for a period of time who have just had enough of the whole thing and want it to end. There is an interesting example of a well known author who decided to stop earlier in the year. Art Buchwald pulled the plug on dialysis but the results weren't quite what he expected. He continued to live without dialysis and if memory serves me has gone 4-6 months without treatment. That isn't the usual outcome and every patient is different.
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Yes, I see the Same on our unit, but the unit I am on is a Acute Renal unit, a lot of very ill patients. It was just a general quesion "Is quiting Dialysis Suicide" Say if a fit 20 year old refused to carry on with dialysis, I would say that would be suicide. Say, a old person(what ever that is) ill, skin and bones lived their life. Maybe a different answer :-\
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Is refusing Chemotherapy when diagnosed with terminal cancer suicide?
Is refusing dialysis when diagnosed with ESRD (which is terminal) suicide?
There is no difference in the questions. Both are terminal and a "treatment" can prolong life.
To me, I'm living an extended life by choice, and by choice I can quit anytime and it would not be suicide. It would be "letting nature take its course."
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I must say that in my opinion stopping dialysis IS suicide. Whether it is wrong or right is another matter. That is not for me to decide. If I dive under water and stay there, nature takes its course and I drown. Isn't that suicide?
The definition of 'suicide' from Dictionary.com is "The act or an instance of intentionally killing oneself". It doesn't state whether it was someone on a machine or not.
If someone stops us from going to dialysis and we die, isn't it murder?
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Is refusing Chemotherapy when diagnosed with terminal cancer suicide?
Is refusing dialysis when diagnosed with ESRD (which is terminal) suicide?
There is no difference in the questions. Both are terminal and a "treatment" can prolong life.
To me, I'm living an extended life by choice, and by choice I can quit anytime and it would not be suicide. It would be "letting nature take its course."
Aren't we all living an extended life by choice, anybody can just jump from a bridge, stop eating, hang themselves healthy or not healthy?
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Is refusing Chemotherapy when diagnosed with terminal cancer suicide?
Is refusing dialysis when diagnosed with ESRD (which is terminal) suicide?
There is no difference in the questions. Both are terminal and a "treatment" can prolong life.
To me, I'm living an extended life by choice, and by choice I can quit anytime and it would not be suicide. It would be "letting nature take its course."
Aren't we all living an extended life by choice, anybody can just jump from a bridge, stop eating, hang themselves healthy or not healthy?
No.
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I must say that in my opinion stopping dialysis IS suicide. Whether it is wrong or right is another matter. That is not for me to decide. If I dive under water and stay there, nature takes its course and I drown. Isn't that suicide?
The definition of 'suicide' from Dictionary.com is "The act or an instance of intentionally killing oneself". It doesn't state whether it was someone on a machine or not.
If someone stops us from going to dialysis and we die, isn't it murder?
Yes that is murder. Thus... so is Abortion! HA! GOT YOU THERE all you pro choice people!!! (Not directed at you Bajanne)
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There is a difference in the 2 diseases, Sometimes terminal cancers goes into remission and nobody's can explain why! Kidney failure on the other hand does not go into remission and stays constent
and C'mon u can do better then just "no."
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There is a difference in the 2 diseases, Sometimes terminal cancers goes into remission and nobody's can explain why! Kidney failure on the other hand does not go into remission and stays constent
Tell that Art Bukhwald~ http://www.pbs.org/newshour/bb/entertainment/jan-june06/buckwald_3-28.html
I can't find out if he is still alive. I will guess he is.
Okay. I won't say anymore, you know my opinion. I will try and make this topic a poll.
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I am saying yes it is, dont know how to explain how or why i think that way, i just do :-\
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I must say that in my opinion stopping dialysis IS suicide. Whether it is wrong or right is another matter. That is not for me to decide. If I dive under water and stay there, nature takes its course and I drown. Isn't that suicide?
The definition of 'suicide' from Dictionary.com is "The act or an instance of intentionally killing oneself". It doesn't state whether it was someone on a machine or not.
If someone stops us from going to dialysis and we die, isn't it murder?
It doesnt matter what they have as the defiantion.
One has to actually physically do something to themselves that brings their death in order for it to be suicide. The act of quitting dialysis is not such a thing because you are not physically doing an act to yourself. Because if it was everyone committs suicide, by not eating right at every meal, not exercising everyday etc etc etc.
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But that is committing Suicide by not eating right, just like smoking a cigarette you are slowing killing yourself, I'm not saying that smoking will always kill. Smoking or not eating right is like taking a trip where u can choose a path you either take the safe journey or u take the suicide trip you could survive but the chance of you dying is higher
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Because if it was everyone committs suicide by not eating right at every meal, exercising everyday etc etc etc.
That's an interesting thought. Are people who smoke cigarettes committing suicide, albeit slowly?
But getting back to the topic at hand ...
Art Buchwald is still alive. And he has some kidney function remaining. Please don't use him as an example.
A more appropriate story was that of the American author James A. Michener. An article from the American Association of Kidney Patients (AAKP) magazine Renalife writes:
The reasons to consider the "No Treatment" option were behind Pulitzer Prize winning author (Tales of the South Pacific) James Michener's choice in Austin, Texas, to discontinue dialysis after two years. Michener withdrew at the age of 90 after additional medical problems jeopardized the quality of his incredible life, and died Oct. 16, 1997, ten days later.
It's an interesting article entitled, So You Have Kidney Failure! Kidney Transplant, Dialysis, or No Thank You: Three Sides of the Same Story.
By Eli A. Friedman, MD & Amy L. Friedman, MD
http://www.aakp.org/AAKP/RenalifeArt/2005/soyouhavekidneyfailure.htm
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But that is committing Suicide by not eating right, just like smoking a cigarette you are slowing killing yourself, I'm not saying that smoking will always kill. Smoking or not eating right is like taking a trip where u can choose a path you either take the safe journey or u take the suicide trip you could survive but the chance of you dying is higher
Then since humankind isn't perfect by default any choice we make is considered suicide.
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No because some choices we make we don't know whats gonna happen next. But with a cigarette or not eating we know it we know what we are doing to our body!
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Okay, I must admit that I can not see this perspective from a patients point of view. And in everyones opinion, the act of quitting a life sustaining therapy is questionable. Okay, lets try this.
Is quitting eating and drinking completely, suicide?
Is feeding yourself harmful or poisonous chemicals, suicide?
Is quitting to care about life and death and terminating oneself because you don't care anymore, suicide?
Maybe I am wrong but I see that as you ARE committing suicide when you choose to stop the therapy. I do realize that without dialysis, any person with failing or failed kidneys would certainly die. The only question here is, when. I also do realize that dialysis patients could very well die from their life prolonging treatment exercises. Now if you CAN prolong your life with dialysis and choose not to, is that not saying that you gave up your will to continue living? Sure, we could all die at any time but are you going to tell me that your just going to throw away your life when you can still function enough to enjoy some of what life still has to offer? Simply pulling the plug when you could continue with a semi normal life is what I concider taking the short course to the inevitable. I'm sorry but I can not accept that.
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Doesn't matter if we know what happens next or not. Just because one way takes two weeks and the other may take 60 years doesn't remove the fact that the end result is the very same.
In not so many words what you are saying is that if people do not take every chance possbile by any means possible to prolong their life it is suicide.
BS.
That would be saying if someone was on dialysis and dialysis just wasn't working anymore and they refused to have a transplant they are committing suicide.
People die because they refuse blood on religious grounds. So that must be suicide. Wait since their religion is behind that view it must be murder then. :o
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No if you can't do anything about it it's not suicide and very sad too.
If someone is in a war and can't get there hands on food of course thats not suicide, but if that person has the chance to eat food and does not take it because they are fed up with life then yes then it's suicide.
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I think quitting dialysis is suicide. It is legal, but it is suicide all the same.
I think any time you plan out your death, it is suicide.
If however, you were stranded some where and there were no dialysis clinics, that would be an accident. ;)
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If you needed dialysis and chose not to go that route, would that be letting
nature take its course or would that be suicide?
I struggled with going on dialysis and remember someone at church asking
me if I was going to do it. I am glad I did. I feel differently about it now that I'm
on it. There are a lot of people who have cancer for instance going thru chemo
and it is not working. They would gladly change places with me. I have a friend
who is going to be buried tomorrow who found out she had cancer 2 mos. ago
and had surgery and was doing chemo. If I got to the place where I was suffering
really bad I don't think I would continue it. I would want to just go on home then.
I hope I don't get to that place and don't have to make that kind of a decision.
I see people at the clinic being carried in on stretchers. I would not want that.
I've seen my Mom, 2 brothers and a husband on life support and I never want to
be on it but I am actually am, I guess, just on a different type.
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See I agree with a lot that has been said here. I just don't think that anyone that turns down dialysis is opting for suicide! Why? Because this is different! We have no kidneys and would die. But I know there are some religions that the person would opt for no dialysis yet are against suicide. But since I am young I still do dialysis because I hope for a transplant and a normal life again one day! If I was 90 I would not want to be made to live longer because by then I figure ... with starting down this road since real young .. by then I will have gone through so much that I won't be like some 90 year olds that have not been through a lot and are just starting with illness. I don't want to be one of those people I hear about being brought in on stretchers not even aware where they are and have no family around them. Of course maybe I will feel differently when I reach that time. I am against suicide and assisted suicide just like I am against abortion and murder. I just don't think that not doing dialysis could be put in the same category as suicide. That is all.
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Doesn't matter if we know what happens next or not. Just because one way takes two weeks and the other may take 60 years doesn't remove the fact that the end result is the very same.
Not to point out the obvious but this statement holds true for anyone, not just the sick or injured.
In not so many words what you are saying is that if people do not take every chance possbile by any means possible to prolong their life it is suicide.
BS.
Now your blowing this right out of proportion. What I am saying is that if a relatively healthy and functional person refused life prolonging treatment simply because they don't want to live anymore, that's suicide. There's no BS about it.
That would be saying if someone was on dialysis and dialysis just wasn't working anymore and they refused to have a transplant, they are committing suicide.
In my honest opinion, if that person could live their life normally after the transplant ( minus the medications and routine tests ) then YES!
People die because they refuse blood on religious grounds. So that must be suicide. Wait since their religion is behind that view it, must be murder then. :o
I have never heard of that happening before but as stated earlier, if you intentionally refuse something that can save your life, then you must have intent on killing yourself. Murder is when someone else takes your life away from you.
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I guess I think that if you know doing something will lead to your death and you do it anyway, yes, technically it is suicide. And doing nothing IS doing something.
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I guess I think that if you know doing something will lead to your death and you do it anyway, yes, technically it is suicide. And doing nothing IS doing something.
I think you have it right, Sara.
Part of the problem may be using the word suicide.
For many folks suicide = eternal damnation.
I personally believe that God has a special place in his heart for the chronically and terminally ill.
I'm no theologian, so I may have this all wrong.
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If I stopped dialysis tomorrow would it be suicide? If I had the doc tell me there was nothing they could do to stop a progressive disease tonight besides the kidney failure, I would let go.
Sometimes I think it is the situation and circumstances you find yourself in whether you can make the decision to stop dialysis. It is up to each creature what their time is and when it is time to go. I think God will understand when a dialysis patient has had enough and turns up at the pearly gates.
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If I stopped dialysis tomorrow would it be suicide? If I had the doc tell me there was nothing they could do to stop a progressive disease tonight besides the kidney failure, I would let go.
Sometimes I think it is the situation and circumstances you find yourself in whether you can make the decision to stop dialysis.
Okay, I can understand if there was farther complications other then only failed or failing kidneys.
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Not to point out the obvious but this statement holds true for anyone, not just the sick or injured.
Exactly. By that definition of suicide just because one method may take two weeks while another may take 60 years means the latter doesn't get to make a claim its not suicide. Either it is all suicide by that defination or none of it is. There is no middle ground.
Now your blowing this right out of proportion. What I am saying is that if a relatively healthy and functional person refused life prolonging treatment simply because they don't want to live anymore, that's suicide. There's no BS about it.
Not at all. Either one can use artificial means to say alive past their natural life or not. There is no part way in the matter. Also its not for you to determine if the person is "relatively healthy". It is the person who is affected who gets to make that decision.
No its not suicide. All mainstream religions and the government do not consider it to be suicide.
In my honest opinion, if that person could live their life normally after the transplant ( minus the medications and routine tests ) then YES!
So in fact you are admitting that taking the medications and routine tests is not a normal thing. Yet you disagree over one letting the natural process take its course if they wish?
I have never heard of that happening before but as stated earlier, if you intentionally refuse something that can save your life, then you must have intent on killing yourself. Murder is when someone else takes your life away from you.
Jehovah witness' do not accept blood transfusions because of their religious beliefs and yes they have died from it. My buddy is a witness and he has made this point very clear to me if anything were to happen to him. He and many other members carry a card around with him that states they are a witness and refuse blood.
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There is a difference in the 2 diseases, Sometimes terminal cancers goes into remission and nobody's can explain why! Kidney failure on the other hand does not go into remission and stays constent
Tell that Art Bukhwald~ http://www.pbs.org/newshour/bb/entertainment/jan-june06/buckwald_3-28.html
I can't find out if he is still alive. I will guess he is. ...
From Wikipedia: "... In February, 2006, Buchwald checked himself into in a Washington, D.C. area hospice. Although his kidneys were failing, he elected to forego kidney dialysis, saying that he wished to finish his days his way and to avoid end-of-life ailments that befall so many elderly individuals. However, his health did not fail as rapidly as he expected.
In June, 2006, Buchwald was again interviewed by Diane Rehm after leaving the hospice. He reports that his kidney is working and that he "blesses him every morning. Some people bless their hearts, I bless my kidney." He reported he was looking forward to getting a new leg and visiting Martha's Vineyard.
In July, 2006, Buchwald returned to his summer home on Martha's Vineyard, Massachusetts, a place he never expected to see again. While there, he is working on a book to be called, Too Soon to Say Goodbye, about the five months he spent in the hospice. Eulogies that were prepared by his notable friends and colleagues, but were never delivered, will be included in the book."
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By the way, I noticed that none of us have mentioned that we had a member of IHD who stopped dialysis and passed away. Old Boris did that. There is an account of it in our memorial section on the home page.
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By the way, I noticed that none of us have mentioned that we had a member of IHD who stopped dialysis and passed away. Old Boris did that. There is an account of it in our memorial section on the home page.
FINALLY someone mentions "oldborris" and had any of you took the time to read the memorial section, you would know that. ::)
http://ihatedialysis.com/memorial.htm
Thank you bajanne
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By the way, I noticed that none of us have mentioned that we had a member of IHD who stopped dialysis and passed away. Old Boris did that. There is an account of it in our memorial section on the home page.
FINALLY someone mentions "oldborris" and had any of you took the time to read the memorial section, you would know that. ::)
http://ihatedialysis.com/memorial.htm
Thank you bajanne
Sorry, I failed to spot that as the link to it was not in the main menu. :'(
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This might sound offensive to some, but I am going to say it anyway.
I believe termination of life/euthanasia/ suicide is the inalienable right of every human being. As this is OUR life, surely we have the right to end it if life becomes unbearable? Is it not the one thing we DO have control over?
If someone has had enough of dialysis then it is up to them. It is THEIR body. I know family always comes into these things, but it really isn't a sin to think about number 1, especially when number 1s life is torture.
Yes, quitting dialysis is 'suicide'. I am not using the word in a judgemental way, merely that I can't dress it up as anything else.
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I guess I will chime in on this one. From my experiences as a dialysis employee and from everything I have read here I agree there are reasons, and some very good ones for quiting dialysis. I also agree that choosing to refuse treatment is your choice. I am also not saying that all types of suicide are bad. It all depends on the circumstances of the individual. Those that are terminally ill have good reason to want to die and I can't blame them in any way for doing so. I would even support them in that choice. It's the people out there that are trying to get attention by doing something stupid and fail to get that attention and die that are in the wrong. Even having said these things I believe that consciously and purposely choosing to do or not do anything that will directly result in your death is suicide regardless of the circumstances. It has nothing to do with the reasons behind it, it has to do with the act and the outcome.
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I voted that I do not think quitting dialysis is suicide, and, on an intellectual level, I do think that's true. I couldn't do it myself if I thought I would still have a chance, because I would keep hoping that tomorrow someone may come out with a cure and I would like to stay alive as long as I feel like I'm making a contribution.
I will tell you, though, I might stop dialysis, and I wouldn't think it was suicide, if it got too be to much of a financial burden on my family. I'm really worried about that. Right now I still have private insurance, I'm employed, and I haven't started dialysis, but my medical bills are pretty darn high. I take Epo, which I pay $50 a month for (4 injections), but on the new insurance my company is thinking of going to next year, it's not covered and I'll have to pay 80% of retail, which, as close as I can tell, is about $800 a week. The Dialysis Center I will be going to isn't covered on the new insurance, and neither are two of my doctors. They said I can go out-of-network, but I'll have to pay 60%. I don't think I'll be able to afford it. If it gets to the point where I'm just draining my family financially, I couldn't live with that. Then, I'd be afraid that I'd end up dying anyway and I'd leave them in a financial ruin. I worry a lot about how much all of this is going to cost...
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When my husband passed away, he had been on a ventilator and was taken off for 3
days and needed to go back on it and did not want to. He made that very clear.
Do I believe he committed suicide, no. I would have felt the same. We both had living
wills. It would have prolonged his life maybe for a little while, but there is a difference
between being alive and living.
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By the way, I noticed that none of us have mentioned that we had a member of IHD who stopped dialysis and passed away. Old Boris did that. There is an account of it in our memorial section on the home page.
FINALLY someone mentions "oldborris" and had any of you took the time to read the memorial section, you would know that. ::)
I read it, but I can't remember everything I read on this site. ::)
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I have read about Old Boris, But I was talking from experience, the three I knew personally who gave up dialysis. All died within a couple of weeks after stopping dialysis. But all three had much more problems than just kidney failure. Was it right for them to stop dialysis? I had a long talk with one of them, he was very ill, his liver transplant was failing fast. He was in so much pain. He told me that he had lived his live to the full, he was only 55 years old. Plus he had just had enough of all the pain. No chance of another liver transplant, no chance of a kidney transplant. Even on dailysis he said the Doctors had given him just 6 months. But it would have been a six months of HELL. At the end of the talk that I had with him, I sort of agreed with him. Why pro long his life when all it would have been was pain and suffering. Was this Suicide? I am not sure, he did end his own life :-\ But he ended his live at the time that he wanted to end it.
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Okay. I can understand if there are other reasons behind someones decisions to stop dialysis treatments. Wether they are terminally ill and staying on dialysis will make little difference, religions against such a act, finical status or whatever else that could be a contributing factor in making a hard but logical choice. Thinking on these lines, stopping dialysis treatments would NOT be considered suicide, but rather, deductive reasoning.
But if dialysis treatments are working and you can still make ends meet, still function away from the machines and can still make a contrabution to society but feel so emotionally distraught because you will have to live like that for the rest of your life and just can't bear to continue it any longer, then this would fit the definition of suicide.
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Okay. I can understand if there are other reasons behind someones decisions to stop dialysis treatments. Wether they are terminally ill and staying on dialysis will make little difference, religions against such a act, finical status or whatever else that could be a contributing factor in making a hard but logical choice. Thinking on these lines, stopping dialysis treatments would NOT be considered suicide, but rather, deductive reasoning.
But if dialysis treatments are working and you can still make ends meet, still function away from the machines and can still make a contrabution to society but feel so emotionally distraught because you will have to live like that for the rest of your life and just can't bear to continue it any longer, then this would fit the definition of suicide.
Killing yourself is killing yourself. I don't think it really matters what your emotional state of being is (maybe it matter morally, but not as a matter of fact) or what your contribution to society is.
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When I think of killing yourself I feel that you are going against the natural order of life, or going against what your body wishes. For example somebody who puts a gun to their head, takes an overdose of medications, etc. With dialysis I feel that if I were to stop I would not be going against nature or my body. Therefore, in my personal definition of suicide, stopping dialysis wouldn't fit the criteria. Although upon writing this, I realize that perhaps this is an oversimplified view. Does a diabetic patient who doesn't want to do insulin committing suicide Hmmmm......... ???
