When should we really pull that plug?
About nine years ago, 17-year-old Briton Steven Thorpe suffered multiple injuries in a car crash and was placed in a medically-induced coma.
Doctors at the hospital told his parents he would never recover and asked them to contemplate donating his organs to science before his life-support machine was turned off. But his family declined and sought the opinion of neurologists at a Coventry hospital. Five weeks after much arduous and diligent medical assistance, he was discharged from the hospital almost fully recovered.
Belgian Rom Houben was diagnosed to be in a coma for 23 years by doctors after being in a vehicular accident in 1983. He was finally correctly diagnosed by another team of doctors as being paralyzed and not having the ability to inform them on his condition.
About five years ago 22-year-old Aaron Denham was lying comatose in a hospital bed in Southampton with a broken neck, smashed pelvis and punctured lung. Doctors had decided to pull the plug on his life support, and family were advised to start making funeral preparations. Then he moved slightly. He subsequently made a recovery, despite having to endure hours of attention and therapy. He walked again as well.
These are but three of the thousands of examples of people, young and old, who were misdiagnosed, or who recovered to lead normal lives, after doctors had given up on them; deemed them beyond assistance. There have been other cases of persons living with cancer and other ailments past the time which medical science suggested was their limit.
Our chief executive officer at the Queen Elizabeth Hospital, Dr Dexter James, is no Jack Kevorkian and should not be seen as such. But he has raised some eyebrows with his suggestion that authorities might have to consider discontinuing treatment for some terminally ill patients. He noted that it posed an ethical dilemma, and based most of his argument for consideration of such a stance on the spiralling cost of providing health services to people deemed “terminally ill”.
Dr James stated there were cases where the QEH kept patients on life support even though all the indicators pointed to their being brain-dead. He added that somebody had to make the call on addressing the matter.
“The question I want to ask: is Barbados ready for a conversation and a debate around futility of care versus rationing? . . . . That is an ethical dilemma that we have to address if we are really serious about fixing some of these systemic problems,” he said.
Notwithstanding that from the time we are born, we all instantly become “terminally ill”, it is a dangerous thing when human beings start to play God. And for the atheists among us, it is also a dangerous thing when human beings take unto themselves more power than should be their domain.
It is difficult to place a value on human life. Do we give the son of the millionaire or billionaire more time on life support in the hope of recovery? Or do we pull the plug on the gardener’s daughter if after nine months the cost of maintaining her on the machine starts to make slight dents in the budget? What really will be
Dr James talks about situational ethics in this matter. But when dealing with human life, how safe is it to take only into consideration the specific context of an action, while ignoring the absolute moral standards by which we live. Even the atheists have a code that appreciates the sanctity of human life.
We appreciate Dr James’ concerns and constraints in trying to manage a hospital. We would be foolhardy to ignore the importance which financing such a facility entails. If one wants an example of the difficulties, one merely has to use our hospital as an example with its chronic shortages of beds, medicines, staff, et al., to understand the headaches of running a hospital.
But that must be measured against the myriad circumstances that can impact the critical decision to end human life, based on human judgement which will never be infallible. Messrs Thorpe, Houben, Denham and surely thousands more can attest to this.
Dr James brought no empirical evidence, especially where numbers of terminally ill patients at the QEH are concerned, to support his argument that such persons are a financial burden. We know of no mass number of people on life support at the hospital.
There are circumstances in the past where families have pulled the plug on their loved ones, and much thought would have gone into such a final decision. But we think that such a call coming from a top official at a hospital is a somewhat dangerous thing.
We believe that such a suggestion, having come from the hospital’s chief executive officer, might lead some families in the future to be rather watchful of the fortunes of their loved ones lying in various stages of “terminal illness” on the beds of the Queen Elizabeth Hospital.