Public Discource – Life or Death… You Pick for Me

Our class was assigned a public discourse project in which we had to research a topic of our choice and complete a paper that included our personal view on the issue as well as the other side of the issue, and also a piece of art or music that could pertain to the topic and support and contrast your personal view on the issue, and how they relate.  This project was certainly interesting in that the research could be done on a topic of choice.  I have a peaked interest in science and medicine and therefore chose a topic that relates to both as well as many other issues, that being the removal of a feeding tube that is supporting a life that cannot be supported free living. This project required immense amounts of research to ensure that the facts being stated within the paper were accurate.

This project acquired many difficulties throughout the process. The most demanding aspect of the writing that was crucial in writing a successful public discourse paper was to keep the topic as focused on a certain issue and not letting the paper drift into a larger category.  This was incredibly difficult in finding facts that pertained only to the issue being discussed making sure they wouldn’t draw out the more general and broad issue.  It was difficult for me to stray away from bringing in topics such as euthanasia and physicians assisted suicides which certainly have an overall close relation to the topic of life sustaining machines for those in permanent vegetative states.  It was also nearly impossible to discover a song that related specifically to the issues of feeding tubes and/or permanent vegetative states.  I was able to find a plethora of songs on suicide in general however that would cross into the issue of generalizing our issue. Even though this paper had its difficulties, the challenge brought feelings of accomplishment to me once the paper was completed.  I feel as though my paper successfully portrays my views on the issue while appropriately crediting the other side as well.

Imagine lying in a hospital bed, permanently unconscious, brain-dead, with a feeding tube down your throat remaining entirely motionless while the future of your life dangles by the fingertips of doctors and family around you; and your input though seemingly most important remains tucked away and will forever go unheard.  Your mind, your body and your life are taken out of your hands, and the decision of life or death is no longer yours but must be made eventually.  This issue of life or death, by means of a feeding tube, is certainly controversial and has stirred up heated debates globally for numerous years.  Views on this issue are affected by morals, ethics as well as strong personal beliefs and professional points of view.  The decision of life or death for someone other than one’s self can put unbearable pressure on both doctors and family members of the person involved.

The use of a feeding tube is a necessity for patients said to be in a permanent vegetative state.  However, diagnosing a patient as being undoubtedly in a state of permanent vegetation comes with an immense amount of examination.  The British Medical Journal defines permanent vegetative state as “a clinical condition of unawareness of self and environment in which the patient breaths spontaneously, has a stable circulation, and shows cycles of eye closure and opening which may simulate sleep and waking” (Wade 841).  This definition shows that life is sustainable and bodily functions are regulated when in the state of permanent vegetation but the quality of life is debatable.  The quality of life itself may be a matter of opinion that varies in every situation involving a feeding tube, but doctors can with sharp accuracy state the assurance that there is no possible way the patient’s state will improve over time.  The issue of diagnosis itself is controversial in that there may not always be enough evidence to prove or disprove a patient’s actual state of being.  What one doctor views as criteria enough to be dubbed permanent vegetative state may vary from that of another comparable doctor.

These issues touch heavily on morals and ethics, and how these two factors greatly impact the side one takes on this issue.  Some people would argue that since the patient cannot comprehend any information and is unable to communicate their desire to live or survive, that it is unethical for others to make this decision for them, and should not remove the one piece of hope keeping them alive.  These people believe that the patient’s life is worth living and should be sustained by machinery for many years to come.  Others believe that it is in the patient’s best interest to be removed from the world seeing as though each day passes without comprehension, speaking or understanding.  This side of the issue also believes that since the patient is in such a state of utter uselessness and is unable to express their choice of life or death, that the patient has no view on the topic at all.  The patient is in a state in which knowledge and understanding are nonexistent and removal of a feeding device would cause no physically comprehended harm to the patient.  Ethical issues are the leading reason this debate continues on over the years, and unfortunately these issues are a matter of opinion and interpretation on all aspects involved in one being in a permanent vegetative state.

Great Britain has publicly showed their views on the subject, numerous times.  In Britain the removal of a feeding tube can be granted but needs the approval of the High Court.  The article, The permanent vegetative state: practical guidance on diagnosis and management, states that in years leading “up to October 1998, court approval to stop active medical treatment had been given for eighteen patients” in Great Britain (Wade, Johnston 841).  Having granted the removal of eighteen patients shows that the occurrence of this decision is not frequent however cases do exist on a national level.  Having brought these cases in front of a court allows for professional decisions to be made, and the verdict depicts the future of the patient’s life.  Therefore the pressure is distributed amongst many professionals and not just the family and doctors; to me this eases the decision and allows for a more mutual and justifiable decision to be made.