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When I think of killing yourself I feel that you are going against the natural order of life, or going against what your body wishes. For example somebody who puts a gun to their head, takes an overdose of medications, etc. With dialysis I feel that if I were to stop I would not be going against nature or my body. Therefore, in my personal definition of suicide, stopping dialysis wouldn't fit the criteria. Although upon writing this, I realize that perhaps this is an oversimplified view. Does a diabetic patient who doesn't want to do insulin committing suicide Hmmmm......... ???
That is my exact view but I couldn't put it into good enough words! Thank you! I mean, I would not "off" myself .. but I just don't think stopping dialysis would fit into the same catagory as shooting yourself or hanging yourself or slitting your wrists .. no matter how wrong it is.
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Obviously, the whole question of whether quitting dialysis is suicide or not is a matter of semantics. To say it is not suicide because the patient is simply withdrawing life-support treatment is silly, since a person who ceases to eat or drink, or puts a bag over his head so he can't breathe, is also withdrawing life-support treatment from himself, and everyone would characterize this as suicide! Just because eating is normal life-support while dialysis is an unusual form of life-support does nothing to change the matter. That said, the Roman Catholic Church has held in the famous case of Mr. Cinque, who wanted to terminate his dialysis in a Catholic hospital in New York in 1985, that ceasing dialysis is not suicide, since it is merely the withdrawal of 'extraordiinary means' used to sustain life. But the significance of this distinction is too Jesuitical to make sense to me.
Also, it is perfectly legal to commit suicide, in contrast to what some posters maintain. Laws against suicidie existed in most Western countries until the 19th century, when the suicide of a British Prime Minister, Lord Castlereigh, made suicide seem respectable enough to be de-criminialized. Some insurance companies do in fact pay out on life insurance policies even if the person insured has killed himself, as long as that event occurs more than 2, or with some companies, 3 years after the policy was taken out. The fact that most companies will not pay has nothing to do with suicide being illegal, just with company policies.
Personally, I applaud those on dialysis who have the courage to commit suicide, since I find these courageous people in some ways more life-affirming than those who continue with dialysis. To kill oneself on dialysis says that the patient values the dignity of true human life so highly he is so profoundly offended by the living death that one is forced to endure on dialysis that he prefers to die rather than disgrace his humanness with the inadequate existence provided by a machine that can only replace 10% of normal renal function. I say this as someone who, during the eight years I was on dialysis, frequently considered suicide but simply lacked the courage to do it, however right the decision seemed. The irrational, instinctive will to live at all costs, even if life has become a disgrace to human dignity, is very difficult to overcome.
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the Roman Catholic Church has held in the famous case of Mr. Cinque, who wanted to terminate his dialysis in a Catholic hospital in New York in 1985, that ceasing dialysis is not suicide, since it is merely the withdrawal of 'extraordiinary means' used to sustain life. But the significance of this distinction is too Jesuitical to make sense to me.
I am curious. What did the Catholic church say? The reason I am curious in what they said is because I am Roman Catholic.
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Hi Stauffenberg, I dont think we've had the pleasure of meeting you. Can you please go to the introduce yourself section and tell us more about you? You seem very informative and i am sure you have lots to share with our little community here. Hope to hear from you again soon...
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I would have to say it's a form of suicide. Last year when I became very depressed, I told the social worker that I wanted to quit and she called 911 and I ended up in the hospital for a few days. There are many forms of suicide, such as, not complying with your med schedule or being a drug or alcoholic addict, missing dialysis treatments for no reason. Nearly anything to extreme came be labeled "suicide or suicidal".
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Personally, I applaud those on dialysis who have the courage to commit suicide, since I find these courageous people in some ways more life-affirming than those who continue with dialysis. To kill oneself on dialysis says that the patient values the dignity of true human life so highly he is so profoundly offended by the living death that one is forced to endure on dialysis that he prefers to die rather than disgrace his humanness with the inadequate existence provided by a machine that can only replace 10% of normal renal function.
Are you nuts??? I for one value my life as I am still contributing to society in many ways. I value the dignity of life and would definitely go off dialysis when I am no longer able to function. Dialysis does not have die in it you know!
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Dialysis does not have die in it you know!
It does here (http://ihatedialysis.com/images/mybanner3.gif) :P
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But you have to spell it dielysis
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Personally, I applaud those on dialysis who have the courage to commit suicide, since I find these courageous people in some ways more life-affirming than those who continue with dialysis. To kill oneself on dialysis says that the patient values the dignity of true human life so highly he is so profoundly offended by the living death that one is forced to endure on dialysis that he prefers to die rather than disgrace his humanness with the inadequate existence provided by a machine that can only replace 10% of normal renal function.
Are you nuts??? I for one value my life as I am still contributing to society in many ways. I value the dignity of life and would definitely go off dialysis when I am no longer able to function. Dialysis does not have die in it you know!
I definitely agree Kitkatz! Even though sometimes it sucks, what in life doesn't? However, I can see where stauffenberg is coming from. If you absolutely abhor doing dialysis and you are so miserable, yet you continue on because you are scared to die, you might see a person who quits dialysis as courageous.
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Tell you the truth I am so appalled with what you wrote Stauffenberg. You applaud those on dialysis who have the courage to commit suicide >:( So in your view, what you wrote, NO one should be alive on dialysis :o We should all have knocked ourselves off years ago. I have been back on dialysis for over 18 years now. Had my ups and downs. But until I can not bounce back to reasonable health. Would never consider suicide. I know we all hate to have to rely on a machine to live. But in my view the courage is in the fight to survive, not the cowards way out with suicide.
The cowards way out. I do know three personally who have stopped dialysis. But they had no hope even to survive on dialysis. No Way do I think they were Cowards. I am talking about patients who are reasonable well (what ever that is :-\) and stop dialysis.
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Personally, I applaud those on dialysis who have the courage to commit suicide, since I find these courageous people in some ways more life-affirming than those who continue with dialysis. To kill oneself on dialysis says that the patient values the dignity of true human life so highly he is so profoundly offended by the living death that one is forced to endure on dialysis that he prefers to die rather than disgrace his humanness with the inadequate existence provided by a machine that can only replace 10% of normal renal function. I say this as someone who, during the eight years I was on dialysis, frequently considered suicide but simply lacked the courage to do it, however right the decision seemed. The irrational, instinctive will to live at all costs, even if life has become a disgrace to human dignity, is very difficult to overcome.
Are you insane? >:(
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Obviously, the whole question of whether quitting dialysis is suicide or not is a matter of semantics. To say it is not suicide because the patient is simply withdrawing life-support treatment is silly, since a person who ceases to eat or drink, or puts a bag over his head so he can't breathe, is also withdrawing life-support treatment from himself, and everyone would characterize this as suicide! Just because eating is normal life-support while dialysis is an unusual form of life-support does nothing to change the matter.
The problem in that theory is in that eating and drinking are not considered extra ordinary measures to stay alive.
In order to commit suicide one needs to take some out of the ordinary measure. Declining medical intervention in a terminal disease has never been viewed as out of the ordinary.
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Also, it is perfectly legal to commit suicide, in contrast to what some posters maintain. Laws against suicide existed in most Western countries until the 19th century, when the suicide of a British Prime Minister, Lord Castlereigh, made suicide seem respectable enough to be de-criminalized. Some insurance companies do in fact pay out on life insurance policies even if the person insured has killed himself, as long as that event occurs more than 2, or with some companies, 3 years after the policy was taken out. The fact that most companies will not pay has nothing to do with suicide being illegal, just with company policies.
In what country is this? In the US, if someone else saves you from yourself, you are force to seek psychiatric help or for repeat offenders, typically submitted to a psychiatric hospital. And life insurance companies will NOT pay out if it was proven that the person in question had committed suicide.
Personally, I applaud those on dialysis who have the courage to commit suicide, since I find these courageous people in some ways more life-affirming than those who continue with dialysis. To kill oneself on dialysis says that the patient values the dignity of true human life so highly he is so profoundly offended by the living death that one is forced to endure on dialysis that he prefers to die rather than disgrace his humanness with the inadequate existence provided by a machine that can only replace 10% of normal renal function. I say this as someone who, during the eight years I was on dialysis, frequently considered suicide but simply lacked the courage to do it, however right the decision seemed. The irrational, instinctive will to live at all costs, even if life has become a disgrace to human dignity, is very difficult to overcome.
:o Are you insane? I would applaud those on dialysis who have the courage to NOT commit suicide. I can only imagine the severity of the emotional factor here considering that I personally, have not gone through that ordeal of dialysis but WOW! How did you come to this conclusion?
Obviously, the whole question of whether quitting dialysis is suicide or not is a matter of semantics. To say it is not suicide because the patient is simply withdrawing life-support treatment is silly, since a person who ceases to eat or drink, or puts a bag over his head so he can't breathe, is also withdrawing life-support treatment from himself, and everyone would characterize this as suicide! Just because eating is normal life-support while dialysis is an unusual form of life-support does nothing to change the matter.
The problem in that theory is in that eating and drinking are not considered extra ordinary measures to stay alive.
But they can be in the right scenario.
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Personally, I applaud those on dialysis who have the courage to commit suicide, since I find these courageous people in some ways more life-affirming than those who continue with dialysis. To kill oneself on dialysis says that the patient values the dignity of true human life so highly he is so profoundly offended by the living death that one is forced to endure on dialysis that he prefers to die rather than disgrace his humanness with the inadequate existence provided by a machine that can only replace 10% of normal renal function. I say this as someone who, during the eight years I was on dialysis, frequently considered suicide but simply lacked the courage to do it, however right the decision seemed. The irrational, instinctive will to live at all costs, even if life has become a disgrace to human dignity, is very difficult to overcome.
This is excellently said, and I agree wholeheartedly. (Wish I would have said it)
I'd been on dialysis before and then got a transplant that lasted for 17 years (I know you have heard that a million times now) BUT, I never intended to go back on dialysis once my transplant gave out. I didn't have the courage to do it. I would have saved myself 10 surgeries so far......
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But they can be in the right scenario.
Not for able people.
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But they can be in the right scenario.
Not for able people.
Well what about those TV commercials we see where people in poor, 3rd world counties who can't find enough food and water. You would not consider that, extra ordinary measures to stay alive?
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Well what about those TV commercials we see where people in poor, 3rd world counties who can't find enough food and water. You would not consider that, extra ordinary measures to stay alive?
Nope, not even close.
To eat food and drink is an normal ordinary measure of everyday life. Just because there may be a lack of it doesn't make it an extra ordinary measure.
To be extra ordinary it has to be something that is not of the norm. Last I knew the world around, eating was a normal thing to do.
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I voted no it is not suicide to stop dialysis. I already told you all that if the circumstances were right I would end it and quickly. I would hope my partner and family would be respectful and not leave me as a muttering nonsense vegetable on dialysis. At least make sure I have a quality of life. I cannot understand why in our unit a lady who has Alzheimer's in on dialysis. She had no idea what is happening to her and can be belligerent and fight the staff. She also yells crazy things all night. She has to be sedated before they bring her into the unit. Is this the way to treat our elders? Are we showing her respect? Are we prolonging her life for the right reasons? When the time comes for me, let me go!
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Although people might try to impose various psychotherapeutic interventions even on those who rationally try to commit suicide, suicide is still not illegal anywhere in the Western world today. The illegality of suicide used to mean that the body could not be buried in a public cemetery, and that the will was invalid, with the entire estate being confiscated by the state rather than going to the appointed heirs.
Food and water are the things people ordinarily need to stay alive, and if they stop taking these and die, society would not hesitate to call that action suicide. Dialysis is what endstage renal patients ordinarily need to stay alive, so when dialysis patients cease to dialyze, this is suicide in exactly the same way as an ordinary person refusing to eat and to drink is. To say that one person is committing suicide because his action represents the withdrawal of an 'ordinary' support of life while another person is not committing suicide because he is withdrawing a support for life which is statistically unusual in the population, and thus 'extraordinary,' seems to me to be an utterly arbitrary distinction. If my house is on the edge of a cliff so I have to take extraordinary precautions when leaving my house in the dark so as not to die by falling off the edge, if I deliberately decide not to be careful then that is suicide, however 'extraordinary' it may be to have to take such measures to survive!
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Tell you the truth I am so appalled with what you wrote Stauffenberg. You applaud those on dialysis who have the courage to commit suicide >:( So in your view, what you wrote, NO one should be alive on dialysis :o We should all have knocked ourselves off years ago. I have been back on dialysis for over 18 years now. Had my ups and downs. But until I can not bounce back to reasonable health. Would never consider suicide. I know we all hate to have to rely on a machine to live. But in my view the courage is in the fight to survive, not the cowards way out with suicide.
The cowards way out. I do know three personally who have stopped dialysis. But they had no hope even to survive on dialysis. No Way do I think they were Cowards. I am talking about patients who are reasonable well (what ever that is :-\) and stop dialysis.
That is how I feel! And that is who I meant! I don't expect any young people to want to end their life because dialysis seems too hard! Life is hard! But I still say to not do dialysis is not suicide. Just how I feel. I feel suicide is to deliberately end your life .. a healthy life .. because you are depressed or grieving .. those people need help. But a dialysis patient .. one who is old and dialysis is just prolonging their life when it is at a stage where they have already lived their life .. then if they decided to put their lives into God's hands and live their last days eating what ever they like and drinking what ever they like and just enjoying life, then let them. It could be said that they are not doing suicide but finally living out the last days of their lives.
Well what about those TV commercials we see where people in poor, 3rd world counties who can't find enough food and water. You would not consider that, extra ordinary measures to stay alive?
Nope, not even close.
To eat food and drink is an normal ordinary measure of everyday life. Just because there may be a lack of it doesn't make it an extra ordinary measure.
To be extra ordinary it has to be something that is not of the norm. Last I knew the world around, eating was a normal thing to do.
I agree! Dialysis is an extra ordinary measure and eating and drinking are NOT.
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Except that dialysis is not ordinary as you try to suggest. Anytime a person is in END STAGE such actions taken to prolong life against natural process are considered extra ordinary.
Hmm if house was on a cliff huh.
Then maybe you can explain the difference between ordinary precautions while living on a cliff and extra ordinary precautions living on a cliff.
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This is just too complicated for me. It's a persons right to seek medical attention or not. My parents both decided chemo wasn't doing it 4 them and they died with dignity by there own choices. Do I think they committed suicide? Absolutely not.
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The Merriam-Webster definition of "suicide" is:
1 a : the act or an instance of taking one's own life voluntarily and intentionally especially by a person of years of discretion and of sound mind
Apparently M-W has trouble with the word since the definition is convoluted. According to this definition, somebody who "voluntarily and intentionally" takes their life because they don't like the colour of the sky is of "sound mind". They probably mean as opposed to insane but in the US, the legal definition iof sane is knowing the difference between right and wrong. And "years of discretion" has me stumped.
Let's assume that"extra ordinary" is an action taken to prolong life against natural process.
Taking insulin is an action taken to prolong life against natural process.
If a diabetic refuses to take insulin is that suicide or not?
If suicidal patients refuse to take anti-depressants which suppress the suicidal ideation refuse to take the anti-depressants because they prolong life against the natural process which is to commit suicide, then what? (Wrap your mind around THAT!)
I believe in the right of dialysis patients to terminate. It was one of the first things I asked. I was told that yes, I could quit if I wished but that the staff hoped that I would talk to them before taking such a step. Knowing that I can stop has ironically kept me going.
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The way statistics are collected in the United States, voluntarily withdrawing from dialysis is not counted as suicide, though this is a bureaucratic, not a philosophical determination. Statistics show that per 100 patient-years, 3.5 patients will die from voluntarily withdrawal from dialysis. One way to see this is to say that if a patient were to stay on dialysis for a century, he would have decided to let himself die rather than continue 3.5 times. Or, more plausibly, if a patient stays on dialysis for 10 years, his chances of deciding to give up on the treatment are 35%.
The actual suicide rate among American dialysis patients, in addition to those who voluntarily withdraw from dialysis therapy, is almost twice as high as in the general population, or 1.84 times higher than the average rate.
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The way statistics are collected in the United States, voluntarily withdrawing from dialysis is not counted as suicide, though this is a bureaucratic, not a philosophical determination. Statistics show that per 100 patient-years, 3.5 patients will die from voluntarily withdrawal from dialysis. One way to see this is to say that if a patient were to stay on dialysis for a century, he would have decided to let himself die rather than continue 3.5 times. Or, more plausibly, if a patient stays on dialysis for 10 years, his chances of deciding to give up on the treatment are 35%.
The actual suicide rate among American dialysis patients, in addition to those who voluntarily withdraw from dialysis therapy, is almost twice as high as in the general population, or 1.84 times higher than the average rate.
You always have the most fascinating statistics. How many are transplant patients whose grafts failed and went back on dialysis? That could be the tipping point.
How about some annotation?
;)
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I got my information from M. Kurella, et al, "Suicide in the United States End-Stage Renal Disease Program," Journal of the American Society of Nephrology, 16 (3) (March, 2005) 774-781 and R. B. Fissell, et al, "Factors Associated with 'Do Not Resuscitate' Orders and Rates of Withdrawal from Hemodialysis in the International D.O.P.P.S.," Kidney International, 68 (3) (September, 2005) 1282-1288.
Every renal patient should get involved in reading medical journals and monographs, since that is where you can find the truth that the nephrologists and dialysis nurses don't want you to hear. Typing in "Entrez Pubmed" on the internet is a good first step, since that gives you ready access to abstracts of millions of medical journal articles published over the last 30 years.
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Knowing that I can stop has ironically kept me going.
This is exactly how I feel. As long as I'm in "control" I feel better about dialysis.
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Rerun...I agree...
I still think quitting dialysis is not suicide.
Giving up on life is suicide.
When it gets real bad and I do not have a life anymore and dialysis is the any thing keeping me here, I am leaving! I think a quality of life is more important than quantity. If I can be a feisty old woman, then let's have at it with the dialysis. But if I have lost my mind, quit it.
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D&T City Link (http://groups.msn.com/DialysisTransplantCity/_notifications.msnw?type=msg&action=showdiscussion&parent=51&item=6265) about a news article talking about "Many nephrologists Unprepared for End-of-Life Decisions"
Direct Link to the News Article: http://www.renalbusiness.com/hotnews/69h14981737045.html
Article from RenalBusinessToday.com
"WASHINGTON--Sixty percent of nephrologists don't feel well prepared to make the decision to stop dialysis in kidney disease patients nearing the end of life, according to a study in November's Clinical Journal of the American Society of Nephrology."
I figured this was relevant to this topic so I thought I would share this.
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My father had a friend who was 60 and diabetic, he knew his kidneys where failing and he decided not to have dialysis. Is this suicide?
He lived in Swaziland and would of had to pay for his treatment which you can not sustain for a prolong period of time. This would have bankrupted his family if he tried to stay alive. Is this suicide?
Being a British citizen he could have returned to the UK and received treatment, but would still have had to accommodate himself and would have been away from his family (or his family would have to move with him) and lived out the rest of his life on dialysis. I'm not sure how practical this would have been, but deciding not to do this for me was definitely not suicide. It was a sad event, but he had lived for a very long time as a diabetic (I'm not sure how long or even if from birth.) and this in it's own right was an illness that should have killed him if he did not take insulin.
So I think another question could be when does it become acceptable not to use medical intervention to prolong your life?
If he did not take his insulin when first diagnosed with being diabetic this would have been seen as unacceptable as living with diabetics is seen as a normal thing, but refusing to have dialysis because of his circumstance is acceptable.
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See in that case I would say dialysis at a later stage in life, that would bankrupt your family... not doing dialysis is not suicide but more like turning down that tank that rumours have said sick people have gone in to be frozen til a cure is found but costs a lot. Does this make sense? If you can't afford it and it is the normal course .. how is that suicide? You didn't cause your kidneys to fail! The natural course of things would be death. Just for me being 32 .. I don't want to think about death (it depresses me enough that my friend Jamie died when he was my age on dialysis as it is ...)
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My father had a friend who was 60 and diabetic, he knew his kidneys where failing and he decided not to have dialysis. Is this suicide?
He lived in Swaziland and would of had to pay for his treatment which you can not sustain for a prolong period of time. This would have bankrupted his family if he tried to stay alive. Is this suicide?
I wouldn't call that suicide but this does raise a rather interesting thought.
Say you were in need of medical services but could not afford them. All the medical institutions in reach of you, turned you away because you could not pay for their services. Wouldn't that be considered involuntary manslaughter?
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I wouldn't call that suicide but this does raise a rather interesting thought.
