Should doctors decide when you die?

CBC news reported today on an end-of-life case that made it to the Supreme Court of Canada.

The emotionally charged question about whether a doctor should have the authority to order life-support tubes pulled from a minimally conscious patient without the consent of the patient’s family was the subject of a Supreme Court of Canada hearing Monday.

The case is about Hassan Rasouli, who has been on a ventilator and feeding tube for the past two years at Sunnybrook Hospital in Toronto, after bacterial meningitis destroyed parts of his brain following surgery for a brain tumour.

Rasouli, at first in a coma, was deemed to be in a persistent vegetative state, but that diagnosis was changed to one of “minimal consciousness” after he seemed to wake up and could occasionally give a thumbs-up sign, or grasp a ball.

Nevertheless, Rasouli’s doctors at Sunnybrook didn’t change their minds that he should be taken off hydration and feeding systems and moved into palliative care.

Rasouli’s family sought an injunction to prevent removal of the tubes, and then argued successfully at two lower court levels that the doctors did not have to right to halt use of the life-preserving equipment. The doctors appealed those decisions to the highest court.

Outside the court in Ottawa Monday, Rasouli’s daughter Mozhgan said, “My father represents the value of life … I know that he wants to be alive.” She continued, “It is unfair, it is unfair — he should be treated like anyone else.”

So who should decide?

Hassan Rasouli with his wife and daughter at a Toronto hospital

Hassan Rasouli with his wife and daughter at a Toronto hospital

Here are few opinions I tweeted today about this topic.

  • I believe that If a patient did not provide advance directives or living will then the desire of his/her biologic or alternative family should be respected.
  • I know it can be very expensive to keep a patient in a vegetative state on life support but since when do we, doctors, allow finances to dictate our code of ethics?
  • You might argue that such practices consume medical resources on a futile treatment. However, isn’t that what we do with almost all cancer patients with bad prognosis and short life expectancy? We do it all time. We always treat patients with terminal illnesses.
  • It is about patient’s quality of life rather than “when they will die” or how much they cost our system. Who are we to judge the value and quality of a life of someone?
  • In my opinion it makes all sense to pull the tube but my opinion should never override patient’s wishes in all issues especially if related to life and death decisions.
  • Health insurance, even governmental, should continue to pay for patients even when medical expenses are too high. We expect that from private insurance companies why would we expect less for the governmental one?
I wanted to share with you the few random thoughts that raced in my mind as I read the article, I will be definitely following this story closely to see what the Supreme Court will decide. Such a decision will have significant ethical and medical repercussions that will touch all of us.

Categories: Health, Human Rights

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