by The Open University
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Vic was not consulted about his needs and the possibility of his death was never discussed. The uncertainty about his religious needs resulted in a staff member having to make a decision on his behalf and hope that it was the right one. An added dimension to the uncertainty about Vic?s wishes was the relationship which he had with his sons, in which there was a lot of unresolved conflict.
Li did not have a choice about her place of death because she was unable to speak, but previously she had communicated her needs for what should happen to her at the time of her death, and her family acted as strong advocates to ensure that her wishes were carried out. One important dimension to Li?s choice and control was the way that the home staff communicated with Li prior to her serious illnesses and made themselves aware of her wishes.
Andrew seemed to be a key member in the decisions about his treatment until the end of his life. He was the first person to be told his diagnosis and was able to express where he wanted to die. Comments from course testers revealed that they found this death to be particularly distressing, as this example shows:
There was definitely a sense of being out of control for Andrew and his carers due partly to the fact that he was at the beginning of his own independent life and therefore in transition and the fact that the disease itself was rapidly progressive. At times there seemed little room for choice and only one way forward.
During her illness Meg experienced her involvement in the decision to attempt to save her renal function not only an opportunity to be involved in the decision-making process, but also a signal that she was worth saving. When the treatment options are limited there is not always a clear way to demonstrate someone?s worth. Although Meg was dying her sudden death added a complex dimension to the issue of control and choice. It is difficult to know how prepared she was at the moment of death.
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