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Recently watched someone close die over a couple days, after a long decline. The last 24 hours were monstrous to inflict on anyone. Torture. Evil. Hours and h

Recently watched someone close die over a couple days, after a long decline. The last 24 hours were monstrous to inflict on anyone. Torture. Evil. Hours and hours of faltering breathing, often restarting with what was plainly a panicked adrenaline-pumping response. It looked like they felt like they were about to drown every few minutes, hour, after hour, no relief. No IV fluids (terminal anyway, so no trying to keep them alive with techniques like that) and unable to drink, so certainly terribly thirsty the whole time. Unable to communicate or really engage with surroundings, and quite high on pain meds anyway (the closest thing to a mercy in all this). It’s fucked up that that’s a fairly normal way for dying people to make their exit. I’m sure there are all kinds of problems with trying to provide a way out when someone can’t make the choice for themselves, without opening it up to abuse, but damn, I hope this isn’t the best we can do because it’s terrible.

conroydave 2y ago
Watched my grandfather pass in the same way. Didn’t seem right to let him pass of basically lack of food and hydration after 95 years even though also terminal. I just wanted to see him comfortable and he was far from it.
- dghlsakjg 2y ago
  In the last days when organs start failing, food and drink don’t necessarily make things more comfortable since the body can’t handle it.
  - conroydave 2y ago
    Thanks for sharing. Helps a little bit
- pineaux 2y ago
  Same here, but i have been told that dying is like that unless thoroughly drugged.
spurgu 2y ago
I'm sorry for your loss. Edit: I feel a bit dumb now, I hadn't actually read the article yet, went straight for the comments. Seems like I'm just reiterating what it says. When I'm in that shape I just wanna go in peace. Preferably at home, in my own bed, surrounded by loved ones. No tubes down my throat, no shots to keep me alive at any cost, with no end in sight. Here's some good discussion on the topic between two doctors that I watched recently: https://youtu.be/O0YIGAUDlzQ?t=242 https://youtu.be/O0YIGAUDlzQ?t=242
- lurking_swe 2y ago
  The problem with this perspective in my opinion is that many times, especially for an elderly person, a small emergency can very quickly escalate into a life and death situation, and the outcome is not clear until it’s too late. you may enter the hospital thinking you have a decent outcome, but you end up with a bad outcome. for example, nobody plans to go on a ventilator. But if you need one (like severe pneumonia), you’re already pretty messed up and you’re going to have a painful death with or without the tubes.
  - tremon 2y ago
    you’re going to have a painful death with or without the tubes But I feel that was the main point at the start of the thread: if death is certain and going to be painful, why must we drag it out? Why is that additional lifespan (measured in days) so much more important than comfort?
    - kqr 2y ago
      The point is that it's not certain. With the medical assistance you might recover fine and live another five happy years. Is it really worth trading away that opportunity just to not accidentally die on a ventilator? I'm not sure.
      - AlexandrB 2y ago
        There's a good article[1] on this topic that talks about how older doctors generally choose to forego lifesaving measures. I think about it a lot because it seems like when a professional who's in the best position to know the tradeoffs makes this kind of decision for themselves they probably understand the risk/reward better than you or me. [1] https://www.saturdayeveningpost.com/2013/03/how-doctors-die/ https://www.saturdayeveningpost.com/2013/03/how-doctors-die/
briffle 2y ago
