I've concluded that I don't really care enough to update my blog about the day to day happenings in my life, so I'm changing the focus a little bit with this post.
The other day I discussed the following case with a friend (yes, we're med nerds):
There is a 9 year old boy who is definitively brain dead. There is no chance of recovery. He requires a ventilator to breath, and in one month his body will completely shut down (his heart will stop beating). The parents are Orthodox Jews and believe (in accordance with their religion) that death is when the heart stops. They do not believe that brain death means that someone is dead.
The doctors want to remove the boy from the ventilator; the parents insist he be left on it until death (from their perspective) occurs. Who would you choose to side with if say you were on an ethics board?
Evaluate the scenario from two worlds, one in which there are finite resources and the boy is occupying room space in the hospital as well as using up a ventilator that might be needed elsewhere; the other where there are "infinite" resources, there is no burden to the hospital, doctors, medical staff, or other patients if the boy is left on the ventilator.
Additional details:
- Yes, the boy is completely brain dead, 0 chance of recovery
- The parents are willing to pay the money to keep the boy on the ventilator
- It's their only child
I'm interested to see what you all come up with...
4 comments:
Infinite resources: Let the kid live. Hospital benefits from the money. The family is happy. No problems. Easy call. Who is going to disagree?
Finite resources: I would say rule with the doctors. I'm going to seem like an asshole for saying it, but the kid doesn't contribute anything to society. Nothing. Our government isn't ruled by religion. I'd use the term brightline, since you're a debater, in a sense that if you kept him alive, where would you draw the brightline in letting our government be ruled by religion? It's not "just being respectful of religions." Other people useful to society are much more likely to die because the government decided follow a religon. If anyone really feels like they disagree with me about that, I'll elaborate more on it.
I guess in debate terms again, it's really just weighing the net benefits. If you keep the kid alive, the net benefit is happy parents. If you let someone else use that space, there's a high probability you'd save someone's life. Someone living is better than the happiness of the parents. You could be saving a 9 year old boy who isn't brain dead and make THEIR parents happy. That child could still contribute to society as well. That's my take on it anywho.
What if I contend that even in the infinite resources situation, the doctors should pull the plug. Why is it that in the name of religion people can receive scientifically pointless medical treatment? What if I say that death is when the body is completely broken down? Can I just chill on a ventilator till there is only dust left to ventilate?
There are Indian tribes that use hallucinogenic drugs as part of their traditional rituals. If we legalize their use of such drugs is recreational drug use in society going to go up? Definitely not. But the courts have ruled that such tribes cannot legally use such drugs. Where's the brightline for accommodating for someone's religion?
Infinite resources: Let the kid live. Whether the motive is religion, or emotion or whatever, nobody gets hurt, the family doesn't have to live with whatever misplaced guilt at pulling the plug on their only son. Plus the money goes to the interns/nurses/hospital staff, who definitely don't have easy lives. If they can get a little more pay with no extra work, why not?
Finite resources: pull the plug. Wasting time and money and beds for people that can be helped, and the world already is overpopulated.
Back to your contention:
Would it make you feel better if people can recieve scientifically pointless medical treatment in the name of emotion? Or loyalty? Or love? Not that I don't agree with you, but it's easier to sympathize with his parents if they wanted to wait the month because they couldnt bear the guilt of directly stopping their son's heart, even though they have no choice...I don't know that you could pin this completely on relgion. Don't get me started on Jehovah's witnesses and blood transfusions though... :P
Infinite resources: Allow the kid to "live" until his heart stops. There's no loss, assuming the kid can't feel anything and isn't in any pain, and the parents can rest easy with their religion.
Finite resources: I am extremely hesitant to say "pull the plug," because were I the parents, aside from the whole religious argument, the bottom line is that's my son lying there on a table, who I love (hopefully these parents love their kid) and I'm motivated by something else than "oh gosh, someone isn't dead until their heart stops, so let's just wait until that happens and then go on with our lives." I'll parallel this to the story of when my first dog died. She was a hopeless case, and she was in a lot of pain, and though at first I cried and asked my parents to let us take her home so she could die there, I had this strange about-face realizing that that would prolly just hurt her more, and that the sooner we ended her life, the less pain she'd be in. Now arguably, this boy isn't in any pain, but just emotionally for the parents, I don't think there is much sense in dragging our a sure death. It's going to happen in 30 days or so, and it's not like their love for their son is going to change in that time period. Dragging out the emotional pain just seems masochistic. Religiously though, they'd be suffering emotionally as well if they ok'ed the ventilator being shut down.
In the end, I'd say pull the plug, because I believe that the pain the parents would suffer from defying their religious beliefs would be less than sitting through a hopeless, unresponsive death that nothing could possibly prepare them for. Plus, I think they'd have some religious/emotional guilt if some other little kid (another kid with Orthodox Jewish parents, let's say) needs the ventilator asap because she'll die soon and keeping their son hooked up for the rest of his "life" will kill not one, but two children.
That said, I can't imagine how awful it would be to walk out of the hospital knowing your child was dead, regardless that was of your consent or not.
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