When Pain is Medicine
“We can’t stop treatment. We are supposed to do everything we can to keep the patient alive,” says the doctor about the man who has multiple organ failure, has “blood and urinary infection” and whose “kidneys are not functioning”.
The fight to prolong life at all costs continues. The wife and the daughter are allowed into the intensive care unit for five minutes each in the morning and evening. The daughter says, her 84-year old father, her best friend, was “wailing and roiling in pain, all I wanted to do was run, somewhere far, where his cries wouldn’t reach me.”
The man has many tubes inserted into his body. He cannot turn his head to the left because of the catheter going into his neck. He is in agony after every dialysis, in all “a harrowing experience.”
She stands by his side, “trying to convince all those who seemed to have a say on his life that it was a cruel line of treatment they were imposing.” The man got no sedatives or pain killers “for fear his weak heart could not take more chemicals.”
The daughter feels that the sight of him stripped of any sense of comfort or dignity on that hospital bed was unbearable. The doctor says the situation is bad. ‘‘If the situation is that bad, why can’t you get rid of all these wires and needles, and give him some sedative so he can sleep?’’ asked the daughter. But the doctor feels that he is supposed to do everything he can to keep the person alive.
“I didn’t get it,” writes the daughter. “Why keep the patient alive for a few more days, if it involved excruciating pain? Keep the patient alive for whose benefit?”
The saga continues. In hospital after hospital, all through India, patients are kept on life prolonging treatment even when they have no hope of recovery, because doctors feel they need to do everything to keep the person alive.
Doesn’t the problem lie right there? Is there clear understanding about what is the primary purpose of medical treatment? Is it to keep the heart beating at all costs?
In India, a new law is contemplated on end of life care. The original draft law published on the government’s website had made advanced directives invalid. We hope the draft is being corrected. There is a lot of discussion about euthanasia. While it goes on, no one talks about our right – yours and mine – to die a natural death, with some dignity when cure is not possible. The medical system doesn’t seem to know at all what its duty should be.
Isn’t it time we suspended the discussions on euthanasia and law, and go deep down into the basic issue – what is the duty of the medical profession? We need it there in golden letters, bold enough for every medical student and doctor to see that our duty is to cure when possible, relieve suffering and provide comfort, permitting dignity and recognising that death is the inevitable consequence of life, and that a natural death is NOT a failure of the medical profession.
Please read the article by Sindhu S, Pallium India’s volunteer, published in The Hindu: When Pain is Medicine
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