Honoring Questionable Parental Wishes In Old Age

[dsully]

Hello,

This Thanksgiving the topic was brought up about my mother and step-father’s wishes regarding their old age. They are currently approx. 60 years old. Their wishes are that if they ever fall into any kind of grave medical emergency, they do not want great efforts to be taken to preserve their life. Here are two things specifically that were said: (1) If I ever get cancer, we are going to walk into our garage, get in the car, and run the exhaust until we both die. (2) If I ever become any kind of vegetable, I want you to pull the plug. Regarding (1), I am not sure how serious they were about this, though I have not definite reason to doubt them. Regarding (2), they were serious enough about this to enact a will which gives my brother (not me) the right to carry out their wishes of “pulling the plug.”

All this rather came as a shock to me, as the conversation was had at the dinner table while everyone was quite tipsy on alcohol (except for me who does not drink, because of previous issues with alcoholism and a desire to live a holy life). I am trying to process through all of this.

What are your reactions to something like this? Have you ever been put in a similar situation. What does the church teach about preserving human life in old age? Does it ever depend on the wishes of the individual? What moral ground do I have to stand on if my parents’ wishes are against church teaching (they are not Catholics, though my step-father was a Catholic for years but left the Church after his divorce of his first wife and marriage to my Mom)? How should I handle this?

Thanks,

A concerned 32 year-old who never expected that he would have to be in this situation.

 

[BlueEyedLady]

Honestly, if I were 60+ and I got cancer suicide would probably be high up on my list too. After watching my elderly grandmother go through chemo and die a slow, painful death and suffering through months of humiliation and loss of dignity I decided that I will never go through that.

I don’t want to be on life support, and depending on my condition and prognoses I don’t even want a feeding tube. I don’t want to spend years in a hospital bed for people to feel obligated to visit and pity. No way.

My fiance and I have talked a lot about this and we are on the same page. We’ve put it in writing as well, and given each other the power to make medical decisions. Yes, both of our families would strongly disagree with our choices, but they are ours.

 

[EasterJoy]

Yes, the Church has teachings, and you’d be wise to brush up on them before you have a talk with your parents. Don’t just assume you know, because there are both legal and moral subtleties that need to be understood.

My experience is that few people who ever speculate about what circumstances of life would make it no longer worth living actually carry those wishes out when their time comes. It is like being 50 and swearing that you’ll quit driving when you hit 70. When you actually hit 70, the question has this way of looking very different.

The good thing to do is to encourage your parents to put their wishes in writing proper for the laws of their state and to specify who they want to have their medical decisions when they cannot do so for themselves. They should talk at length with this person and the person’s back-up designee concerning what they want, preferably when they visit their doctor, since the doctor can be much more clear about explaining the implications of their choice. I know many people who say one thing, but then become far more conservative when their physician explains the medical implications of what they are actually saying! Definitely have them include their primary physician(s) in this discussion!! (Don’t have one? They should!!)

Bring the conversation up with your parents and tell them to arrange to talk to their physician about it. No one can follow their wishes if they don’t take the trouble to think them out and then communicate them. And yes, within Church teaching there will still be decisions to be made, decisions that belong to your parents.

 

[EasterJoy]

Honestly, if I were 60+ and I got cancer suicide would probably be high up on my list too. After watching my elderly grandmother go through chemo and die a slow, painful death and suffering through months of humiliation and loss of dignity I decided that I will never go through that.

I don’t want to be on life support, and depending on my condition and prognoses I don’t even want a feeding tube. I don’t want to spend years in a hospital bed for people to feel obligated to visit and pity. No way.

My fiance and I have talked a lot about this and we are on the same page. We’ve put it in writing as well, and given each other the power to make medical decisions. Yes, both of our families would strongly disagree with our choices, but they are ours.

Chemo is optional, but suicide is not a morally-allowed option, even in those places where it is legal. As for loss of capacity being humiliating, please reconsider what it is that gives a person their human dignity. As our late Holy Father showed in his life, sickness and dignity are not mutually exclusive, nor is care the same thing as pity. That is not an end-of-life issue, but an attitude issue, and a very important one. Some dying person in your future may one day need for you to deeply appreciate the difference.

