Waseda WeeklyWaseda Weekly

As I get older, stories about death, serious illness, and dementia have become far from being something that only happens to other people.

I recently heard news about a senior colleague who had been very kind to me. This colleague, who had been involved in medicine for many years, had clearly stated when they were healthy that they did not want life-prolonging treatment. However, as their dementia progressed and they could no longer eat by mouth, they were told that they only had a few weeks left. After much deliberation, their family decided to have a gastrostomy (※1) performed. They have now successfully undergone the surgery and are recuperating at home.

*1 A surgical procedure in which nutrients are directly injected into the stomach from outside the body.

Recently, the importance of "ACP (Advance Care Planning)" (*2), which involves discussing medical care and treatment in advance in case of an emergency, has been emphasized. This initiative, which allows people to record their wishes and review them as many times as needed, aims to reduce the burden on families who are forced to make difficult decisions. However, it has not become widespread in Japan. This may be due to a culture that views death as taboo, stemming from the belief that "speaking ominous things will make them come true," as well as the influence of a sense of impermanence that dictates "accepting things as they are."

*2 Abbreviation for Advance Care Planning

What I realized most acutely through my senior's case is that even if the person themselves expresses their wishes, it is unimaginably painful for family members to accept the fact that their loved one's life is nearing its end.

That's why end-of-life planning isn't something that's "finished by writing it down on paper." I believe that the process of repeatedly sharing changing feelings and the inevitable family conflicts is what truly brings solace to those left behind.

(IK)

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