NO EXIT

When Alzheimer's Steals the Mind, How Aggressively to Treat the Body?
Gina Kolata, New York Times, May 28th, 2004)

Macie Mull was 82 and had suffered from Alzheimer's disease for more than a decade when she developed pneumonia. Her nursing home rushed her to the hospital where she spent the night, receiving intravenous antibiotics. The next day she was back at the nursing home, more confused than ever.

Now she was choking on her puréed food; eating was becoming impossible. And so, one Sunday afternoon, the administrators of her nursing home in Hickory, N.C., asked Mrs. Mull's daughter what to do: Did she want a feeding tube inserted? At that point, Mrs. Mull muttered only a few random words and could no longer recognize her daughter. The feeding tube would almost certainly prolong her life, but was it worth it?

The question of how aggressive to be in treating late-stage Alzheimer's patients is one of the most wrenching and contentious issues in medicine. For every patient who, like Mrs. Mull, reaches the final stage of the disease, there typically are about five or six family members faced with decisions about whether to authorize medical treatments for patients whose bodies live on though their minds are gone.

New research has found that Alzheimer's patients at the end of their lives often receive everything that medicine has to offer...

Modern man is a problem-solver. He is profoundly upset and dispirited by the notion that his can-do resolve, backed by no end of workshops, scientific research and technology, can not cope with whatever society or nature throws his way. But this heart-wrenching article shows that there are some dramas that don’t have happy endings and that, whatever we do, we make it worse. Neither religion, with its prohibitions against suicide and commands to care for the elderly, nor secular humanism, which tends to define quality of life as simply living as long as one can in the hope of dying in perfect health, can help us much here. With a huge Boomer generation set to retire soon, we are walking eyes wide open into an ethical sewer where we may be forced increasingly to choose between seeing ourselves as either murderers or torturers.

In the old days, wise men used to call pneumonia the old person’s friend. Nineteenth century novels and histories often speak of seniors who went for a walk, took a chill and passed on a few days later. Such blessings will not be for us, for we are of an age where it is bliss to be a child and a humiliating terror to be aged and infirm.