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After watching my father die with COPD, it because obvious that euthanasia happens in the US all the time. He opted out of lung-reduction surgery and was ready

After watching my father die with COPD, it because obvious that euthanasia happens in the US all the time. He opted out of lung-reduction surgery and was ready to die. So the hospital withheld IV hydration and provided a morphine drip and he was gone in 36 hours. How long can one live without water, a few days max? So that's what killed him. My sister-in-law who's a physician told me that's how it's typically done. I was horrified at the time.

tmpz22 2y ago
My dad has COPD and continues smoking. I'm going to go through this sooner than later. I've already made peace with this, I've seen the alternative in other family members and ultimately its the decline in dignity that pushes my moral compass to accept self-euthanasia as a humane option.
MichaelZuo 2y ago
I’ve heard it’s even more common per capita than in Canada, the difference being that it’s not on the record, so no statistics are collected about it.
hombre_fatal 2y ago
It's ethically childish that we use roundabout measures like that instead of just putting someone out of their misery overtly. It creates a drawn out process where the family has to wait around until they pass at some unknown point instead of coming together in one moment, making peace, saying their farewell, and witnessing the finality together. It took my girlfriend's vegetative mother a week to die as she struggled to breathe that whole time, put on just enough morphine to supposedly feel no pain and not a drop more. By the time she finally croaked, most of the family that had shown up to see her out had left because nobody has time to wait around days or weeks for death to happen. And it was emotional hell for her two daughters. They could've just given her a nice dose of morphine, but our ethics are too infantile. Instead we do make-believe.
- rightbyte 2y ago
  > It's ethically childish that we use roundabout measures like that Dogmas and tabus might be there for a reason. Culturally I think we need to pretend thing we don't think are true.
  - yatopifo 2y ago
    Comments here made me realize how heterogeneous our worldview actually is. There is a rather clear split between Canadian and American comments. The first group talks about euthanasia positively, but the second group is largely cautious, looking for negatives but not rejecting the idea altogether. I did not expect there would be such a dramatic rift.
7thpower 2y ago
Yes, I think that is not well understood. When my father-in-law passed, in a rural assisted living facility, we found they had stopped feeding him despite saying they were and our requests that they continue. We were stuck in this uncomfortable position of not being able to move him somewhere else, being completely blindsided by his (bone and bladder) cancer and how quickly it progressed, and not knowing what standard of care to advocate for understanding that he was passing. One of the things that was also frustrating is that when we would ask for more pain medication, they would refuse as it might lead him to stop breathing (I thought, ‘so what?’), yet they were making decisions that ultimately accelerated to his demise. Looking back, I don’t know that ceasing nutrition was a bad choice, but it wasn’t their decision to make. When I talked to friends in healthcare they effectively gave me the ‘oh, you sweet summer child’ talk. My FIL, while he could communicate, could not wait to be out of pain and I wish he had the agency to make the decision before having to go through endless pain in the delirium of opioids. There are, of course, details I’m leaving out, but my general takeaway is that in at least some cases the euthanasia debate is not about whether the call is being made, but who is making the call. That is not alone reason to support one side of the debate or another, but it is an important nuance that I was naive about until I witnessed it first hand. Edit: what I described does not appear to meet the traditional definition of euthanasia, but I will leave the post in its original form and just clarify that I mean making decisions that hasten someone’s death either passively or actively.
- mjevans 2y ago
  The setup for 'Living Wills' and directives to doctors, at least in the US as recently as ~4-5 years ago, suck. I remember thinking at the time that I saw what family was filling out that they failed to express the nuance that I would like for my own directives. Generally if there's still hope for recovery to a not-shitty life then I'd prefer to proceed towards that. Even as extreme as E.G. that Leadale anime's setup where the protag's broken from the neck down but can live in a VR gameworld (deeper immersion so they can still move, taste, etc). If there's still real hope for reaching that, it might be worth toughing it out and waiting. However that sort of nebulous criteria that requires a human to evaluate isn't present. I can't empower the doctors with such vague goals and say 'make your best call as a HUMAN doctor with that vague goal'. If that good route isn't an option, then I wouldn't want to stick around either... and the lack of a clear legal euthanasia option in much of the US pushes people to roundabout failures for lack of food / water intake, or just giving in to inevitable statistics when a cold or stressed body complication like a heart attack happen. Heck, if my brain's the part that's fraying apart and I want to die anyway, please harvest the working organs as my method of death so someone else can live better.
JohnBooty 2y ago
it because obvious that euthanasia happens in the US all the time [...] So the hospital withheld IV hydration and provided a morphine drip and he was gone in 36 hours I had a family member with late-stage terminal COPD opt out of further treatment. They were in respiratory crisis and were going to be intubated for the nth time with no real hope of recovery, and so they said "fuck it" and delined further intervention. The hospital (a Catholic hospital, even) provided a morphine drip and they were gone within an hour. I was never really clear on what killed them in the end, if it was the morphine or the COPD. I guess technically it was the COPD. Anyway, as somebody who went through something similar: I'm so sorry. COPD is such a slow and crappy way to go. Have you been able to find some peace in the years since?
- dogman1050 2y ago
