[full disclosure: an old friend recently chose to draw life to a close -
she had a rare and untreatable condition that caused her entiree
intestinal tract to undergo systemic change and tissue overgrowth that
was slowly shutting down all ability to eat, drink, or absorb nutrition.

her life might have been sustained for another year or two had she
elected to have a series of gastric tube implants - but they would have
failed one after another as the tissue changes advanced

she decided that to undergo such, and only gain another year or so was
not any way to live - and went into hospice care instead. after
withdrawing any form of tube nutrition, she passed quitely in her sleep
last week; at home, with her family - as she wished.

all of us in the circle that she called 'friend' had private moments
during those few weeks before she passed - talking and laughing with her
about  - oh, just anything. there was no pain, nor sorrow -

in her view, she was about to embark upon the greatest adventure
unknowable to any of us in advance -
what lies ahead after we die?]

as to the post:

imo - this is a specific instance of the debate that has gone on since
time immemorial

who gets to decide when enough is enough? should anyone get to make such
a decision?

one either believes that only the 'individual' has that right, or you
don't.

specifically:

the individual may or may not have been depressed - a supposition on
your part -

for discussion let us posit that they were or had been

whether there was or was not depression prior has no actual bearing on
the conditons that came to apply after the cancer diagnosis - as it
stands with the concurrent diagnosis itnow clearly falls within the law,
and with such, the 'prior' request became moot.

thus, all palliative care practioners have a legal obligation to follow
the written directive of the individual, and may not allow family or
friends wishes to supercede those of the individual

so to, do family members have to wrestle with the decisions their loved
one make. would it have been legal to 'assist' the individual in
obtaining such a pill?

not as such [directly obtaining a pill under false premises] in the
united states - but in some states, and some other countries, with a
doctors partnership, yes.
cite:

http://www.euthanasia.com/bystate.html
[note: oregon's death with dignity law was upheld by the u.s. supreme
court]

http://www.assistedsuicide.org/suicide_laws.html

Tom,

How very sad but you must know that at 70 and being ill with diabetes
followed by lung cancer a person can lose of appetite and their desire
to eat and their desire to live.

Depression accompanies many illnesses. Is he taking medications?  Does
he drink ensure?
Patients can live a long time just on ensure, believe it or not!

If he is allowing medications, you might look into megestrol, thats
what the VA has my husband taking to help him regain a desire to eat
and to prevent further body mass loss.

He may feel like so many others who have discovered our broken medical
system and feel its not worth it or the costs and doesn't wish to be a
burden and knows exactly how he wants to live and die.

Depressed or not we all have choices to make concerning our health
issues...I just hope our rights to refuse medical treatments are not
taken from us...

February ~ 2008 Online Patient Name Change Movement

If you missed Personal Statement for Patients or The Real History
Behind the Name Change movement!

Please read:
http://www.rescindinc.org/

Personal Statement for Patients
http://cfsviraltreatment.com/personal_statement/index.html

What is Fibromylagia?
http://www.spineuniverse.com/displayarticle.php/article155.html

Beyond Nuclear:
Four Score Organizations Express Opposition to Yucca Mountain Nuclear
Waste Dump

Excerpt:
"Shipping tens of thousands of high-level radioactive waste trucks,
trains, and barges through 45 states and the District of Columbia
risks severe accidents and terrorist attacks," said Kamps of Beyond
Nuclear. "This could release catastrophic amounts of deadly
radioactivity in major population centers, representing potential
Mobile Chernobyls and dirty bombs on wheels rolling past the homes of
millions of Americans," Kamps added.
http://www.commondreams.org/news2008/0111-03.htm

Keep yourself abreast of updated research and share it with others
all
over the world.  Be sure to compare Post Polio Syndrome, Fibromyalgia,
Myalgic Encephalomyelitis, CFIDS, CFS, MS, MCS, GWI/GWS and all
related diseases and symptoms to studies involving: radiation,
nuclear, and chemical poisonings...

Fatigue is an issue, but then again, so are neurotoxins being
produced
in our bodies...DS

Research
http://www.ncf-net.org/Discoveries.htm

Please continue to keep my husband, George, and my loved ones in your
prayers, thank you.  There are many, many others who need prayers and
thoughts as well... I'm keeping you in my prayers :-)

Soft hugs to all who need them,
Diana Saba
Disabled Retired Nurse

Welcome to Diana's World 1997- 2008
http://hometown.aol.com/dgsaba/myhomepage/index.html

June 21, 2004
HHS - CFSAC Listserv Subscription Information - Past Meeting Schedule
http://www.hhs.gov/advcomcfs/june_meeting_min.html#dsaba

Online WACOC News - Google Groups  Sorted to dates...via AMF
Newsgroup
http://groups.google.com/groups/search?q=Online+WACOC+News&start=0&sc...

