Who makes the call?

Who I am: The case manager assigned to a heartbreaking case. The concierge to this morbid soliloquy.

Where we are: Seven months of chemotherapy, now radiation for the pain.

The cards on the table:

The doctors have another trial they can do. This is a research facility, there is a price to scientific breakthroughs. The word salvage chemotherapy is being bandied about. The family, I am sure, doesn’t understand what that means.
Daughters have grown accustomed to having to climb into bed with mom for quality time. They just have to catch her when the medication has her lucid with the pain at bay but before she falls asleep. Short window, but they are quick studies.
She cannot make the decision to leave her kids behind because she is a fighter, and she is raising fighters. Her work is not done, her journey as a mother is now starting. She has not had to do the womanhood talk, wipe the first heartbreak tears, or worn the atrocious mother of the bride dresses.
He can’t make the decision to continue because this is no way to live. They started this journey fearless and reckless, full of the future and talks of growing old together. He can’t make the decision to stop because he can’t give up on her. That would be giving up on them. That would mean accepting lonelier nights, raising wounded replicas of her. Being mom and dad. Losing his partner in life.

The catch:

She can’t make her own medical decisions anymore and that’s a great relief, it’s out of her hands now.
He can’t force the kids to pick, they picked to continue chemo last time and now she is peeing in a bag, medicated to the precipice of unconsciousness and too weak to walk. She has lost all her hair, barely holding onto her moxie, muscle and no store carries clothes small enough to fit her frame.

Reality check:

She is dying. No one has acknowledged it out loud. Not the doctors, she can assist in much needed medication trials. Not her husband, he vowed to be her person, her fighter, her companion forever. Not her kids, she is mom, the glue that makes home … well, home.
She will be dead soon. Her moments of lucidity are behind us, she has serene smiles and painful grimaces at this point.

The crux of the matter:

Whose responsibility is it to pick her last chapter?

Do we offer dignity and comfort? Are we too late for Hospice? Science and breakthroughs for those coming after her? What are her obligations to the next generation? Or mercy?
Looks like we will keep putting the ball in each other’s court and maybe nature might intervene and end this morbid waltz.