  I have, thanks. I'll always remember his last words to me, "You're a prince."
  - JohnBooty 2y ago
    I'm so glad to hear that. We were able to have some closure as well, similarly... it was a comfort...
  - airstrike 2y ago
    That's a beautiful memory. I'm sorry for your loss.
  - travisporter 2y ago
    That teared me up
- toasterlovin 2y ago
  > The hospital (a Catholic hospital, even) provided a morphine drip and they were gone within an hour. FWIW, Catholic ethics are actually fairly well thought out on this issue. You're not allowed to withhold basic nourishment (food, hydration, non-invasive breathing support), but you are allowed to opt out of invasive procedures such as intubation and provide pain management if the patient or the patient's guardian decides that it would significantly affect quality of life and the patient doesn't have long to live. Obviously there is discernment involved in the last bit, but Catholicism is all about discernment. Here's the National Catholic Bioethics Center on the topic: https://www.ncbcenter.org/resources-and-statements-cms/summary-end-of-life-care https://www.ncbcenter.org/resources-and-statements-cms/summa...
anon291 2y ago
We need to be clear on terms here. Killing someone with a drug intended to stop the heart / prevent respiration is unequivocally euthanasia. Withholding treatments is not euthanasia. Nor is pain medication that hastens death. Those are things we can have an ethical discussion about. As for IV drip.. that's another discussion. I personally would not ever do that. Water is a basic thing for humanity, and should be provided. Unless he explicitly refused the water. Then, that's his choice. I think I ultimately reject the idea that this is not well-understood, because the largest organizations opposed to euthanasia (the Catholic church for example) has given endless thought to this, and explicitly accepts the situation you described. Opponents of euthanasia are not ignorant.
- wat10000 2y ago
  Why can someone make the choice not to have water in their IV, but can’t make the choice to have a fuckton of morphine in their IV?
  - s1artibartfast 2y ago
    I think a lot of it comes down to deontological logic and morality versus consequentialist morality. It is recognized that the outcome is the same. The difference lies and how you get there
    - wat10000 2y ago
      I was thinking that the divide probably lines up pretty well with people who think the Trolley Problem is a great moral quandary versus people who think it’s obvious you pull the lever and don’t understand the fuss. Which is basically what you said.
      - s1artibartfast 2y ago
        I completely agree. I thought about bringing it up in the post, but opted for brevity. Also, I am genuinely amused that my post is getting downvotes. People are fascinating
HideousKojima 2y ago
Withholding aid is morally fundamentally different than proactively ending someone's life.
- gambiting 2y ago
  In the sense that it's worse? My dad also spent days dying from extremely aggressive cancer, being in unimaginable amounts of pain, with all of his organs slowly shutting down, his limbs becoming swollen from pooling blood, unable to drink, unable to eat, crying about how much pain he's in and how much he wants to go home. And all the hospital could do was give him enough morphine to knock him our and we waited by his bedside for 4 days until he finally drew his last breath, probably due to lack of fluids at this point. Tell me - where does the "morality" stand here compared to him proactively ending his own life with a drug before all of this happened, if he had such an option and decided to take it? How is what he went through morally better like some people say it is compared to euthanasia(I don't know if you think that, but it's a common argument). There's no dignity in any of this.
- dghlsakjg 2y ago
  This is not at all decided. This is just the trolley problem rephrased.
wonger_ 2y ago
Reminds me of this experience of someone from the UK: https://jameshfisher.com/2017/05/19/granddad-died-today/ https://jameshfisher.com/2017/05/19/granddad-died-today/ "Terminal dehydration is a way to skirt the Suicide Act, because we can claim that withholding water is just like withholding treatment. Ramping up painkillers and sedatives is a way to skirt the Suicide Act, because we can claim that the medication helps the patient cope with their death, rather than inducing their death."
standardUser 2y ago
> So the hospital withheld IV hydration and provided a morphine drip and he was gone in 36 hours. I watched loved ones die this way. It's cruel, absurd and grotesque. A doctor will look you dead in the eye and say "your loved one will be dead within a few days" and instead of killing them mercifully you are forced to watch them die of dehydration. A maddening and indefensible relic that I believe younger generations will abolish. There's obviously far more complicated end of life situations, but this particular case is extremely common.
- SoftTalker 2y ago
  Death by dehydration, at least for an old sick person, is rather natural and though it sounds awful it’s not really painful for the dying person. Before IV hydration it’s how most people died.
- bamboozled 2y ago
  I believe younger generations will abolish. I wouldn’t count on it. I’ve learned young people are just the same as everyone else. I hope I’m wrong but I used to think they had more empathy. Let’s see.,
- dghlsakjg 2y ago
  My BIL is a head hospice nurse. If it helps, they don’t ever deny people fluids who want or need them. What happens towards the end is the body stops being able to process fluids due to failing organs. Pushing fluids into someone in this state makes them less comfortable. People aren’t thirsty or suffering from a lack of fluids. As far as putting someone out of their misery, there’s a reason that they put them on high dosage opioids. If you want to keep someone out of pain while helping their heart and lungs stop peacefully, you couldn’t pick a better drug.
  - muhis 2y ago
    Thank you for this comment. I have also worked a bit with hospice. Unfortunately, there is a lot of misinformation regarding this issue. I find it sad that some are left with the incorrect notion that their loved ones were denied care at their last moment. I.v. fluids may somewhat alleviate sedation of a dying person, but they can increase swelling, formation of pleural fluids and cause shortness of breath. If a dying person won’t drink anything anymore, it’s mostly a sign that they don’t need any extra fluids.

