I am a 66-year old physician. I am Board certified in Psychiatry and Geriatric Psychiatry and have been practicing for forty years. I am a Distinguished Life Fellow of the American Psychiatric Association. I have been a clinician, a teacher and an administrator, and am on staff of medical school, hospitals and nursing homes.
I was born in the northwest part of undivided India and when that part became Pakistan my family moved to India and we became refugees. I was seven at that time. I had polio at age three and I was a sick child through most of my childhood. On the other hand I have seldom been sick during my adult life. I came to the United States in 1966. I have seen poverty and hunger and I have seen affluence and power. I have been on both sides of discrimination of many kinds. I have traveled far and wide. I have read extensively and written a lot.
I am happily married for over 38 years, have two well-settled children, three grand children and a host of other very loving and concerned family members, and friends.
I have seen a lot of misery, both in hospitals and in extended care facilities.
I know that unnecessary procedures and tests are not uncommon. Patients are being kept “alive” in the name of ‘dignity of human life’. “Quality of life” has lost all meaning. A patient may be in deep coma, have contractures and bed sores, and have tubes in every orifice of the body, artificial breathing and feeding, but “alive” nonetheless, for months or even years. More tests, more procedures, more consultations, more medications. And more complications. More than half of Medicare dollars are spent on patients who die within two months.
I submit that a significant reason why we like to prolong life and misery is greed and self-motivation. The hospitals, long term care facilities, doctors, lawyers, religious organizations, pharmaceutical companies, medical appliance manufacturers, and families, are all trying to prolong life and prolong miserable existence for financial reasons, directly or indirectly.
THEREFORE, I declare today that if and when I am unable to participate in decisions regarding my care, for reasons due to physical or mental incapacity, I direct that if there is no reasonable expectation of regaining meaningful quality of life:
I want DNR (Do Not Resuscitate)
I want DNH (Do Not Hospitalize)
I want no feeding tube. If you feed me and I choke, so be it.
I do not want artificial breathing, heart stimulation, tracheotomy or dialysis.
I want no chemotherapy, radiation or designer antibiotics if it is purely to prolong life.
Yes, I want palliative care and freedom from pain.
I have had a good life; I want to have a good death. I want my relatives and friends to celebrate my death as they have celebrated my life. I know it is going to be hard, but it is my last wish.
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