When Parents Say “No to Intubation”: Dignity and Quality of Life at the End of Life

Many families face a difficult question in their loved one’s final moments:
“Doctor, if we don’t put in a breathing tube, does that mean mom won’t survive?”

The honest answer is yes — the chance of survival may be lower.
But the more important question is:
“In what condition does she want to survive?”

Modern medicine is no longer focused only on “prolonging life.” Instead, it emphasizes quality of life and, most importantly, respecting the patient’s wishes about how they want their final days to be.

 

Key Principles in End-of-Life Care

1. Respect the Patient’s Wishes

If patients can express their will while they are still conscious—whether verbally or through an advance directive—those wishes should be respected and followed.

2. Decisions Can Change

End-of-life choices are not permanent. If patients change their minds at any point, their new wishes should always be listened to with compassion, not just treated as a piece of paper.

3. Life-Prolonging Measures Are Not Always Beneficial

For elderly patients with severe illness, intubation may not restore health but instead bring more pain—such as a tracheostomy, being restrained in the ICU, or being unable to speak or embrace loved ones. Sometimes, we “sustain life” but fail to “sustain a life worth living.”

4. Weigh the Benefits and the Burdens

While intubation can extend life, it often comes at the cost of suffering. Medical decisions should balance both potential gains and harms, rather than focusing only on survival time.

5. Dignity and Peace Are Priceless

A peaceful passing without unnecessary intervention is not defeat—it is a choice to leave the world with dignity.

 

The Role of Doctors and Families

Doctors are not only responsible for treating disease but also for preserving the humanity of their patients. That means listening as much as speaking, and helping families understand that sometimes, doing nothing more may be the most loving act of care.

For families, if the opportunity arises, gently ask loved ones:

“If one day your body grows weaker… how would you like us to care for you?”

The answer may not be about doing everything possible—but about doing what truly matters to them.

 

The Essential Lesson

• Good care does not always mean extending life at all costs.

• Quality of life and dignity at the end are invaluable.

• True love is honoring the choices of those we love.

The best care is not always about “doing everything,” but about “doing what they truly wish, with understanding and love.”

 

Source:

รู้ก่อนลืมแก่กับหมอเก่ง

www.cherseryhome.com