Say you were in need of medical services but could not afford them. All the medical institutions in reach of you, turned you away because you could not pay for their services. Wouldn't that be considered involuntary manslaughter?
It may be, but at some point people die. Why can't people just pass naturally. Why is it either suicide or murder. I mean they can keep people alive. No question. But, at what point do you just let them go peacefully.
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Why can't people just pass naturally.
Let me ask you this. Do you think kidney disease is natural, or for the matter, normal? Don't let your current position answer this question for you. Try to think from a healthy persons perspective.
But, at what point do you just let them go peacefully.
This is just my opinion but I would suppose when 2 conditions are met.
1.) When the person in question is welcoming death.
2.) When all options to prolong life have failed or would be useless to continue or try.
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Is disease (any disease) natural? Yes. Is it brought on by different environmental and personal choices? Yes. If you chose to smoke and you get Lung Disease then that is a personal choice. If you get ESRD from eating a bad bag of Spinach than that is Environmental. If you end up with ESRD due to diabetes then that is related to the parent disease.
When Adam ate the apple that brought on death for mankind. You can debate it all you want, but people will die. And when you have a debilitating disease, which ESRD can be, then you need to go before you drain all resources to keep you alive.
But, people usually decide. We do all we can and after they have been on the ventilator and dialysis and IV's, and feeding tubes, then they are allowed to die.
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I wouldn't call that suicide but this does raise a rather interesting thought.
Say you were in need of medical services but could not afford them. All the medical institutions in reach of you, turned you away because you could not pay for their services. Wouldn't that be considered involuntary manslaughter?
It may be, but at some point people die. Why can't people just pass naturally. Why is it either suicide or murder. I mean they can keep people alive. No question. But, at what point do you just let them go peacefully.
I agree with Rerun and have to say "FINALLY!" that is exactly how I felt! People DO have a right to pass naturally! I just wouldn't stop dialysis at the age I am at because I know I still have a long life to live!
Why can't people just pass naturally.
Let me ask you this. Do you think kidney disease is natural, or for the matter, normal? Don't let your current position answer this question for you. Try to think from a healthy persons perspective.
But, at what point do you just let them go peacefully.
This is just my opinion but I would suppose when 2 conditions are met.
1.) When the person in question is welcoming death.
2.) When all options to prolong life have failed or would be useless to continue or try.
The medical way in which our lives can be prolonged are NOT natural. Death IS natural.
Don't worry Sandman, no one is wanting to die here. But don't take away our choice of being able to die naturally just because medical science can keep us alive. Sometimes you just have to accept that people DO die!
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Really I enjoy the debate. It makes me think as well as others. In the end we report to our maker. If HE thinks it is suicide then I'm screwed. :o
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Really I enjoy the debate. It makes me think as well as others. In the end we report to our maker. If HE thinks it is suicide then I'm screwed. :o
Oh, I agree. I do enjoy the debate and I get to learn other peoples views as well.
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So I think another question could be when does it become acceptable not to use medical intervention to prolong your life?
I'm 26 at the moment with no intention of stopping dialysis, but I am relatively healthy and live as normal a life as possible. I hope I never get to the point where I have to ask myself is dialysis adding enough benefit to my life.
I have seen some people and I am grateful I'm not them.
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accepting death is not suicide! Don't tell people that it is!!! It's not and you aren't doing any good by saying that it is. What's wrong with you people?
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accepting death is not suicide! Don't tell people that it is!!! It's not and you aren't doing any good by saying that it is. What's wrong with you people?
Did your "Cocaine" addiction give you that revelation? Or did you learn it while abusing some other drug? You post like you have the definitive answer and everyone else is wrong. What's wrong with YOU?
- Epoman
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accepting death is not suicide! Don't tell people that it is!!! It's not and you aren't doing any good by saying that it is. What's wrong with you people?
But refusing medical care that could bring a high quality of life to you and your loved ones is selfish. Just because you are scared of having to fight. Even the "normal" healthy people without kidney failure have to fight every day of there lives.
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Well this certainly has been a colorful debate and I'm going add this comment.
Plain and simple I am not on dialysis yet and I'm really scared of the prospect of going on dialysis, About 9 months ago the possibility of someday being on dialysis became a reality. Now I can somewhat objectively put in my :twocents; worth.
I used to (6 months ago) think there is no way I'm going to go through all the problems related to being on dialysis and that I would let nature just take it's course. I thought this way because I felt alone.
I actually started to have a lot more respect for those that have endured this disease and still fight the fight everyday, because I started to realize that I was looking through a window at something I knew nothing about and that I am scared of it.. and all these other people aren't looking through a window, they are actively living it, and I respect the fact that they have what it takes to tolerate this disease without giving up.
I do honestly believe that anyone can reach the point where they can say enough is enough. Is it suicide? I don't think so, but I do think everyone has their own level of tolerance to the effects of any disease, so with that it becomes a personal choice. As long as you have explored all options available.
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accepting death is not suicide! Don't tell people that it is!!! It's not and you aren't doing any good by saying that it is. What's wrong with you people?
I accept the fact that I'm going to die. And sooner rather than later. I'm quite comfortable with that, and have been for over twenty years. But that doesn't mean I'm going to hasten it. I have a few more documentaries in me yet to produce/direct.
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I used to (6 months ago) think there is no way I'm going to go through all the problems related to being on dialysis and that I would let nature just take it's course. I thought this way because I felt alone.
I'm also pre-D, and before I found this site, thought I would "let nature just take its course". Dialysis was so impossible to comprehend, so terrifying, so defeating. But now I've come to understand so much about how dialysis works and how to deal with the problems that inevitably come your way, even though I'm still on the outside looking in, and I have had that understanding expanded by reading about all the folks who are really LIVING while on dialysis. I feel as if I will still be able to enjoy life when I am on dialysis. The essential me won't be taken away, and might even be improved!
That having been said, when the essential me does finally go away, I don't want the corporeal me to be hooked up to every gadget known to humankind just so monitors can light up. As W. C. Fields said, "If at first you don't succeed, try, try again. Then quit. No use being a damned fool about it.!
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accepting death is not suicide! Don't tell people that it is!!! It's not and you aren't doing any good by saying that it is. What's wrong with you people?
C'mon, Lost Sheep. I defended your right to make a choice concerning the end of your life, and I still do. I do think it's sad that you said because you can't eat, drink and have sex like you did you might as well be dead, but, it's still your decision. You can't dictate your opinion, any more than you want others to dictate theirs.
Everyone has a right to their own opinion, especially concerning how their life will end. Everyone's life experiences will alter that opinion, but it's still the right of the individual to make that choice.
For some people, stopping dialysis is suicide, for others, it isn't.
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In short, for me to accept death would be to accept defeat , sorry it ain't in me.
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In short, for me to accept death would be to accept defeat , sorry it ain't in me.
It would be for me, too, Joe Paul. I agree with you.
But I know not everyone feels that way, and, if someone else felt that they had done everything they could and they wanted to stop dialysis, I would defend their right to stop dialysis without calling it suicide.
I just think everyone has the right to evaluate their own circumstances and make their own decision. Some of us are stronger than others, and so maybe we would have made different decisions. But, at the end of the day, we all get to make that decision ourselves. I just hope that anyone who is considering making a decision like that will talk to everyone in their life that matters to them, it's a huge decision that affects a lot of people, not just the person stopping dialysis.
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There seems to be an essential confusion in this discussion between what technically constitutes causing one's own death, which is what suicide basically means, and wrongly causing one's own death, which is how some people posting seem to define it.
It is highly arbitrary to define some things as natural and others as artificial, since almost everything in life is a continuous admixture of both. Is it natural to push organic matter down the largest hole in your head, hoping it will go down the right tube to your stomach and nourish you, rather than down the wrong tube to your lungs and suffocate you? Described this way, eating sounds like quite an unnatural thing. Yet if a healthy person locks himself up in his room and decides not to eat, this would certainly fit the ordinary definition of suicide. But what if you need special 'food' to live, such as dialysate slowing through your veins for four hours three times a week? Isn't refusing to 'eat' that 'food' also suicide? Both eating and dialysis are artificial, in that both require considerable expense, effort, and human intervention to occur; neither is a process governed automatically by the nervous system like shivering in the cold or breathing.
I would say that stopping dialysis is clearly suicide in the case of a person who knows he cannot survive without it, but so what? Your life belongs to you, and when you rationally determine that the cost of each day in discomfort, inconvenience, pain, and the endurance of meaninglessness is greater than the benefits of whatever good things are likely to happen, then it is just common sense to kill yourself. The only exception I can think of would be the case where some other people were dependent on your continued existence to an extraordinary degree; but in most cases, no one has a right to force another person to endure an unhappy life just because it would be of some benefit to the person compelling another to live. Your personal priorities have the highest status possible in a society of ethical interdependencies when it comes to deciding whether your own life is worth continuing.
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So before medical science, when a person,.....lets say looses their kidney function for example,....and becomes ill resulting in death,....that was not suicide. Right? But.....since man and science and dialysis machines.....now it is killing yourself? What a joke. Man does not determine what constitutes "sin" does he? Who died and made you in charge? If it is true that because one do not uses mans machines to continue to exist then one is committing suicide, I guess all of the people on breathing machines and such life support are suicidal. When they made their living wills and decided to "pull the plug" at some point, they became suicidal. Nobody here is talking about blowing their head off or slitting their wrists or overdosing of any kind. Life, ability to breath for free is how it has always been. You have to pay for medical science. What about the extremely poor people without the means for treatment? Should they do anything they can (rob a bank) to survive, and if they fail to do so they then are suicidal? There are many things a human can do to stay alive but choosing not to doesn't make them a killer.
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I think stauffenberg makes a very good point. Yes folks, I do agree with his premise.
The only thing I would argue is from this comment:
But what if you need special 'food' to live, such as dialysate slowing through your veins for four hours three times a week?
Dialysate should never flow through your veins. That would be manslaughter.
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I worry about the pain, how awful a person would feel. I know sometimes I feel not too perky on my long stretches. So I just fear how I would feel and how long it would go on. But I do feel if and when I ever come to that point I won't want to feel like a burden to my family. I've always been very independent and just can't see myself being comfortable with someone having to take care of me. Which would probably be one of my kids. I think it's just a very individual choice. Not suicide.
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As just a caregiver and not a patient...this whole subject fills me with dread.I didn't realize I felt that way until reading all this debate.
As a person who loves a dialysis patient-I don't ever want him to choose to leave me.(I know-selfish of me) that being said-I hope I would have enough compassion to let him go-IF he was suffering and his quaility of life was compromised.
But as a caregiver-I have not liked facing this thread,or lost sheeps choice,and I am not sure a non-dialysis patient can really understand. Is it suicide? Is it a natural passing? I don't think I care-I just don't want him to go.
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In short, for me to accept death would be to accept defeat , sorry it ain't in me.
It would be for me, too, Joe Paul. I agree with you.
But I know not everyone feels that way, and, if someone else felt that they had done everything they could and they wanted to stop dialysis, I would defend their right to stop dialysis without calling it suicide.
I just think everyone has the right to evaluate their own circumstances and make their own decision. Some of us are stronger than others, and so maybe we would have made different decisions. But, at the end of the day, we all get to make that decision ourselves. I just hope that anyone who is considering making a decision like that will talk to everyone in their life that matters to them, it's a huge decision that affects a lot of people, not just the person stopping dialysis.
You are correct...this is how I feel at this point of my life. Keep in mind, Ive only been in clinic now, will be a year in April. Who knows how I will feel years from now, thing is I'M LIVING for today, 1 day at a time.
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I don't think you can give a one-size-fits-all answer to this question. Whether or not it is suicide depends on the reasons an individual person has for quitting. It's a matter of attitude, I think. If you are depressed, and overwhelmed and you decide to stop so you don't have to deal with the emotional strain anymore, then it does seem suicidal to me. If you are quitting for reasons like the ones kenvo's friends gave, where there are other medical complications, and continuing to have dialysis will only add more suffering to a life that is going to be ended very soon anyhow, I can't see that as suicidal.
Suicide is a very loaded word for so many people - it's hard for those with a religious upbring to see past the concept of "it's a sin" .
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I must say that in my opinion stopping dialysis IS suicide. Whether it is wrong or right is another matter. That is not for me to decide. If I dive under water and stay there, nature takes its course and I drown. Isn't that suicide?
The definition of 'suicide' from Dictionary.com is "The act or an instance of intentionally killing oneself". It doesn't state whether it was someone on a machine or not.
If someone stops us from going to dialysis and we die, isn't it murder?
Sopping dialysis is not suicide. In fact, there is no one who can force you to even start it. You could let nature take its course right when diagnosed from the begining. Some people feel horrible on dialysis, and why should they have to do it? To make others happy? No.
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My father had a friend who was 60 and diabetic, he knew his kidneys where failing and he decided not to have dialysis. Is this suicide?
Years ago one of my distant relatives (an aunt-in laws second husband) got very sick and needed to go on dialysis. He refused it and died three weeks later. Everyone was all upset about it, how could he do this, so on and so on. THis was even before I got sick and knew what dialysis even was. He was a big, huge guy and he was a professional wrestler for years. He was in his 40's at the time of his death and he just wanted to let go of his life. He left behind a wife, they had no kids. I remember the family being all upset and fighting about it, if he did the right thing or did his dying mean he commited suicide.
Donna
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Isn't this debate interesting? My dad at 89 wanted to live - he still had things inside he wanted to say to our nation; he wanted to see my daughter become a woman. But he was refused dialysis because of his age. By the way, apart from the kidney failure, he was a very healthy man. No Alzheimers, no other health problems. Our family doctor cried when he realized they would not allow my father dialysis. My father at 89 who had achieved much in my country, as an educator, as a minister of the gospel, as a farmer, who raised children who have made names for themself in our country and abroad, still felt he had something to live for. And to think that someone under 40 would consider they had achieved enough to consider giving up!
I do not like dialysis, but I am eternally grateful that I can continue to teach and see my daughter and grandson develop.
And dialysis also brought me some special friends - right, Goofynina?
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Wow, I never heard of anyone being refused dialysis because of their age. Could he have moved to the USA, where he wouldnt be denied?
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All I know is if Angela515 would have given up on dialysis, she wouldn't have recieved her new kidney last week.
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Wow, I never heard of anyone being refused dialysis because of their age. Could he have moved to the USA, where he wouldnt be denied?
That is still the policy in Britain and in some other countries. I know of a family friend in London who was sent home to die, and a man I considered quite young, just under 70, who was also taken off, in my country and subsequently died. I am told that it was like that in the US too, many years ago.
[Would you guys have liked another illegal immigrant in your system?]
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I didnt mean that he would come illegally, I meant go through the system the correct way.
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I didnt mean that he would come illegally, I meant go through the system the correct way.
I was just kidding really. ;D He did have a visa, and some of his children are American citizens, so I suppose that could have been one way, but by the time we understood how serious it was, it was a bit late. We even offered to buy a dialysis machine, but they would still have had to run it, so they said no.
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In every country the medical system tries to discourage patients from initiating dialysis if, because of extreme age, senility, dementia, or serious co-morbidities they are not likely to do well or to profit from the extension of their life. To my knowledge, however, there is no official policy in Britain, Germany, or Canada, three countries outside of the U.S. where I have had personal experience of dialysis, to forbid dialysis to anyone who really wants it. When I was on dialysis in England from 1996 to 1997, and then again briefly in 1998, I saw some extremely old patients, some totally senile, with many co-morbidities, and no one was questioning their right to contrinue on dialysis.
However, I once read in a public library in Britain in 1991 a pamphlet, published in 1982, for patients about to begin dialysis. I was struck by the comment that "dialysis is not forever; the patient should select some up-coming goal, like living to see the grandchildren marry or finish university, and plan to continue dialysis only until that goal is reached." That was not the policy by the 1990s, however.
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Wow, I never heard of anyone being refused dialysis because of their age. Could he have moved to the USA, where he wouldnt be denied?
At one point in time in the USA, people were indeed refused dialysis because of their age. The term "Death Squads" ring a bell.
- Epoman
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If someone wants to end there medical treatment then thats there decision. I don't see anything wrong with that. An I gotta say If when I'm an old man and have other heatlh problems that lead to a poor quality of life I would think of stopping treatment too.
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I think there is no "one size fits all" answer to this question. I see patients so elderly, confused and sick while on treatment, that it appears they are being tortured rather than dialyzed. What is the answer for them when it has been determined that they are "no longer capable" of making their own medical decisions? Life support is life support, whether it is a dialysis machine or a ventilator, the only difference may be the amount of time required for life's end after discontinuation of life support. To ask if it is wrong to end your life support, mustn't you also ask if there is still a quality of life and by whose definition? By the family? By the patient? To ask if it is wrong to end your life (or life support) is usually closely related to your faith, or lack thereof, in God. Are you making a decision that should only be made by Him? If someone who had success, health, love, and family chose to end their life because of a mental illness, is that "wrong"? Would he be condemned because his mind was sick rather than his body? Extreme physical pain or extreme mental pain; is there a difference in the "rightness" or "wrongness" of ending your life? I believe that God would not condemn a person for ending their life because of the effects of illness, whether it is physical or mental. And when you ask if suicide is "wrong" isn't that the real question? Is it wrong by the moral standards of our society which are based on the Judeo-Christian belief in God?
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When I was very young I certain considered that option. The thought comes across mind occasionally.
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Another interesting poll
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As a physician who has participated in withdrawal of care in a number of patients and even one that I recall that had ESRD, it is a quite settled issue medically, legally and ethically. It is the right of the patient to withdraw from medical care even when it a very appropriate and needed care for sustenance of life.
Is stopping dialysis suicide? The short answer is no. Yet, the caveat to that is that one of the duties of a physician in this situation is to determine first that the patient is not suicidal and that is why the request was made by the patient. Thus, often, the patient in this situation will have an examination by a psychiatrist. Any hint of suicidal ideation places the request null and void and in fact, the medical team in this situation must administer the treatment until a time is deemed that the patient is not suicidal. Yes, as you can imagine, this in some cases can be quite difficult. However, in most cases, the patient no longer wishes to endure what ever treatment it is and simply wishes to let the underlying disease take its course and they are almost uniformly granted this option.
So, yes, it is true that medically, legally and ethically, it is not suicide to withdraw any medical treatment, yet it is imposed upon the practice and duty of the physician to first exclude suicide as the underlying motive. For a medical team to continue a treatment against a patient's wishes, here in California a psychiatrist or psyche nurse must declare that the patient has suicidal ideation and is therefore a danger to himself or others. Without this determination, yes, a patient may withdraw, withhold or refuse any and all medical treatments. In fact, without the patients informed consent, I am not allowed to perform any treatments or examinations upon any patient. Under our laws, the patient is the one in control whether the reality of practice actually allows the patients to truly control their own treatments.
Peter
Peter
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While I agree with you that the medical profession and the law, and even some Jesuitical reasoning by religious theorists, decides quite artificially decide not to "call" stopping dialysis suicide, there is no ethical consensus on this, since it is always open to philosophers to debate this issue as they will and ethics no conventions exist, as they do in law and medicine, to paper over the problem and pretend the issue is solved by playing ridiculous games with labels.
The problem in thinking about this issue logically is that people begin from the unproved assumption that committing suicide is wrong, evil, or condemned by some invisible entity in the sky, and so if voluntarily deciding to end your life by withdrawing a life-sustaining intervention is suicide, then that action, despite its reasonableness in many situations, has to be wrong. But in fact there is nothing wrong with leaving a movie you find dull, or dropping a relationship that has turned sour, or getting out of a burning building where you have lived for a long time, nor even in ending your life if it becomes intolerable to you and there is no way to fix the problem. It is just common sense to get out of an unendurable situation, and it is a pity, given all the unavoidable tragedies in human life, that people create an artificial tragedy for themselves by imagining that they owe some duty to some invisible force to continue living when it is no longer tolerable to the person whose life it is.
If you define suicide as any voluntary choice to set in motion a chain of events with the knowledge that it will lead to your death, then it is 100% obvious that withdrawal from dialysis is suicide. As I have said before, if you need food, water, and air to live and decide voluntarily to go without any or all of these, then you are obvioiusly committing suicide. So by the same reasoning, if in addition to food, water, and air, you also happen to need dialysis to continue living, it logically follows that if you decide to forego dialysis you are actively willing your own death and doing everthing required to kill yourself, as much as if you had swallowed 1.5 gms of cyanide or hanged yourself from the nearest tree.