> and unable to drink, so certainly terribly thirsty the whole time. I know people that work in hospice, and they say this is a big misconception (the article hints at it too). they patients don't die from lack of water, they don't want water because they are dying, and their body can't process it. In fact, as you kind of touched on at the start, giving them IV fluids can cause them to drown since their body can't process the water. Death is pretty ugly thing, that comes for us all. I got to learn the fun way that in the state of Oregon, it is illegal to disable a pacemaker. Even when the person has a DNR, and it is really the only thing keeping them alive. The best the doctors can do is turn the pacemaker down as low as possible, and hope its not enough to keep the person artificially alive. Which seems kind of really weird, when its also the first and one of the only states that allows medically assisted suicide..
- BalinKing 2y ago
  I'm no expert myself but recently had a relative in hospice,[0] which prompted me to look into this issue a bit. There are a few papers (for a recent example, Kingdon et al. (2020))[1] that say that the data is actually extremely low-quality on both sides of the issue. Personally, this makes me wonder if "fluids are bad" might just be received wisdom and/or anecdata... hopefully someone will do a better study(ies) at some point in order to get actually reliable data. [0] We did end up following the hospice's recommendations not to administer IV fluids, for what it's worth. [1] https://spcare.bmj.com/content/bmjspcare/11/1/68.full.pdf https://spcare.bmj.com/content/bmjspcare/11/1/68.full.pdf
- Flumio 2y ago
  The best thing they can do is shoot me with a nice does of heroin and after the high.just ending it. We know how to end life's.
  - FerretFred 2y ago
    It's probably ironic that it's never been easier to buy that drug (and others) and decide your own fate compared with trying for a dignified and hopefully pain-free death the "legal" way.
louwrentius 2y ago
I’m quite convinced that I live in a country where we never let people die like this. Also, I guess prolonging treatment is in the interest of for-profit hospitals as found in other countries, thus as long as your suffering is profitable, you wil…
- bamboozled 2y ago
  I made a similar comment already but I kind of agree. I’m not sure if it’s about profit it’s also about legal concerns. I think legally doctors are supposed to keep you alive until they can’t anymore?
  - ksenzee 2y ago
    No, truly, doctors are not legally required to keep people alive against their will. It’s just that you have to have made it clear in advance what kind of life-saving and comfort measures you want. You have to say “yeah actually I don’t want all that.” It’s hard on the doctors to watch people dying painfully with too much life support, too. They know what kind of death they want, and it’s not that. (As the article reflects.)
- ksenzee 2y ago
  I would be surprised if there exists a country where people never die like this. You would have to euthanize every single person who died of a long list of natural causes.
  - mensetmanusman 2y ago
    Maybe NK will implement mandatory euthanasia at 63 or something crazy.
  - raffraffraff 2y ago
    This is from personal experience, but there is a difference between letting someone take 2 weeks to starve or die of dehydration, and big-letters "euthanasia". Sometimes the people who work in palliative care are nuanced enough to ease you out when your final days come. Where I live, euthanasia is not legal. But when my sister was dying from cancer she directly told her palliative meds guy "I watched my uncle gasp for two weeks. I'm not going like that. You hear me?" When it came to it, she didn't. It still wasn't petty because death-by-cancer never is. She was extremely weak and thin and tired. But on her last day she spoke to everyone in the family, gave weak hugs, said goodbyes. I guarantee you that guy took away days (at least) of suffering. We all knew that. He knew that. She knew that. Nobody said it though. And I think that's better than someone who can't afford to deal with a disability being asked if they're prefer to die than cost the state lots of money. Horror stories both sides of the nuance.
camel_gopher 2y ago
That breathing pattern is called the death rattle.
- tmjwid 2y ago
  When my dad died last year from aggressive relapse of cancer, his death rattle was so intense my mum couldn't deal with it and had to leave the room when it was happening, it's a disturbing experience. She's still traumatised by it today.
bamboozled 2y ago
