Scattered thoughts on life support and ethics.
Three newsworthy items these past weeks once again focus on the
morality and ethics involved in prolong life support.
The first case is the young girl who suffered cardiac arrest
while undergoing a minor operation, tonsillectomy.
She was revived and admitted to the hospital in a coma. There
was ECG evidence of brain activity and she was placed on life support equipment
in the ICU. However subsequently without her gaining any signs of recovery
subsequent ECGs revealed the loss of all brain activity. If there is no
functioning brain there is not a human being; not even an entity that could take
care of itself. Without the respirator
supplying oxygen to the lungs and the feeding tubes as well as the IVs she would
be physically dead.
At this point if not fettered by laws the hospital would
have discontinued the supporting. However the family objected and support was
continued until the hospital could get a judicial order to discontinue the
support. The family got an injunction and moved her out of the hospital on
support to another unknown facility.
The second case is even more disturbing. A young pregnant mother
in a first trimester pregnancy suffered a stroke rendering her unconscious. Upon
arriving at the hospital she was put on life support, but it quickly became
obvious that there was no brain activity. Despite the patient’s living will requesting
not to be placed on life support and despite the family’s desire to honor that
wish; a court order that due to the pregnancy with an active fetus that life
support to be continued until a viable baby could be delivered.
That means that for the next five to six months the family
will have to live not with an unconscious person but a human incubator who will
be allowed to die when a baby is delivered. A baby that will enter life without
a mother.
The third notable event was the “death” Saturday of Israel’s
former prime minister and war hero Ariel Sharon after eight years in an
irreversible coma.
The eight years may have been a triumph of medical management
but in my opinion was an obscene adherence to the religious ethic of preserving
life.
What is common in all three cases is the concept of what is
a living person and when it is time to permit the natural course of life to take place; i:e: death.
In Ecclesiastes Chapter 3 we read.
א לַכֹּל, זְמָן; וְעֵת לְכָל-חֵפֶץ, תַּחַת
הַשָּׁמָיִם.
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1 To everything there is a season, and a time to every
purpose under the heaven:
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2 A time to be born, and a time to die;
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Why can we not follow
that advice? Why must we have laws that prevent honoring a persons own wishes?
Yes it is imperative to make sure that no one is deprived of the chance to recover from a coma for financial or other reasons. But on the other hand the convictions of various religious groups should not be imposed on all. Nor should limited resources be held captive to a family's or individual's desire not to let go.
Doc, I agree with you 100%.
ReplyDeleteNone of us on this planet are "getting out alive."
Accepting and embracing death as part of the cycle -- our society just doesn't want to do it.
Youth is glorified -- it's all about staying and being young. In that mind-set, death has no part in the picture.
In the end, when someone mourns, they are mourning for themselves, for their loss. Keeping someone alive when they clearly can't have a possible chance at a good quality of life, is selfish.
Olive, in my years of practice the ones that insisted on continuing or starting life support when there was no evidence of brain activity where most often those with guilty feelings; children who had neglected the parent or had a falling out as well as even distant relatives who had never visited. You are right it is selfish.
ReplyDeleteI personally have no desire to be kept in a state of mere existence by extraordinary means. However, I witnessed a miracle in which someone to whom the doctors said was brain dead come out of a coma. The miracle was that not only did she come out of the coma, she remembered the things and people prior to the coma, she was not in a vegetative state and she talked of her experience while in the coma. Ultimately nothing happens without the knowledge of God and He is still in control. For all those who will challenge that statement, I say that the intellect of man will never equal the wisdom of GOD. In all your years of practice did He allow you to experience any miracles?
ReplyDeletePat: There are several concepts raised in your comments. 1-The decision that the "Brain is dead" is based on the lack of evidence of any "electrical"activity which means any metabolic cell action. It is true that we have seen some times hearts to begin to beat again after a prolong period of asystoley. But our available equipment the EKG can not determine low grades of cell action.
ReplyDeleteAs for miracles; yes there were incidents of unexpected positive outcomes that I could not rationally explain. There have been episodes of brain injury with deep prolong coma and low grade brain activity-the key words- that suddenly regained consciousness. But none in which there was no activity. I would suppose those that did could be considered a miracle.
Even in this day of ultra scientific knowledge things take place that for lack of a better explanantion can be considered the action of a supreme being; a God represented by any religion.