 

[BlueEyedLady]

Chemo is optional, but suicide is not a morally-allowed option, even in those places where it is legal. As for loss of capacity being humiliating, please reconsider what it is that gives a person their human dignity. As our late Holy Father showed in his life, sickness and dignity are not mutually exclusive, nor is care the same thing as pity. That is not an end-of-life issue, but an attitude issue, and a very important one. Some dying person in your future may one day need for you to deeply appreciate the difference.

Excuse me? I understand the difference. I never looked down on my grandmother. But when she was sobbing because she couldn’t feed herself, control her bowels, or speak a full sentence much less do anything that she loved I understood why. I knew why she didn’t want people to see her, I knew that she felt humiliated. Morally acceptable or not I knew why she wanted to just die and why she would have done anything to do so had she been able.

That was a hard thing for me to understand at 16, and it was devastating to witness. But now that I’m older I understand that she had lived a full life, had fallen in love, gotten married, raised children, been blessed with grandchildren, traveled, and just lived her life to the fullest. There was no reason for her to have to suffer like she did, and I decided after that that if I can do anything about it that won’t be me, and it certainly won’t be my husband.

Yes, I can say that if I’m ever diagnosed with something that is in all likelihood terminal there is a very good chance that I will take my own life before my body is withered, my mind is ravaged, and my family is witnessing it.

 

[SuscipeMeDomine]

It sounds like your family needs to have a serious conversation, and not one where people are tipsy. Your parents need to have a living will or proxy for health care in order to have someone carry out their wishes. And if their wishes are not in line with what you could carry out, they need a different person to handle it.

Even in the best of situations, making decisions about someone’s health care can be difficult. I was in that position with my mother and had to find a way that met her wishes while being something I could live with. In turn, I have arranged for someone else to take charge of my health care if it should be needed and we had a long and serious conversation about what I would want in different circumstances.

As my lawyer pointed out, the issue is not so much the long-term illness where someone’s health goes down over time. It’s more a question of what do you do when there’s an accident, a stroke, or similar sudden illness that may leave you unable to make decisions.

 

[BlueEyedLady]

It sounds like your family needs to have a serious conversation, and not one where people are tipsy. Your parents need to have a living will or proxy for health care in order to have someone carry out their wishes. And if their wishes are not in line with what you could carry out, they need a different person to handle it.

Even in the best of situations, making decisions about someone’s health care can be difficult. I was in that position with my mother and had to find a way that met her wishes while being something I could live with. In turn, I have arranged for someone else to take charge of my health care if it should be needed and we had a long and serious conversation about what I would want in different circumstances.

As my lawyer pointed out, the issue is not so much the long-term illness where someone’s health goes down over time. It’s more a question of what do you do when there’s an accident, a stroke, or similar sudden illness that may leave you unable to make decisions.

I agree 100% with this. If anyone ever asks you to carry things out that you cannot, do not lie to them. They deserve to be able to find someone who can, not be lied to and have their wishes disregarded.

My MIL actually just had a long talk with my fiance about her end of life wishes. He is her only atheist child, but he’s also the most reliable one not in a convent. He has been made aware of her desire for last rites, what kind of care she does and does not want, what would be in line with her faith, and that if she is cremated her ashes are not to be scattered. Although he disagrees with some of this he loves and respects her and he will carry all of it out, because none of it violates his moral code. Now let’s say that he felt really strongly that it would be wrong to not scatter ashes. In which case he should tell her that he can’t have them buried and she needs to find someone else. He should not scatter her ashes against her wishes.

Everyone deserves to have their end of life and after death wishes respected to the greatest extent possible. Don’t ever lie about what you can and cannot do!

 

[TheRealJuliane]

Excuse me? I understand the difference. I never looked down on my grandmother. But when she was sobbing because she couldn’t feed herself, control her bowels, or speak a full sentence much less do anything that she loved I understood why. I knew why she didn’t want people to see her, I knew that she felt humiliated. Morally acceptable or not I knew why she wanted to just die and why she would have done anything to do so had she been able.

That was a hard thing for me to understand at 16, and it was devastating to witness. But now that I’m older I understand that she had lived a full life, had fallen in love, gotten married, raised children, been blessed with grandchildren, traveled, and just lived her life to the fullest. There was no reason for her to have to suffer like she did, **and I decided after that that if I can do anything about it that won’t be me, and it certainly won’t be my husband.
**
Yes, I can say that if I’m ever diagnosed with something that is in all likelihood terminal there is a very good chance that I will take my own life before my body is withered, my mind is ravaged, and my family is witnessing it.