There is no essential difference between 'artificial' and 'natural' life support, nor is there any real difference between actively killing and passively letting die when you are discussing your treatment of yourself. Putting food and water in your mouth to continue living requires a whole complex series of actions to keep you alive by these means, and this differs only in degree but not in kind from the complex series of actions to keep yourself alive by attaching yourself to a dialysis machine. But are equally 'artificial' interventions to keep yourself going, and stopping either should be called what it is: suicide.
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Dear Stauffenberg,
This is a quite interesting topic that I would have to disagree on your point that there is no consensus. Once again, withdrawal of medical care by a patient is the right by virtue of the ethics of autonomy. In such, the entire medical field, judiciary and ethics are quite satisfied and in agreement with this and I have once again personally been involved in many such cases where autonomy and substitued judgement were invoked on patient care decisions. Nevertheless, let's take a look at it and use your definition. Please correct me if I don't properly represent your position.
I have on more than one occasion been involved in the care of a patient in the ICU on full life support for severe COPD where the patient is no longer able to live on their own without a mechanical ventilator. In the situation where we are not able to wean the patient from the ventilator, we have two options. First, place a tracheostomy and send the patient to a special nursing home for patients on ventilators. Or, secondly, we may withdraw care and extubate or take the patient off of the ventilator. In this case, we place the patient on a morphine drip. Now, the patient or family make the choice to remove the ventilator. Then I write an order for the morphine drip. The morphine in this situation actually has the effect of relieving the suffering feeling of suffocating. It is giving for that relief only.
Now, according to your definition, we not only have an act of removing the machine and the endotracheal tube, but I have now likewise placed the patient on a medicine that may actually hasten the death of the patient. (This is actually a situation that I have been involved with several times and I have in reality written those very orders.) Now accorcing to your definition of suicide, I am now guilty of murder as well?
The answer once again is no. My intent was to relieve suffering, and my intent was not to kill or murder the patient. I do understand your point on ending dailysis and why some may construe that to be a suicide, but the consensus amongst the medical profession, the ethics establishment and most importantly among the judiciary is that I have not committed murder, nor has this patient committed suicide. There is a right to autonomy recognized in most western nations. You have the right to self determine your medical treatments including the legal, ethical and medical right to refuse or remove life sustaining treatment. Having participated in many like situations, I must most respectfully disagree that there is not a consensus on this issue as you contend. Any patient determined to have suicidal ideation will not be allowed to withdraw life sustaining medical treatments. This is the law, the ethics and the fudiciary duty of a physician to their patients. Any physician that does NOT exclude suicide in this circumstance is potentially subject to criminal and medical board investigations and prosecutions.
Most respectfully,
Peter
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There is never a consensus about anything in philosophy, which includes ethics as one of its sub-specialties, and even if there were, it would be utterly insignificant, since philosophy is not a public institution with the power to lay down official consensus conclusions, nor is it a society governed by majority rule. Rather, it is a system of OPEN inquiry which always remains open, so no one has the right to lay down the law to it and say, "This is the consensus."
In any case, the consensus in medicine and law about all these issues is utterly trivial and pointless, since it is only a consensus about HOW TO USE A WORD, which is not a consensus about the real, substantive issue involved, which is whether deliberately disconnecting yourself from the machine that is necessary to keep yourself alive amounts to killing yourself.
For decades the suicide rate has been undercounted because coroners bend over backwards to find excuses not to have to label an act as a self-killing. Medicine simplifies the many cases where patients lives are deliberately shortened or ended by active or passive responses to life threatening situations by just tinkering with the semantics and CALLING some things "passive euthanasia," "do not resuscitate orders," "withholding treatment," etc., even though in fact these are killings.
The basic axiom of the criminal law is that motive does not matter: otherwise Robin Hood and others like him would go free for having a benign intent in stealing. All that matters for determining criminality is the commission of the criminal act and the intent to commit the criminal act, which is defined as the intent to bring about the natural consequences of the act. Since the required intent for homicide is to cause someone else's death, and the natural consequence of discontinuing dialysis is death, to intend to withdraw oneself from dialysis is to intend one's death and so to commit homicide in the eyes of the law. Luckily for modern dialysis patients, suicide is no longer punishable as a crime, as used to be the case (only attempts to commit the crime could actually be punished, of course, though the estates of those who killed themselves used to be confiscated), since otherwise those withdrawing from dialysis could certainly be prosecuted for self-murder under the old statutes.
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Fair enough,
I will simply and respectfully agree to disagree with your own consensus on this issue.
May God bless,
Peter
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no
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article considers the one in five Americans who chooses to stop dialysis
Caroline Cassels
Medscape Medical News 2005. © 2005 Medscape http://www.medscape.com/viewarticle/538855
Nov 3, 2005
New York, NY - A feature article in the November 3, 2005 issue of the Wall Street Journal reports that one in five dialysis patients opts to discontinue their treatment in favor of death and examines this decision through the experience of one such patient, Joe Mole [1]. Mole, a 42-year-old carpenter, stopped treatment in 2003 after four years on dialysis.
"Between 1995 and 1999, about 36,000 people died this way, government statistics show," WSJ staff reporter Michael J McCarthy writes. "Between 2001 and 2002, the latest data available, an additional 25,000 had died; the mean age of those who chose to quit dialysis was 74. The number is likely to keep growing because more people are receiving dialysis," McCarthy notes.
From 1988 to 2003, the number of Americans receiving dialysis nearly doubled, to 325,000, with another 100,000 starting treatment every year. This increase, writes McCarthy, is largely fueled by the corresponding rise in the incidence of diabetes and its subsequent negative impact on kidney function.
Of sound mind...
McCarthy reports that psychiatric research shows patients who choose to discontinue treatment are generally of sound mind and not suicidal. They typically cite "the discomfort and tedium of treatments, nausea, vomiting, exhaustion, and troubles with veins. They usually have chronic, but not terminal, health problems such as diabetes, hypertension, and heart disease," he writes.
"They don't leave family members to confront a sudden loss with little more than a suicide note. Rather, they sometimes quit treatments despite having family and friends who plead with them to choose life," reports McCarthy.
Such was the case with Mole, a type 1 diabetic who suffered a variety of complications, including amputation, impaired vision, and, finally, renal failure requiring hemodialysis.
McCarthy chronicles Mole's daily struggle with these complications, the factors that ultimately led him to decide to stop treatment and the impact this had on his family, friends, and church.
"One night in January 2003, Mr Mole lay on his bed with his sister, Ms Kimble, at his bedside. 'I can't take it any more,' she says he told her. 'I'm just too sick.' "
Source
1. McCarthy MJ. Years on dialysis brought Joe Mole to a crossroads. Wall Street Journal; November 3, 2005:A1. Available at: http://ihatedialysis.com/forum/index.php?topic=2037.0
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A family member chose to stop chemotheraphy. She suffered from diabetes and stomach cancer. I feel that she did not commit suicide by stopping treatment. She may have lived longer continuing treatment, but she felt her quality of life was poor.
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my opinion is ... no , stopping dialysis is not suicide
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I have to say no, it is not suicide
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:grouphug; Wish I knew what to say Mike.
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I think the distinction is allowing something to kill you, verses killing yourself.
It isn't suicide.
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Is smoking suicide?
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Is walking out your front door?
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MY front door? No. ;D
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Everyone knows that sitting on the tracks while the subway car races toward you is not committing suicide, but just letting something else kill you.
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to argue about such an obvious topic is proof that people have way too much time on their hands.
if you do anything that you KNOW will kill you, by definition, that is suicide. who cares if the law says its illegal? everyone knows that the law is generally stupid. and smoking is not suicide. plenty of people do it for years and it doesn't kill them, so that is no guarantee that you will die. another stupid comparison.
that's like saying 'living is suicide'.
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However, if an insurance company will pay out on a life insurance claim then it's an important "stupid" discussion. Some things aren't always as obvious as they may seem.
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this is one of those topics that really has no single answer that will serve everyone, obviously.
personally, i don't believe that suicide is a 'sin,' so i have no problem with someone ending their life in whatever way they choose, as long as they don't take anyone who wants to keep living with them.
but i do believe that if you choose to end your life, and you follow through with that choice, regardless of the circumstances and method, it IS 'suicide.' if i believed in an afterlife, i would probably be happy to leave this plane, but i don't, so i won't....yet....
:guitar:
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I think it's more about what your loved one's would think should you choose to quit dialysis and die.
Would they view your choice as suicide? How would it effect them? For example, if you are 75 years old and
chose not to have dialysis anymore, your loved one's might understand that. But if you are 45 years old and
chose the same thing, loved one's would probably have a different perspective. You cannot ignore the fact
cessation of dialysis will effect your loved ones. Who knows, maybe they'd be happy you were gone, but I doubt it.
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good point, sunny. my oxford dictionary defines a suicide as 'someone that intentionally kills themselves.'
we've all probably considered it at one time or another. but as you said, for me, its not an option at this point, mainly because of the effect it would have on my loved ones.
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here's what i wrote on this very topic a week or so ago...
To Be, or Not.....
Over the past few years, having been afflicted with renal failure and needing dialysis to stay alive, I have had numerous occasions to ponder the value of my life, as it is now.
One of the many inconveniences of my condition is that it can be very difficult to get a good night's sleep. From time to time I find myself staring into the blackness of the night and thinking about my limited options.
The intermittent leg cramps, constant itching, physical weakness and fatigue, the loss of sexual desire and social interaction, as well as the inability to continue my life as a musician and tai chi instructor, the need for a multitude of medications, the side-effects of those medications and the very process of dialysis itself, having to be hooked up to a machine for ten hours every night.....
Sometimes, I can't help but wonder if its worth the trouble. Sometimes I think it would be better to just stop dialysis and go to sleep for good. It would take about two weeks for me to die, they say. After a week of no dialysis, the toxins would build up in my system and I would likely slip into a coma, which would last about a week, until all of my organs shut down and my ordeal would be over.
These types of thoughts often crawl through my mind in my hours of insomnia.
Then, the morning sun begins to brighten the sky and illuminate my room.
I hear the sounds of robins, greeting the new morning. I think of the loved ones that have stood by me in this battle of survival. My wife, my daughters, my cat. Yes, my cat. She often comes to lay with me when my pains force moans from my lips at night.
These are the treasures that keep me going. That give me reason and purpose and the desire to go on. Life can be hard and painful. But love makes it all good and right.
Love to you all...
~LL~
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While it would be criminally selfish of someone to insist that another person continue living a life he hated just to keep the other person happy, or to preserve the other person from misery in reaction to the unhappy person's death, a person contemplating suicide may still want voluntarily to consider its effect on other people close to him. Generally, though, if the person hates his own life to the point of preferring to die, his continued existence will not be much of a pleasure to those close to him.
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regardless of our situation in life, we are as happy or as unhappy as we choose to be.
loving and being loved can make one very happy indeed. and that is the point of life, if there is one; to be happy. you can be happy with yourself, your accomplishments, your achievements, but without others to share your happiness with, it can be bleak.
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Sometimes what keeps us going is the love of others.
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I really don't care whether it is or not. My life isn't bad and I certainly don't want to quit dialysis. If I wanted to commit suicide, I could find much easier and less painless ways to do it. I'd rather spend my time enjoying what time I have left.
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I really don't care whether it is or not. My life isn't bad and I certainly don't want to quit dialysis. If I wanted to commit suicide, I could find much easier and less painless ways to do it. I'd rather spend my time enjoying what time I have left.
:clap; :2thumbsup; :clap;
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There is a good discussion of people dealing with this issue here http://www.lifeoptions.org/forums/patient/posts/70.html
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I was reading this post and was actually appalledt that people think its suicide to stop dialysis. I understand its a touchy subject with many ways of looking at it but the fact remains that it is not suicide. When someone committs suicide (or intentionally kills themselves) that person is perfectly healthy and their only way of leaving this world is to kill themselves. Like rerun said our life would have stopped if we didnt have dialysis. God gave us this disease and in his eyes it was already our time to leave. Modern medicine intervened and said hey here is an option for you if you want to continue for awhile longer. I knew someone that stopped dialysis bc it was in their religion that modern medicine shouldnt prolong there life when god put in her path this disease to end it. My life was saved 4 times by modern medicine and I come to think religiously I think I shouldnt be here anymore. However I endure the pain and struggle for my loved ones. Saying to stop dialysis is suicide is ridiculous.
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It seems that we are looking at different definitions of suicide. I hear some people worried about the sinful nature of the action, while others are concerned about the technical definition.
I look at it this way. If the action taken (denying dialysis care to the patient) was taken by another, would it be murder?
If so, then it would be suicide. Suicide is an offense/sin against your community, removing your graces and talents and wisdom from them. I agree that it is letting nature take its course,but I also believe nature is fallen, and that God has given us medical technologies to sustain life.
In our world, morality is difficult. If we accept that, then the easy way out is rarely the moral decision. I would pray that all of you would engage the struggle of moral thoguht baout our shared condition. It's part of the package deal.
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...I knew someone that stopped dialysis bc it was in their religion that modern medicine shouldnt prolong there life when god put in her path this disease to end it. My life was saved 4 times by modern medicine and I come to think religiously I think I shouldnt be here anymore...
Does God put things in our path? God "created" us with brains of sufficient capacity to develop modern medicine. One might therefore consider Medicine a gift of God. I consider the suggestion that one should forego medical treatment because it fights against what God has willed to be absurd. This is my opinion only and is not meant as a criticism of anyone.
Just because modern medicine is there for us, do I think it is suicide to opt not to take advantage of it? No. Suicide is something that is actively done. Opting not to receive treatment is not. I do, however, believe that a parent opting to withhold medical treatment from a child for religious reasons is child abuse, potentially leading to criminally negligent homicide.
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Is it suicide to have a "Do Not Resuscitate" order in place? No, of course not. Taking extraordinary measures to keep yourself alive is not required of you.
Some cancer patients choose not to do chemo or radiation, instead allowing the disease to take it's course. Is that suicide?
When taking dialysis becomes more than a person can bear, is it not merciful to let them choose to discontinue it?
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This subject has been debated many times on here and it's still a matter of interpretation. If you're diabetic, is stopping your insulin suicide? There are many analogies that are similar so the point is.....is it suicide or just giving up? I, personally, will hang on as long as I can because I have people and animals who love me and and depend on me. I won't go quietly into the night.
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What I am going to say here is very Hard, but True.
My Son-In-Law, Committed Suicide, Five Years Ago. He left my Beautiful Daughter and my Two Young Grandchildren, alone. He Chose to end his Life.
My Husband, does Dialysis, because he wants to Live. If He ever, wanted to stop Dialysis, which is His Choice, It would be nothing like Suicide. I know, I have been there.
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Thank you for that Mizar. You are strong to share your story but people need to wake up and see that stopping dialysis is NOT suicide. Thanks again for sharing!
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I agree with Rerun. No! The death would be "Renal Failure". Or Cancer. Or any naturally occuring disease, for which there is no cure.
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This subject has been debated many times on here and it's still a matter of interpretation. If you're diabetic, is stopping your insulin suicide? There are many analogies that are similar so the point is.....is it suicide or just giving up? I, personally, will hang on as long as I can because I have people and animals who love me and and depend on me. I won't go quietly into the night.
:grouphug; miss you Flip :grouphug;
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I think most people would agree that the most sensationalistic people in the world are journalists. When Australia's richest man decided not to have dialysis after his transplant failed, his death made front page news here in Australia and around the world. Not one journalist even ventured to suggest that he committed suicide by deciding not to have dialysis. Every publication around the world stated that he had died from renal failure. I really don't believe that your choice not to live your life on a life support machine can be, or is, viewed as suicide. If it were, journalists are going to be the first to scream it from the rooftop.
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MY front door? No. ;D
Doesn't that depend if you have one of those California earthquakes or fires? :rofl;
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This is a hared one to answer . as there is no right or wrong answer to it. I am Mormon (LDS) and thy would say yes it is suicide . But I'm not share I have worked in the hospitels for to long and seen to much suffering . My Mom fut to the bitter end God bless her . I am not on Dialysis yet and I dint know wat chose Ill mack when that day comes all I know is for me today is a good day to live and when that time comes to make the chose to stopDialysis or not I hope and pray I'm not judged to harshly for what ever I choose and I hope I will never jug some one for thee chose . As I have not wokt in thee shoes so I guess I'm prow chose on all and live it to god to jug Carol
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I am sorry, but I disagree. I too am LDS and the following is from LDS.org . . . "The Church of Jesus Christ of Latter-day Saints believes in the sanctity of human life, and is therefore opposed to euthanasia. Euthanasia is defined as deliberately putting to death a person who is suffering from an incurable condition or disease. Such a deliberate act ends life immediately through, for example, so-called assisted suicide. Ending a life in such a manner is a violation of the commandments of God.
The Church of Jesus Christ of Latter-day Saints does not believe that allowing a person to die from natural causes by removing a patient from artificial means of life support, as in the case of a long-term illness, falls within the definition of euthanasia. When dying from such an illness or an accident becomes inevitable, it should be seen as a blessing and a purposeful part of eternal existence. Members should not feel obligated to extend mortal life by means that are unreasonable. These judgments are best made by family members after receiving wise and competent medical advice and seeking divine guidance through fasting and prayer. " There is a difference between euthanasia and dying from natural causes. I am sure there comes a time when after every effort has been made and quality of life has become such that a decision could be made to stop. For me now, my decision is to go forward. I'm not ready to leave her yet.
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This is an excert from my blog written last week...
It was a very sad day today at the dialysis unit. I was told that one of the patients had decided to stop dialysis treatments. This is something that anyone on dialysis has given thought to. I myself have had fleeting thoughts of how many more years of this can I endure, but it passes, I know that I am young and in great health except for two bum kidneys. Once I was told about the patient not coming back to dialysis, my mind wondered to that place that I never let it go, I imagined the heart wrenching decision that family made, and the sadness I know they are feeling.
I have to say that I am proud of that family to put the patient’s quality of life first. It is a decision that I can’t even imagine making.
And then life goes on, we were all hooked up to our machines, blood was cleaned, and alarms went off… life went on.
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dkerr I do agree with you I beast my statement on a very several long tacks with my Bishop and this is Wat he explained to me . that stopping Dialysis was not the same as stopping life support .That in Gods eyes it it was suicide. That is where I bass my thoughts . But I do agree that it is not not . I hope I did not offend you. Carol
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No offense taken. I just wanted to clarify. Having said that, we had a member in our stake who had been on dialysis, had a transplant, was back on dialysis, had a transplant, and when that failed, she decided she'd had enough and stopped.
At this point in my life, just starting out on dialysis, I'm no where near ready to throw in the towel.
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I think it works out like this: You may be committing suicide if you refuse a treatment that is highly likely to prolong your life. It's not committing suicide if you refuse a treatment that is only possibly going to prolong your life.
For most of us, dialysis is already known to prolong our lives. Our medical histories bear that out. So for most of us, refusing dialysis is really refusing to prolong your life.
But in 1992, my dear mom was diagnosed with adenocarcinoma of unknown primary ("CUP"), a cancer for which the median survival rate is less than 10% after 5 years even with treatment. And she had all the standard tests and treatments for this disease, but her cancer continued to worsen.
Should my mom have then gone for clinical trials with unproven therapies? In America only, or should she have gone traveling around the world trying to find some clinical trial somewhere that could possibly have a beneficial effect?
I don't think so. After the state of the practice in treatment has been exhausted, and the disease continues to worsen, you're not "committing suicide" if you refuse to go participating in clinical trials, trying alternative medicine in desperate hope, etc.
So my mom decided that once the standard tests and treatments did not work, that was enough for her. Eventually she moved into a hospice, and died shortly thereafter. And I agreed with her decision.
When dialysis was first being experimented with during the 1940s, it would not have been "suicide" for a patient with ESRD to not volunteer to try the new technique either. Because the first volunteer patients all died. No one yet knew if dialysis would ever work.
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I think it works out like this: You may be committing suicide if you refuse a treatment that is highly likely to prolong your life. It's not committing suicide if you refuse a treatment that is only possibly going to prolong your life.
Good point.
8)
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Excellent point. I also think that if the body can't do a required thing on it's own, (kidney function, eating, breathing) it's not suicide to refuse artificial intervention such as dialysis, feeding tubes or ventilators. The body can't do a required function, so it's a natural death.
