Dying for a conversation

Two years ago my Dad died of cancer. The last year of his life we watched him become incredibly frail. He rarely smiled, barely ate, and it became increasingly obvious that every movement was painful. Yet he was lucky. He died suddenly of a heart attack before things got really bad. This, too, was cancer related – the heart attack was triggered by profound anaemia, brought about by the cancer in his bones.
We were all dreading his downward spiral. He was so afraid of it he would not discuss it. He denied until the last that he was dying, even though it was writ large on his face. I have an email from the week before he died, loudly proclaiming his robust health and his expectation of a long future life.
Who knows what choice my Dad would have made, if he’d had the option of choosing a dignified death, and cutting short his suffering. Who knows whether it would have brought him comfort, or presented him with an insoluble dilemma. I have no idea.
I also don’t know what I would decide, if it were me. I am not afraid of pain, and right now my will to live is fierce, fuelled by my children, my husband, and my friends. What I do know, without doubt or hesitation, is that I want the choice.
Right now I am watching my Mum being consumed by the intolerable demon of dementia. It terrifies her, yet I don’t think she would choose to end her life, because that would require her to admit that she is sick.
But what would she have chosen, if she had had this conversation before dementia started to erode her brain?
The Victorian Government is creating a law to give people the power to write “advanced care plans” that specify their wishes in case of future illness, such as cancer or dementia. This stops far short of euthanasia, yet our current laws don’t allow us to specify our wishes for conditions we don’t yet have. It’s a big step forward, and the biggest step is that it encourages us to think about these things before they happen. Do I want to be resuscitated if my brain is severely damaged? if I have dementia and get pneumonia, do I want treatment, or do I want to be able to slip away relatively peacefully?
It is encouraging to see these choices made possible, but it saddens me that we can’t take it one step further. Facing terminal disease, would you rather die peacefully from, say, a morphine overdose, or suffer the long, painful, and traumatic failure of each internal organ, one by one?
Facing the unavoidable collapse of your power to think, feel, and remember, would you cling to life until the very last moment, or choose to control your death, and depart while you still know who you are? There are no right or wrong answers to these questions. The only certainty is that they need to be asked.
I know that I don’t want to live through dementia until the bitter end, abusing my children and lashing out at those who try to help me. I don’t want to be remembered that way.
My Mum watched her own father die of dementia. I think it fuels her fear. Who knows how she would feel if she had been able to say “I will go so far, and no further.” If she had the certainty of a peaceful death at a time of her own choosing. Perhaps it would comfort her, or perhaps not. But I know for sure that if I ever get dementia, it would comfort me.


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