psych evaluation quitting dialysis

[dstevens]

I have been on dialysis for 14 months now and have been considering quitting. It was my choice to start it and as far as I thought it was my choice to quit if I wanted. I was told by my doctor that if I wanted to quit that I would have to be admitted for a 3 day psych evaluation before being allowed to stop. Has anyone heard of such a thing and is this true? I cannot imagine it is. Just thought I'd throw it out there and see.

[jbeany]

Wow!  That's a new one.  I've never heard that little rule before, and can't imagine how your doc would get that to work.  I'd say if you're getting that kind of hostile response to thinking of going off of life support, it's time for a new doc ASAP.  I'll grant you that we ALWAYS encourage people to talk to a counselor before stopping, just to make sure the decision is not the result of a treatable depression, but hellllloooooo, even the Catholic Church doesn't think stopping dialysis is suicide. 

What state are you in, and what are the involuntary commitment laws there?  And how does your doc think his practice is going to hold up if he starts trying to commit every patient who makes a decision against his advice?   

[MooseMom]

I'd be interested in knowing just how your doc is going to enforce this. 

I'm really sorry to hear that you are considering quitting, but I understand it.  This seems to be an ongoing theme on IHD lately.   

[MaryD]

We were told in a pre-dialysis seminar that if we decided to stop dialysis, our medical staff would do everything in their power to keep us comfortable.  I assumed that this would be the 'norm' everywhere.

I think the idea of changing your doctor is a good one.  I wish you peace and a clear head.   

[RichardMEL]

dstevens,

Your profile doesn't say where you are located - that may be useful to know for others and may have some bearing on things - I mean which country or state/province etc. Different locations, doctors, renal units etc have different policies.

Having said that I do find it an interesting situation. Again I am not sure of your age or other circumstances, but that may well have something to do with that also. For example, I don't think many would question an older person (with no offence intended to anyone) suffering greatly their decision, perhaps someone younger with relatively few other issues they may be suggesting it is an issue of depression or something like that. Again, I am not trying to suggest anything about you in particular - just some general thoughts.

I too am sorry that you feel D is ding nothing to help you or making your life worse or perhaps that you have little quality to your life in your situation. Have you discussed your feelings and choices with anyone else bar the doc - eg social worker ?

personally I am of the view that if someone is fully cognisant and "in their right mind"(which may be the question the doctor may be suggesting) that if one wants to make a choice regarding THEIR body and THEIR life they should be allowed to, and given all means to do so comfortably and with as little stress as possible. Of course that's the big question - is it a well thought out and considered choice or something brought on by frustration, depression, or other factors that perhaps may be clouding things? Again, not suggesting anything personal here to or about the OP, just some general thoughts.

[Rerun]

I think your doctor is just throwing that out there.  He must think you are just depressed or something.  I don't think if you call them and say you are not coming anymore they will come to your house to get you. 

               But, do seek your own counseling if you are depressed and can't think of one reason to keep breathing.

[noahvale]

*

 

[dstevens]

Thanks everybody for the replies. I am still in PA. I actually just saw my pulmonologist today to ask him about the whole situation and he verified what I had thought, my nephrologist is completely full of it. He said they would set up an appt with a hospice and do everything they could to make sure I was comfortable. He said they can't make me go through a psych eval as long as it is deemed that I am mentally capable of making such a decision (which he said he would vouch for). It is such a weight off of my shoulders as I did not want to have to put myself through all that on top of everything else. It just disgusts me that someone I trusted would blatantly lie about something like that. It all boils down to money....I'm sure he realizes if I quit dialysis that's one less person they can suck money out of via my insurance and god knows that's the majority of dr's (at least the ones I have had the displeasure dealing with) top priorities. I really wish I could've tried Cleveland Clinic or John's Hopkins as I just can't imagine them being as awful as UPMC has been.

[jeannea]

Not sure exactly where you are in PA. The Philly hospitals don't have to be your only choice these days. Lehigh Valley, Hershey or Harrisburg if you're west of the city. If you're in the city, Johns Hopkins or something in NJ.

I think your doctor was trying to scare you so you don't quit. I can understand wanting to quit. But please only do it if you're sure this is what you want. Don't do it out of momentary anger.

[cariad]

I'm so sorry to hear that things have not got any better for you. I remember your posts and reading about how much you have been through. Is there a reason you were unable to go to a hospital other than UPMC? My experience has always been that a competent hospital and compassionate doctors make all the difference.

Please let us know if there is anything we can do to help you solve some of these hospital issues. If that really isn't the issue and you know it is just time to stop the fight, then please let us know if there is anything we can do to make that process easier.

[donnal]

Good grief, you have so much to cope with.  If you do decide to stop, please, please check out your hospice.  The services they provide vary a great deal.  Make sure they will provide you with palliative  care.  I looked into it for my friend and it was very confusing. Some come to your home. Some have inpatient facilities but you can only be there for 2 or 3 days and then you are returned to your home until you are worse.  Fees also vary.  Check your insurance coverage first.  You will be in my prayers whatever you decide.  donnal