tmpz22 2y ago

My dad has COPD and continues smoking. I'm going to go through this sooner than later. I've already made peace with this, I've seen the alternative in other family members and ultimately its the decline in dignity that pushes my moral compass to accept self-euthanasia as a humane option.

MichaelZuo 2y ago

I’ve heard it’s even more common per capita than in Canada, the difference being that it’s not on the record, so no statistics are collected about it.

hombre_fatal 2y ago

It's ethically childish that we use roundabout measures like that instead of just putting someone out of their misery overtly. It creates a drawn out process where the family has to wait around until they pass at some unknown point instead of coming together in one moment, making peace, saying their farewell, and witnessing the finality together. It took my girlfriend's vegetative mother a week to die as she struggled to breathe that whole time, put on just enough morphine to supposedly feel no pain and not a drop more. By the time she finally croaked, most of the family that had shown up to see her out had left because nobody has time to wait around days or weeks for death to happen. And it was emotional hell for her two daughters. They could've just given her a nice dose of morphine, but our ethics are too infantile. Instead we do make-believe.

rightbyte 2y ago
> It's ethically childish that we use roundabout measures like that Dogmas and tabus might be there for a reason. Culturally I think we need to pretend thing we don't think are true.
- yatopifo 2y ago
  Comments here made me realize how heterogeneous our worldview actually is. There is a rather clear split between Canadian and American comments. The first group talks about euthanasia positively, but the second group is largely cautious, looking for negatives but not rejecting the idea altogether. I did not expect there would be such a dramatic rift.

