1Arctic-Stranger
This came up in our hospital ethics committee the other day. It came as a case study, and not an actual case in the hospital. I want to hear your responses, and will comment on it later.
A retired Doctor was volunteering as a hospice worker. His client was an elderly woman with several children and grandchildren, who was dying of cancer. Around Christmas she stopped eating, and went into a coma. Per her wishes, the family had stopped hydrating her.
The daughter asked the Volunteer Doc how long Mother had. The doctor told her that, given her lack of food, and now water, she could expect to live a week or less.
The daughter asked if there was any way to keep her alive until the new year, without feeding tubes or a reinserting a central line for hydration. The doc asked why and the daughter said that the new tax laws go into effect Jan I, and the inheritence tax would going through some radical changes, and less of her resources would go to the government, and more to her family, if she made it until Jan 1.
"She was a practical woman," the daughter said. "She would have wanted her family to be well provided for."
Any thoughts?
2EncompassedRunner
I have less problem with this situation where the potential conflict of interest results in prolonging life, such that it is, than where (as in the Schiavo case) the potential conflict of interest results in bringing a quicker death.
3christiguc
I'm not that well-versed in these issues but I find them very interesting. I hope you all don't mind if I join in and post.
The situation Arctic-Stranger gives is a very difficult situation. You have her express wishes that were given before she stopped eating and you have her daughter's account of what her wishes would be in this specific situation, with her mother being a practical woman. Let's just presume the daughter is expressing this wish, not for her or her family's personal benefit but for the thought of the practical side of her mother.
If you compare the effects that the "radical changes" in the tax law would have on the inheritance to the prolongation of life of at the most six days (Christmas to Jan 1), a practical woman, looking specifically at those trade-offs, could reasonably wish for non-drastic measures be taken to extend her life. However, if her mother was a practical woman, she probably made an informed decision (taking into account everything she was feeling at the time) of when to stop eating. Since she knew her death was approaching, she most likely knew of these new tax laws (Congress doesn't just make and pass these bills in a week) and didn't think them a large enough factor to change her plans to stop eating. She didn't even think them a large enough factor to definitively change her wishes on what steps should be taken when she falls into a coma. I grant that she may not be aware of the coming laws, but she would have been if her estate was among her large concerns with her death. Because the "practical woman" argument works in basically the same strength both ways, I don't think it a proper reason to overturn her previous wishes.
There is more information that I would like before making that decision final. What kind of things could be done to extend her life without restoring hydration or feeding? Could the changes guarantee to keep her alive until the new year?
Presumably her doctors know what what factors went into her decision to stop fighting: pain? weariness? a reluctance to rely on machines to sustain life? feeling that 'it is time'? If the means to keep her alive don't go against the reasons behind her decision, I would find the situation less problematic. If the doctors don't know her reasons, however, I don't think they can presume to guess her intentions.
The fact that she might survive naturally (without forced hydration, etc) to the new year makes the decision easier for me. It isn't quite a trade-off of 6 days for a larger estate--it is a trade-off of (presumably) going against her expressed wishes for extra insurance that she live until the new year.
That's just my reaction to the situation. I don't have any experience in this field. What do other people think?
The situation Arctic-Stranger gives is a very difficult situation. You have her express wishes that were given before she stopped eating and you have her daughter's account of what her wishes would be in this specific situation, with her mother being a practical woman. Let's just presume the daughter is expressing this wish, not for her or her family's personal benefit but for the thought of the practical side of her mother.
If you compare the effects that the "radical changes" in the tax law would have on the inheritance to the prolongation of life of at the most six days (Christmas to Jan 1), a practical woman, looking specifically at those trade-offs, could reasonably wish for non-drastic measures be taken to extend her life. However, if her mother was a practical woman, she probably made an informed decision (taking into account everything she was feeling at the time) of when to stop eating. Since she knew her death was approaching, she most likely knew of these new tax laws (Congress doesn't just make and pass these bills in a week) and didn't think them a large enough factor to change her plans to stop eating. She didn't even think them a large enough factor to definitively change her wishes on what steps should be taken when she falls into a coma. I grant that she may not be aware of the coming laws, but she would have been if her estate was among her large concerns with her death. Because the "practical woman" argument works in basically the same strength both ways, I don't think it a proper reason to overturn her previous wishes.
There is more information that I would like before making that decision final. What kind of things could be done to extend her life without restoring hydration or feeding? Could the changes guarantee to keep her alive until the new year?
Presumably her doctors know what what factors went into her decision to stop fighting: pain? weariness? a reluctance to rely on machines to sustain life? feeling that 'it is time'? If the means to keep her alive don't go against the reasons behind her decision, I would find the situation less problematic. If the doctors don't know her reasons, however, I don't think they can presume to guess her intentions.
The fact that she might survive naturally (without forced hydration, etc) to the new year makes the decision easier for me. It isn't quite a trade-off of 6 days for a larger estate--it is a trade-off of (presumably) going against her expressed wishes for extra insurance that she live until the new year.
That's just my reaction to the situation. I don't have any experience in this field. What do other people think?