Am I misunderstanding here, or are you saying you would assist someone’s suicide?

Or even more? Based on your own evaluation of their misery?

 

[BlueEyedLady]

Am I misunderstanding here, or are you saying you would assist someone’s suicide?

Or even more? Based on your own evaluation of their misery?

Uh…no. Well, I would if there wouldn’t be any legal repercussions, and it would never be based on my own evaluation, they would have to either tell me at the time that that’s what they wanted or there would have to be very specific circumstances outlined beforehand should they be unable to communicate.

But as far as that specific line goes that was more in reference to the fact that I wouldn’t put my husband on life support or a feeding tube in the event of terminal illness, especially since he’s made it clear he wouldn’t want that. We’ve talked a lot about what medical circumstances would cause us to consider suicide and I would also like to think that as devastating as it would be if he were terminally ill and wanted to end it before he was in a hospital bed suffering and dying a slow, painful death I wouldn’t argue or try to guilt him out of it.

And if we are old and the prognosis isn’t good we don’t want to subject ourselves or each other to chemo, invasive surgery or intensive medical procedures that will only prolong a low quality of life.

 

[dsully]

Thanks for the replies. There is some good advice in there. Perhaps I should clarify a few things:

It sounds like my parents have already designated my brother as the one to carry out their deathbed decisions. Presumably they have done this because they think he shares their views more closely.

On the one hand, I realize that they have the right to do this. On the other, I feel passed over as the eldest son who traditionally would be the one designated to care for the family. Apparently they feel that, because of my belief in God, I am not going to faithfully carry out their wishes.

The odd thing about this conversation was that it almost seemed like they wanted me to contradict them, to persuade them the other way. In fact, they told me where the document is located and went out of their way to say that the safe is unlocked.

I’m not one for drama–but I do want to know what the Church teaches on these issues so that I can be praying for everyone involved, whatever their decisions are.

It was this weekend that I realized I am the priest for my family. I am the one to pray for them and watch over them spiritually.

Blue Eyed Lady, you remind me very much of sister-in-law. Very intelligent, sharp, compassionate, yet atheist. I understand where you are coming from since I more or less held an atheistic worldview for my teen years and into my early twenties. It wasn’t until I went through rehab that I converted. One of my goals is to read more books by the New Atheists, because I love and have compassion for atheists. Some of you are remarkable human beings. I just don’t understand the entirely naturalistic or materialistic worldview. It seems that cultures have always believed in a transcendent, spiritual reality that accompanies the physical one.

Dan

 

[PJM]

=dsully;10076840]Hello,

This Thanksgiving the topic was brought up about my mother and step-father’s wishes regarding their old age. They are currently approx. 60 years old. Their wishes are that if they ever fall into any kind of grave medical emergency, they do not want great efforts to be taken to preserve their life. Here are two things specifically that were said: (1) If I ever get cancer, we are going to walk into our garage, get in the car, and run the exhaust until we both die. (2) If I ever become any kind of vegetable, I want you to pull the plug. Regarding (1), I am not sure how serious they were about this, though I have not definite reason to doubt them. Regarding (2), they were serious enough about this to enact a will which gives my brother (not me) the right to carry out their wishes of “pulling the plug.”

All this rather came as a shock to me, as the conversation was had at the dinner table while everyone was quite tipsy on alcohol (except for me who does not drink, because of previous issues with alcoholism and a desire to live a holy life). I am trying to process through all of this.

What are your reactions to something like this? Have you ever been put in a similar situation. What does the church teach about preserving human life in old age? Does it ever depend on the wishes of the individual? What moral ground do I have to stand on if my parents’ wishes are against church teaching (they are not Catholics, though my step-father was a Catholic for years but left the Church after his divorce of his first wife and marriage to my Mom)? How should I handle this? Thanks,

A concerned 32 year-old who never expected that he would have to be in this situation.

IF they were Catholics I’d advise talking to your priest. Still talking to their Minister might be in order? So long as they are of “Sound Mind” they like every one of us has the god given “right” to choose heaven or hell.

Do they understand the Commandments? The fifth being thou “SHALT NOT KIll?” I’m asking this seriously. If they have a Christian Faith Practice background; then the Minister has a position he can make them aware of. As to the “pulling the plug” issue; there is alot of issues that go into that decission. Circumstances COULD make it a real option if SUFFERING is the only issue; it’s clearly is Not!

