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Would You Buy Cigarettes for a Man Suffering from Emphysema? An Ethical Question

Updated on January 6, 2017
Diana Grant profile image

I am interested in the world around me, human rights, current affairs, psychology, law, justice, and philosophical and ethical questions

If you knew that smoking was killing him would you still give him a packet of cigarettes?

A few months ago I received a message from a stranger that someone I knew, but hadn't seen for a few years, was very ill in hospital with emphysema and was asking to see me. I dropped everything and went to the hospital immediately, as I knew it was important, or he wouldn't have sent me this message.

Cigarettes in a dirty ashtray

Source

I was completely shocked by what I saw:

I wasn't even sure if it was him at first. He was lying in bed, slumped over with his eyes closed, gasping for breath. He had a hospital nightshirt on, and it had slipped to one side so that his shoulder was hanging out, and it was just like looking at a skeleton. He had lost all his muscle, and his arms were about as thin as a broomstick. He had an air tube up his nose, needles in his arms and a urine bag on one side of the bed. He'd lost most of his teeth, and white spittle was drooling out of his mouth.

After we had talked for a few minutes, he begged me to go out and buy him some cigarettes.

Health Warnings on English Cigarette Packets

Source

My choice was painful - whether to refuse a dying man his wish to leave this world with a fag in his hand, or whether to give him what he wanted

It wasn't even as though it would make him happy - nothing could do that. It would just ease his pain for a few minutes and feed that insatiable craving.

I pointed out that he couldn't smoke in hospital, and that we should wait till he went home. He became insistent, agitated and voluble, and, like a small child, kept saying, shouting,even, "I want it now, I want it now - just get it!".

It was pitiful seeing this desparately ill man begging for the very thing which had caused his illness.

I felt guilty refusing him. He became more clamorous and demanding, whilst still accepting that he couldn't smoke till he got home - he couldn't even get out of bed, so smoking in the toilet was not an option. Eventually, he made such a fuss that I did go out and buy some cigarettes. Then he begged someone in the next bed for a lighter, and once he had all his paraphernalia, he quietened down, and did in fact wait until he went home two days later.

Once there, he only managed to have one or two, because someone confiscated his lighter so that he wouldn't fall asleep smoking and set fire to his bed, which was a distinct possibility. The thought did cross my mind that that might turn out to be a blessing in disguise in his situation,

And I still had that feeling of guilt, because I had colluded in his harmful behaviour.

What would you have done?

Comforters: A cigarette pattern - isn't that pretty? Yes - pretty lethal!

Source

The issue really is whether, if you are that close to death, you might as well have a little bit of what you fancy to ease your suffering

There was some talk, in my presence, with the doctor who was suggesting a procedure putting a tube in his chest to help his breathing, and he was told he could have it done the following day, but that there was only a 60% chance of success, which wasn't good odds. He was left to think about it, and was later told that the general opinion was that it was not worth the risk, and one doctor even said that as they could not do anything to help him, he might as well go home and smoke.

He could have said smoke himself to death. But that was left unsaid.

Is "tough love" too harsh to inflict on a dying man?

If he is bedridden and immobilised, would you go shopping for him if he begs and pleads?

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Post Script: Sadly, my Friend Died on 25th March, 2012

There was nothing more the doctors could do for him to help his condition. It is customary for the medical team or a doctor at hospital to discuss treatment with the next-of-kin and the patient, if able to take decisions. They explained why the only course left was palliative care, as the bodily functions were gradually closing down. No more food as the body didn't need it, and not even any water except to moisten his mouth, as he wouldn't be thirsty. And upping the administration of morphine, to ease the pain.

We agreed.

As it transpired, I was the last person to buy him a packet of roll-up cigarettes. And in retropect, I'm glad I did.

What do You think about buying cigarettes for someone wth emphysema - would you do it?

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    • Spirit Whisperer profile image

      Xavier Nathan 5 years ago from Isle of Man

      This is a great hub. You have the ability to make people think and this is indeed a great gift. The hub is a true reflection of the inner dialogue we all have when it comes to dealing with dilemma. Bottom line is that most people are afraid, not for others but for themselves. They fear guilt! Thank you.

    • Diana Grant profile image
      Author

      Diana Grant 5 years ago from London

      Yes, Spirit Whisperer, I suppose the fear of guilt is what keeps most people on the straight and narrow.

      It is more problematic when you feel guilty if you do and guilty if you don't - it's quite a balancing act isn't it?

    • profile image

      almorr 5 years ago

      This hub should be read by any young person who is thinking of starting smoking. DO NOT START. This guy has smoked himself to death, he has lived smoking and he will die smoking. Smoking has already been banned in public places in most western countries, it is an absolutely vile habit, so please do not start. Learn your lesson from this man.

    • Cathleena Beams profile image

      Cathleena Beams 5 years ago from Lascassas, Tennessee

      It is a bad addiction. One of the hardest ones to break.

      I have never been a smoker, but I have friends who are and have tried numerous times to stop, yet they are unable to follow through with their resolution. They tell others that they are going to try to quit and do for a short period, but then you come across them puffing away again with cigarettes in hand.

