Is Quitting Dialysis Suicide

[Bill Peckham]

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.

[Quickfeet]

  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.

[dialysis.sucks]

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.  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???  )

[amanda100wilson]

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.   

[Deanne]

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.

[Hemodoc]

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.

[iKAZ3D]

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

[Jean]

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!!

[ianch]

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.       
 


     

[kristina]

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  ...

[cdwbrooklyn]

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.   

[Simon Dog]

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.