To The Mountain of Dreams ~ 2006
http://hometown.aol.com/dgsaba/myhomepage/writing.html

"Never give up your dreams or on yourself"
~In Memory of my Foster Mother~

"Miss me but let me go"
~In memory of my sister~

"What lies behind us and what lies before us, are tiny matters,
compared to what lies within us"
~Ralph Waldo Emerson~

As a used-to-be oncology nurse who worked with cancer patients off and
on for 15 years, I can tell you from experience that there are people
who innately know - what for us would be a long time - before a formal
terminal diagnosis is given that they are dying.  As one who has
watched patients with compromised lung function slowly drown in their
own fluids, I can guarantee you it is not a nice way to die.  The lack
of oxygen and feeling of slowly being suffocated because they cannot
get enough of the needed nutrients to their bloodstream is terrifying
to most.  It is scary as anything you can imagine to draw what for
others may be a shallow breath, but for you is a deep one, and not
feel much air at all entering your damaged lungs.  It becomes a fight
to get that essential oxygen to the heart, brain and tissues.

In the wild, many of the larger animals, when realizing they are
nearing the end, will go off alone and pass on to whatever is on the
other side for them.

As Americans, our obsession with youth and vitality and doing
everything we possibly can to keep the heart beating no matter the
consequences has clouded the wisdom of letting go when it is time to
let go.  Getting old is not a bad thing.  Dying when you are sick
isn't necessarily a bad thing, either.

There is a good chance your friend knew what was coming before the
diagnosis showed up on paper and chose not to suffer through the
process of slowly suffocating to death.  Just because they choose
differently than we might have, that doesn't make it the wrong thing
to do.

I've watched cancer patients die.  Over a period of time, they slowly
lose all dignity.  First it's the pain.  With chemo and radiation, the
hair falls out, secondary infections abound as good cells are killed
along with the bad ones from the poison that is chemotherapy, and
generalized body weakness is a constant thing.  The appetite leaves
because the chemo makes everything taste metallic or downright gross
and the person loses weight rapidly, looking after no long time like
an Auschwitz survivor.  The skin becomes thin.  The gums bleed when
the person brushes their teeth and the teeth may, in fact, fall out
from the gum disease secondary to the immunocompromised state.
Diarrhea and incontinence follow, and the patient can no longer
control their bodily functions.  The pain is brutal.  With certain
cancers, including lung cancer, it can take upwards of a year or so to
die, but there is the sensation the whole time of marching towards the
door that says "exit."  Mentation changes and patients forget loved
ones, forget good memories, forget who they are in the end.  The sad
thing is that most of this could be done much more lovingly if we
would realize that all life ends in death and that medicating people
in pain without the fear of addiction in terminally ill patients is
not a bad thing.  If I'm going to die, screw addiction.  Make me
comfortable.  I don't want to go out writhing in pain simply because
my family is concerned about how much pain medication I'm getting.

Why this happens more often than not is because the family and "loved
ones" are not willing to let go.  If you ask the patient, they will
tell you one or the other of their circle of influence will be crushed
when they die, and they hold on knowing this.  I've watched people who
are a mere shell of who they had been hang on for what seems an
impossible amount of time until that specific family member tells them
it's okay, they'll be all right, it's okay to let go and pass on.
I've seen it firsthand.  For me, it's not just hearsay.

This is one of the reasons for the advanced directive.  It is meant to
be decided upon while you are still alert and able to think clearly,
and in it you put what you want done in this situation or that.  It
relieves the family of having to fight over whether or not to keep
Uncle Joe hooked up to tube feedings through an NG tube for 8 years
when all that is left of him are the brain stem functions.  In many
other countries, old people don't go into nursing homes and have all
this crap shoved at them...they stay at home, and are loved and cared
for and pass on into the next world with dignity and peace and without
the artificial intervention so many Americans demand.

Advanced directives can be as specific as you want them to be.  I
helped my mom with hers.  She said no feeding tubes.  Ever.  I asked,
so if you're in an accident and your trachea is crushed and you are
going to recover with full mental capabilites but you can't eat until
the neck injuries heal you don't want to live?  She hadn't thought of
that.  The same with the ventilator.  Once we talked it through, I
helped her make detailed guidelines and it was signed, sealed and
notarized.  Now if something happens we know what she would want.
There are no questions to agonize over.

Your friend's desires are being honored, and he is passing on out of
this life with what is, for him, at least a modicum of dignity.  Leave
him go in peace.  Remember the good times and support him through
this.  I can guarantee you the choice was not made lightly.

Trisha in MO