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I personally do not stress or agonize over this at all. I have a strong will and determination to live as long as I can and to do everything in my power to do it as healthily as possible. However, I'm glad that if it all ever gets to be not a life worth living, I can choose not to continue dialysis and nature will then take it's inevitable course. People can call it whatever they like, but it's very personal and I in no way see it as wrong.
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:thumbup;
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I'm on a bit of a tanget here. If you decide, while sane, to stop dialysis for whatever reason, and you tell a professional such as a psychologist,
therapist , social worker, etc., are they required legally to notify the authorities? In California I thought these professionals were under some
kind of a legal or moral obligation to notify in this case, or is it only if in their judgement the act of suicide is imminent?
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No.
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I'm on a bit of a tanget here. If you decide, while sane, to stop dialysis for whatever reason, and you tell a professional such as a psychologist,
therapist , social worker, etc., are they required legally to notify the authorities? In California I thought these professionals were under some
kind of a legal or moral obligation to notify in this case, or is it only if in their judgement the act of suicide is imminent?
As a person on dialysis, you can decide to stop treatment and doctors must abide by your wishes. They may argue against it, but in the end, it's your decision.
Here is more information on the topic:
Nephrologists’ Changing Practices in Reported End-of-Life Decision-Making
http://cjasn.asnjournals.org/cgi/content/full/2/1/107
Which patients choose to stop dialysis?
http://ndt.oxfordjournals.org/cgi/content/full/18/5/869
8)
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I googld the word suicide by definition quiting is suicide googl seed the act that ends your one life. But I think most people here are looking at it from a morel standpoint . I still think its the persons right to Chou's. I was toking with one of my coworkers ho is a psych nears and her tack on it was this its a Chou's but when you start toking sabot it to cear givers thy have a obligation to call it in and have you checkout by mentel health staff. if you don't have a diagnosis of mentel illness then you can Chou's to quit. I just Thoth Id share thispersons take on the Queston. It is a very personal chose Carol
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Carol. That is why I posed the question about the choice to stop dialysis and mental health professionals. Many of we
dialysis patients could be diagnosed as having "mental illness" because of depression. I know I have periods
of depression just because of this illness and what we go through. So couldn't we be prevented from making
the choice to forego dialysis because of "mental illness". I intend to change my advance directive to indicate now
that if my conditions deteriates enough I want to be able to choose to stop. I have seen too many patients
in the dialysis unit who are bedridden, in pain and barely conscious. I do not want to continue living in that state!
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I have talked to my social worker at D about it, Steve and she said that if you are not mentally incompetent and are your own guardian you have the choice whether to stop or not. However, if you are not in your right mind or mentally challenged and have a guardian, it is up to your guardian and/or nephrologist if you may stop dialysis or if you are acting in a suicidal manner, they can then evaluate you and see if you really wish to stop or if it is the suicidal thoughts talking.
So, the answer is if you are competent, you can do anything you want with your own body. And as for the original question, in my mind stopping dialysis is not suicide because you are not actively taking your own life, you are letting nature take its course. It is no more suicide than refusing or stopping chemotherapy. However, it would be suicide if you refused to eat for a month or stuck a knife through your back and twisted it through your kidneys, as those are both active acts of self-destruction.
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So, a guy is hanging on the outside of a railing of a bridge, can either jump, in which case it is suicide, or just stop holding onto the railing and let nature take its course, in which case it isn't.
I think it is suicide, but we need to be able to say that in some cases, suicide is a morally acceptable choice. That's hard for some people, so we re-define suicide.
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Steve Yes it is confusing . I had a patient that was on dialysis and wonted to stop.He ended up on the psych whored the resin was he had a history of depression and stored to tell his care givers and the staff at dialysis. which by low have to git him evaluated by the mentel health people. But if he had just stop going to dialysis and not Sade a whored to anyone no one cooed fours him to go on . This was a big deal on my psych unit as the staffknow of my CKD and how i stand on this topic . Morally all agreed with me he shooed of bin allowed to Chou's . but the mentel health low did not agree with that thought . so he was with us for a wall. So i guess what I'm saning so don't tuck about it with medicall staff. I think we should have the Right to choose . The other thing is that the low is different in each state to so googl the low in your state. Carol
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I have a questen that was asks of me .So now i ask you all Dos the family still git to collect on you life insherens if you go off dialysis or not cues the insherens company calls it suicide? Yes we do need to redefine the worded so its exportable to all ! Carol
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Good replies, Carol. I raised the question because I have spoken about my depression to both my
nephologist and my internist. Of course they both pill pushed, said they would give me anti-
depressive medication. I said no thanks because these meds just mask the reality of a dialysis
patient's life, dealing with a chronic illness that changes your life drastically.
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I think it is suicide, but we need to be able to say that in some cases, suicide is a morally acceptable choice. That's hard for some people, so we re-define suicide.
Excellent point.
8)
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I think it is suicide, but we need to be able to say that in some cases, suicide is a morally acceptable choice. That's hard for some people, so we re-define suicide.
Excellent point.
8)
I can't agree that intentionally killing oneself, as most would define suicide, and allowing one's body to die of a disease or organ failure are the same thing. I make the distinction based on the act itself - shooting oneself, jumping off a bridge, taking an overdose - those are acts I may decide to commit (or not). Allowing my body to go its course would not be suicide in my book. I do not decide to have the disease, I decide how to treat it.
Now, then, is it suicide to smoke? We could argue both ways I suppose, but most would not consider it an act of suicide even though it can mean death and people choose to smoke (or not).
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Again, that to me is analagous to saying that someone who refuses to eat is not committing suicide, they are just allowing nature to take its course.
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But with that, you have chosen not to eat even though it is a small act that EVERYONE has to do to stay alive. It is not an unnatural means of life support, like dialysis, tube feeding or a ventilator. Eating does not reduce quality of life or leave the eater surviving but not truly living. Long-term eating does not have terrible side effects that may end up being worse than starving. So I stand by my statement. However, if people want to be or their caregivers want them to be on ventilators, dialysis, and feeding tubes, more power to them. But medical personnel, whatever their view on the matter do not have the right to intervene in the case of sane, competent people nor do they have the right to go against their Advance Directive if they do become unable to give consent, otherwise it would be considered medical battery, a very serious offense that can cause the loss of their medical license. That being, no the law does not view this as suicide, but merey "dying with dignity".
There was this one woman at my center (let's call her "Betty" for the sake of her family and also for the sake of respect and privacy to the deceased) who was in her 50's, in a nursing home, in a wheelchair, had heart failure, had a catheter, was in and out of the hospital frequently and had severe dementia from whatever. Betty did not know where she was half the time, screamed out in miserable pain, talked to herself and yanked out her cath repeatedly, spraying blood all over herself and her chair, and when she wasn't doing that, screamed to be taken off almost immediately after she got on the machine.
Yet Betty's sister, who was her guardian insisted that the treatments were beneficial to her even though Betty (whose treatments were suppsed to last 4 1/2 hours) maybe got in about 2-3 hours of her treatment on a good day, 10-30 minutes on a normal day and had an unacceptable Kt/v due to her drasticallly shortened treatments and the fact that she had a cath.
Now, Betty had no quality of life (she never left the nursing home she lived in, except to go to dialysis), she was mentally not there (when asked where she was at dialysis when she did speak, she would say that she was at the dermatologist or the beautician), her heart was failing, and she did not complete treatments. Betty ended up dying in the hospital 5 months after I started dialysis due to her heart failure anyway, but if her family had decided she had had enough and removed her from dialysis so she could die in peace like she said she wanted, would they have been killing her? No.
Just like if any one of us says "Enough is enough" and stops, we are not committing susicide, we are merely dying with dignity and I applaud anyone brave enough to end their suffering if that is what they feel is right.
But everyone has their own truth and as long as they don't push it on me, I respect it. But if they do, they WILL hear it from me at both ends.
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I'm going to try to do this one moor time my computer isaking up . So here i go Agni the the rd. I angry with both of you . We should have the right to chows to stop dialysis as long as a person is not psychotic and hearing voices telling you to stop dialysis . then medecol staff have to git an evaluation for you. Everybody at one time or a nuther has had some depression . its how you dell with it . The lady at your center Betty Yes it is sad to have to set and watch a family member not AWOL to let go . so the pt hasto suffer longer be-cos of it . That is why i have 2 Gordian's picktout my husband how will truly try to do as i wish and my sister how is stronger and he know this to . plus i have it in black and wight what i wont and don't wont . each state has a slightly different defunition of suicide. or end of life CARE I in my job have bin Abel to see both side of the fens with my job and some times i agree and some times i feel like :banghead;. wen that time comes for ency of us i hope its quick and panels for us all which ever are chose ma be Carol
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idahospud,
Looks like you need a new computer, computer maintenance, or a keyboard.
I got through most of what you wrote though.
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What if someone with chronic kidney disease was told by thier doctor that they needed go on dialysis, and they decided to refuse this treatment? What if the person told a family member or friend that, although the person was otherwise healthy, they were not going to go on dialysis? Is it rational to refuse dialysis when a person is otherwise in good health? The ethics of refusing treatment do not only affect the person with kidney failure, but those who are close to the person. Whether or not family and friends admit it, the person may be not thinking clearly.
If a person had been in an accident and refused help from paramedics, say for a broken leg that was bleeding, such an actions would be considered extreme. As a society we would not condone a person who is injured refusing treatment. We would try to find out why they do not want treatment, and if the condition is life threatening, give the treatment with or without consent. It is a natural part of being human to want to help someone. Kidney failure is a hidden disease, people cannot always tell how ill a person is from the outside. This can lead to denial, even as refusing treatment will have a predictable outcome.
In my case, I found there was no way to get help for my mother, even as I felt she was near death and that her decision did not seem to be rational. Her doctor patient relationship was confidential and there is no law against a person refusing medical treatment as an adult. I questioned myself if by not insisting she get counselling this amounted to assisted suicide, because in my conscience that is what I felt. She perhaps needed some sort of intervention, but that would require the agreement of at least a majority of family members and some dared not go "against her". Everyone thought that doctors were monitoring her, but she had basically told the doctors she was not going to listen to them, it was her choice.
If a child is kept from dialysis by parents, for whatever reason, the child will be taken away from the parents for the safety of the child. For a "rational adult" to refuse dialysis, there seems to be not much a person can do. Unless they can be talked into counselling, and there are those who also will be able to seem rational to a counselor, but then not follow through.
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cedar, please go to the introduction section and tell us about yourself. :waving;
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It is a personal choice.
A GROWN person can decide not to do dialysis or Chemo or any other medical choice.
It can be hard on a family but think about the person who actually has the disease and then think about there wishes.
As for assisted suicide it should be legal and binding by law if the person is in full mental control and able to make such decisions.
It can be made so the patient feels no pain.
We just had a person mother here recently decide not to do dialysis. There is a detailed thread of how it all went. It was sad but in the end her family did what she wished for and made sure her last few weeks were comfortable for her.
Sometimes people know when it is there time.
Other times maybe they just want to give up.
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Firstly I've been disguested by this topic but let's face it NOT having Dialysis in my age = suicide without doubt. I'm the youngest on IHD aged 16. I will never thought of ending my dialysis and yes I admit that I had a thought about stop coming to hospital to dialysied beacuse it's annoying, boring, world torn us apart. Everyone here have felt that but it's their life their decision. I WILL never tell anyone on dialysis or other disease to give up on any treatment they are having. It's utter ridiculous, outrageous ! It's not like Sancitiy of life is it? It's you ! You make the decision to live or not. I'm agnostic but all I know is one truth everyone will die, so WHY ending it so early? I can't stand people giving up their lives.
OK on the other point of view. Pretending I'm 70- 90 I think well most people my age dies around this age anyway and I'm still suffering, shall I stop my treatment? So I will feel better... The FACT is no you won't feel better cause fluids adds up every day and the only way to get rid of it is dialysis. You won't feel any better anyway. IF you say you want to end dialysis ? Why don't you consider Voluntary-suicide ? I know everyone wants Euthanasia when their time is up.
Conclusion: NEVER GIVE UP, YOU WILL NEVER WALK ALONE ! Plus if you are bored invite friends, relative or anyone you know who's free and they can go and visit you. Do whatever possible but please,please and please don't end your life off-planned
-Maxridex
P.s I don't care or mind you hate me, everyone got their opinions. However I do care about the people who reads it all and get my message. Finally....
OH yeah I'm 16 :D
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For me, the option of quitting dialysis is a better exit ticket.
Previously I felt happy that I'd sorted out an exit in the form of helium asphyxiation although that had the disadvantage that I had to be capable of ordering and receiviing balloons and a bottle of He. Now I don't have to cash in the new ticket until the last minute.
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I understand that it is a "choice" to refuse dialysis, but sometimes it can be difficult to know if that choice is rational or if the person is "giving up". If there are no other medical problems, it would seem like giving up. Suppose person felt they should not get treatment, for the sake of others?
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I will probably anger some people by saying this but here goes. Kidney disease is devastating. When given the options the person must make the decisions that are right for them. I was presented with three options. Preemptive transplant, dialysis when the time came or not be treated at all. I have children so I went for the transplant. But if I didn't have young children I may have made another choice. I wouldn't call not having dialysis or a transplant giving up. Is is selfish of the person that decides not to do treatment, to think of themselves and not their loved ones? Or is it selfish for the loved ones to disagree with that decision? Transplants and dialysis are not cures. There are risks and medical problems associated with both. The majority of people have a better quality of life with these treatments, some don't. If an informed person makes a decision it should be respected.
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I tend to agree, Romona. The OP's problem, (as I heard it) was thta she had no way of knowing whether the decision was informed or not, because her mother (his mother? sorry gender wasn't clear to me) would not communicate about the decision. This is the major problem. People who under go trauma (like CKD-5 patients) can isolate and develop and exacerbate depression. I think having a psych eval in this case would have been appropriate.
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I wanted my mother to have an evaluation, but she "seemed rational" to others, and no one wanted to upset her by requesting clarification of her reasoning for refusing treatment. I think people felt in general that the doctors had things under control and that she was listening to them, but she was not. She also challenged anyone who tried to talk with her, as if they had the problem and she was fine. This might be a natural reaction for some people, but in response to such a serious issue, it does not allow for solving anything. Knowing my mother, I felt something was wrong, yet was told it was her own choice. We were all to blame for not getting her help. I feel that while choice is important, discussing a person's reasoning and plan for treatment is equally important. It is not just about the person who has kidney failure, because people do want to help, and loved ones are affected as well.
Thank you for your views on this subject, it really helps. (And I am female, added that to my profile later). Thanks again.
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But what if the person says, "I just dont want to do it- and thats my reason to choose no dialysis."
To whom does the reason have to be valid enough?
If thats the choice- there is nothing to solve, which is very painful for family. I sympathize with that 100%, when its your own ... you always want them to choose life no matter what.
Please understand I am not trying to be mean at all, and I mean no disrespect for your situation.
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Does anyone know what the insurance point of view is on this? I.e if a patient chose to stop dialysis would they still pay out? Or would they say it was suicide and refuse to pay? I haven't entered the poll, cos I can't make up my mind. Each time I read a post I think yeah, that's what I think, then I read another post with an opposing view and I think yeah, that's what I think. This is possibly connected to the fact that I find it difficult to answer when someone asks me if I want tea or coffee. Ha ha.
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When someone you love is refusing dialysis, it can be important to know why, and saying "because that is my choice" may not be enough for others to have a reason to be able to come to terms with. What if that choice were not based on rational ideas? What if a person, having not ever had dialysis, had an impression that was not fully accurate? What if the decision was based on fear? This is the only life we have, and while of course it is the choice of the individual who has declining kidney function to received dialysis or not, at least in this country, sometimes a person may need feedback from others as well. I am not saying that refusing dialsys may not be the right decision for a person, but the reasons behind the decision does matter to loved ones. When anyone is facing such a situation, support seems absolutely necessary, and part of that would seem to involve understanding as much as possible what the person is going through.
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I'm not going to pick a side because, I don't have to deal with dialysis as the rest of you do, but my question is if the doctor told you that you have cancer and there was no cure, but if you started a rigorous treatment plan of chemo and radiation you could live longer, and you decided not to except that treatment. Would you consider that suicide?
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Does anyone know what the insurance point of view is on this? I.e if a patient chose to stop dialysis would they still pay out? Or would they say it was suicide and refuse to pay? I haven't entered the poll, cos I can't make up my mind. Each time I read a post I think yeah, that's what I think, then I read another post with an opposing view and I think yeah, that's what I think. This is possibly connected to the fact that I find it difficult to answer when someone asks me if I want tea or coffee. Ha ha.
My Uncle Died in March and his Insurance paid out. They said that he died of natural Causes. Which is true but it was his choice to stop Dialysis... I have trouble with this subject becasue I am starting Dialysis and I do get depressed and just the thoughts that run thorough my head like .. Would it be better if I just didn't do Dialysis?, Would I not be a burden on my family...? But, then I see my Brothers and sisters and my nieces and nephews and I realize that the reason I want to live longer is Becasue of them and what they mean to me.. I choose to Fight and be a VICTOR not a VICTIM.... I have to for myself. But, that is my choice. Each of us have things in our lives that we wish we could change I am sure that all of us wish that Kidney Disease did not exisist.
But, it does and someone once told me it is not the trials and turbulations in life that define us it is how we handle it and get through it that makes us stronger.
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I can only imagine what it must be like to make the decisions someone who needs dialysis must make. Sometimes though if no real decision is made, that in and of itself can become the decision because time eventually will take care of things. Even if someone does not want to be forced into something, the disease itself will not repsect that wish.
I do not believe that the "burden theory" holds true for close family members themselves. At the same time, it is not their choice. If someone's quality of life becomes "not worth it" that may change things, but it would seem to make that decision before trying is speculation.
The life of a person with kidney failure matters a great deal to loved ones, even as the decision is not theirs.
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My SIL said for years that she would not go on dialysis - that she would just go out in the field and die first. Her husband was pretty upset with this decision, but never pressured her.
Part of her reason for not wanting dialysis was having seen the difficulties her father had many years ago.
In the end, she choose to do NxStage. It isn't easy, but it keeps her alive and doesn't have all the negatives she envisioned.
I think being well-informed is important. Once a person knows as much as possible, the final decision should be theirs. No one can really fully understand what others are living through. We shouldn't judge others for their choices. Those choices may not be the ones we would make, but we don't live in their skin.
Matthew, I think you are very wise for someone who has only lived for 16 years. Please continue to share that wisdom.
Aleta
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To the insurance question- my husband was told before he started, by a doctor, if he didn't want to do dialysis, it was not considered suicide and the insurance would pay out. It would be considered natural causes.
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Also, it's not the same as refusing chemo if you have cancer. I have cancer and have to do chemo, but there are no definite outcomes for chemo. Most people do chemo, knowing that the treatment itself is hell, but knowing also there's no guarantee it'll work. Dialysis does work - it's just a pain the in a...So I see it as quite different to making a decision not to go through chemo. Tinah, I hate to think about you feeling depressed about it - I hope you also read some upbeat posts too, and realise that living on dialysis can be a positive thing too. We all wouldn't know each other if we didn't.
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I agree with Hanify's post.
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You always have a choice, and you know when it is time to stop.
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I don't exactly know what this discussion is about. But, my wife's an RN, She makes good money. We have a fairly good life style. Bue she gambles. Every payperiod we are in the red in our bank account. She is 57. Retirement isn't too far around the corner. We live in a fairly nice Mobile home, which is paid for, but we live in a trailer park and it costs about $500 a month. My wife is otherwise a lovely person besides the uncontrollable gambling. She doesn't go to win, She goes to play. IF it doesn't cease, we are gonna be homeless. (I don't really know what else there is) I am worried about this. If that occurs, I won't want to carry on. I will have had enough. I love my wife. But if we become homeless because of her gambling, I'l just have to leave her to face life on her own.
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The discussion is if you think quiting dialysis is the same as committing suicide. Do you think a dialysis patient has the right to stop treatments if he feels his life is not worth living? Lots of different opinions here.
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My husband wanted to put another point of view forward. He says that if he stopped me from doing my dialysis it should and would be considered murder wouldn't it? So therefore, why should he be charged for murder if I'm not going to be 'charged' (for want of a better word) with suicide? Maybe the issue is actually our reaction to the word suicide?
