My Mother's End-of-Life Discussion That Changed How She Died

I am a physician. The hardest thing I’ve ever had to do was to end my mother’s life.

My mother was diagnosed with breast cancer at the age of 47. After a seven-year battle that involved multiple surgeries and countless rounds of chemotherapy, she decided that she had fought long enough. She didn’t want to suffer any more. Initially, I didn’t agree with her decision: she was still young; her doctors were hopeful; and there were still some therapies that she hadn’t tried. Over the course of many painful discussions, I became convinced that she had thought through everything. It was her choice to die peacefully and at home. She signed paperwork to this effect and entered home hospice care.

Unfortunately, as with many patients’ wishes, hers did not get fulfilled. One day, her breathing became labored. My father panicked and brought her to the local hospital. By the time I arrived, her blood pressure was dangerously low and she was barely breathing on her own. The ICU doctors were hovering, ready to put her on a breathing machine.

I could have never imagined how hard it was to ask everyone to stop their efforts and let my mother die. There was paperwork clearly documenting her wishes, yet the doctors and nurses asked me multiple times whether I wanted to change my mind. My father and my sister both knew her wishes too, yet they, too, were paralyzed by the thought of letting her go.

Since my mother’s death, I have been on the other side of these discussions as the emergency physician talking to patients and their families. I have learned that less than 30% of families have these discussions, and as a result, many patients end up with life-prolonging measures that are very likely to be against their wishes. As hard as it may seem to have such end-of-life talks in advance, it is many times harder when the patient is in extremis and the family is distraught.

Last week was the two-year anniversary of my mother’s death. In her memory, I urge you to have a discussion with your family members now about how they want to live, and to die. Make sure your doctor knows, and that you have paperwork documenting these wishes. That way, you will be able to honor your loved one’s final wish, and you will know what to do when you are faced with the most difficulty decision of your life.