Biomedical Engineering Reference
In-Depth Information
in 1983 at the age of 20. A formal martial arts enthusiast, Houben was assumed to be in a PVS for
over two decades. After therapy he is now able to communicate via typing, and he reads topics
while lying down, using an assistive device. “I want to read,” says Houben, via keyboard, “talk
with my friends via the computer, and enjoy my life now that people know I am not dead.”
3.
With diagnosis technologies constantly in development, should PVS victims ever be “allowed
to die”?
2.4 T
HE TERMINALLY ILL PATIENT AND EUTHAN
ASIA
Terminally ill patients today often find themselves in a strange world of institutions and
technology devoted to assisting them in their fight against death. However, at the same time,
this modern technologically oriented medical system may cause patients and their families
considerable economic, psychological, and physical pain. In enabling medical science to pro-
long life, modern technology has in many cases made dying slower and more undignified. As
a result of this situation, there is a moral dilemma in medicine. Is it right or wrong for medical
professionals to stop treatment or administer a lethal dose to terminally ill patients?
This problem has become a major issue for our society to consider. Although death is all
around us in the form of accidents, drug overdoses, alcoholism, murders, and suicides, for
most of us, the end lies in growing older and succumbing to some form of chronic illness.
As the aged approach the end of life's journey, they may eventually wish for the day when
all troubles can be brought to an end. Such a desire, frequently shared by a compassionate
family, is often shattered by therapies provided with only one concern: to prolong life
regardless of the situation. As a result, many claim a dignified death is often not compatible
with today's standard medical view.
Consider the following hypothetical version of the kind of case that often confronts
contemporary patients, their families, health care workers, and society as a whole. Suppose
a middle-aged man suffers a brain hemorrhage and loses consciousness as a result of a
ruptured aneurysm. Suppose that he never regains consciousness and is hospitalized in a
state of neocortical death, a chronic vegetative state. His life is maintained by a surgically
implanted gastronomy tube that drips liquid nourishment from a plastic bag directly into
his stomach. The care of this individual takes seven and one-half hours of nursing time
daily and includes shaving, oral hygiene, grooming, attending to his bowels and bladder,
and so forth. Suppose further that his wife undertakes legal action to force his caregivers
to end all medical treatment, including nutrition and hydration so complete bodily death
of her husband will occur. She presents a preponderance of evidence to the court to show
that her husband would have wanted just this result in these circumstances.
The central moral issue raised by this sort of case is whether the quality of the indi-
vidual's life is sufficiently compromised to make intentional termination of that life morally
permissible. While alive, he made it clear to both family and friends that he would prefer
to be allowed to die rather than be mechanically maintained in a condition of irretrievable
loss of consciousness. Deciding whether his judgment in such a case should be allowed
requires deciding which capacities and qualities make life worth living, which qualities
are sufficient to endow it with value worth sustaining, and whether their absence justifies
deliberate termination of a life, at least when this would be the wish of the individual in
question. Without this decision, the traditional norms of medical ethics, beneficence and