I’ve witnessed similar and in a way, I think the person was kept alive too long. I personally think they would’ve died from other causes well before it got to the stage they were at. Euthanasia is probably a pretty important thing because of this. If we’re going to resuscitate people in their 80s, then maybe we shouldn’t let them go through the “long death” a few years later. All in all it’s a tragic thing the only constellation is that I guess after 24 hours in that, one welcomes death with open arms.
- LorenPechtel 2y ago
  I saw it with my father--to take the pain the morphine also took his memory. And in the end there was only suffering--fortunately, the problem would quickly kill making him eligible for terminal sedation.
anonzzzies 2y ago
Here they would ask you (unless dementia and not arranged, which is an ongoing issue) if you want more morphine and you can keep saying yes until you don’t wake up. Or click the button yourself; there is no limit (also; very hackable these limiting machines). Probably many people in a long decline would just hold the button until not waking up; that is the way it should be. Some people worry about the gov making us wear masks; I worry about govs preventing me from getting out when I want to. Not your fucking business mate.
- ozim 2y ago
  You know that government doesn’t care about you. They care about your relatives who are burdened not “accidentally” holding that button for you when somehow you would still like to live.
  - lotsofpulp 2y ago
    In the US, the big reason is religious groups that want to force their religion onto others.
    - anonymouskimmer 2y ago
      There are anti-euthanasia atheists (E.g. Kevin Yuell).
      - dghlsakjg 2y ago
        There are pro assisted suicide religions too. Neither of those matter because they don’t hold massive, disproportional influence over a huge part of the US political establishment.
        anonymouskimmer 2y ago
        In general in the US only White Evangelical Protestants and Black Protestants have less than a majority who believe assisted suicide / euthanasia should be available for "great pain and no hope of improvement", and those two groups still have over 40% who believe it should be available. And that's as of 2015, so the trend may be higher by now. https://www.pewresearch.org/short-reads/2015/10/05/california-legalizes-assisted-suicide-amid-growing-support-for-such-laws/ https://www.pewresearch.org/short-reads/2015/10/05/californi...
magicalhippo 2y ago
My dad had cancer that had spread to the lungs. He got pneumonia at the stage where he was having to use an oxygen machine at home. At the hospital he asked the doctors if he'd be able to go home, and they said it was highly unlikely. So, he asked them to turn off the oxygen, which they did. He passed peacefully a few hours later. Sure, we might have gotten a few extra months with him, but I'm so glad the doctors respected his wishes. My worst fear was him having to endure something like what you describe.
- LorenPechtel 2y ago
  That was my mother's philosophy. The hospital is for fixing you up and sending you home. If the sending home part isn't going to happen she didn't want treatment. The reality is there comes a point where the doctors can only prolong the dying--and in an awful lot of such cases that's a negative for the person.
kstenerud 2y ago
Someone I know acquired potassium cyanide for this reason. She's getting up there in age and wanted some insurance against a horrible death.
- LorenPechtel 2y ago
  Yeah, we are so obsessed with keeping people alive that this sort of thing is prudent behavior.
toss1 2y ago
So sorry to read of your loss, and the painful way it goes. Sadly, this is just one of millions of descriptions of why the phrase "Slow as death" exists. Generally, life really does not want to give up, and the process is indeed terrible.
ChumpGPT 2y ago
I watched someone die of ALS for 6 months, it was pure hell on earth. A middle aged guy who basically was vibrant and in average health struck down from out of no where, the final moments were horrific when they turned off the life support. Even his diagnoses was difficult since no doctor wanted to deliver the news and it required a trip to the MAYO Clinic to finally get an answer. I have often wondered why he was chosen to carry such a burden, a harmless and kind person.
wordsinaline 2y ago
When I think about having a kid I think about how this is how they will end. When you give birth you also give death.