Suffering being a part of the Normal human condition and can be of GREAT spiritual benefit.

. Luke.14: 7 Whoever does not bear his own cross and come after me, cannot be my disciple.”

1Pet.4: 13 ” But rejoice in so far as you share Christ’s sufferings, that you may also rejoice and be glad when his glory is revealed.

Heb. 2: 10 For it was fitting that he, for whom and by whom all things exist, in bringing many sons to glory, should make the pioneer of their salvation perfect through suffering.

I’ll keep you all in my prayers,

pat/PJM
But if other life or death isses are present it could be an option. Again the Minister ought to be talking to them in private.

 

[TheRealJuliane]

Uh…no. Well, I would if there wouldn’t be any legal repercussions, and it would never be based on my own evaluation, they would have to either tell me at the time that that’s what they wanted or there would have to be very specific circumstances outlined beforehand should they be unable to communicate.

But as far as that specific line goes that was more in reference to the fact that I wouldn’t put my husband on life support or a feeding tube in the event of terminal illness, especially since he’s made it clear he wouldn’t want that. We’ve talked a lot about what medical circumstances would cause us to consider suicide and I would also like to think that as devastating as it would be if he were terminally ill and wanted to end it before he was in a hospital bed suffering and dying a slow, painful death I wouldn’t argue or try to guilt him out of it.

And if we are old and the prognosis isn’t good we don’t want to subject ourselves or each other to chemo, invasive surgery or intensive medical procedures that will only prolong a low quality of life.

This is the only part of your post I don’t have an issue with. There is such a thing as palliative care, which means relief from pain and letting things take their natural course. That does not include suicide or homicide. Medication for relief from pain gets better all the time, and doctors as well as other health professionals are very aware of the desire for the dying to be as pain-free as possible.

You know, I worked for a short time with kids who were very, very handicapped. Many people would have said their lives were nothing but misery and maybe they should have been allowed to die. Yet taking care of them was one of the most redemptive experiences I have had outside of church. It really shifted my perspective about what a life consists of. They couldn’t speak, most of them couldn’t walk, some of them couldn’t even swallow. Very brain damaged, all of them. Yet, they were alive and we tried to give them the best experience they could have, while they were still here. They went on field trips, we had family dinners (it was a group home, so the “family” was each other and us, the staff, but it was at the table), we took them everywhere a “normal” kid would go. They went to school, most of them included in classrooms and not put in a “special ed” room, something I agree with and support. And it wasn’t a one-sided relationship either. They could show and give love. I can’t explain it, but as I said, my perspective on the value of a severely handicapped life changed while I worked with them.

I get very offended when people casually toss off “I wouldn’t ever want to be a VEGETABLE.” People are never vegetables, and it’s insulting to think that even a human being in a coma is not still a human being, loved and cared for by God Almighty, his or her family and friends, and even caregivers. Life has value from conception to NATURAL death.

 

[mymamamary]

Hello,

This Thanksgiving the topic was brought up about my mother and step-father’s wishes regarding their old age. They are currently approx. 60 years old. Their wishes are that if they ever fall into any kind of grave medical emergency, they do not want great efforts to be taken to preserve their life. Here are two things specifically that were said: (1) If I ever get cancer, we are going to walk into our garage, get in the car, and run the exhaust until we both die. (2) If I ever become any kind of vegetable, I want you to pull the plug. Regarding (1), I am not sure how serious they were about this, though I have not definite reason to doubt them. Regarding (2), they were serious enough about this to enact a will which gives my brother (not me) the right to carry out their wishes of “pulling the plug.”

All this rather came as a shock to me, as the conversation was had at the dinner table while everyone was quite tipsy on alcohol (except for me who does not drink, because of previous issues with alcoholism and a desire to live a holy life). I am trying to process through all of this.

What are your reactions to something like this? Have you ever been put in a similar situation. What does the church teach about preserving human life in old age? Does it ever depend on the wishes of the individual? What moral ground do I have to stand on if my parents’ wishes are against church teaching (they are not Catholics, though my step-father was a Catholic for years but left the Church after his divorce of his first wife and marriage to my Mom)? How should I handle this?

Thanks,

A concerned 32 year-old who never expected that he would have to be in this situation.

In all honesty, I think you need to ask your Parish Priest and the apologists for our site. I doubt there are a lot of people here, myself included, who are qualified to speak on such matters, (Br. Jr education perhaps…), so the apologist forum is the best place to ask, and of course, Your Parish Priest. Accept only Church teaching, not emotional statements etc.

