In A Coma Did Her Husband Have The Right To End Her Life?
This clip presents a really touchy subject. I am not sure how I feel about it. Many of my family members would prefer to make a choice about how they want to live if they are terminally ill and in great pain. Yet my daughter and others in the medical profession are taught to save a life under any circumstances at any cost. That is their ethical value. This clip is from my one hour long television special on severe head injury and coma.
Nancy Jobes from Morristown, New Jersey was in a vegetative state and her family choose to end her life. Another case that took place a bit earlier was Terri Schiavo a woman from Florida who went into a vegetative state after a cardiac arrest in 1990 led to severe brain damage due to lack of oxygen. Her case became a prolonged legal battle between her husband, who wanted to remove her feeding tube to allow her to die, and her parents, who wanted to continue life support.
Laws related to ending life-sustaining treatment for individuals in a vegetative state, vary significantly by state. The act of ending someone’s life, referred to as euthanasia or assisted suicide, is distinct from the decision to withdraw or withhold life-sustaining treatment. The former is generally more controversial and tightly regulated, if not outright illegal, in many jurisdictions.
In the United States it’s generally accepted that a person has the right to refuse life-sustaining treatment through what’s known as “advance directives“ or a “living will“.
However when a person doesn’t leave an advance directive and is in a vegetative state, the situation becomes legally complex. A surrogate decision-maker guided by what’s believed to be in the best interest of the person or what the person would have wanted, can decide to discontinue life-sustaining treatment. But disputes about who should make the decision or what the person would have wanted can lead to legal battles.
In some states and in some countries, euthanasia, where a doctor provides a patient with the means to end their own life, is legal but this is only an option for mentally competent adults with a terminal illness, not for individuals in a vegetative state.
In this clip I presented the thoughts of several medical ethicists. A fundamental principle in medical ethics is respect for patient autonomy, which means respecting patients’ rights to make informed decisions about their own medical care. If a competent patient refuses a life-sustaining one, many ethicists would agree that this wish should be respected.
When patients are not competent to make decisions, the decision often falls to a surrogate decision-maker, usually a close family member or a legally-appointed guardian. Ethicists endorse making the decision that would best promote the welfare of the patient, considering their values and previously expressed wishes if known.
When a patient is in a vegetative state or has a terminal illness with no hope of recovery, continuing life-sustaining treatments may be seen as causing more harm than good. In such cases, many ethicists would support the withdrawal of these treatments.
Many ethicists believe in the importance of allowing a dignified death. In cases where life-sustaining treatment only prolongs the process of dying without improving the quality of life or the prospects of recovery, the withdrawal of treatment can be seen as a way to respect the patient’s dignity.
Karen Ann Quinlan became a significant figure in the right-to-die movement in the United States at that time. In 1975 at the age of 21, Karen Ann Quinlan collapsed at her home in New Jersey after consuming a combination of drugs and alcohol. The incident left her in a persistent vegetative state, which is a condition of severe brain damage where a person is awake but not aware.
Quinlan was kept alive on a respirator, and she had a feeding tube to provide nutrition and hydration. After several months with no improvement in her condition, her parents requested that her respirator be turned off, a decision that sparked a significant legal and ethical debate.
Their request was initially denied by the hospital due to concerns about potential legal consequences. The case went to the New Jersey Supreme Court, which in 1976 ruled in favor of Quinlan’s parents. The court recognized the right to refuse life-sustaining treatment on behalf of another, incompetent person, under certain circumstances. It held that if the hospital ethics committee agreed with the prognosis, the respirator could be removed.
Following the ruling, Quinlan was taken off the respirator, but contrary to medical expectations, she continued to breathe independently. She lived for nearly a decade more, until her death in 1985.
The case of Karen Ann Quinlan was a landmark in the history of medical ethics and law. It influenced the development of laws regarding end-of-life decisions, the use of living wills or advance directives, and the role of hospital ethics committees.
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