Mrs Inglis and her son

[clivex]

How can that judge and jury live with themselves after that sentence? How could a prosecuting lawyer live with himself too. Well easily, because they are filth...

She gets more than a burgler who assaults, more than some rapists and more than those involved in terrorism...

Thank god that bloke who poleaxed that burgler got free on appeal.

Lets hope Mrs Inglis gains her freedom too

 

[krizon]

The dreadful thing is that medical treatment can now sustain the vestige of life, thanks to god knows how many machines and drugs, long after any signs of recognising one is alive have deserted the patient. Thus, you can be kept breathing for 20 years in a PVS - you know nothing, you feel nothing, you're not more than a circulating pump, but medics can relax assured that, however distressing - in fact, insanity-inducing - such a situation may be for the families of the ruined person, they have "saved a life". We need a much better definition of what "life" means, and whose needs are served by keeping a mere circulatory and respiratory system going (basic cortex responses) in lieu of giving that person the ability to recognise that they are alive, and that they're enjoying what life they have.

The Hippocratic Oath seem to mean that you keep a system viable, rather than a sentient human, with their complex range of senses and emotional responses. That, to me, is appalling. There are squeals about genetic modifications and especially any hint of eugenics (which is actually all intended for the greater good of humanity in breeding out, say, the gene likely to give your offspring spina bifida or epilepsy), but we're supposed to tamely accept that any of us could be kept 'going' via the wonder of medical equipment, not only whether we want to or not, but whether our nearest and dearest, those who've borne us, loved and cared for us far more than any clinician ever could or will, feel that death should take its natural course. It's like being embalmed alive.

The sooner we can become as civilised towards our species as we are towards brain-dead or suffering animals, the better. No, it won't lead to 'abuse', because once doctors can pronounce all the normal signs of 'life' to be extinct, and that they'd definitely be extinct without a range of apparatus and drugs, then the patient can be allowed to drift into death in a more normal state. I thought the purpose of medical treatment was to try to save people from unnecessary death (although some 10,000 people, dead due to MRSA infections picked up in hospitals, wouldn't probably agree), and to return them to either a full active life, or the very nearest thing. Not to gaze in self-satisfaction that a pair of lungs can be kept working due to a bank of tubes, and thus pronounce that they've saved a 'life'.

I hope to God that Mrs Inglis is released on appeal. She was, it would appear, driven literally to the point of insanity by seeing the state her young, once-active son was reduced to. I didn't think we sent the mentally unstable to jail any more - I thought we gave them care. In fact, of the two, she needed it, while her son was, it seems, beyond it.

 

[redhead]

Care in the Community, Krizon.

What Community, and who Cares?

Many doctors no longer take the Hippocratic Oath feeling, as you do, that it binds them too closely to the preservation of life no matter what the cost. However, the original oath never advocated this, but the culture of medicine at the time demanded it. Many doctors of that time were, theoretically, guilty of breaking the oath because they treated the illness alone and kept the person at arm's length.

Fortunately there is more understanding for those who suffer terminal illnesses and the advance of Palliative Care in the past 20 years or so accepts that the individual should be allowed a dignified death.

I recently re-read Lyle Watson's The Romeo Error (sequel to the 70's cult book Supernature) which deals with the very fine (and sometimes quite blurry) line between life and death, so as things stand such a situation is quite a dilemma for both the medics and the patients' families. It must be harrowing to make the decision to switch off all the machines, particularly as there have been cases where patients on life-support have revived years after their treatment commenced, but there is always the hope that a loved one will revive - particularly in view of such cases as the man (in the Ukraine, I think) who came round from a coma after 25 years.

At what point does a doctor determine that life is completely extinct?

At what point does someone lose hope to such an extent that they decide to let a loved one go?

At what point does one determine whether quality of life justifies extinguishing the chance of life?

Horrible decisions and not ones I would make lightly - just in case. It's a moral pitfall and a decision that one would be replaying mentally over and over again "Did I do the right thing?".

Perhaps we need a register like the Organ Donors, stating whether or not we would wish to be kept on life support after a certain time and amount of treatment has elapsed? That way we would be following the wishes of the only person whose opinion really matters. The patient's.

I hope everything goes the right way for this poor lady.

 

[krizon]

You can make a living Will, as I have, redhead, which clearly states to my executors (who are my solicitors) that I'm not to be kept 'alive' (which is a lot different from sentient) by artificial means should I lapse into a PVS or long-term coma. Unfortunately, that's as far as determining one's own fate goes at present, without having to be labelled a suicide or involving someone else in manslaughter or worse.

I imagine that doctors don't determine that life is extinct. I think it's usually the coroner's job to do that, although a doctor or paramedic, or even a passerby could determine that life was extinct by noting the person had no pulse.

Well, you've kind of answered your own question about 'hope': the point at which you lose it is the point at which you lose it. I don't think there's a manual which indicates the correct point at which you no longer hold out hope - but what are you hoping for? Someone who is permanently and irrevocably brain-damaged, who may be in appalling pain or mental distress all the time may not want you to have any hope at all. If they're incapable of communicating their wishes to you, you just have to believe that what you do for them - keeping them going, or letting them go - is the right thing, and then accept it. Hope is a false virtue, I think. You can hope all you want that they're miraculously going to spring up from their tubes, catheters, and beeping machines and cry, "I'm cured!" but you know it isn't going to happen. So stop hoping, and be realistic - but only for the other person, not yourself.

Again, it depends what you mean by 'the chance of life'? Our raceday supervisor at several racecourses in the south fell down his stairs at home, and broke his neck. I've received an e-mail tonight to say that, paralyzed from the neck down, very changed for the smart, bright, active man he was before his fall, he'll be coming to Plumpton in March with a driver and two carers. It'll be only his second outing in his entirely dependent life. He's like BADDAM's owner, a tetraplegic. Every hour of his life is monitored and attended to by other people. Now, that's possibly one 'chance of life', although whether we'd all want it, even in that manner, is debatable. I wouldn't, but that should surely be my choice - not yours, my doctor's, my friends', or Auntie Mabel's? I feel that we should all be allowed to leave a valid statement with our doctor saying what we'd want done in the event of such an accident. Some of us may be young, have a family, etc., and be desperate to cling onto any vestige of that life. Some of us - I'm 65, don't have my own family - would be quite happy to say 'sayonara' (although why I'd say goodbye in Japanese, I don't know) and hope that my doctor would respect my wish to be humanely destroyed. So yes, you've got a very good idea in a sort of Final Wishes register, so that nobody can insist on your being kept going for their sake, rather than your own.