Is Quitting Dialysis Suicide

[flip]

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.

[Mizar]

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.

[Lilu323]

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!

[nursewratchet]

I agree with Rerun. No!  The death would be "Renal Failure".  Or Cancer.  Or any naturally occuring disease, for which there is no cure. 

[pelagia]

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.

  miss you Flip

[Lucinda]

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.       

[Chris]

MY front door? No. 

Doesn't that depend if you have one of those California earthquakes or fires?

[idahospud]

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

[dkerr]

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.

[kimcanada]

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.

[idahospud]

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

[dkerr]

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.

[RightSide]

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.

[Zach]

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.

[nursewratchet]

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. 

[monrein]

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.

[idahospud]

 

[BigSteve]

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?

[pelagia]

No.

[Zach]

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

[idahospud]

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

[BigSteve]

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!

[Kitsune]

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.

[Wallyz]

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.

[idahospud]

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