Whose Choice Is It Anyway?

Originally published in allaboutestates.ca on January 8, 2015:

Provided by Dr. Renee Ruiter Kohn, Clinical Manager @ Elder Caring

The media has recently focused on the subject of caregivers to elderly parents where the job has been characterized as an all-consuming role that can trigger a host of difficult emotions, including anger, fear, resentment, guilt, helplessness, and grief. Canadian caregiver Mr. Ron Siwicki, his mother’s caregiver, was arrested on December 16th for letting his 90-year-old mother die on the floor after she fell. He is charged with criminal negligence causing death and failing to provide the necessities of life.
Friends have said Mr. Siwicki is a compassionate, caring person, who was devoted to his mother. His lawyer Mr. Mike Cook told reporters that Mr. Siwicki was complying with his mother’s wishes when she fell out of bed in mid-December. She didn’t want medical attention, so he fed her nutritional drinks until she died. He then called 911. “The case is rare,” Mr. Cook said, because the charges usually involve parents who don’t get their children medical attention”. Siwicki’s mother lived with him and the outcome could have a broader significance as more people care for their aging parents and relatives at home”, Cook suggested.

As the judge in this case has granted a publication ban we do not have the details but are left with serious questions including: What happens with aged relatives at home? What if they don’t want care? What if they want to die peacefully in their own home? What if Mrs. Siwicki was in her bed or sitting in an easy chair? Did Mr. Siwicki do the right thing or the wrong thing? What would each of us do if we were in Mr. Siwicki’s shoes?
Wanda Morris, chief executive of Dying with Dignity Canada, said the Siwicki story is sad and shows that there needs to be more education for families who may find themselves with a loved one who refuses medical care.

Commenting on the Siwicki matter she said “Care is a broad term, so the education I’d like to give people is to know that you always have the right to refuse a treatment,” she said and continued “So if she (Mrs. Siwicki) didn’t want to go to hospital, [it’s] absolutely her right. She concluded “She clearly wanted comfort care only and wanted to end her life, but she didn’t have to do that on a floor, and I suspect she was in some pain probably from a broken hip.”

Arthur Schafer, an ethics professor at the University of Manitoba, said that if Siwicki is telling the truth about his mother, the criminal charges against him should be dropped. By the truth Dr. Schafer may be referring to the sincerity of Mr. Siwicki’s intentions. So we wait for the truth to emerge but as we wait we are reminded that there are so many uncharted roads for caregivers to travel. We realize once again that our role as care managers includes developing clearer roles and responsibilities along with educating and supporting caregivers in their daunting job.

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