Quick Decision to End Life Support: Cause for Concern?December 10th, 2013
Timothy Bowers was 32 years old, and enjoying life. The Indiana mechanic was recently married, and he and his wife were expecting a baby. All of that changed suddenly, tragically, and permanently on November 2nd, when Tim fell from a tree stand while hunting. The 16-foot drop left him with a crush injury to the 3rd, 4th, and 5th cervical vertebrae of his neck. He was suddenly and severely paralyzed, unable to move his arms or legs, and unable to breathe without a ventilator.
As is common after a severe injury, Tim was surrounded by family in the hospital, where he was heavily sedated. When the family learned of his prognosis, that made the unusual request to immediately discontinue the sedation, so they could apprise him of his injuries, and so Timothy could make his wishes known. When he awoke and learned his diagnosis, according to his sister:
“We just asked him, ‘Do you want this?’ And he shook his head emphatically no.”
And so the medical team agreed to discontinue Timothy’s ventilator. Surrounded by family and friends, he died later that afternoon, one day after his accident.
Even Arthur Caplan, the celebrated director of medical ethics at New York University, seemed a bit conflicted about these events. On the one hand, he said:
Patients often change their minds after they have had time to meet with spiritual advisers and family.
On the other hand, Timothy had previously made his wishes clear to his sister about not wanting to be machine-dependent if ever he was in such a debilitated state. So this decision appears to be in line with his values.
Nonetheless, I am worried about the rapidity here. What’s the rush? In Ohio, there is a law dictating a 48-hour waiting period before removing life support in hopeless cases. Are we so utilitarian in our thinking that we must urgently forgo a few days of further counsel, therapy, and prayer?
I am all in favor of patient autonomy, but I wonder if Timothy Bowers was pushed to make such a monumental decision on short notice.