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My husband wanted to put another point of view forward. He says that if he stopped me from doing my dialysis it should and would be considered murder wouldn't it? So therefore, why should he be charged for murder if I'm not going to be 'charged' (for want of a better word) with suicide? Maybe the issue is actually our reaction to the word suicide?
There are different rules to someone killing someone else, someone intentionally taking their own life before its natural time to pass and that of someone letting nature take its course.
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I think quitting dilaysis is suicide. It is witholding a life sustaining need from your body. In my mind starving oneself is suicide as well. I also belive that if a person does not wish to live that they should have the right to end their lives with dignity.
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Ok I've got a bit of a unique opinion on this... I think.
Firstly I voted No - I don't think it's suicide. Here's why:
When Richie was first diagnosed with ESRD (while in the hospital) we were given the choice to start dialysis or not. Our doctor presented us with the facts and said we would need to make the decision by the end of the day. Richie's mom's mom (Richie's grandma - who died when his mom was 16) had done dialysis (she was sick by something - i cant think of what it was) towards the end and it was painful for the whole family to watch her suffer; so his mom really didn't want Richie to go on. The only way he would stay alive was on dialysis. The answer was obvious to me - of course he would go on dialysis. He was a little hesitant, but he decided to do it. When Richie started in the clinic, our social worker Lynn (we love her shes like an aunt to us) one of the first things she told us was he has the choice to stop treatment at any time for any reason - no questions asked. My response was 'doesn't he need this to live?' and she replied 'yes - but its every patients choice to stop treatment, no matter what the circumstances.'
Dialysis is an option, its one that keeps my best friend, husband and love of my life - in my life - for which i am so grateful. At this time if he came and said that he wanted to quit (which he has said half heartedly - especially when he was doing in clinic HD) i would plead with him and probably force him to go. We are only 25 (will be 26 this year), we have only been married for 1 1/2 years. Now if many years down the road, and he is back on dialysis and we are old and gray, and he wanted to quit. That is his choice and if he just couldn't take it any more, then it would be ok.
Now I saw alot of people comment on what if a cancer patient chose not to do chemo - well my grandmother did. When she was first diagnosed with breast cancer, she did all the necessary treatments, including having a double mastectomy. She was cancer free for 5 1/2 years. then she had a fall, and they found it in her spine - to start. It was quickly spreading throughout her body. She was given the choice to try treatments or not. She didn't. She went home and lived the last 3 1/2 months of her life doing as much as she could. the last 1/2 she had become a frail body that was all skin and bones. she had to have a nurse to help care for her - bathe her, change her diaper, and anything else that needed to be done. She was on a hospital bed in the front room. it was hard to watch her, and at the time i didn't understand why she would choose to let her life just go away; but her life would have been just as bad just much sooner.
Choosing to let nature take its course - is not suicide. Medical professionals are not allowed to take a patients life, thats why patients are given a choice to sign a "DNR", thats why we were given the choice to start dialysis, and why when he started HD he was told he had the choice to stop treatments, and why my grandmother was given the choice to get treatments for her cancer.
Now when i was growing up my life was tough, we didn't have a lot of money after my parents got divorced, when you look up the definition of 'dead beat dad' my birth father's picture would be right there. anyways in my early teens i always thought my life was horrible, all i wanted to do was not have my life; so i attempted to end it. my best friend at the time came into the room as i was attempting to make the cut deeper, she stopped me and I've always thought that it was by divine intervention. things did start to get better in my life, and i never would have had the chance to meet my husband if i had completed. suicide is a choice as well - and I've found that in most cases things get better (both from my own experience, as well as friends, and people from group therapy.) suicide is not an option. that is why there is 51/50 - that puts you in observation for 24hrs. its not natural to take your own life, its not ok to take your own life.
if you have an illness that you will never overcome, that you see as a burden on yourself and others, and that one way or another will take your life, why shouldn't a person have the choice on when and how their life will end.
thats my :twocents; thats just how i see things.
TJ
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Very nice post Tiffany. :)
It is the patients choice, even if someone doesn't agree with it.
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Yes, I think that's right too. it comes down to our own choice. And it shouldn't be regarded as suicide. Interesting topic.
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I think that Dialysis is an option to keep me alive
if and when my kidneys are not able to work any longer.
My hope is, that whilst and when I would be on Dialysis
that something might be discovered
to make life on Dialysis more bearable.
My other hope is that I find a doctor soon
who is able to stop my MCTD/SLE flare-up
destroying my kidneys, so that I have
much more time left until the start of Dialysis and therefore
giving the aforementioned discovery
more time
to come along.
At the moment I educate myself as best as I can
(being a non-medical person) about Dialysis,
whilst I write many letters to doctors and
application to Hospitals etc., to find the specialist I am looking for.
I still have many plans and
perhaps I am a "chronic optimist".
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I do not believe stopping dialysis is suicide. Suicide is when you do something to your own body that causes you to die. With renal disease, most people do not just want to die. They get tired of living the kind of life that dialysis requires so they stop the treatments that make them feel this way. The person's BODY then, on it's own, starts to break down and THAT is essentially what kills you.
When people are suffering from a disease or a cancer, they have every right to stop TREATMENT. They are not shooting themselves in the head or hanging themselves. They are stopping treatment. That person's body is responsible for no longer holding out.
I am young and have two young children. I have been sick since I was 15. I have been in and out of the hospital, and I have had a hard, hard life. There have been moments that I have just wanted to quit. I would never do that now as my family needs me. But when I'm old and I have to go through this again, I may make a different choice.
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To the insurance question- my husband was told before he started, by a doctor, if he didn't want to do dialysis, it was not considered suicide and the insurance would pay out. It would be considered natural causes.
This is a difficult topic...
So the parents who didn't get their 11-yr-old daughter treatment for diabetes didn't help murder their child...they just let her die of natural causes? I think not doing dialysis is no different than refusing treatment for any life-threating condition. i do believe it is a form of suicide but then again I'm not sure I disagree with suicide under certain conditions - other than the Bible disagrees with it.
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There is a big difference between a child making a life threatening decision and an adult making a life threatening decision. That is why children are not allowed to drive, smoke, drink alcohol and a long list of other things. They are not mature enough to do so.
When a person is an adult, they have the right to discontinue treatment. It is not the same as killing oneself.
If God wanted someone to live, stopping dialysis would not kill them would it? God would just cure them.
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God gave us free will. Sadly, if we want to kill ourselves, God will allow it.
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To the insurance question- my husband was told before he started, by a doctor, if he didn't want to do dialysis, it was not considered suicide and the insurance would pay out. It would be considered natural causes.
This is a difficult topic...
So the parents who didn't get their 11-yr-old daughter treatment for diabetes didn't help murder their child...they just let her die of natural causes? I think not doing dialysis is no different than refusing treatment for any life-threating condition. i do believe it is a form of suicide but then again I'm not sure I disagree with suicide under certain conditions - other than the Bible disagrees with it.
I dont know if that would apply to a child....I just repeated what we were told. See, in my mind, thats different because the mother made (or father) the choice for the child, the child didn't have the right to grow up and make an adult choice. I dont agree with that- parents dont always make perfect decisions and I dont think that one should be allowed. Now- if your a legally consenting adult and you choose to quit dialysis I agree with you having that choice, BUT if you were my loved one I would do anything I could to inspire/beg/whatever -to make you continue dialysis because I love you. I say that- and then it occurs to me- what if you're suffering? I wouldn't want someone I love to suffer. :'(
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But your not killing yourself when you stop treatment. Your body shuts down. You don't shut your own body down. If God wanted someone alive he would cure the kidney disease. That is my feeling.
Stopping treatment and your body naturally dying is NOT the same thing as taking your life. No one should be made to suffer when their body is failing them. It is not fair to put people who have an illness and do not want to continue painful treatment in the same catagory as those who take their own life, when their body is perfectly healthy.
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Stopping treatment and your body naturally dying is NOT the same thing as taking your life. No one should be made to suffer when their body is failing them. It is not fair to put people who have an illness and do not want to continue painful treatment in the same catagory as those who take their own life, when their body is perfectly healthy.
that is what I think too.
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But in case of a child, where the parents chose under religious beliefs is a hard subject. If the religion does not approve on the way they interrupt the Bible, who is to judge those beliefs.
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Wow, this is quite an ethical discussion. Choosing to withhold treatment is not suicide. I am a hospice nurse and I have had patients with ESRD who have decided agianst dialysis as well as cancer patients that have opted against chemo. They have a life-threatening illness and are choosing not to prolong their life. They are not choosing to take their own life (the disease is trying to do that!). I have also had the misfortune of having to deal with BOTH of these illnesses with my husband in the past year. He was diagnosed with a stage IV myxosarcoma of the left atrium (heart) and went through 6 rounds of awful, horrible chemotherapy. He developed an infection at the end of round six, because he was so immunosupressed. Because he was so dehydrated and his BP was so low, his kidneys were starved of fluid and blood volume causing tubular necrosis which caused them to fail, which is why he is currently on dialysis. (Prior to chemo, he had healthy kidneys, now he runs high creatinine levels, the last being 7.65, and a GFR of 8) He was in ICU and very close to death during that whole infectious process. Ask him today if he would go through chemo again if the cancer came back and he responds with a resounding, "No". Why? Because his quality of life was terrible during treatment and has never returned to what he perceives as "normal". I hope we never have to cross that bridge but if we do, he has the right to decide what to do with his own body and I can disagree but ultimately, it is my job to support that.
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It all depends on your quality of life and whether its high enough to push you to endure the pain and humiliation of Dialysis.
If you have no girlfriend and no one really loves you. Or people at work hate you and mock you for your illness. Or every time you have severe pain at treatment, the staff says you're making it up. Or its your fault. If you live paycheck to paycheck and wear the same clothes every week.
If this describes you, you should probably quit Dialysis.
Wait, I think that describes me.
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Quality of life versus quantity of life.No stopping dialysis is not suicide.
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I absolutely don't see dialysis as in any way painful or humiliating. Just a bit boring at times. I'm one of the lucky ones I guess. But I do believe it is our choice whether we do it, and I don't regard it as suicide.
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I don't think quitting dialysis is suicide. I can easily see how years of this could wear someone down to that point.
Some of what Stacy wrote describes me but i still have some hope for a better life in my future!
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Is obesity a sin? Should women be allowed to drive? Is the person who invesnted the cell phone going straight to hell?
Understand what I'm sayiing. Point of view.
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Is obesity a sin? Should women be allowed to drive? Is the person who invesnted the cell phone going straight to hell?
Understand what I'm sayiing. Point of view.
No. Yes. And YES, straight to hell! >:D
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good think I'm scheduled for dialysis. I feel like stirring up more ship.
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I think it is suicide..... cause you know you are going to die when you stop D.
Just the same as you know when you jump from a building you are going to die.
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good think I'm scheduled for dialysis. I feel like stirring up more ship.
Good think, indeed! :o
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I am sure I have answered this before, but I compare it to any life prolonging treatments. If a cancer patient does not want chemo or radiation,but knows they will die without it, we don't consider that suicide. Decades ago, if one had kidney failure they wouldn't know. When they died, they died of natural causes. Today is no different, except we can choose dialysis or transplant, if we so desire. But, if a person chooses neither of these treatments, I don't see how that can be considered suicide. Your organs are failing and eventually that means an earlier death. I want all the time I can get, so I will try any type of treatments. :thumbup;
Dan and Zach, you both seem to be in good form today :2thumbsup; :rofl;
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good think I'm scheduled for dialysis. I feel like stirring up more ship.
Good think, indeed! :o
Yes, our ships don't need stirring!
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I don't think it's suicide at all... it's just a form of life support. And if you were very ill and your quality of life was bad. You should be able to stop it.
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good think I'm scheduled for dialysis. I feel like stirring up more ship.
Good think, indeed! :o
Yes, our ships don't need stirring!
It is too hot for ship stirring today :rofl;
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I'm keeping the ship tied to the dock today just so it's safe from stirring.
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I think it is suicide..... cause you know you are going to die when you stop D.
Just the same as you know when you jump from a building you are going to die.
We will all die of something. SOme kidney failure, some heart failure, etc,etc... If someone is 100, the body is shutting down, if the body can't do what it is meant to do, you will die from it. Period. That's the death. Not stopping dialysis.
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Well, my husband says it is not, but my pastor says it is. I hope I never have to make the choice.
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My pastor says it is not. We are extending life with dialysis.
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Is eating fried butter suicide? :rofl;
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Is eating fried butter suicide? :rofl;
I laughed so hard I almost wet my pants! :clap; :clap; :clap;
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Is eating fried butter suicide? :rofl;
I laughed so hard I almost wet my pants! :clap; :clap; :clap;
Me too!! :rofl; :rofl; :rofl;
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Is eating fried butter suicide? :rofl;
I laughed so hard I almost wet my pants! :clap; :clap; :clap;
Me too!! :rofl; :rofl; :rofl;
I was thinking about smoking or over eating - but you're right - who is beating their chest about fried butter balls??
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Is eating fried butter suicide? :rofl;
That's one horrible way to go!
Death on the toilet while your pants are down!
That and you better stock up on paper products!
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good question.....If I choose to take a pill, knowing my life will end because of it...suicide?
If I choose not to take a pill, knowing my life will end because of it...sucide?
IMO...yes, any action, or inaction, initiated by you when you know the end result is death is suicide. If I choose not to brake at the bottom of a hill, knowing I am going to slam into the rock face....is that just gravity taking its course?
I am loving the justification given in some of these threads....I would have never thought considered giving up as "nature taking its course" Very interesting
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I am really not certain. I had a nurse tell me a few years ago that according to the hospital Dialysis is considered essential and a form of "life support" (this was when there was talk of a nurses strike, but they declared D would always be staffed because of that). Going by that definition(and I see no reason to dispute it, because obviously without dialysis we WILL die) then choosing to stop treatment is a form of suicide. However I am a staunch supporter or euthinasia and our choice to live life as we see fit for ourselves.
I also think the context of the choice is important. For example if I was say 90 years old, had lost my legs, had X Y Z other problems and was in pain, than it would be a decision based on quality of life. However that same decision (to me, anyway) would be different for me in my situation - apart from ESRD I am fairly healthy, I am relatively young and fit and my prospects for a successful transplant are better than 50/50. I think in that situation where the possibility for a better quality of life exists then if I decided to quit dialysis that WOULD be an act of suicide.
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At the end of the day i dont think stopping dialysis is suicide , i look at dialysis as finding another option to live. If we wanted to commit suicide would we choose to do dialysis in the first place ? Then of course by not choosing dialysis we wouldnt be commiting suicide but dying of natural causes.
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Our bodies can't go on forever and I feel being on dialysis is a form of life support. Just as being on a ventilator is a form of life support. If I choose not to do dialysis, I don't consider it suicide, I consider it a natural form of death. Would you leave someone on a ventilator for years just to keep them alive?
My definition of suicide is to "take" my own life intentionally. Stopping dialysis is intentional but without the machine you'd die anyway. But if I took a gun to my head or an overdose, I, me, personally would feel like I'm "killing myself".
If there weren't dialysis, you wouldn't consider dieing from ESRD suicide, right? It just so happens we live in a time that it is available for us but it is an "unnatural" way to live.
I believe when our bodies stop working on their own and you're put on life support, there comes a time when people have to face the fact we are all going to die and "taking someone off a machine" isn't suicide. Its a natural process when the body stops working.
I guess every one has "their" own definition of quality of life. For me, when I can't take care of myself, I'd rather be dead. I even have in my DNR that if there is no hope for me and I can't eat or drink on my own, I don't want any food or water given to me by unnatural means. I feel that would be letting nature take its course. I do a lot of hospice volunteer work and its sad to see people in nursing homes just lying there on machines just waiting to die. You are just prolonging the inviable.
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In countries where they deny dialysis for the poor or the elderly, are they committing murder? :waiting;
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In countries where they deny dialysis for the poor or the elderly, are they committing murder? :waiting;
YES BU STEALTH :stressed;
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In countries where they deny dialysis for the poor or the elderly, are they committing murder? :waiting;
YES YES YES and YES :stressed;
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the decision should be yours, but first ask questions and be informed. Opinions are a dime a dozen, mix religion into the mix and then your off on another angle.
My friend try to live as long as you want to, look for something new everyday and maybe a new reason to live then.
If you think that the rest of don't have some of the same feelings from time to time then your being lied to. Life is grand until its not anymore let it be between your God and you.
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I absolutely don't see dialysis as in any way painful or humiliating.
Everyone has a different experience on dialysis. For me, HD was pure hell and it was painful, horrible, and I just felt sicker as each day went by on it. PD however, was a life-saver while waiting for a transplant. It was not painful, I felt better everyday, and not only could I enjoy life, but I could -tolerate- life. Some people it's the complete opposite, and some have no problems with either.
As for the topic, I don't believe stopping dialysis or choosing not to even start dialysis is suicide. It's the patients right and choosing to let nature take it's course and not be on life support is no where near the same as being healthy and choosing to end your life.
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If you concider quiting dialysis suiside, then you must concider unplugging life support, murder. Both should be decided after much thought and concideration and never rushed into, but neither, in my opinion, should be concidered suiside or murder. They are decisions and choices regarding quality of life, vs quantity of life.
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It's a matter of cause and effect. For example, if you jump off a 100ft high bridge to rocks below, everyone will get splattered and die. The cause of death was the person who chose to jump — it was suicide.
If a person was tied to a bungee chord before jumping, not everyone would get splattered over the rocks. Only those whose bungee chord was too long. Hence the cause of death was the length of chord — not suicide unless the person deliberatly chose too long a chord.
In the case of not undergoing dialysis, only those with kidney disease will die. Hence it's the disease that kills & it's not suicide.
Well, that's my logic. :twocents;
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Exactly! :thumbup;
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Making the Decision to Stop Dialysis
Dialysis at the End of Life
By Angela Morrow, RN, About.com Guide
Updated April 14, 2010
For patients with kidney failure, renal dialysis1 may be the only treatment keeping them alive, so the decision to stop dialysis is often a difficult one to make. By the time stopping dialysis even becomes an option, patients are often so sick and have such poor quality of life that the decision whether to continue or not may be quite easy for some to make. If you are a dialysis patient near the end of life or the decision maker for one, how can you be sure you are making the right decision to stop or continue dialysis?
Renal Failure
Kidney failure can be acute (sudden) or chronic (long-standing). Acute renal failure2 is a sudden loss of the kidney's ability to remove waste. It can be caused by certain diseases, extremely low blood pressure as a result of illness, injury, surgery, or certain infections. Chronic renal failure3 is the slow loss of kidney function over time. Chronic kidney disease is usually caused by diabetes or high blood pressure but can be caused by many other diseases as well. The final stage of chronic kidney disease is called end-stage renal disease (ESRD). Patients who find themselves faced with the choice to continue or stop dialysis almost always have ESRD.
When Might Discontinuing Dialysis be Considered?
Dialysis is a life-sustaining treatment and very beneficial when used appropriately, but it is important to recognize that dialysis also has limitations. It may not be beneficial to prolong life with dialysis if quality of life suffers dramatically. Prolonging life with dialysis may actually be prolonging the dying process4 for some patients, which is usually not desirable. It's generally agreed upon that patients might consider discontinuing dialysis if:
the patient also has an acute illness that will cause a great deal of disability if he survives (for example, a stroke),
the patient has a progressive and untreatable disease (diabetes, or cancer, for example), or
the patient has dementia5 or some other severe neurological disorder.
Discontinuing dialysis should never be considered in patients who can continue to lead a long and enjoyable life. If, however, a patient has kidney failure as a result of diabetes, has also gone blind, sustained double below-the-knee amputations of his legs, and is confined to his bed between trips to the dialysis clinic, he may question whether continuing dialysis is right for him. Another example is the healthy dialysis patient who suffers a massive stroke that has permanently damaged her brain. Her family may question whether to continue dialysis and prolong her life or whether they should allow a natural death6.
Making the Decision
Stopping dialysis for yourself or your loved one is a very personal decision and one only you can make. To make the decision that is right for you, I recommend taking these very important steps:
Talk to your physician about risks and benefits of continuing dialysis and the risks and benefits of stopping it.
Talk to your nurse, who often spends more time with your or your loved one, about quality of life. How would quality of life be affected by continuing or stopping dialysis?
If you are making the decision for someone else, check their Advance Directive7 for clues about how they would want to spend their final days.
