• Debra Berry

The Freedom to Choose

May 8, 2021: The Freedom to Choose

I am a retired RN. The last 15 years of my career, I cared for terminally ill individuals and their families. It was the most rewarding time of my career.

My greatest passion in caring for the individuals, as they navigate the end stage of their life, is to advocate for their choices. I believe choice upholds one's self respect dignity .

Recently, my beloved eight-five year old aunt was faced with the decision about starting dialysis due to chronic renal failure. She called me and shared her physician told her she needed to start dialysis soon. She was of course upset and was struggling with the news. She shared with me, she wasn't sure she wanted to depend on dialysis, even though she knew without it her life expectancy would be shortened.

My aunt told me during recent visit with Ann, the nurse practitioner, at her nephrologist office, Ann told her if she herself ever had to be on dialysis or have chemotherapy she would never do it. My aunt said, "I haven’t forgotten that conversation, it’s just stuck in my mind.”

Then, my aunt relayed a conversation she had had with her nephrologist, telling me she had discussed with him about the possibility of not choosing dialysis. She said he had told her, "You do not want to die that way." She continued saying, he told her, "If you do not have dialysis, you will suffer terribly, have a lot of pain and eventually be in a coma." She was of course distraught and frightened as she told me all of this, who wouldn't be?

The hospice nurse in me took over as I tried to protect her from such unnecessary fright. I told her, " I am so sorry! I want to apologize to you on behalf of both Ann and your physician." I knew Ann and I told my aunt I was pretty sure she had never been faced with making a decision for herself about dialysis or chemotherapy. I also told her had I ever witnessed a physician sit at the bedside as one of his/her patient’s died.

I reminded my aunt proceeding or not with dialysis was her choice. I also knew she still needed more information before making her final choice. Regardless, I told her I would stand with her and support her choice no matter which one she chose.

My aunt did choose to start dialysis, that was five months ago. Last week, she was faced again with a life threatening decision. This time, she chose to not pursue further treatment.

My beloved aunt made her transition to eternal life three days ago. Today, I celebrate life as she is laid to rest, and I celebrate and am grateful she was able to choose best for her.

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