Wednesday, November 26, 2008

The quality of mercy

The long goodbye has been longer than we ever thought it would be; instead of days or weeks, it's now been over a year since my mother-in-law was admitted to a nursing home.

In hindsight it was naive to think that the suffering would be so short in duration. It was also not apparent at the time that the nursing home into which she'd first been admitted was integral to the condition she was in when I first wrote about her long goodbye.

It was the cost of the facility that changed our perspective about her condition; at $6000 a month for care, she could not stay there overlong. She was moved to a family facility, a setting that was less institutional and more home-like, and at half the cost. Her condition actually improved, buying more time for my father-in-law and mother-in-law to disentangle themselves from each other.

And yet the ultimate challenge remained, one that might have been forced sooner by the institutional facility that the home facility has delayed. At what point does one finally say, "Enough," and begin to reduce the life-prolonging care which only prolongs suffering as well?

For many the question will be asked of them abruptly; they may not fully understand the question at the time, hurting from loss and confused by the suddenness, and yet the question may be very easy to answer. But the question is so much more difficult when a loved one's decline is subtle, difficult to measure. What if organ failure has not started, but is very nearly begun? What if intravenous antibiotics will heal a minor injury, but trip organ failure? Do you refuse or pull antibiotics?

In this case, there will be no recovery. There will be no restoration to wholeness, there will be no guarantees that the antibiotics will even work.

We opt for mercy.

We opt not to turn this poor person, trapped inside a body that will no longer obey their will, trapped in a bed or a chair all day, unable to express their will, confused and no longer able to recognize loved ones or respond to stimulus consistently. We opt not to make this person a pin cushion poked with needles with no assurance but that there will be more opportunities for further poking in the near future.

And although it pains us greatly, we opt to make our final this long goodbye.

One of the biggest frustrations with the so-called pro-life adherents is their inability to deal with this question; everything must be done to prolong life, no matter the quality of that life. There is never a moral hazard perceived, that such protracted efforts might constitute nothing more than prolonged torture.

The quality of mercy never enters into this equation.

What is mercy but having the emotional and spiritual fortitude to end suffering? Is there any virtue in prolonging suffering if it's not yours but that of another who can no longer help themselves?

Is it not our moral obligation not to merely extend life, but to provide mercy, permitting the peace of death to descend rather than perpetuate the harassment of life by being harassment itself?

We all have to answer these questions on our own and with our families. We are giving our answer today. May you have the ability to make your own choices, and when choosing for others, the strength to choose mercy as you deem necessary.


[Cross-posted at Oxdown Gazette. Photo: Lake of the Clouds, Porcupine Mountains, Michigan's Upper Peninsula by wisconsinhiker via Flickr.com]

Comments:
Just happened over here after recognizing your name at Dick Jones's blog. I'm "Mrs. Perils". My nearly 91 year old mother has just started her 7th year of living with us, and I find I am gathering all kinds of narratives and information about the impending end of life. I know it is almost never a pretty thing, death, and have been trying to figure out how I should get prepared for her further decline.
I hope you and your are doing all right.
 
Just happened over here after recognizing your name at Dick Jones's blog. I'm "Mrs. Perils". My nearly 91 year old mother has just started her 7th year of living with us, and I find I am gathering all kinds of narratives and information about the impending end of life. I know it is almost never a pretty thing, death, and have been trying to figure out how I should get prepared for her further decline.
I hope you and your are doing all right.
 
Very glad to have you stop by, give my best to your spouse.

It's really difficult to "prepare" for the end of life; we don't discuss it often enough throughout our lives, and our culture is so death-phobic. But there are basics that should be addressed (and you likely have already). The legal documents are the worst part -- springing power of attorney, health care power of attorney, guardianship and conservatorship, all must be notarized and witnessed properly depending on state law. But there's also the funeral; what does your mother want in the way of a service? Has she cleaned up the odds and ends that will help family she left behind? I struggled with jewelry that had some unknown provenance -- what was valuable, what was sentimental and why, as an example. And family photos.

Wow, that one is huge. Only my MIL knew who was in those photos and what the events were, and now she's gone.

Feel free to drop me another comment any time; all of my friends are now at that age where we're dealing with end of life. We might as well keep each other company and share the load.
 
Thank you so much for responding. I would like very much to stay in touch with you.
Mr. Perils says hello. He said you had gotten into political activism, and maybe were still busy with it. I hope it went well.
 
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