Thou shalst not kill...
Sunday, August 13, 2006 12:46:15 PM
officously to keep alive
From the council of medical ethics:
A 90 year old woman had been patient in a nursing home for four years. She had two major strokes and was now paralysed, unable to speak, unable to eat or drink and incontinent. The last three years her condition had ben thus stable. She is bedridden, has contractures in arms and legs, an is quite unable to move. She is dependant upon being given foof through a gastrostomy and has been so for two years. By accident the PEG (Gastrostomy) tube fell out, and she was remitted to the nearest hospital for a new one.
The Hospital refused, and the woman's children agreed. The children had a year earlier signed a document to the effect that they did not wish for their mother to be given parenteral food or antibiotics; but the doctor at the nursing home had continued his treatment anyway until the tube now had fallen out. The children had at that time in their desperation contacted the Board of Health, who had insisted that this frail old body should be kept alive indefinitely. Their reasons for this heartless decision was that the woman wasn't "dying", and that denying her PEG was tantamount to murder.
So the matter this time went to the Ethical council, who agreed with the Board of Health that the woman should be kept "alive" (depending on the definition of "life" of course). Their reason was however that they felt the Hospital should have contacted the doctor at the nursing home and "discussed" the matter with him.
With all due respect; the Council for medical Ethics has here given a legal advise, not an ethical one. If the involved persons had wanted guidelines as to the proper bureaucratic process for terminating parenteral feeding, they could have contacted the Board of Health who consists of lawyers and buraecrats and therefore excel in such byzantine matters. The question they asked was: "Is it ethically right to refuse to operate this woman in order to prolong life in a woman in a vegetative state?" - or, they could equally correct have asked the opposite question, "Is it right to operate on a braindead person in order to keep the heart beating?"
Instead of an answer to this question (which could have been interesting indeed), the Council chose to evade the question and give the petitioners a lecture in formal departementese procedures.
Shame, shame! The Council has done better in the past, if this is a sign of incipient cowardice gripping its members, the council will soon be faced with the question: "Is it ethically correct to keep a council of Ethics alive which refuses to adress ethical questions?"