7thpower 2y ago

Yes, I think that is not well understood. When my father-in-law passed, in a rural assisted living facility, we found they had stopped feeding him despite saying they were and our requests that they continue. We were stuck in this uncomfortable position of not being able to move him somewhere else, being completely blindsided by his (bone and bladder) cancer and how quickly it progressed, and not knowing what standard of care to advocate for understanding that he was passing. One of the things that was also frustrating is that when we would ask for more pain medication, they would refuse as it might lead him to stop breathing (I thought, ‘so what?’), yet they were making decisions that ultimately accelerated to his demise. Looking back, I don’t know that ceasing nutrition was a bad choice, but it wasn’t their decision to make. When I talked to friends in healthcare they effectively gave me the ‘oh, you sweet summer child’ talk. My FIL, while he could communicate, could not wait to be out of pain and I wish he had the agency to make the decision before having to go through endless pain in the delirium of opioids. There are, of course, details I’m leaving out, but my general takeaway is that in at least some cases the euthanasia debate is not about whether the call is being made, but who is making the call. That is not alone reason to support one side of the debate or another, but it is an important nuance that I was naive about until I witnessed it first hand. Edit: what I described does not appear to meet the traditional definition of euthanasia, but I will leave the post in its original form and just clarify that I mean making decisions that hasten someone’s death either passively or actively.

mjevans 2y ago
The setup for 'Living Wills' and directives to doctors, at least in the US as recently as ~4-5 years ago, suck. I remember thinking at the time that I saw what family was filling out that they failed to express the nuance that I would like for my own directives. Generally if there's still hope for recovery to a not-shitty life then I'd prefer to proceed towards that. Even as extreme as E.G. that Leadale anime's setup where the protag's broken from the neck down but can live in a VR gameworld (deeper immersion so they can still move, taste, etc). If there's still real hope for reaching that, it might be worth toughing it out and waiting. However that sort of nebulous criteria that requires a human to evaluate isn't present. I can't empower the doctors with such vague goals and say 'make your best call as a HUMAN doctor with that vague goal'. If that good route isn't an option, then I wouldn't want to stick around either... and the lack of a clear legal euthanasia option in much of the US pushes people to roundabout failures for lack of food / water intake, or just giving in to inevitable statistics when a cold or stressed body complication like a heart attack happen. Heck, if my brain's the part that's fraying apart and I want to die anyway, please harvest the working organs as my method of death so someone else can live better.

JohnBooty 2y ago

it because obvious that euthanasia happens in the US all the time [...] So the hospital withheld IV hydration and provided a morphine drip and he was gone in 36 hours I had a family member with late-stage terminal COPD opt out of further treatment. They were in respiratory crisis and were going to be intubated for the nth time with no real hope of recovery, and so they said "fuck it" and delined further intervention. The hospital (a Catholic hospital, even) provided a morphine drip and they were gone within an hour. I was never really clear on what killed them in the end, if it was the morphine or the COPD. I guess technically it was the COPD. Anyway, as somebody who went through something similar: I'm so sorry. COPD is such a slow and crappy way to go. Have you been able to find some peace in the years since?

dogman1050 2y ago
I have, thanks. I'll always remember his last words to me, "You're a prince."
- JohnBooty 2y ago
  I'm so glad to hear that. We were able to have some closure as well, similarly... it was a comfort...
- airstrike 2y ago
  That's a beautiful memory. I'm sorry for your loss.
- travisporter 2y ago
  That teared me up
toasterlovin 2y ago
> The hospital (a Catholic hospital, even) provided a morphine drip and they were gone within an hour. FWIW, Catholic ethics are actually fairly well thought out on this issue. You're not allowed to withhold basic nourishment (food, hydration, non-invasive breathing support), but you are allowed to opt out of invasive procedures such as intubation and provide pain management if the patient or the patient's guardian decides that it would significantly affect quality of life and the patient doesn't have long to live. Obviously there is discernment involved in the last bit, but Catholicism is all about discernment. Here's the National Catholic Bioethics Center on the topic: https://www.ncbcenter.org/resources-and-statements-cms/summary-end-of-life-care https://www.ncbcenter.org/resources-and-statements-cms/summa...

