To treat or not?

[Lise]

Here's an interesting case about a dying man who is refused treatment by his own family doctor on the grounds of principal. I'm not sure where I stand on this. On one hand, a doctor should do all within his/her power to prolong life and yet if you see someone slowly wasting away (your body being "cut down" to stall infection) is not doing the patient justice either.

  Penny for your thoughts?

  [FONT size=5]Doctor offers to treat dying Winnipeg man after colleagues refuse[/FONT]

 A doctor in Winnipeg has agreed to treat a dying 84-year-old man amid a legal and medical row between his family and physicians who say keeping him alive is unethical, a published report said Wednesday.

 Three doctors at the city's Grace Hospital have refused to continue providing care to the elderly patient, Samuel Golubchuk, who they say has no brain function and should not be kept physically alive on a ventilator.

 But another, unnamed doctor has come forward and agreed to be Golubchuk's physician of record, according to a report in the Winnipeg Sun that quotes a spokeswoman for the city's regional health authority.

 That will enable routine care to be provided to Golubchuk and his life support to be maintained, medical officials said.

 [A href="http://www.cbc.ca/canada/story/2008/06/18/winnipeg-doctor.html"]Source[/A]

[Gopher]

I'm not sure where I stand on this either. Maybe if I knew of the dying man's previous wishes, it would help me sort through the moral maze.

[Richard]

I have nothing intelligent to say, so I'll blather on and act like an idiot, lololololol

huhuhuhuhuhuhuh

[P.C.]

That's a tough one.  I think all I can come up with, is that I'm glad to not be the one to have to make this decision.  

[Russ]

I hate to say this.. but he's brain dead.. thus nothing there in spirit.

  Im of the opinion that the doctor's in the right here.

  If we allow this.. whats to stop say trying to get the heart of a frozen man beating again a week after he freezes and keep him alive on life support for twenty years, making a further drain on money, resources, and manpower?  

[Lise]

But Russ, imagine if your loved one lying before you brain dead. And you had that decision to pull the plug. Would you do it?

  I couldn't....... maybe I'm selfish but when the time comes, I'm going to hang onto loved one as long as possible. I owe that person that at least.

  As a medical doctor, your first responsibility is to treat all patients no matter what. You have that power to prolong life or hasten death. That's a huge responsibility. I don't know... if I had been a doctor, I would do all that I can to stay the hand of Death as much as I can. Who am I to refuse treatment when I know I can do something?

[P.C.]

   I'm seeing Russ' point.  Lise, sadly by the time a person has reached this point, the loved one you are trying to hang on to has already left you, in mind, soul and spirit.

  I also don't think anyone is refusing treatment when they know they can do something.  On the contrary, they are refusing treatment because it is absolutely certain, that they can't do anything.  I think it may be harder to face our loved ones being alive..... but 'not there' AND with no hope of their return, than it is to face their passing.

  As for a doctor's responsibility to prolong life .....at a certain point, that is no longer their job.  I think that order comes down from a higher power.....and if doctors had to ability how and when to accept this, they might be able to make more rational decisions.  Who would benefit from prolonging a life that remains only because of the valiant attempts to cheat death (the ventilator) ?

  Having said all that.....I still wouldn't want to be the one faced with that decision.

 

[Lise]

 Therein lies the question - are your loved ones really brain dead? How do you know for certain? How do you know that they're inside there, trapped, unable to voice that they wish to hold on for just a little longer? We don't know that. Then how can we turn off the ventilator without knowing what they want? Do we dare make that decision?

   Perhaps they have already passed on but I would rather be there, be able to hold their hand a little longer, have a little hope a little longer..... it's probably the hardest thing to do to see your loved one go away slowly by slowly but I don't want to give up. Not yet.

  I see your point about the doctor's responsibilties but still - if you had the choice, the power, you would do all you can before you exhaust all avenue. As a doctor, you owe it not just yourself but to your patients who put their lives in your hands. I don't know.... when the time comes, I would still appreciate a doctor who would help me fight even if we knew it would be a losing battle. I rather have hope then nothingness.[/DIV]

   
 

[P.C.]

 Therein lies the question - are your loved ones really brain dead? How do you know for certain? How do you know that they're inside there, trapped, unable to voice that they wish to hold on for just a little longer? We don't know that. Then how can we turn off the ventilator without knowing what they want? Do we dare make that decision?

  I think they do know that though.  Once the brain is registering zero activity, there is no coming back.  It goes beyond a doctor's assessment or opinion of the patients condition.....these types of decisions are no longer ambiguous....they are science.  Of course there are circumstances, where I would like the choice to 'hang on' a little longer.  It's unlike a coma though. People have miraculously come out of comas after years.....but the difference is, there IS brain activity.  

   I see your point about the doctor's responsibilties but still - if you had the choice, the power, you would do all you can before you exhaust all avenue. As a doctor, you owe it not just yourself but to your patients who put their lives in your hands. I don't know.... when the time comes, I would still appreciate a doctor who would help me fight even if we knew it would be a losing battle. I rather have hope then nothingness.

  I'd like to think this isn't a rash decision.  They have fought the fight for a long time knowing it was futile.  I think there comes a time when we rob people of dying with a shred of dignity intact....and I hope I have a doctor (and family) that recognizes the difference.[/DIV][/DIV]

[Lise]

I don't categorized brain dead as something you see beeping on the monitor. Sorry, PC but I like to believe that somewhere inside all that matter and flesh there is still someone there. He or she may not hear me but I gotta believe that there's still the slightest chance that they might wake up. I've got to hope, you see, because hope is all I have, all I have to hang on.

  When that person goes, it will be God's will. Until then I will not turn off the ventilator. It might seem the stupiest choice in the world but to me, it's my choice and my choice alone.

[P.C.]

I hear ya Lise.....and I don't think it's stupid AT ALL.  I think I've always felt the same as you....it's only been the last couple years, that my thoughts on this have shifted.   I had always thought of it in terms of me standing over a loved one filled with hopes for miracles.....only recently did I see it in reverse.....and I decided that I would not want to put my loved ones through that. (And my thoughts would be different again if it were someone in their 20's or 30's.)