conroydave 2y ago

Watched my grandfather pass in the same way. Didn’t seem right to let him pass of basically lack of food and hydration after 95 years even though also terminal. I just wanted to see him comfortable and he was far from it.

dghlsakjg 2y ago
In the last days when organs start failing, food and drink don’t necessarily make things more comfortable since the body can’t handle it.
- conroydave 2y ago
  Thanks for sharing. Helps a little bit
pineaux 2y ago
Same here, but i have been told that dying is like that unless thoroughly drugged.

spurgu 2y ago

I'm sorry for your loss. Edit: I feel a bit dumb now, I hadn't actually read the article yet, went straight for the comments. Seems like I'm just reiterating what it says. When I'm in that shape I just wanna go in peace. Preferably at home, in my own bed, surrounded by loved ones. No tubes down my throat, no shots to keep me alive at any cost, with no end in sight. Here's some good discussion on the topic between two doctors that I watched recently: https://youtu.be/O0YIGAUDlzQ?t=242 https://youtu.be/O0YIGAUDlzQ?t=242

lurking_swe 2y ago
The problem with this perspective in my opinion is that many times, especially for an elderly person, a small emergency can very quickly escalate into a life and death situation, and the outcome is not clear until it’s too late. you may enter the hospital thinking you have a decent outcome, but you end up with a bad outcome. for example, nobody plans to go on a ventilator. But if you need one (like severe pneumonia), you’re already pretty messed up and you’re going to have a painful death with or without the tubes.
- tremon 2y ago
  you’re going to have a painful death with or without the tubes But I feel that was the main point at the start of the thread: if death is certain and going to be painful, why must we drag it out? Why is that additional lifespan (measured in days) so much more important than comfort?
  - kqr 2y ago
    The point is that it's not certain. With the medical assistance you might recover fine and live another five happy years. Is it really worth trading away that opportunity just to not accidentally die on a ventilator? I'm not sure.
    - AlexandrB 2y ago
      There's a good article[1] on this topic that talks about how older doctors generally choose to forego lifesaving measures. I think about it a lot because it seems like when a professional who's in the best position to know the tradeoffs makes this kind of decision for themselves they probably understand the risk/reward better than you or me. [1] https://www.saturdayeveningpost.com/2013/03/how-doctors-die/ https://www.saturdayeveningpost.com/2013/03/how-doctors-die/

briffle 2y ago

> and unable to drink, so certainly terribly thirsty the whole time. I know people that work in hospice, and they say this is a big misconception (the article hints at it too). they patients don't die from lack of water, they don't want water because they are dying, and their body can't process it. In fact, as you kind of touched on at the start, giving them IV fluids can cause them to drown since their body can't process the water. Death is pretty ugly thing, that comes for us all. I got to learn the fun way that in the state of Oregon, it is illegal to disable a pacemaker. Even when the person has a DNR, and it is really the only thing keeping them alive. The best the doctors can do is turn the pacemaker down as low as possible, and hope its not enough to keep the person artificially alive. Which seems kind of really weird, when its also the first and one of the only states that allows medically assisted suicide..

BalinKing 2y ago
I'm no expert myself but recently had a relative in hospice,[0] which prompted me to look into this issue a bit. There are a few papers (for a recent example, Kingdon et al. (2020))[1] that say that the data is actually extremely low-quality on both sides of the issue. Personally, this makes me wonder if "fluids are bad" might just be received wisdom and/or anecdata... hopefully someone will do a better study(ies) at some point in order to get actually reliable data. [0] We did end up following the hospice's recommendations not to administer IV fluids, for what it's worth. [1] https://spcare.bmj.com/content/bmjspcare/11/1/68.full.pdf https://spcare.bmj.com/content/bmjspcare/11/1/68.full.pdf
Flumio 2y ago
The best thing they can do is shoot me with a nice does of heroin and after the high.just ending it. We know how to end life's.
- FerretFred 2y ago
  It's probably ironic that it's never been easier to buy that drug (and others) and decide your own fate compared with trying for a dignified and hopefully pain-free death the "legal" way.

louwrentius 2y ago

I’m quite convinced that I live in a country where we never let people die like this. Also, I guess prolonging treatment is in the interest of for-profit hospitals as found in other countries, thus as long as your suffering is profitable, you wil…

bamboozled 2y ago
I made a similar comment already but I kind of agree. I’m not sure if it’s about profit it’s also about legal concerns. I think legally doctors are supposed to keep you alive until they can’t anymore?
- ksenzee 2y ago
  No, truly, doctors are not legally required to keep people alive against their will. It’s just that you have to have made it clear in advance what kind of life-saving and comfort measures you want. You have to say “yeah actually I don’t want all that.” It’s hard on the doctors to watch people dying painfully with too much life support, too. They know what kind of death they want, and it’s not that. (As the article reflects.)
ksenzee 2y ago
I would be surprised if there exists a country where people never die like this. You would have to euthanize every single person who died of a long list of natural causes.
- mensetmanusman 2y ago
  Maybe NK will implement mandatory euthanasia at 63 or something crazy.
- raffraffraff 2y ago
  This is from personal experience, but there is a difference between letting someone take 2 weeks to starve or die of dehydration, and big-letters "euthanasia". Sometimes the people who work in palliative care are nuanced enough to ease you out when your final days come. Where I live, euthanasia is not legal. But when my sister was dying from cancer she directly told her palliative meds guy "I watched my uncle gasp for two weeks. I'm not going like that. You hear me?" When it came to it, she didn't. It still wasn't petty because death-by-cancer never is. She was extremely weak and thin and tired. But on her last day she spoke to everyone in the family, gave weak hugs, said goodbyes. I guarantee you that guy took away days (at least) of suffering. We all knew that. He knew that. She knew that. Nobody said it though. And I think that's better than someone who can't afford to deal with a disability being asked if they're prefer to die than cost the state lots of money. Horror stories both sides of the nuance.