 

[underacloud]

Their wishes are that if they ever fall into any kind of grave medical emergency, they do not want great efforts to be taken to preserve their life.

There’s nothing inherently wrong with this attitude. There are specifics that govern any given situation, but in general Catholic morality allows that extraordinary means (what they might mean by “great effort”) are not required to prolong line.

(1) If I ever get cancer, we are going to walk into our garage, get in the car, and run the exhaust until we both die.

Well, this is out of line with Catholic morality, but it’s hard to say whether they are serious or it’s a glib, throwaway, and deliberately provocative comment. Either way, there’s not much you can do but discourage such a mentality, or perhaps dismiss it as unlikely anyway.

(2) If I ever become any kind of vegetable, I want you to pull the plug.

Again, depending on specifics, this is not inherently problematic.

 

[robwar]

Hello,

This Thanksgiving the topic was brought up about my mother and step-father’s wishes regarding their old age. They are currently approx. 60 years old. Their wishes are that if they ever fall into any kind of grave medical emergency, they do not want great efforts to be taken to preserve their life. Here are two things specifically that were said: (1) If I ever get cancer, we are going to walk into our garage, get in the car, and run the exhaust until we both die. (2) If I ever become any kind of vegetable, I want you to pull the plug. Regarding (1), I am not sure how serious they were about this, though I have not definite reason to doubt them. Regarding (2), they were serious enough about this to enact a will which gives my brother (not me) the right to carry out their wishes of “pulling the plug.”

All this rather came as a shock to me, as the conversation was had at the dinner table while everyone was quite tipsy on alcohol (except for me who does not drink, because of previous issues with alcoholism and a desire to live a holy life). I am trying to process through all of this.

What are your reactions to something like this? Have you ever been put in a similar situation. What does the church teach about preserving human life in old age? Does it ever depend on the wishes of the individual? What moral ground do I have to stand on if my parents’ wishes are against church teaching (they are not Catholics, though my step-father was a Catholic for years but left the Church after his divorce of his first wife and marriage to my Mom)? How should I handle this?

Thanks,

A concerned 32 year-old who never expected that he would have to be in this situation.

honoring one’s parents does not mean you have to obey them in doing something you consider morally wrong. There seems to be confusion between honoring and obeying.
You can show respect to your parent because they are your parents but you do not at all
have to obey them in doing something morally wrong and suicide is morally wrong.

 

[EasterJoy]

Excuse me? I understand the difference. I never looked down on my grandmother. But when she was sobbing because she couldn’t feed herself, control her bowels, or speak a full sentence much less do anything that she loved I understood why. I knew why she didn’t want people to see her, I knew that she felt humiliated. Morally acceptable or not I knew why she wanted to just die and why she would have done anything to do so had she been able.

That was a hard thing for me to understand at 16, and it was devastating to witness. But now that I’m older I understand that she had lived a full life, had fallen in love, gotten married, raised children, been blessed with grandchildren, traveled, and just lived her life to the fullest. There was no reason for her to have to suffer like she did, and I decided after that that if I can do anything about it that won’t be me, and it certainly won’t be my husband.

Yes, I can say that if I’m ever diagnosed with something that is in all likelihood terminal there is a very good chance that I will take my own life before my body is withered, my mind is ravaged, and my family is witnessing it.

Humiliation certainly does imply that one feels one does not have dignity because of what one cannot do. It is totally understandable to want to be out from under tremendous suffering! It is totally understandable to feel for people who want to help you and cannot do a thing to help you. Of course it is! I don’t want to give the impression that it is anything else. That is very different from saying that being desperately ill and incapacitated is a humiliation. That implies that the condition is shameful, and it is not.

We aren’t bound to prolong death by medical interventions, but our lives are not our own to end, either. This is what the Church teaches, and it is the truth, even when it is extremely difficult. A Catholic who is asked to cooperate in a suicide is morally bound to refuse.

 

[Catholic1954]

Hello,

This Thanksgiving the topic was brought up about my mother and step-father’s wishes regarding their old age. They are currently approx. 60 years old. Their wishes are that if they ever fall into any kind of grave medical emergency, they do not want great efforts to be taken to preserve their life. Here are two things specifically that were said: (1) If I ever get cancer, we are going to walk into our garage, get in the car, and run the exhaust until we both die. (2) If I ever become any kind of vegetable, I want you to pull the plug. Regarding (1), I am not sure how serious they were about this, though I have not definite reason to doubt them. Regarding (2), they were serious enough about this to enact a will which gives my brother (not me) the right to carry out their wishes of “pulling the plug.”

