Family Members Should NOT Decide When Life Support is Needed

Should the decision to keep a person on life support be made by family members only?

This question has major impact on many people’s lives, their deaths, and their quality of life. Many other questions can be asked in conjunction with this question. How would you like to be kept on life support? Would you want a doctor to make the decision of ‘life or death’? The questions just keep on coming, and every time we seem to find ourselves divided. This issue is relevant because of the recent media coverage over Terri Schiavo’s right to live or die and the fact that any of us could be in her situation. In the case of Quinlan1., the court asked, "If the patient could wake up for 15 minutes and understand his or her condition fully, and then had to return to it, what would he or she tell you to do?" It is a question everyone would want to discuss with individuals in that position. I intend to discuss the scientific background, the current situation, the way in which the situation has been managed and my own opinion on the situation.

Inaccurate reports in the media have allowed this situation to expand to include the individual voices of the world. Some believe that Terri’s condition was brought on by domestic abuse subjected by Terri’s husband Michael Schiavo, others, doctors included, believe that Terri’s condition was caused by an eating disorder, namely bulimia. Not many people are even aware of what Terri’s condition was: whether it be brain death, persistent vegetative state or minimal consciousness. With assurance from doctors, these conditions are all vastly different.

The medical definition of ‘brain death’ is: ‘the cessation and irreversibility of all brain function, including brain stem’ 2. Some people confuse brain death with PVS, however, it is not the same. When an individual is brain dead there is no activity anywhere in the brain, in PVS there is some activity in the brain steam and some other primitive regions.

Persistent vegetative state or PVS often follows a coma and refers to a state where an individual loses their higher cerebral functions of their brain, but their breathing and circulation (functions of the brainstem) remain comparatively normal. The individual may cry, laugh or open their eyes in response to external stimuli but they will not speak or follow commands. PVS is extremely hard to diagnose because it can take m...

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...o professionals instead of family members because they are too emotional, and not equipped with the appropriate scientific knowledge to make an educated decision. Futility of treatment and financial support must be taken into account with all cases to determine the level of care provided. People do the best they can in all cases, however, not everyone’s perfect- mistakes will be made.

Bibliography:

1 “U.S.News & World Report” http://www.usnews.com/usnews/health/articles/050404/4science.htm Copyright © 2005, L.P. All rights reserved

2 Brain death. In Wynngaarden JB, Smith LH, Bennet JC(eds): Cecil Textbook of Medicine, 20th edition. W B Saunders Company, 1996.

3 Gorman, Christine. “When does the Brain go Blank?” Time 5th April, 2005, pg. 24-25.

4 Johansen, Rev. Robert. 2005. “Starving for a Fair Diagnosis”

http://www.nationalreview.com/comment/johansen200503160848.asp, March 16.

5 http://www.emedicinehealth.com/Articles/17135-1.asp, © 2003-2005 eMedicine.com, Inc. All Rights Reserved. 13th May.

6 “Woman still in coma” The Advertiser 13th May 2005, pg. 7.

‘Healthlink’ http://healthlink.mcw.edu/article/921394859.html © 2003 Medical College of Wisconsin