      I ran into a similar situation as you, Diana, when I came across a gentleman in a wheelchair at the airport. He was on oxygen, and out of breath from trying to roll himself a short distance to the smoker's lounge. He beckoned me over to ask me if I minded wheeling him (a stranger) over to the lounge so he could smoke. He didn't care that smoking was killing him one drag at a time. The need for the nicotine was so overpowering for him. He knows eventually it will take his life, and the saddest part about it is that it doesn't matter enough to him to sustain. I wheeled him to the lounge knowing that one way or another he was going to get there anyway, and rather than watch him struggle, I became his enabler.

    • Georgina_writes profile image

      Georgina_writes 4 years ago from Dartmoor

      Hmm, difficult. My Mum had COPD - I refused to buy cigarettes for her, but as a nurse I have had to wheel patients outside so that they could smoke.

    • UberGeekGirl profile image

      Michelle Harlow 3 years ago from Calgary

      I'm actually going through this with my mother and grandpa right now. Mom is in a nursing home and has let herself get to 450 pounds since my stepdad died so she can't do anything for herself. She begs my grandpa (her stepdad) for treats like extra crispy KFC and sweets and he gets them for her. Doctors say if she lost the weight she could live for years yet (she's only 64) but she's stubborn and lazy and grandpa enables her. I've actually started bullying my grandpa to get him to stop feeling guilty and quit enabling her.

    • profile image

      Keiffer 2 years ago

      We covud'le done with that insight early on.

    • Nancy Hardin profile image

      Nancy Carol Brown Hardin 23 months ago from Las Vegas, NV

      Diana, you did the right thing. He left this world with the feeling that someone cared about him, because of your generous action. I know it was hard for you, but I'm sure now that he's gone, you feel less guilty about agreeing to what was almost his dying request. I too, have emphysema/COPD, I've lived my life on oxygen 24/7 since 1997. I quit smoking the year before I was diagnosed. But if I was in that man's place, I would feel grateful that someone thought enough of me to want me to be happy. In his condition, depriving himself of smoking wouldn't have helped him; it was already too late. Knowing someone was kind enough to do what he asked must have given him comfort. You were a good friend to this man.

    • Lorelei Cohen profile image

      Lorelei Cohen 23 months ago from Canada

      If he had been able to go outside or to a smoking room to smoke then yes. If he was not able to leave his room then no. It is obvious that he was dying, and dying with dignity and as much comfort as possible is very important. But then of course I am someone who has given alcohol to an alcoholic and also money to a homeless drug addict. My reasons for this choices are my own and ones I can live with.

    • Barbara Kay profile image

      Barbara Kay Badder 23 months ago from USA

      What makes all the difference is that he was already dying. If someone had emphysema and wasn't dying, I'd never give them one. Addictions are a terrible thing.

    • MsDora profile image

      Dora Isaac Weithers 23 months ago from The Caribbean

      For sure, you didn't kill him; in fact, you made him comfortable. However, I may not have given him the cigarette, hoping that his anger at me wouldn't kill him. Tough call!

    • profile image

      lmmjenkinson 17 months ago

      I would because he is dying but would I give him several and watch him choke and cough- no. But I see no harm when it presents itself as a last wish. I would feel more guilty if I didn't.

    • Diana Grant profile image
      Author

      Diana Grant 17 months ago from London

      I agree, and was surprised by several responses on social networks that on no account would they give him cigarettes.

    • Blond Logic profile image

      Mary Wickison 17 months ago from Brazil

      I would buy them for him. The time for lecturing about the dangers of smoking has past.

      I know how strong that craving for cigarettes can be as I have lived with smokers all my life. The venom which is spewed when they don't have a cigarette is awful. A friend of ours has emphysema and continues to smoke. It is sad to see the decline in vitality due to the addiction.

      I remember seeing a couple in the UK. He was in a wheelchair with oxygen being pushed by his wife. She would stop and put a cigarette in his mouth as he could no longer hold it.

      I get very angry that a smoker can be so selfish not only spend the vast sums of money from the family funds to feed his habit but also expect the rest of the family to accept this addictive behavior.

      Smoking has devastated so many families.

    • Diana Grant profile image
      Author

      Diana Grant 17 months ago from London

      In other words, "damned if you do, and damned if you don't"

    • profile image

      Donald B. 16 months ago

      My 87 year old grandfather was sent home from the hospital a few days ago.. His heart has been failing over the past several years and week ago had a massive debilitating heart attack.

      His doctors said the best thing to do is make him comfortable, he does not have much time left. His heart and kidneys are failing..there is nothing that can be done.

      The man has smoked since about the age of 10...heavily...

      But now that he is on his deathbed he is being refused his cigarettes by family members. It tears me apart seeing my grandfather asking for a cigarette...after being told "No" his head drops and he stops talking..just sits there with his head down until finally asking to be helped back to bed.

      And then to make the issue even more family dividing.... Months before his debilitating heart attack we put together an official living will that is bound by US state law in which he stated "I do not want to die without my cigarettes". The two people designated in the living will who swore/signed to carry out his wishes...are the same people refusing to give him the cigarettes.....

      I personally think the people refusing his wishes / refusing to let him smoke are being completely selfish. They are trying to prolong a dying man's painful last days on this earth due to their inability to let him go. They will regret this some day...some day they will realize all they did was cause him even more physical and emotional suffering.

    • Diana Grant profile image
      Author

      Diana Grant 14 months ago from London

      This is such a troubling situation - you want people to have what they want in their last days, and you fear feeding their deadly habit.

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