All this rather came as a shock to me, as the conversation was had at the dinner table while everyone was quite tipsy on alcohol (except for me who does not drink, because of previous issues with alcoholism and a desire to live a holy life). I am trying to process through all of this.

What are your reactions to something like this? Have you ever been put in a similar situation. What does the church teach about preserving human life in old age? Does it ever depend on the wishes of the individual? What moral ground do I have to stand on if my parents’ wishes are against church teaching (they are not Catholics, though my step-father was a Catholic for years but left the Church after his divorce of his first wife and marriage to my Mom)? How should I handle this?

Thanks,

A concerned 32 year-old who never expected that he would have to be in this situation.

The Church of course would not allow #1. We are not allowed to take our own lives, under any circumstances. #2 however is permissable. The Church does not require extraordionary means to keep one alive, it is allowed to “pull the plug”. My mother has said that if she ever gets cancer, she will stand in front of a fast moving truck. At 81 years young, that has not happened yet, one of her 5 kids or my Dad will push her out of the way in time. She does have the right to refuse treatment however, and I think that would be the way she would choose to go.

 

[gabanzo]

When my mother was ill with a bladder infection, four doctors told me not to give her antibiotics because she would not have meaniful life. I ignored them. I had to put her on a feeding tube. I was told she would need the feeding tube for the rest of her life. She needed it for 2 months. My mom is very happy now in fact, happier than I have ever seen her and very grateful I did what I did.
I think many people die needlessly because we don’t give them a chance to recover and many people when faced with death, will change their tune, from not wanting to be treated to wanting to be treated.

 

[Julia_Mae]

A concerned 32 year-old who never expected that he would have to be in this situation.

I haven’t read the other responses but I wanted to tell you, first, I don’t see that you are in any situation. Your parents are talking about what they have decided, as of now, and your brother has the responsibility. The prayer is: God’s will be done.

Second, I am in my early 60s, my daughter is 40 and I have a DNR in my purse. I’ve made it very clear I am taking the first exit. My daughter has made it very clear she would want for herself every possible life-saving procedure. We are each other’s medical proxies because we respect one another’s wishes. These issues are about control. As we age, we become less able and the horror is we will end up suffering and have no way to stop it.

Your parents may have chosen your brother because he is the one who understands it is their choice to make, not a church’s choice. It’s not a moral dilemma, it’s obeying the last wishes of the people who are living in the bodies.

As for the suicide threat: everyone says this. Or almost everyone: if they get cancer they’ll commit suicide. My mother said it. But they almost never do. Because it’s not an event, it’s a process, because spouses don’t pass simultaneously, because people have hope. Because they can live long enough to see the last episode of their favorite TV show.

Accept what they are saying and let it go. Unless one of them is very ill right now, in the 15-20 years that is likely to elapse before any of this matters, all kinds of things can change.

 

[EasterJoy]

When my mother was ill with a bladder infection, four doctors told me not to give her antibiotics because she would not have meaniful life. I ignored them. I had to put her on a feeding tube. I was told she would need the feeding tube for the rest of her life. She needed it for 2 months. My mom is very happy now in fact, happier than I have ever seen her and very grateful I did what I did.
I think many people die needlessly because we don’t give them a chance to recover and many people when faced with death, will change their tune, from not wanting to be treated to wanting to be treated.

It should be noted that these are usually not once-and-for-all decisions. The decision-maker, whether patient or family, doesn’t need to feel that consenting to treatment once will mean the treatment has to be continued indefinitely.

For instance, the legal and moral choices surrounding the use of a feeding tube are the same whether the patient already has one or not. The question is whether the intervention sustains life or prolongs death, and the sense of how to answer that may legimately evolve without any moral violation.

If, after 2 months, your mother was instead suffering her way through yet another of a series of infections that had essentially not let up since treatment started, you might have concluded that her immune system was indeed shutting down and that treatment was only perhaps forestalling the inevitable. The fact that you had gone ahead with antibiotics the last ten times in a row wouldn’t have changed your ability to decide the final situation, and discontinuing treatment woudn’t have made your initial choice “proven wrong.”