I was pleased to see an article in this weeks New York Times science section written by a nurse, a former college English professor, describing the upsetting and bloody death of a patient  with terminal cancer.

The patient had carried a diagnosis of terminal lung cancer and apparently ‘bled out’ in front of her.  A complete cardiac arrest was called and carried out including, an attempt at intubation, tracheostomy, chest compression, cardiac ‘shocking’ with defibrillation equipment–in other words, the complete process.

There was a bemoaning of the bloody and ultimately unsuccessful ‘mess’–reality was far worse than TV or movies offer. The nurse was clearly traumatized by what she experienced–and rightfully so.

What was interesting to me were the myriad comments which responded to her article.  Those that interested me the most were the ones which questioned why the cardiac arrest had been allowed to take place to begin with.

I totally agree with that sentiment–her diagnosis and prognosis should have placed her into a category of DNR [do not resuscitate].  She would have begun to bleed, then quickly allowed to die without the ‘brutality’ of the entire process which unfolded.

For those who have never seen a full code in progress–it is rather ‘brutal’ –but this procedure can and has saved many lives.  It should be reserved to those who can benefit from it. 

Those with terminal diseases, in which there is no chance of improvement or recovery, should not be subjected to this procedure. Death must be allowed to  mercifully intervene and relieve them of their suffering.  But there must first be an understanding that without clear and definite expressions of will such as appropriate legal documents–a ‘code’ will be called.

The placement and response to this article is an encouraging sign.  We must foster more such dialog in the media and in society in general.  Only in this way will be cease to ignore the natural process of dying and continue to consider it a ‘disease’ which must always be ‘treated’ even when there is no hope of restoring a reasonable quality of life.

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