Art Buchwald did it his way. Others make the choice every day. My mother-in-law has now made the choice, too, and I’d even made a similar decision myself, although I was fortunate because it turned out to be unnecessary.
It’s the choice NOT to be treated for a disease or condition — a choice, instead, to let nature take its course, or to put ourselves into God’s hands. No chemo, no dialysis, no surgery, no invasive drugs — whatever it is, some patients decide they would rather NOT be treated, because they believe they are choosing quality over quantity of life.
I bring this up, because a reference to this article in the LA Times arrived in my email yesterday: http://www.latimes.com/features/health/la-he-enough5feb05,1,346255.story?coll=la-headlines-health — and even more importantly — because we learned this week that my mother-in-law has decided to refuse chemo for her ovarian cancer. She’s 86, frail, and failing and she has decided the nausea, baldness and other side effects which might buy her a few months, will exact too high a price. I understand her decision completely.
According to the article in the LA Times, more and more Americans are refusing life-extending treatment. I think it’s safe to assume most make those choices with their own quality of life in mind. There’s also the fact that most of us don’t ever want to be a burden to our loved ones. We don’t want to suffer, we don’t want our children and loved ones to suffer, we don’t want them to have to watch us suffer, and we don’t want to incur the cost burden it puts on our own finances. We’d rather have our kids end up with our hard-earned money, or leave it to a charity near and dear to us, than have some anonymous corporation get it.
I’m in a unique position of having been in that position — and I refused treatment. In my case, I decided that a few months of quality was more valuable to me than two years of weighing the horrors of chemo alongside trying to maintain some quality of life. At least that’s what I think was happening. There’s also the fact that I never really did believe I had cancer — I never bought-in entirely — so if I allowed myself to go through chemo, I’d be giving in to the diagnosis. Honestly, it’s all mixed up in my head. That was such an enormously stressful time.
I’ve had a handful of patients tell me their doctors pressured them into a treatment they didn’t really want. That was my experience, too. At the end of my misdiagnosis debacle, I accused my oncologist of insisting I go through chemo because it was the only way he could make money from me. I stand by my accusation, and I think that happens every day, although — to be clear — I DON’T think it’s the norm. In most cases I think life-extending treatments are offered in good faith. But that doesn’t mean a patient needs to go along with it.
Choosing — or refusing — treatment is the ultimate decision a patient must make. Sharp patients realize it is their decision — and theirs alone — to make.
Thanks, Art Buchwald. You’ve left a legacy you didn’t know you’d be leaving. Just one more reason why you were a gift to us all.
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