Talk to your family and close loved ones about your decision. It's much easier to make a decision if you have the support of others.
Consider what death is like for someone with kidney failure. It may be preferable to stop dialysis and die of kidney failure than to continue dialysis and wait for death from cancer8, lung disease, stroke, or another concurrent illness.
With complete information, careful thought, and a compassionate heart you can be sure that whatever decision you make is the right one.
This About.com page has been optimized for print. To view this page in its original form, please visit: http://dying.about.com/od/lifesupport/a/dialysis.htm
©2011 About.com, Inc., a part of The New York Times Company. All rights reserved.
Links in this article:
http://dying.about.com/od/glossary/g/dialysis_def.htm
http://adam.about.net/encyclopedia/infectiousdiseases/Acute-kidney-failure.htm
http://adam.about.net/encyclopedia/infectiousdiseases/Chronic-renal-failure.htm
http://dying.about.com/od/thedyingprocess/a/process.htm
http://dying.about.com/od/neurological/a/dementia_cause.htm
http://dying.about.com/od/ethicsandchoices/g/AND.htm
http://dying.about.com/od/planningahead/a/adv_directive.htm
http://dying.about.com/od/thedyingprocess/f/dying_of_lung_cancer.htm
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Okarol.
That about says it all. great post.
Thanks
Ed
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In countries where they deny dialysis for the poor or the elderly, are they committing murder? :waiting;
YES YES YES and YES :stressed;
Okay, I agree that refusing medical treatment to people who want it can be considered murder. (At least in a layperson's vocabulary, if not a legal one.) It certainly strikes me as cruel and unethical, especially if the person, regardless of age, is still enjoying life and has family and friends whose lives they contribute to daily.
But what is then for those here in the US who are forced into it by their families? Everyone who has ever watched a senile dementia patient wheeled into treatment and strapped down to keep them still so they don't yank out the cath or the needles, please raise their hand.
:waving;
One of the patients at my center thought his own daughter was either the nurse or a taxi driver whenever she came to pick him up.
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heh is it suicide if u jump out of a plain and the parachute doesnt work?
sorry... it just seemed to fit ?
idk whether or not it is suicide, just like i dont know if doing dialysis is playing god... What i do know is, without it u die, with u it prolong death, so theres many sides to the issue.
As I always say quality vs quantity. choices...
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A quote from the movie Matrix Revolutions seems to fit in some situation. "The problem is choice" plus a few other words I kinda remember or piecing together from the movie.
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My doctor's PA (who doesn't always know what he is talking about) told me the other day "If things stay the way they are you could do this for another 25 years." I think he thought THAT would make me happy??? I'm like... are you KIDDING ME? OMG who would want to live like I'm living for another 25 years! Really?
But.... I'd like to live another year. I'd like to see a couple of more Christmases. But, I just cannot think of doing this another 25 years. I just can't think about it.
:urcrazy;
I like having the option of quitting. It keeps me going. AGAIN..... :urcrazy;
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Charles has been talking about this off & on since day 1.....he's told me at least once that the only reason he's doing all this (dialysis, dealing with the pain, the diet, etc) is because he doesn't want to let me & our daughter down any more than he already has. Some days, he feels as though his quality of life is just not worth it...he was a very active man prior to this...he can't even continue to do the job that he loves & was very good at (he installed hard wood floors...got some homes in Iowa in the parade of homes for the floors & detail he added). Now, when he gets "stable," he has to start a whole new career & he's not sure how to handle that. I know he wants, more than anything, to be able to play with our daughter like he used to, take the dogs for a run in the park...or even just a walk right now (he can barely get up or down the stairs of our apartment). It's something we've discussed at length. I look at the man he was before, & the man he is now....I understand where he's coming from, but at the same time, I am having to continually remind him that we are only at the beginning stages right now. It could very well get better. He could begin to get back some, if not most, of what he used to be. We have agreed, that if in at least 2 years time, things aren't getting any better for him, then we will discuss it again.
So, to make a long answer short....no, I don't believe that if you stop dialysis you are committing suicide. Dialysis is just an option for most who, like us, aren't ready to let go just yet. I thing that the people on dialysis who have dementia or other severe neurological disorders, maybe their families just aren't ready to let go.
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No stopping dialysis is not suicide. Don't pay any attention to those who say it is. They apparently do not have "Living
Will" that states in that they do not want to go on a Dialysis machine to sustain their lifes. Mine clearly states that along with a machine that helps you to breathe. Kidney's are Vital Organs, without them you die.
My grandfather, who was a preacher, had kidney failure and was asked if he wanted to dialyize and he said no, that he was ready to see his Lord and no problems in seeing him now rather than later! He knew nothing about Dialysis. Guess some on this thread thinks he commited suicide. How can that be if he never tried it in the first place.
Summer, my husband is going to stop it. He is tired of life tied to a machine. He, like your husband, was so healthy and full of love for life, not just in what he did, but for living for his children and wife. He worked hard to provide and people depended on him. This DEADLY disease stripped him of all of that. High B/P and B/S (Diabetes) took his Kidneys (Vital), his limps, sight and mind (slightly). He is in a wheelchair now cause he can't get a prothetic on if he retains even the least bit of fluid.
Anyrate, when he decides to stop, I will be there for him just as Iam there for him now. I will do whatever he requires of me. If he wants to live out his life tied to a machine for support, then I will be there. If he doesnt, then I will be there. I Love my husband, unconditionally! I thank God for dialysis cause it has given my more time to get my ducks in line and more time with this precious man that he has sent to me. I also love him enough to understand that he is a man of Love, Pride & Dignity. He is also a believer in Jesus, so this is not a hard decision for him cause he does know where he is going when he dies.
I have learned alot from my husbands disease, but the one thing I do know is that I will not put myself through what he did. If I get terminal cancer or ESRD, I refuse to put our children through that. I guess I'll be commiting suicide, huh?
It is true that God created man, but he did not create a Dialysis machine, man did. If God did, it would RUN PERFECT!!!!!!
Seriously, I am so thankful & blessed to have whatever time I have with hubby. We just enjoy every moment cause there wont be any more left when the time comes. I have also seen this wonderful man dewindle into a totally dependent on others for his needs. It is so tough for me to watch this awesome guy suffer in the way that he has. But, I hold my tongue and go with my heart for this man that I love soooooo much! He does not want to go on living like this. Some may think it is the kind of life they want for years, but to my husband, it is not living!
That's his choice and I will honor it as his wife! IT IS NOT SUICIDE TO STOP DIALYSIS!!!!! It is a in the "Living Will"
that we all should have.
lmunchkin
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Very heartfelt message lmunchkin - it sounds like you've had a good life with your hubby and will give him the dignity he deserves to decide what is best for him.
I saw this article you may be interested in. It's called "Should I stop kidney dialysis?"
http://www.revolutionhealth.com/conditions/kidney-bladder/kidney-disease/treatment/stop-dialysis
Stopping dialysis is removing the artificial kidney, and allowing a natural death, in my opinion.
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I just know I'm so grateful, so far it has worked for me. Would I continue if needed again?
I don't know the answer yet and it will be between me and the voice in my head.
I love life but I now know dying not so bad, I believe I have seen or at least got real close. Thank you all
This question is very personal between the inflected person and how much they can take ,God knows.
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Very well put, B.Hunter! I do believe "God Knows".
lmunchkin
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For some of who have lost all hope and dreams of being a father ,mother or anything else besides a burden to our family and self.
Just think , those poor people on top of the twin towers who jumped to their death, Do we burn to death because that's what God would want us to do or jump, we could get there faster.
Life is what most of us understand and want. We all have a right to our own opinion so far.
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For some of who have lost all hope and dreams of being a father ,mother or anything else besides a burden to our family and self.
Just think , those poor people on top of the twin towers who jumped to their death, Do we burn to death because that's what God would want us to do or jump, we could get there faster.
Life is what most of us understand and want. We all have a right to our own opinion so far.
That image of people jumping off the building is burned in my memory as the helicopter could not help them, sad, sad memory.
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This article is referenced somewhere else in this thread, but I wanted to ask another question.
Would refusing to begin dialysis be considered committing suicide?
"Art Buchwald, 80-year-old humorist and columnist is suffering from kidney failure and recently made public his decision to forego dialysis that could possibly prolong his life."
WATCH HERE: http://www.pbs.org/newshour/bb/entertainment/jan-june06/buckwald_3-28.html
He lasted a year before passing away.
CONVERSATION AIR DATE: March 28, 2006
Buchwald on Choosing How to Live and Die
SUMMARY
Eighty-year-old humorist and Pulitzer Prize-winning columnist Art Buchwald is suffering from kidney failure. He recently made public his decision to forego dialysis that could possibly prolong his life, at what he considers too burdensome a cost. In the following interview, Buchwald discusses his life, death and laughter.
EDITOR'S NOTE: Buchwald died at his home on Jan. 17, 2007, at age 81.
Transcript
ART BUCHWALD, Humorist and Columnist: We can party now. We got the place until 5.
JEFFREY BROWN: Art Buchwald can't help but enjoy life and make others laugh, even as he nears his own death. The 80-year-old humorist and columnist is suffering from kidney failure and recently made public his decision to forego dialysis that could possibly prolong his life, at what he considers too burdensome a cost.
Buchwald's spending his final days here at the Washington home and community hospices in Washington, D.C., surrounded by friends and family...
JEAN-DAVID LEVITTE, French Ambassador to the U.S.: This is the moment...
ART BUCHWALD: Oh, boy.
(APPLAUSE)
JEFFREY BROWN: ... and being feted by dignitaries, including French Ambassador Jean-David Levitte, who recently honored Buchwald for his contribution to arts and culture during his 14 years as a journalist in Paris.
ART BUCHWALD: I didn't know dying was this much fun.
(LAUGHTER)
Thank you.
(APPLAUSE)
JEFFREY BROWN: Through more than five decades, Art Buchwald has written some 8,000 columns, read by hundreds of thousands of readers, beginning in 1948 in Paris, where he lived and documented the highlife for the European edition of the New York Herald-Tribune, hobnobbed with an array of celebrities and, through humor, explained Americans and the French to one another.
Back in Washington, beginning in the 1960s, he turned his sharp wit on the foibles of politicians of all stripes. At its height, his column appeared in 550 newspapers worldwide and won Buchwald a Pulitzer Prize for outstanding commentary in 1982.
Starting with the Johnson presidency, Buchwald's writings were collected in numerous books, Democrats and Republicans, up to George W. Bush, all targets of his satire.
In the '90s, Buchwald published two memoirs, one on his Paris years, another on his early life and the trauma of never knowing his mother, who was institutionalized in a psychiatric facility soon after Buchwald's birth.
He and his sisters would grow up in a series of foster homes, before he left high school to join the Marines and serve in the Pacific during World War II. All in all, quite a life, and he's still at it, writing two columns last week and a new one just today.
When I called to ask if he felt up to talking about his life and his decision on dying, he said, "Sure, come on by."
I had a great time reading your memoir, "Leaving Home," in which you wrote: "I must have been six or seven years old, terribly lonely and confused, when I said something like, 'This stinks. I'm going to become a humorist.'"
ART BUCHWALD: Yes. I wasn't joking. I discovered at a very early age, because I was a foster child and everything, that I could make kids laugh, so I got all of my love from the crowds. And I've been doing that all my life.
JEFFREY BROWN: And so what did humor come to mean for you? What did it let you do?
ART BUCHWALD: I don't explain it as what it means to me; all I know is that I can be funny. And I've found out they pay for it, and that's when it really got good, when I started on the Herald-Tribune, and they were paying me for making people laugh.
JEFFREY BROWN: How did you know, from wine and restaurants and the Paris highlife?
ART BUCHWALD: I didn't. And when the editor asked me after I took the job that same question, "What did you know?" I said, "I was the wine taster in the Marine Corps."
JEFFREY BROWN: When you came back to Washington and you're writing about politics and all the foibles of Washington, it's great fun to go back and see that you wrote about Republicans, Democrats, Reagan, Clinton, Nixon, Carter. You're bipartisan, huh?
ART BUCHWALD: Well, I had a line in my talk which said, "I'm not a Democrat or a Republican; I'm just against who's ever in power." And they asked me about Nixon and I said, "I worshipped the very quicksand he walks on."
(LAUGHTER)
JEFFREY BROWN: So they all provided material for you, huh?
ART BUCHWALD: I'm still here. I've been doing this for 55 years. So, yes, they provided me with material.
To this day, this president has been very good to me. Humor is one thing; satire is another. And after all of these years in the business, I think you want to be known as a satirist, because you want people to nod their heads instead of laughing, saying, "Yes, he's right."
JEFFREY BROWN: You mean nod their head, as in, "I'm learning something, as well as laughing"?
ART BUCHWALD: Yes. Yes, I'm on their side.
JEFFREY BROWN: I see. You feel like you're on the side of the reader, is that what you're trying to do?
ART BUCHWALD: Yes, I'm not on the side of, I don't know, the reader, but I'm on the side of good against evil. I am a good person.
JEFFREY BROWN: Now, where does all of this material come from? Do you just sit and read the newspaper?
ART BUCHWALD: Where does it come from? You pick up the newspaper every day, you got Vice President Cheney.
JEFFREY BROWN: You mean, you read it, you get mad, but then you write it as something funny?
ART BUCHWALD: Yes, I do better when I'm mad. I learned that people want to laugh, and also the readers, or most of them, want somebody to say, "This is full of it. This is not what it's about."
And as you know, each administration does the same thing: They twist things; they do everything except possibly tell you the truth. So I figured, well, I think, for the heck of it, I'll tell them the truth, at least as I see it.
JEFFREY BROWN: We came to talk to you in this hospice...
ART BUCHWALD: Yes.
JEFFREY BROWN: ... because you've made a decision...
ART BUCHWALD: Yes.
JEFFREY BROWN: ... not to go on to dialysis...
ART BUCHWALD: Dialysis, yes.
JEFFREY BROWN: ... which could prolong your life.
ART BUCHWALD: Yes.
JEFFREY BROWN: Why did you decide that?
ART BUCHWALD: Well, it was a complicated thing. I had lost my leg -- nobody knows why, but gangrene set in, and I lost this leg. It had nothing to do with the kidney. This leg had to do with the kidney.
I examined it, and I said, "I'm not going to go into dialysis." They took my leg, and I was furious. So I finally made the decision, because we do have choices, and I said, "I'm not going to have it."
So I went into this hospice. I was supposed to go in two or three weeks. That was the average for people that didn't take dialysis. I've been here since February 7th.
The doctors don't know what's going on. I don't care if they don't know what's going on, because I'm having such a good time. And my mantra now is, "Death is on hold."
JEFFREY BROWN: Death is on hold?
ART BUCHWALD: Yes. And here I am doing a show with you, and I'm supposed to be dead.
JEFFREY BROWN: You don't mind at all talking about these things, living and dying, do you?
ART BUCHWALD: I don't, for several reasons. One is that, as I say, people don't like to talk about death. In fact, they don't mention it.
And if someone talks about it on television or radio, it makes it OK for them to talk about it. But we can't avoid the fact that we're all going to go.
We can talk -- and I wrote a column about this -- about the hereafter. Some people believe in the hereafter, that this is one step of their way to heaven or whatever. And other people, a lot of my friends, think it's over as soon as you go, that you die, it's over.
So I wrote a column on that, because everybody has a different opinion on it. Also, it depends on faith. If you're a believer, like several of my friends, then you believe they're going to meet their people in heaven, their loved ones. At the same time, I know people who say, "I don't know."
And I wrote at the end of the column, I said, "The question isn't: Where are you going? It's: What are you doing here in the first place?"
JEFFREY BROWN: You know, a lot of people, of course, are uncomfortable talking about dying, partly because they're just afraid.
ART BUCHWALD: Yes, fear.
JEFFREY BROWN: Are you afraid of dying?
ART BUCHWALD: No, apparently, I'm not.
JEFFREY BROWN: You're not?
ART BUCHWALD: Apparently, I'm not. I don't know what's coming. I'm not predicting anything, but it's an interesting thing.
But in the past month, when I decided to make my choice, it's been the happiest years of all. I've seen friends, caught up with all the people in my life from every different place. I've been talking to people. We talk about everything under the sun.
If I was at home, I wouldn't see these people. Like most people, you just die. But here, everybody knows it, so everybody is kind to me. And even people send me cheesecakes.
JEFFREY BROWN: And as you have a chance to say good-bye to people, what do you want them, friends and your readers, to remember about you?
ART BUCHWALD: Well, I guess being the person I am, I want them to remember me for laughter, that I made them laugh. And I also want them to remember me, that I was a good guy. I mean, that's part of the fantasy. And we have -- my children and I have already planned my memorial service.
JEFFREY BROWN: You have it all planned?
ART BUCHWALD: Yes, so it's going to be a beautiful ceremony, and it could be a very hot ticket.
JEFFREY BROWN: Art Buchwald, thanks so much for letting us come talk to you.
ART BUCHWALD: Delighted to be here. Better here than some of the places I could be.
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The Catholic Church recently came out with a ruling that refusing dialysis for ESRD was not considered suicide in the Church's eyes. They ruled that dialysis was considered an extraordinary measure and could be refused if the patient decided they did not wish to endure that.
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Thanks Henry. :waving;
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Suicide is a touchy subject and I think everyone has their own definition. I don't think you can put a black and white definition on it. I know a lot about suicide having lost my best friend when he took his life at age 22 and losing a cousin last year who was 33. I've also considered taking my life several times, not sure what got me through those dark times, but I've been down that road.
I'm such a free spirit I have my own take on suicide that differs from our government and a lot of people. I believe ANYONE should be able to do what they want with their life as long as they don't harm anyone else in the process. That means to me if you feel like your life is not worth living and you have a compelling reason to check out, you should be able to without anyone interfering. I also can't stand it when people say, "If you take your life you are going to hell." That really irks me. If your life is so bad you choose to end it, I can't see how a loving God is going to send you to hell. Even more so, if you stop medical treatment, God is not going to punish you.
Now I know this raises a lot of questions because let's say someone isn't thinking clearly. Like the night I got so drunk and nearly jumped off a bridge but was saved by my friend. I wasn't in my right mind that night. I don't think I really wanted to die and looking back I'm glad I didn't. So, there is an exception to my own rule. I would want people to get help that could benefit from it but who's to say? I mean it's not so black and white then is it?
I will leave off with this, 15 years ago I really wanted to take my life. I had just lost what I thought at the time was the love of my life. I was miserable. I thought I couldn't go on. I really thought my life was over. A police officer was worried about me and approached me. I reached into my backpack and told him I had a gun. I was very young and stupid. I didn't have a gun, I just wanted him to shoot me. He backed away. I walked down the street and about 10 minutes later a police officer jumped out at me pointing a shotgun at my chest and screamed at me "Let me see your hands motherf$#%%@! At that moment I made a decision to live. But it really was 50/50. What if I didn't do it? Would I be alive today? Looking back I'm so glad I complied and lived to see another day. That woman wasn't worth it. Time heals all wounds. She doesn't mean anything to me now. She's not even on my radar.
My point is things do get better. You could give up but how do you know things won't get better? How do you know there isn't a major medical breakthrough in kidney disease right around the corner that will change your life forever? It's not even out of the realm of possibility. They just developed the first lab grown kidney in a lab here in Boston a few months ago. There's still a long way to go as this was done for a rodent, but it's on the map. 60 years ago if you had end stage renal disease it was a death sentence. Now there are people living decades on dialysis alone! This is what keeps me going. I know things will get better. But I still believe we all should have the right to decide how we exit this world ourselves. I don't condone suicide, but it's up to the individual. I don't know if any of this will make any sense to anyone else. This is just my take on giving up/suicide. I don't think we can put in a neat little box and classify it because it's all open to interpretation.
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Very heartfelt message lmunchkin - it sounds like you've had a good life with your hubby and will give him the dignity he deserves to decide what is best for him.
I saw this article you may be interested in. It's called "Should I stop kidney dialysis?"
http://www.revolutionhealth.com/conditions/kidney-bladder/kidney-disease/treatment/stop-dialysis
Stopping dialysis is removing the artificial kidney, and allowing a natural death, in my opinion.
Would you consider a diabetic who quits taking insulin allowing a natural death?
Withdrawing medical care even in the face of certain death is not considered suicide by the courts, nor by many religious institutions. It is instead considered the right of an autonomous person to chose to withdraw that care. Yes, they would die of the underlying disease and not by suicide legally and by many religious systems.