anon291 2y ago

We need to be clear on terms here. Killing someone with a drug intended to stop the heart / prevent respiration is unequivocally euthanasia. Withholding treatments is not euthanasia. Nor is pain medication that hastens death. Those are things we can have an ethical discussion about. As for IV drip.. that's another discussion. I personally would not ever do that. Water is a basic thing for humanity, and should be provided. Unless he explicitly refused the water. Then, that's his choice. I think I ultimately reject the idea that this is not well-understood, because the largest organizations opposed to euthanasia (the Catholic church for example) has given endless thought to this, and explicitly accepts the situation you described. Opponents of euthanasia are not ignorant.

wat10000 2y ago
Why can someone make the choice not to have water in their IV, but can’t make the choice to have a fuckton of morphine in their IV?
- s1artibartfast 2y ago
  I think a lot of it comes down to deontological logic and morality versus consequentialist morality. It is recognized that the outcome is the same. The difference lies and how you get there
  - wat10000 2y ago
    I was thinking that the divide probably lines up pretty well with people who think the Trolley Problem is a great moral quandary versus people who think it’s obvious you pull the lever and don’t understand the fuss. Which is basically what you said.
    - s1artibartfast 2y ago
      I completely agree. I thought about bringing it up in the post, but opted for brevity. Also, I am genuinely amused that my post is getting downvotes. People are fascinating

HideousKojima 2y ago

Withholding aid is morally fundamentally different than proactively ending someone's life.

gambiting 2y ago
In the sense that it's worse? My dad also spent days dying from extremely aggressive cancer, being in unimaginable amounts of pain, with all of his organs slowly shutting down, his limbs becoming swollen from pooling blood, unable to drink, unable to eat, crying about how much pain he's in and how much he wants to go home. And all the hospital could do was give him enough morphine to knock him our and we waited by his bedside for 4 days until he finally drew his last breath, probably due to lack of fluids at this point. Tell me - where does the "morality" stand here compared to him proactively ending his own life with a drug before all of this happened, if he had such an option and decided to take it? How is what he went through morally better like some people say it is compared to euthanasia(I don't know if you think that, but it's a common argument). There's no dignity in any of this.
dghlsakjg 2y ago
This is not at all decided. This is just the trolley problem rephrased.

wonger_ 2y ago

Reminds me of this experience of someone from the UK: https://jameshfisher.com/2017/05/19/granddad-died-today/ https://jameshfisher.com/2017/05/19/granddad-died-today/ "Terminal dehydration is a way to skirt the Suicide Act, because we can claim that withholding water is just like withholding treatment. Ramping up painkillers and sedatives is a way to skirt the Suicide Act, because we can claim that the medication helps the patient cope with their death, rather than inducing their death."

standardUser 2y ago

> So the hospital withheld IV hydration and provided a morphine drip and he was gone in 36 hours. I watched loved ones die this way. It's cruel, absurd and grotesque. A doctor will look you dead in the eye and say "your loved one will be dead within a few days" and instead of killing them mercifully you are forced to watch them die of dehydration. A maddening and indefensible relic that I believe younger generations will abolish. There's obviously far more complicated end of life situations, but this particular case is extremely common.

SoftTalker 2y ago
Death by dehydration, at least for an old sick person, is rather natural and though it sounds awful it’s not really painful for the dying person. Before IV hydration it’s how most people died.
bamboozled 2y ago
I believe younger generations will abolish. I wouldn’t count on it. I’ve learned young people are just the same as everyone else. I hope I’m wrong but I used to think they had more empathy. Let’s see.,
dghlsakjg 2y ago
My BIL is a head hospice nurse. If it helps, they don’t ever deny people fluids who want or need them. What happens towards the end is the body stops being able to process fluids due to failing organs. Pushing fluids into someone in this state makes them less comfortable. People aren’t thirsty or suffering from a lack of fluids. As far as putting someone out of their misery, there’s a reason that they put them on high dosage opioids. If you want to keep someone out of pain while helping their heart and lungs stop peacefully, you couldn’t pick a better drug.
- muhis 2y ago
  Thank you for this comment. I have also worked a bit with hospice. Unfortunately, there is a lot of misinformation regarding this issue. I find it sad that some are left with the incorrect notion that their loved ones were denied care at their last moment. I.v. fluids may somewhat alleviate sedation of a dying person, but they can increase swelling, formation of pleural fluids and cause shortness of breath. If a dying person won’t drink anything anymore, it’s mostly a sign that they don’t need any extra fluids.