Clinicals: Thoughts on the Artifical Extension of Life

I must admit I have mixed emotions regarding the beginning of clinical. Firstly, I must say that I love being in the long term care center, and finally providing care for patients, however clinical have raised many questions in my mind.


The primary question that I have been dealing with through the first two weeks of clinical has been the matter of artificially extending life with the use of modern medical science and medications. Of course, as a nurse I whole-heartedly agree with keeping our patients alive, in fact I believe that is a rather central goal in nursing. I simply cannot reconcile myself to the fact that so many people in the long-term care facility are no longer themselves. I believe that every individual consists of spiritual and physical aspects, specifically mind, soul and body. If the mind irreversibly begins to die, is it ethical to preserve the body?

One of the first questions of philosophy is the following: what makes us human, or rather what set us apart from the animals? This is certainly a very complex question that cannot be answered casually in a blog entry, but I think it is worth contemplating as it deeply affects the way we view the world and other people. I am including this quick philosophy side-note because I think some of what makes us human is our ability to communicate, our consciousness, our capacity to empathize with others, feel emotions, and learn. And as I look at my patient with severe dementia I cannot help but think that part of what makes her uniquely her is being robbed by disease. Our intensive medication regimes keep people’s bodies alive far past the time when their personality or mind begins to fade. I am always encouraged when my patient recalls memories of her up-bringing, or shares a laugh, because I feel that the cloud of dementia is lifted and I can briefly see the real person I am caring for. Her mental status does not determine the quality of care I give her, yet it is deeply rewarding for me to see who the real person is beneath all the diagnosis.

My patient goes through cycles in which one thought dominates her mind and conversation. Last Friday, predominant thought was appreciation for me. Every few minutes she repeated her appreciation for my work and how glad she was that I had come. I knew that a great deal of her repetitiveness and conversation was a product of dementia, yet I was also sure that somewhere in her mind those statements were sincere. I do not care if I cannot reverse dementia - but I do care that I can make simple moments and days better for another human being - even if that person does not remember.

One thing that I can say with confidence is this: I do not want to be sustained by medicine long after everything that makes me uniquely “Chanda” has gone. On the rest of this subject, however, I am relatively undecided.