The Ultimate Personal Choice - Deciding My Own Medical Fate

Mallory J Greene
Mallory J Greene
June 5th 2024 - 7 minute read
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When facing a terminal illness, the choice to continue treatment or to stop can consume your every waking moment. While there is no perfect universal answer, there are some key factors to evaluate as you undertake this heart-wrenching personal process.

Perhaps no decision in life feels as profoundly personal yet wrenchingly difficult as determining whether to proceed with further medical treatment for yourself or to discontinue interventions and consciously transition towards the end of life. It's an agonizing dilemma pitting hope against acceptance, aggressive life-prolonging measures against quality of life, and can summon existential questions over the value and meanings we ascribe to human existence itself.

When facing a devastating illness or terminal condition, the choice of whether to continue treatment or to stop can consume your every waking moment with moral, ethical, spiritual and practical quandaries. While there is no perfect universal answer, there are some key factors to carefully evaluate as you undertake this heart-wrenching personal process.

Getting Fully Informed About Your Condition

First and foremost, you'll need to have frank, potentially difficult conversations with your medical providers to gain an honest, clear-eyed understanding of your specific diagnosis, current condition, and prognosis. You'll want to solicit second, or even third, expert opinions to help answer critical questions such as:

  • What is my precise medical situation, its cause, typical progression and overall prognosis?
  • At what current stage of severity or deterioration am I presently at?
  • If I pursue further treatment interventions, what are the reasonable prospects for a cure, remission or stabilization?
  • What is my overall statistical life expectancy outlook with treatment vs. without?
  • Are there any promising experimental options, clinical trials or cutting-edge treatments to consider?

Knowing the full, realistic medical facts is a crucial baseline - however, it's just one component of the broader decision to weigh.

Evaluating Treatment Realities

Next, you'll need to very critically assess the practical realities of what any further treatment regimens would entail in terms of physical, emotional and financial impacts on your daily existence. This includes analyzing:

  • What specific procedures, interventions or inpatient requirements would treatment demand over what projected timeline?
  • What are the common treatment side effects and how might those disrupt my quality of life?
  • Would treatment potentially leave me bedridden, unable to function independently or reliant on machines?
  • How financially devastating could ongoing treatment costs potentially become despite health insurance?
  • Would I need to temporarily or permanently relocate away from my home/community for care?

Ultimately, you may decide that even if treatment holds a chance to extend your life, the personal toll and negatives involved make proceeding too great a burden to bear.

Analyzing Quality of Life Considerations

This is often the most complex and nuanced part of the deliberation process - evaluating the quality vs quantity of life treatment may provide you and whether that aligns with your personal values and priorities. Questions to reflect deeply on include:

  • What are my spiritual or philosophical beliefs around the sanctity of life and sustaining it at any cost?
  • Do I value remaining alive for a potentially limited timeframe more than the quality of that lived experience?
  • How much cognitive function and ability to interact will treatment theoretically preserve?
  • What role does maintaining my sense of dignity, autonomy and not being a "burden" on loved ones factor in?
  • Will I still be able to engage in hobbies, relationships and activities that give me fulfillment and purpose?

Every individual weighs these quality of life perspectives differently based on their belief systems and priorities. Ensuring your outlook and values drive this decision is paramount.

Outlining Your End-of-Life Wishes

In an ideal scenario, you've proactively outlined your preferences for end-of-life care through documented legal instruments such as an Advance Directive, living will, or designated medical power of attorney. Having these wishes explicitly recorded can remove much ambiguity.

However, even without formal documentation, you can still carve out guiding principles based on matters like:

  • Under what specific conditions would you want life-sustaining measures removed?
  • What is your philosophy on remaining on artificial life support systems indefinitely?
  • How do religious, spiritual or ethical beliefs shape your perspective on dying?
  • Would you want "everything possible" done to prolong life or favor a natural death?

Ensure to communicate these outlooks with your loved ones to honor them in making decisions on your behalf later.

Considering All Alternatives

Unless death is truly imminent or your situation is utterly hopeless, avoid rushing into permanent choices. Pursue every avenue and avenue - clinical trials, experimental procedures, palliative care modalities - before abandoning treatment entirely.

You may also have interim options besides the drastic extremes like:

  • Halting harsh interventions but utilizing palliative care for pain/comfort
  • Removing artificial hydration/nutrition but still allowing certain treatments
  • Looking into long-term care facilities over hospice if conditions allow

Be open to incremental steps and give yourself time to evolve as the circumstances do.

Checking Personal Motives

This is an extremely heavy personal choice - make sure you are making it purely for yourself and not subconsciously being swayed by external pressures or influences such as:

  • Feeling you've become an emotional/financial burden on family you want to alleviate
  • Concerns about draining/protecting your family's inheritance from medical costs
  • Internal guilt about dealing with the responsibility or being "ready to go"
  • Tensions with loved ones who may be influencing or pressuring you one way

Only by continually checking your motives can you ensure your choice reflects YOUR values and priorities free of bias.

Accepting Inherent Uncertainty

Even after careful consideration, it's natural to still feel a lingering sense of internal doubt or uncertainty over your decision. A certain degree of personal anxiety about this consequential choice is to be expected.

However, you can find solace and validation in knowing you:

  • Gained a thorough medical understanding from multiple expert sources
  • Heavily weighed your belief systems, end-of-life values, and quality of life priorities
  • Solicitied input from trusted family/advisors but remained true to your own personal outlook
  • Explored all available medical alternatives before making any final determinations
  • Continually checked that you are basing this solely on YOUR best interests

With those pillars in place, any nagging doubt that remains is not a weakness - it underscores the gravity of what you're grappling with and your desire to walk your truth.

Making the Ultimate Human Choice

While agonizing, you can take comfort in knowing this is perhaps one of life's most powerful examples of being able to exercise your fundamental human agency to make a monumental, self-determined choice.

If you ultimately decide to suspend treatment and transition to hospice or palliative care, tend to the finer details of making your remaining time as purposeful and enriching as possible. This includes ensuring:

  • Proper professional resources for pain management and mitigation of suffering
  • Opportunities to share life reflections with loved ones and find personal closure
  • Having your wishes for final arrangements and remembrances honored
  • Connecting with any spiritual or philosophical counseling to find fulfillment

Most importantly, recognize that electing for this path is not failure or defeat - it is a courageous act of self-determination over your mortal autonomy. You are humbly making the most informed, ethical judgment possible given your guiding principles.

Few decisions in life feel as heavy as whether to keep fighting or transition toward the end. However, by thoroughly examining the medical realities yet prioritizing your quality of life values, articulating end-of-life wishes, and committing it purely to your own truth - you can find conviction in making the choice that compassionately aligns with the person you've been.