Life and Ethics

Ending life support that exclusively involves nutrition and hydration infusions: is this the same ethical consideration as turning off a machine that that forces the body to function artificially?

In the case of Terri Schiavo, the removal of the feeding tubes meant that she was literally starved and dehydrated until she died. It appears to be the same ethical and moral dilemma for little Emilio except that Terri’s husband insisted that it was her stated wish that her life never be artificially prolonged, and a court agreed. The hospital that is caring for the baby has an ethical obligation to provide the best care possible and they have done this, but a determination has also been made that there is no medical benefit for the child and that his demise is imminent. As per the hospital’s policy, Emilio’s family has been given a 10-day notice of intent and another 10 days on top of that to give the family time to seek alternative care. Now the hospital’s decision has been put on hold by a court. For what reason?

Artificial life support in cases where the hope of recovery exists is, to me, a no-brainer. This is the very reason such advances in medicine have been made possible: to give doctors time to treat a patient. There is a dividing line, however, when such a determination as “no hope for recovery” is made and a decision rendered in which the support much come to an end. Still, allowing a patient to dehydrate and starve to death in such an environment as advanced medical technology exists seems barbaric and ironic in light of arguments that allowing the life to end naturally would be merciful.

In such cases as these and perhaps many others, what is the ethics question? In Terri’s case there was conflict in prognosis. Some said Terri had no hope and was in a “persistent vegetative state” while others insisted that, though impaired, Terri was very much alive and cognizant and would have lived with feeding assistance; her body would still function essentially. With Emilio, there seems to be no dissension; Emilio will certainly die and soon, obviously too soon for mom. To treat or not? To feed or not? To allow life to fade away while trying to comfort the patient or take steps to deliberately end the life rather than allow it to prolong unnecessarily?

While the hospital says money is not a factor, at least for them, since Emilio is insured, there are still practical realities that must be considered and addressed even if no one wants to. Prolonging this child’s life will accomplish nothing more than to run up a bill. No one has suggested that there is a finite price one can reach when talking about human life. The only consideration with this point is simple: how much shall we spend until we finally agree with the doctors and embrace the obvious?

Emilio’s case also does not appear to genuinely involve “quality of life” issues. According to news reports, the hospital is forced to take extraordinary measures routinely because Emilio’s little body simply will not function due to brain abnormalities. His lungs, for instance, cannot expel a persistent build-up of secretions; he cannot cough. Essentially, then, his body cannot function and will likely never function the way it must.

For me and my own stated desires, if artificially sustaining my life will give doctors more time to diagnose and treat my problem, then ok. If my life cannot sustain itself within a reasonable time frame (and health professionals would be better suited to determine “reasonable” in this case, not lawyers or judges or even Congress), then I should be allowed to die. With few exceptions, this is about as natural as it can get, and it is a reality we humans will never escape. We live until we die, and no medical technology does (or even should) exist that can change this reality.