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‘Do you want us to let you die?’: The bleak new reality in care homes for the elderly

I still remember the day my dear friend John Muggeridge brought home a form they’d given him in the care facility where his wife, Anne Roche Muggeridge lived.
Thu Aug 21, 2014 - 4:32 pm EST
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“Do you want us to let you die?” It’s not exactly the sort of question one expects to hear when talking to a health professional when you’re living in a care home. But that’s exactly what happens all the time, according to an article published by the Daily Mail this week, which says that it is becoming routine for nurses to ask elderly patients whether they “would agree” to a Do Not Resuscitate order.

The first thing I thought when I read it was, “Oh yes, they’ve been doing this sort of thing for ages. Why is it only becoming news now?”

I still remember the day my dear friend John Muggeridge brought home a form they’d given him in the care facility where his wife, Anne Roche Muggeridge lived.

John and I had sat down to have our tea one day, and visibly upset, he showed me this form. It gave a long list of possible health care crises that Anne might suffer and asked John to mark down in each case what he wanted the facility’s response to be, on a scale of one to five. One of these asked whether he wanted her to receive antibiotic treatment in case of pneumonia, that killer of the elderly and fragile.

The kicker was when John told me that they had done this repeatedly, asking him to come into meeting after meeting to tell them whether he was “ready” to downgrade her care instructions. John, though sick with cancer himself, visited Anne every day, gently feeding her meals and praying the Rosary with her. He shook the form a bit as he said in his cultured Cambridge accent, “I want them to save her life! Every time it’s in danger!”

“It has become a common experience for people requiring medical care to be harassed if they decide they actually want medical care, and to be supported and encouraged if they decide they do not want further medical care.”

John and Anne were important and influential figures in the Catholic pro-life scene in Canada through the 1980s, and it might strike a person as ironic that towards the end of her life, Anne, the author of two important books, was briefly threatened by that same Culture of Death she and John had fought so long. It was quite clear that the administration at this care home was trying to wear him down with these repeated requests for confirmation. I was so angry, and couldn’t help thinking, “Don’t these people know who this is?”

We called Alex Schadenberg, the head of the Euthanasia Prevention Coalition and he arranged to attend the next meeting, and together they “explained” that there would be no downgrading, and that Anne’s life was valuable, precious, even if she could no longer recognize anyone or speak, because it was Anne.

John said it was a kindly looking hospital administrator, a social worker and a nurse at the meetings. They would talk in the warmest possible tones, but the message was cold and hard. Let them die because they’re a burden.

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The Mail reports now that in the UK mobile district nurses are being sent out from GP offices under instructions from the National Health Service, asking older people to fill out forms indicating whether a DNR is what they want. The NHS is claiming, with wide-eyed innocence, that these questionnaires are merely a means to “improve care of the elderly and keep them out of hospital,” but the Mail noted, “It is not clear why DNR is on the forms.”

They quoted Roy Lilley, a health policy analyst and former NHS trust chairman, whose mother was visited by a nurse with the form,” who “described the policy as callous.” 

Lilly said, “Elderly, frail but otherwise healthy people are being asked, by complete strangers, to sign a form agreeing they shouldn’t be resuscitated. It is outrageous. People will be frightened to death thinking the district nurses know something they don’t and will feel obliged to sign the form so as not to be thought a nuisance.”

The Mail says Mr. Lilley is warning patients and their families not to sign the forms, saying that by doing so they are “signing their lives away.” He related the story of a meeting with a nurse at his mother’s care home who asked her “within a few minutes” “Where would you like to die,” and, “If you ever need cardiopulmonary resuscitation do you agree to do not resuscitate.”  

The cultural power in Britain of “mustn’t grumble,” particularly among that generation of English people who were raised in the old manner and depended upon it to survive the War, cannot be underestimated. My mother, a war baby, was raised in that way, and raised me with the same attitude. Older people in Britain have it written into their base programming from infancy that “making a fuss” or calling attention to oneself is simply unthinkable. There is certainly a kind of English person who would, literally, rather die that make a fuss.

But this story from the UK is only the tiniest scratch of the great iceberg that passive euthanasia has become in elder care and long-term care facilities. Alex Schadenberg told me that this kind of unsubtle pressure is becoming common around the western world.

It is particularly common in places that have come to depend exclusively upon government-funded public medical care where the goal is to spend as little money as possible. There has been a lot written about the threat of “triaging” of older people whom the strict utilitarian principles of bioethics regard as economically worthless burdens.

“Sadly, the societal attitude towards the elderly and people needing care is worsening while the government is attempting to control medical costs by examining new ways to encourage people to refuse basic care,” Schadenberg told me.

“It has become a common experience for people requiring medical care to be harassed if they decide they actually want medical care, and to be supported and encouraged if they decide they do not want further medical care.”

I have often wondered how many men and women had been sat down in those offices where John Muggridge and Alex Schadenberg sat, and ever so gently pressured to change the instructions and “let them go”. How many were confused and persuaded by this friendly talk of “end of life care” and did not have the years of experience in the pro-life movement, or the rock solid moral principles the Muggeridges had held and defended like a bastion for so long. How many would not know who to call for advice and help?

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  assisted suicide, euthanasia

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