An Ethical Delimma

[Buzzard]

One faced by many, I am afraid, these days, including one person, lets just say, I am very close to.

Incurable metastatic cancer, but the end is not yet imminent. At obscene expense, medical science has reduced the tumors considerably. There are in fact, no physical symptoms of the cancer at this point, though there are side effects from the medication, which are irritating but not debilitating. Eventually, the cancer, being the sneaky, sucky disease that it is, will adapt to this medication and begin to grow again. When that happens, there are two fallback chemotherapy options. The first, being touted by the docs, is very effective, but has some brutal side effects. There won't be a great quality of life, but there will be intervals between treatments where the person in question will feel at least decent.

Second option has considerably fewer side effects, but is not as effective, generally speaking. It will knock back the tumors for a while, but for most people, life will not be as long as with the first option. Docs won't say how much of a difference in life expectancy there is, since "every one reacts differently to different treatments". It is safe to say, that the "rougher" option would bring several extra months of life, though with much worse side effects. Taking the second option then switching to the first is not possible for reasons that are too medically technical to go into here.

The first reaction of the person in question was to proclaim that he had no interest in being an "exhausted, bald, diarreah machine", and would not consider the first option, period. This attitude has been upsetting to his close family, who want him to fight the cancer with all weapons available. Lately, he has begun to think that the gift of life given to him is not one to be casually thrown away. He even asked if not using all the chemotherapy tools available would be a form of suicide.

Like I said, the decision is not upon him but probably will be in a matter of a few to several months. This has been a matter of long prayer, study, and mediation, but no prompting as to a correct path has been forthcoming.

I know that a group of internet strangers cannot make such a harrowing call, but some of you might have some insight that you have gained through similar situations. Your thoughts, feelings, or even random musings may actually be of some assistance.

[sjdawg]

I'm sorry that you are going through this. My Dad also has incurable cancer and he decided against treatment which may or may not prolong his life. We support him in this decision. Over the past 2 years (since his diagnosis) he has maintained a very good quality of life and has in fact lived longer than expected. In his case, I truly believe he made the right decision.

[blackstrap]

Ask a person who has experienced watching a loved one slowly die from cancer and the effects of chemo etc. on the loved one. Ask them if,after that experience,they would have done it again ,or would have perferred a different course.

As for me,I would agree with the first response you spoke of.

[CV75]

The first reaction of the person in question was to proclaim that he had no interest in being an "exhausted, bald, diarreah machine", and would not consider the first option, period. This attitude has been upsetting to his close family, who want him to fight the cancer with all weapons available. Lately, he has begun to think that the gift of life given to him is not one to be casually thrown away. He even asked if not using all the chemotherapy tools available would be a form of suicide.

Ii is natural for him to vacillate, perhaps wildly, between the two extremes you described and hopefully he will eventually settle on course that recognizes the sanctity and proper roles of both life and death. He might approach this in terms of neither ending nor extending his life by means he beleives to be unreasonable, and then taking his decision to the Lord.

[wenglund]

I was a caretaker for my dad during the last several years of his life. After dealing with his multiple bouts with cancer and the onset of Alzheimer, there was only one thing more harrowing than watching him suffer excessive pain for days on end, and that was being the one to decide to let him pass. I wouldn't wish this on anyone else, though I look back on the experience with great privilege, reverence, and sacredness, and in a way I was glad I could spare my dad having to make that difficult choice on top of all that he endured.

I can only imagine how much worse it might be were I the one going through the pain and suffering and had to make life/death decision for myself--particularly if close family preferred that I prolong my own suffering so that I could be with them longer.

I don't know who is footing the medical bills or whether or not that may factor into people's thinking, However, were I able to cover the expenses myself, and not burden my family, I may seriously consider suffering through the extended life, if for no other reason than to send a message to close family members and friends to say just how much I love and care for them, and what I am willing to do for them if they wish, and also how precious I consider the gift of life.

Of course, it is easy for me to say this when I am not actually suffering at this time. Who knows what I might think were I in the situation.

Whatever is decided, I hope all parties concerned will eventually, if not now, respect and support the decision. It is enough for the afflicted to go through the illness and treatment as it is, let alone adding to it the turmoil of family discord and guilt.

These are the times when selflessness, love, and concern for others is most pertinent and burdens are best lightened among many hands, particularly on behalf of those most in need.

For what it is worth...

Thanks, -Wade Englund-

[rpn]

I watched my dad die of pancretic cancer. I watched my other father die in a serious of hospital interventions. And I watched my mother suffer through other interventions. And my sister died of multiple myeloma after spending obscene amounts on medication. (Not to mention that the church handbook says that extraordinary lifesaving treatments are not required.) When I know I am going to die, I'm going to live as rich a life as I can for as long as I have left. I read recently that drs mostly decide that for themselves too. http://zocalopublicsquare.org/thepublicsquare/2011/11/30/how-doctors-die/read/nexus/ It is neither selfish nor suicidal to refuse to artificially prolong life and use up precious medical and financial resources in the process.

Edited March 5, 2012 by rpn

[Storm Rider]

Both of my parents passed away from cancer. My mother regretted going through chemotherapy which destroyed her quality of life. My father chose not to go through chemotherapy and died rather peacefully.

Medicine is capable of keeping an individual alive past their death; it can prolong life when we would have long since been dead even fifty years ago. I have concluded that simply because we can do something does not mean that we should do it. For me I will choose that which brings quality of life. If it destroys it, what is the benefit?

Some decisions are just very difficult, supremely so at times. They are best made before the need arises so that families and couples understand what each feels best about. God bless you and each member of your family with peace.

[The Nehor]

I would take the second option myself (less side-effects, shorter lifespan). The gift of life is valuable but not of infinite worth. Given the choice between dying slowly in a lot of pain with less ability to do anything and the option of being able to function and finish out my life and then quickly continue it elsewhere I see little contest.

I wouldn't make the decision for anyone else unless I had to though.

[thesometimesaint]

I've already made the decision to deny myself medical services in the vain hope of a few extra weeks(months) of no quality of life. It is a very personal decision that each of us has to make. I have no desire to "live" in a prolonged vegetative state, or unable to take care of my basic needs. Let me go home to the father of my spirit. It will be a grand reunion with my loved ones who have gone on before me.

[Teancum]

Buzzard

First let me express my sorrow for the situation you and your loved one are in. My prayers are with you.

As a cancer survivor I will say that this is a very personal decision. My prognosis was positive from the beginning but the treatment ran a full year-chemo, radiation, 3 surgeries. It was tough. I know many cancer patients, some who have suvived and some who have not. I like the motto of the Lance Armstrong Foundation:

We believe that unity is strength, knowledge is power and attitude is everything.

But the also believe when someone decides it is time to let go then that choice should be respected. Check them out. They have great support tools.

So I agree with much of what was said here. Your loved one needs to make the choice prayerfully and carefully. Your family can do best by being supportive, loving and kind regardless of the decision. Keep in mind the Church does believe one must take extreme measure to prolong life. On the other hand there is a story in the bio of Neal Maxwell. There was a young instirute professor that had terminal brain cancer. The treatment was harsh and he was in a lot of pain. He wondered if he should continue the treatment. He counseled with Elder H B Lee. Elder Lee told him that life was ever so precious, even the suffering of it and that the ill brother should continue treatment, that they would bless him to be able to endure the pain. Who knows, said Elder Lee that this test is what you really need to learn what you need for exaltation.

That is tough council. I think again, that your loved one has to be very prayerful and think it through then decide and it is their decision ultimatlly.