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Everyone is going green and natural and organic.... so I think to forgo dialysis would be the thing to do. Only if you want to put needles in your arms and have your blood cleaned and put back in you so you can live 3 more days.
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Rerun, you're right. We are not being green. All that trash and water and electricity used on us.
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I hope you really don't view it like that, ReRun. must be hard if you do.
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Hmmm - gotta say I had the same thought when I started NxStage and saw how much trash I was producing! Not that I planned to stop because of it, but geez, it was tough to realize how much plastic I was using weekly that couldn't be recycled because of the biohazard.
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I know, it does play on my mind too, but I was always a worrier, and at the sge of eight in the seventies, way before they used to worry about trash and recycling etc., I used to worry about it. Was always a strange kid. was told to draw a giant when .i was about six years old. most people drew a picture of a man with nothing to show how big he was. I just drew a pair of legs, gecausemy giant was so bigbthat he wouldn't fit on the page. Used to look at a map of the World, and think about how the continents looked like they fitted together, not many years after the theory of plate tectonics wasfirst suggested. Anyway, I am wittering here, but I just wonder what happened to my brain along the way? All that creative thinking soon disappeared!
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Thanks Noahvale. I will probably update my blog quite soon. My nephrologist in Spokane WA is retiring, so I sought a new unit. They are VERY unsupportive so far and Group Health likewise. Will see how things go, but there is a possibility they won't approve my home dialysis. I have other options that can kick in on August 1st, but I will let them play it out. Sadly, the state of dialysis in America is still abysmal.
Back to the topic of this thread, withdrawal of medical care is actually a fairly common occurrence that I dealt with quite frequently in my practice. As a matter of fact, the very last patient I took care of in the hospital the night I was on call for the last time, Labor Day weekend 2005. I had actually seen him 3 days earlier and he wished to continue all therapies despite very advanced metastatic cancer. Three nights later, he showed up in the ER comatose and septic. I discussed the options with his family and they agreed that any further treatment was futile. I placed him on comfort measures only which in his case was a morphine drip and IV fluids to prevent the discomfort of severe dehydration. He died a few hours later.
There are very well thought out protocols and ethical paradigms to deal with these situations. Once again, withdrawal of care is a very common occurrence in daily medical practice.
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Hemodoc, I welcomed your input on this.
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Peter, did I see you in the Ironman competition?? Ha Ha... The weather today was so strange. Thunder all day!! Never seen that before.
I would hope when it was time to quit there would be help doing so. Comfort measures? I like that.
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Gosh, Rerun, you certainly don't live in Georgia. A few weeks ago we had a thunderstorm that lasted from 5.30 in the evening to 5.30 the next morning. The lightning and thunder were constant throughout!
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Peter, did I see you in the Ironman competition?? Ha Ha... The weather today was so strange. Thunder all day!! Never seen that before.
I would hope when it was time to quit there would be help doing so. Comfort measures? I like that.
Ironman in Coeur D Alene? Sorry, must have been my twin brother. I would like to see Shad come through here but he told me the water in CDA is too cold and that is probably quite true.
Dying from uremia is not a pleasant affair from all that I have read. Folks do go on hospice but it isn't the sort of thing I would want to contemplate. I think I would rather jump in Lake Coeur D Alene before going through that type of experience. Sadly, many on dialysis never see the true benefits of an extended protocol. I readily understand why folks would not want to continue with conventional in-center dialysis. Doing daily dialysis at home, the "usual" side effects of dialysis are essentially absent. In reality, the "usual" side effects of dialysis are in many ways iatrogenic and quite specific to the American experience in many ways.
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Wow, 23 years of in-center dialysis. That is quite a testament.
Group Health has never supported daily dialysis. I was told on Friday by the financial supervisors of FMC in their Arizona center that everything is approved. I will have to see how everything sits tomorrow. I will play it by ear. But to date, not very supportive at all.
Deciding when to withdraw therapy can at times be an easy decision giving the circumstances of continuing but in other cases, it is a quite difficult choice. Thankfully, the guidelines today are well defined, or at least they were while I was practicing. Withdrawing care in the face of uremia is one of the difficult situations for certain.
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Just wanted to add, im 23 year on dialysis and have just now had enough. Not sure what happened or when or what triggered it. But I know I have now had enough and want a change. I am in the UK and under a great Unit. I told my nurses and they have send me to a counsellor who is talking about family and childhood and stuff. I will keep going but have for the first time in 23 years started missing days. One thing that doesn't help is the wiped out feeling after dialysis, even into the next day I recover around 3pm the next day but that doesn't help a person who is intelligent and cannot work. Home to dialysis recover and go back. No life. Might try home dialysis. just wanted to add. fight on friends.
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Charmer, if you haven't tried home dialysis yet maybe that might be a better way to go. From what I've read on this site, many people have seemed pretty happy with PD and they don't have to deal with the wiped-out feelings that are so common with in-center. Whatever you decide, I wish you the best. :cuddle;
Anne
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Just wanted to add, im 23 year on dialysis and have just now had enough. Not sure what happened or when or what triggered it. But I know I have now had enough and want a change. I am in the UK and under a great Unit. I told my nurses and they have send me to a counsellor who is talking about family and childhood and stuff. I will keep going but have for the first time in 23 years started missing days. One thing that doesn't help is the wiped out feeling after dialysis, even into the next day I recover around 3pm the next day but that doesn't help a person who is intelligent and cannot work. Home to dialysis recover and go back. No life. Might try home dialysis. just wanted to add. fight on friends.
The wiped out feeling is from dialysis that is too fast, too infrequent and takes off too much fluids in too short a time. Home hemo allows a more physiologic approach to this. I hardly ever feel "wiped out" after dialysis. In fact, I get off and I am off and running so to speak. I wish you well my friend but the solution is MORE dialysis not less and the only place to get more dialysis is at home. PD is an option for many folks but it does NOT improve overall survival. At your young age, home hemo and transplant give the greatest longevity in general. Best wishes and hope you feel better soon.
God bless,
Peter
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I feel very strongly about this topic. I waited 2 years to deal with dialysis (my neph told me long ago that I really needed it) before I was forced to get a chest perma cath last week when I basically ran out of time. The whole time I was avoiding it, my family was accusing me of killing myelf. I did not see it that way all. I saw it as dying with dignity and on my own terms. I had vey skewed images of what it would be like to have a chest cath and I pictured myself lying in bed 24/7 with no quality of life at alll. I have since learned that is not the case, it doesn't have to be. But I will defend ALWAYS a person's right to decide what to do with their own life and their own death. I think it's horrible that you are allowed to put an animal out of its misery, but you are not allowed to assist in the humane and dignified death of a loved one. Really messed up world we live in. :urcrazy;
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" I believe the debate whether or not withdrawal from dialysis is suicide is a rhetorical fiction. I think the real question is whether or not you feel it is morally wrong to willfully take your own life. If you do think it is morally wrong, then I don't think it matters whether you put a bullet in your head while you are healthy, or whether you pull the plug on dialysis treatments which are maintaining your life. The point is you are willfully killing yourself. Arguments that taking oneself off dialysis is not suicide because you are only allowing nature to take its course are not impressive. That's like arguing that if a parachutist removes his parachute on the descent, it is not suicide because he is only allowing nature to take its course after removing the artificial support system.
I believe we all have that choice, and as a 17 year home hemodialysis patient I can see how patients like myself might get into a medical situation that is intolerable.
I have noticed that there are a lot of articles in the nephrology literature lately which discuss withdrawal from dialysis. It seems that many nephrology professionals are beginning to view withdrawal as a viable option for some patients. The thing that bothers me is that they all put the burden on the patient. Many of them describe death by uremia as a "good death." I think this is a bunch of bull. I've always read that death by uremic poisoning is one of the worst deaths that one could have, and the times I've stretched the interval a little I felt horrible. I don't think I would ever allow myself to die of uremia. I would take action while I was still in good shape.
An ESRD patient who has made an informed decision to end life should not be expected to check into a hospital and slowly die of uremia even though the process may be ameliorated by narcotics. Nephrology professionals should face up to their obligation to their patients who need physician assisted suicide. Dr. Kevorkian has certainly advanced the debate, and I imagine it won't be long until physician assisted suicide will be an accepted practice in the U.S. "
George Harper, MEd, EdS
14 Oct 1997
Home Hemodialysis - 1980-2002
Transplant - 2002-present
http://www.rsnhope.org/programs/kidneytimes-library/article-index/living-long-and-well-on-dialysis/
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I am not sure that I understand the parallel with a parachutist. Parachuting out of a plane, is in itself, an un-natural act. A normally-healthy body with working kidneys, performing a normal physiological function, is not. Dialysis replaces this normal physiological function. Not doing dialysis is also a passive action. Removing a parachute is not. I understand that the outcomes may be the same, but that is where the parallel begins and ends.
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I'm firmly on the Pro choice side here, but I do live in a different country where it is my right and my choice to discontinue treatment. That is something I have realized is extremely important. For me the choice is to fight, but in context I had 50% of my kidneys stolen by medical error and 36 years ago when i was a baby, so with no other medical issues the choice is easier.
I do respect however those that suffer far greater than I do as this disease does quite often come with many other issues. Doctors try to be sympathetic but the reality is that it can be a hard disease to manage.
In my country the right to refuse treatment or stop applying it is respected, albeit there are processes to go through. It is not considered the big 'S' when a machine is maintaining life and without that machine life cannot continue.
I do also realize the US is in the grip of religious devotees which would naturally object to my opinions.
Thank goodness for "real" separation of church and state that exists here, and for choices that allows.
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Ianch, it is perfectly acceptable for someone to stop dialysis in US. We sign a bundle of paperwork each year. Within this is a sheet that we sign that states that we can stop dialysis at any time.
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I don't think it is, to be honest. I had a friend who refused treatment after his transplant failed when he was 19. A lot of people argued that he committed suicide but what I said to those people was "you try living through what he has. I don't blame him. He had a rough life and felt he gave it his all. I think he was very brave."
And I still think that. I don't think that will change.
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I don't think it is but my family does! And my kidney doctor does too! And I would never do this. I've fought too long and hard to live as long as I have! In November it will be 34 yrs since I was diagnosed with ESRD! And the doctors told my parents I wouldn't live past age 30. I'm 41 yrs old and will be 42 in January! And I'm pretty healthy considering.
I had an aunt who refused treatment. And a friends' father who quit after a few treatments. It's not for everyone. And I considered it after I was refused another transplant. I've been on hemo dialysis since Sept. 6, 2002 and there is only one way off for me! And I cannot do PD because I have mesh holding my abdominal muscle together. And a lot of scar tissue. I've had too many surgeries!
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I'm just so tired of this. It is hard to get fluid off me at dialysis. A whole 8 hours and they can't remove 1 liter? I have to sweat the rest off in my hot car. Fall is just around the corner. Then I may have to join the YMCA because they have a sauna. I can't see anymore to drive so how will I get there. I don't want to do this anymore. I don't.
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Rerun, you sound so discouraged...I hope this is only temporary. Maybe you don't need more than a liter taken off--do you feel OK afterwards?
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I'm just so tired of this. It is hard to get fluid off me at dialysis. A whole 8 hours and they can't remove 1 liter? I have to sweat the rest off in my hot car. Fall is just around the corner. Then I may have to join the YMCA because they have a sauna. I can't see anymore to drive so how will I get there. I don't want to do this anymore. I don't.
Rerun when you say they can't take a liter off how do you know you have an extra liter on? Because of edema? How is your albumin level? Low albumin can cause edema.
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:grouphug; Rerun you have suffered more than your fare share and you have made it through it all. I wish things were better for you. You know your not a quitter, though you have every right at this point. You will find your way through this too and you will keep going until it's time to go Home. :beer1;
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I wrote this really awesome reply on Facebook, especially for 4am and considering the fact that I've been up since 9am the day before (getting anything out that is even remotely cogent at this point I deserve a minimum of 30 brownie points for), but Facebook didn't take it I guess.... So I'll just say I agree with Sandman from back in 2006 (apparently). What was weird is it was nearly verbatim what he said. Frankly people can try to sugarcoat it in order to get through it (the same way that every other person committing suicide does "Ill be better off" "They'll be better off" "I won't be in pain anymore" etc...) However, suicide is suicide. Trust me I of all people can relate to wanting to stop dialysis. My kidney failure started at 27, I lost a VERY successful business, my house, multiple vehicles (my poor Vette), my boat, and most importantly my pride when I had to move back in with my mother. I graduated at 16, started my first company at 17 and have been living on my own ever since. Needless to say if there was ever going to be someone that was going to throw themselves off the proverbial "stopping dialysis" bridge it would be me. :rofl; Especially now that it has lead to 10+ heart attacks, 6 cath lab visits and 8 stents in my heart in the last 14 or so months (with more needed). My cardiologist is now starting me on ECP treatments and wants me to wear these support hose things on my legs. I am a 33yr old male... I'm pretty sure I'm never going to wear these things, but it just gets worse and worse and worse. Oh and they've only used my fistula 20 total sticks and only twice with two needles. BOTH TIMES THEY'VE INFILTRATED. I have Steal syndrome and my arm looks like something from a horror movie (or someone on dialysis for 20 years with multiple fistulas in the same arm - I have neither). My ability to play my piano and guitar have gone down to 20% of what they were. Sorry for rambling, its the caffeine. In closing: Stopping dialysis = suicide. (Now why couldn't I of just said that to begin with??? :clap; )
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So anyone. who doesn't have their life -saving operation, doesn't take their medications for whatever illness, doesn't have their chemo., is also committing suicide? What if someone gets ESRD and decides not to do dialysis in the first place? Is that considered suicide, or is it only considered suicide if someone starts dialysis and then stops? what for that matter defines suicide in other circumstances?
The reason that I don't believe that it is, is because it is an active medical intervention to stay alive.
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I think depends on the circumstances and quality of life. If I was to quit right now, it would be suicide. That's because my quality of life is generally good. If I was very ill with no/little chance of improvement and a poor quality of life, I think I'd say differently.
I think it the same as for my pets. If one of them is hurting but she'll be ok in the long run, I'll do whatever I can to treat her and make her comfortable. If she's hurting and nothing will make it better, then the kindest thing I can do is to hold her while the vet puts them to sleep. I'd like the same treatment for myself.
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Medically and legally and religiously, this is a non-issue. Withdrawal of care is perfectly acceptable across all of those realms. While some may question why someone would withdraw care while doing well, it is certainly a legal, medical and religious right to do so. The cause of death in such an instance would NOT be suicide unless there is evidence independently of suicidal ideation, but instead would be death due to chronic ESRD. The only issue from a medical and legal perspective for a provider is to exclude suicidal ideation. If the evaluation suggests that the actions are the result of suicidal ideation, then a court, a deputy or a psychiatrist can hold a patient without their consent and subject them to the therapy that they need to sustain life until they can adequately evaluate and treat the underlying depression that is causing the suicidal thoughts. Where the line between free will and rightful choice and suicidal ideation is at times a bit ambiguous. But legally, with suicidal ideation excluded in a competent adult, you are allowed to act in such a manner and refuse further medical treatment for any condition.
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Medically and legally and religiously, this is a non-issue. Withdrawal of care is perfectly acceptable across all of those realms. While some may question why someone would withdraw care while doing well, it is certainly a legal, medical and religious right to do so. The cause of death in such an instance would NOT be suicide unless there is evidence independently of suicidal ideation, but instead would be death due to chronic ESRD. The only issue from a medical and legal perspective for a provider is to exclude suicidal ideation. If the evaluation suggests that the actions are the result of suicidal ideation, then a court, a deputy or a psychiatrist can hold a patient without their consent and subject them to the therapy that they need to sustain life until they can adequately evaluate and treat the underlying depression that is causing the suicidal thoughts. Where the line between free will and rightful choice and suicidal ideation is at times a bit ambiguous. But legally, with suicidal ideation excluded in a competent adult, you are allowed to act in such a manner and refuse further medical treatment for any condition.
Legally, if considered suicide, it is actually illegal. For some idiotic reason, suicide is illegal in most of the states, so if you fail to kill yourself, you're under arrest. #Logic
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this whole subject has bothered me since I was diagnosed in 2008.Have you ever heard of Greg Laurie? He is a pastor of a mega church here in Ca. Anyways, that is my church and I called one of the pastors for some definition of this. They said yes, quitting or not starting dialysis is suicide and therefore, not a good idea. The underlying reason for this is that it is not up to us to decide when where or how we die., it is up to God. So, I agree. Knowing that many of you will not, LOL!!
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In the case of dialysis its an interesting position to take, but i guess as a secular member of a largely secular society my opinions will differ. I commented only because I came close to giving up as a surprising percentage of patients do in NZ/AU. The physical and emotional toll that in-centre regimes dish out doesn't always support the notion of living, and is known not be doing as much damage as it is treating.
Fortunately my country subscribes to the notion that if a person exists independently and takes their own life then that's suicide. However if existence is dependent on drug or machine then the subscription of that life preserving device is by choice (to a qualifying point).
Now that I have my own machine and the support to conduct best practice, no complication treatments the choice is easy.
Should that or my health change so that i'm a non-functioning citizen (on my opinion) then my position might change again and I'll be respected for that.
1st would countries have a new problem. The current generations have watched their elders suffer because existence (lifespans) has exceeded living-spans. People are starting to question why they are forced to reside as vegetables. The debate is now on.
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I think depends on the circumstances and quality of life. If I was to quit right now, it would be suicide. That's because my quality of life is generally good. If I was very ill with no/little chance of improvement and a poor quality of life, I think I'd say differently.
I think it the same as for my pets. If one of them is hurting but she'll be ok in the long run, I'll do whatever I can to treat her and make her comfortable. If she's hurting and nothing will make it better, then the kindest thing I can do is to hold her while the vet puts them to sleep. I'd like the same treatment for myself.
I agree with you Deanne. It depends on the circumstances, quality of life, age, way of life, hobbies, relationships etc. of a person.
I knew someone who had many health issues, was in a wheelchair, left alone by their family and they felt they had no quality of life anymore and dialysis “on top of all that” would just be too much to take. They refused dialysis and died shortly after.
Another person I knew was new to dialysis but they could not take the mental strain of “being regularly connected to a live-support-machine” as they put it ... sadly there was no way to convince them otherwise...
I have no idea how I would react if I had to start dialysis ... all I know is that I have been fighting most of my life to avoid dialysis
and so far I have been very lucky and my body has not let me down yet ...
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This is a hard question to answer on my behalf as I have so much mixed feelings. The problem was not the machine with me. The machine seems to be doing a good job along with my various vitamins; however, it was a mental thing with me that almost cause me to quit D.
1) The way people would perceive the fact I was on D. Either I received symphony or I was told that a person in my position will not live long or not have a good quality of life. 2) Going to the center and being treated like I'm going to die soon so why bother to care kind of messed with my head. 3) Holding D against me to manipulate me in to doing what they feel is right for me as if I can't think and do for myself. 4) Arguing with techs and nurses that have no people training. 5) Stuck with a schedule that does not allow you to do other things. 6) Getting to know a person and watching him or her pass away. 7) Seeing turnover with techs and nurses. 8 ) Getting on the machine late and missing what plans I had made. 9) Not being able to stay with my family during the holidays because I have a D appointment. 10) Not being able to travel unless I have a D center scheduled, which was very hard to do as the other center wanted so much paper and test before you are considered.
All these things took a huge piece of self esteem from me while I was in-center. I felt I had no control of my life and after 11 years I was about to give up on life until I was introduce to NxStage. I was looking for a way out and giving up on life was my last alternative but I didn't really want to leave this world that way so I seek and found NxStage. Now things are very different and I am much happier. Not knocking any one because we all are different just explaining my mixed feelings. And, yes I do have my off days on NxStage but not as many as I had in-center.
I feel that if you can find another form of D that will make you feel better and help you live a normal life then there's no reason to quit D; however, on the other hand, should you not find peace or comfort in whatever you do, then quitting D would not be suicide.
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I found in-center a real drag. Offered the choice of NxStage or BabyK, with my doc favoring BabyK on an EOD schedule. That's working out great - I have every other day off, and I sometimes do two days in a row to shift my "off" days to create a free day when I need one. This assures I will never be dialyzing on a family member's birthday, anniversary, funeral day, etc.