camel_gopher 2y ago

That breathing pattern is called the death rattle.

tmjwid 2y ago
When my dad died last year from aggressive relapse of cancer, his death rattle was so intense my mum couldn't deal with it and had to leave the room when it was happening, it's a disturbing experience. She's still traumatised by it today.

bamboozled 2y ago

I’ve witnessed similar and in a way, I think the person was kept alive too long. I personally think they would’ve died from other causes well before it got to the stage they were at. Euthanasia is probably a pretty important thing because of this. If we’re going to resuscitate people in their 80s, then maybe we shouldn’t let them go through the “long death” a few years later. All in all it’s a tragic thing the only constellation is that I guess after 24 hours in that, one welcomes death with open arms.

LorenPechtel 2y ago
I saw it with my father--to take the pain the morphine also took his memory. And in the end there was only suffering--fortunately, the problem would quickly kill making him eligible for terminal sedation.

anonzzzies 2y ago

Here they would ask you (unless dementia and not arranged, which is an ongoing issue) if you want more morphine and you can keep saying yes until you don’t wake up. Or click the button yourself; there is no limit (also; very hackable these limiting machines). Probably many people in a long decline would just hold the button until not waking up; that is the way it should be. Some people worry about the gov making us wear masks; I worry about govs preventing me from getting out when I want to. Not your fucking business mate.

ozim 2y ago
You know that government doesn’t care about you. They care about your relatives who are burdened not “accidentally” holding that button for you when somehow you would still like to live.
- lotsofpulp 2y ago
  In the US, the big reason is religious groups that want to force their religion onto others.
  - anonymouskimmer 2y ago
    There are anti-euthanasia atheists (E.g. Kevin Yuell).
    - dghlsakjg 2y ago
      There are pro assisted suicide religions too. Neither of those matter because they don’t hold massive, disproportional influence over a huge part of the US political establishment.
      - anonymouskimmer 2y ago
        In general in the US only White Evangelical Protestants and Black Protestants have less than a majority who believe assisted suicide / euthanasia should be available for "great pain and no hope of improvement", and those two groups still have over 40% who believe it should be available. And that's as of 2015, so the trend may be higher by now. https://www.pewresearch.org/short-reads/2015/10/05/california-legalizes-assisted-suicide-amid-growing-support-for-such-laws/ https://www.pewresearch.org/short-reads/2015/10/05/californi...

magicalhippo 2y ago

My dad had cancer that had spread to the lungs. He got pneumonia at the stage where he was having to use an oxygen machine at home. At the hospital he asked the doctors if he'd be able to go home, and they said it was highly unlikely. So, he asked them to turn off the oxygen, which they did. He passed peacefully a few hours later. Sure, we might have gotten a few extra months with him, but I'm so glad the doctors respected his wishes. My worst fear was him having to endure something like what you describe.

LorenPechtel 2y ago
That was my mother's philosophy. The hospital is for fixing you up and sending you home. If the sending home part isn't going to happen she didn't want treatment. The reality is there comes a point where the doctors can only prolong the dying--and in an awful lot of such cases that's a negative for the person.

kstenerud 2y ago

Someone I know acquired potassium cyanide for this reason. She's getting up there in age and wanted some insurance against a horrible death.

LorenPechtel 2y ago
Yeah, we are so obsessed with keeping people alive that this sort of thing is prudent behavior.

toss1 2y ago

So sorry to read of your loss, and the painful way it goes. Sadly, this is just one of millions of descriptions of why the phrase "Slow as death" exists. Generally, life really does not want to give up, and the process is indeed terrible.

ChumpGPT 2y ago

I watched someone die of ALS for 6 months, it was pure hell on earth. A middle aged guy who basically was vibrant and in average health struck down from out of no where, the final moments were horrific when they turned off the life support. Even his diagnoses was difficult since no doctor wanted to deliver the news and it required a trip to the MAYO Clinic to finally get an answer. I have often wondered why he was chosen to carry such a burden, a harmless and kind person.

wordsinaline 2y ago

When I think about having a kid I think about how this is how they will end. When you give birth you also give death.