A popular case in America involving exactly these issues was that of Terri Schiavo beginning in February of 1990.  Terri was taken to the hospital when her husband found her unconscious on her bathroom floor.  She was found to have had a heart attack due to low potassium and was left in an anoxic state.  Schiavo was later diagnosed with being in a permanent vegetative state.  As years passed Terri’s husband Michael Schiavo found it to be in his wife’s best interest to have her feeding tube removed.  According to the Ascension Health article on the Terri Schiavo case, Michael testified that, “he knew that Terri’s condition might be fatal without treatment, but that he was making a decision that was consistent with what he understood to be Terri’s wishes regarding continued treatment in her current condition.”  Michael’s wishes were immediately challenged by Terri’s parents who wanted their daughter to continue her life more than anything.  The issue was taken to court and the removal of Terri’s feeding tube was granted.  Terri’s parents were not ready to give up and argued the credibility behind the diagnosis of Terri to be in a state of permanent vegetation.  After making its way up to the Florida Supreme Court, Terri was found to undoubtedly be in a permanent vegetative state.  From here it was the final decision that her feeding tube and only source of nutrition be removed, Michael had won the case.  This hearing took more than ten years to finalize and because it includes the major ethical arguments touched upon when it comes to permanent vegetative states of being, is the perfect example of this common debate in society today.

Terri’s parents viewed the removal of her feeding tube to be unethical under the circumstances that she showed signs of movement, as well as showing minor signs of comprehension.  Terri Schiavo’s parents sought to sustain a life that was overall merely inadequate to the world as she no longer had the ability to work for money, support a family, or even dress herself, denoting herself as seemingly useless.  For ten years Terri remained in a hospital room unable to communicate or comprehend others around her, as her loved ones had to spend every day caring for her as well as worrying about her health and future.  Michael Schiavo was logical in his decision to remove Terri’s life sustaining feeding tube.  He understood that Terri was in no way going to improve enough to sustain life on her own and live life as she did before the accident, and knew that it was best for not only Terri to be removed from the world, but for him and the family as well.

Regarding the issue of ethics behind the removal of a feeding tube from one who is diagnosed as being in a permanent vegetative state, I am in favor of the removal.  Seeing as though the person has no benefit or positive gain as each day passes, they can’t enjoy the realm of life, concluding that it is more beneficial for their lives to end, rather than spending each day accomplishing nothing.  The article, Ethical issues in diagnosis and management of patients in the permanent vegetative state adheres to the question of, “whether it is in the best interest of the patient that his life should be prolonged by the continuance of this form of medical treatment or care” (Wade 352).  The answer to this question is always going to be subject to opinion, however if analysis shows that it truly is in the best interest of the patient to be removed from life support based on the numerous months of close examination, then by all means remove the feeding tube.  The issues here aren’t that of suicide or murder, they are issues of ethics and morals behind reasoning in feeding tube removal.  I do believe however that the mode of death could be altered in that a more speedy death takes place.  This issue isn’t one of important significance due to the fact that the patient is incomprehensible of the fact that they are slowly withering away; however a fourteen day suffrage of dehydration seems unnecessary with scientific advancements today, and could be made into a more immediate death.

Doctors are faced with moral and ethical issues on a daily basis, but dealing with these issues for patients in permanent vegetative states are incredibly more weight bearing and stressful.  The issue itself that the patient whom is in the permanent vegetative state is in no control over the future of their own lives makes my stomach churn.  There is no possible way of actually obtaining the thoughts and decision of the patient themselves, therefore others making the decision for them have to choose wisely, and in the patients best interest.    After first determining the patient’s quality of life, the decision can be made.  And as the last drop of nutrients runs through the tubes in the patients beating blood stream, the patient may or may not agree with the decision made by those around them.  No matter how loud or furious their conscious screams to sustain their life, the final cries for help are left as a simple echo within their mind.

Work Cited

Ascensionhealth.org. “Persistant Vegetative State (PVS).”  Ascension Health. N.p. n.d. Web. 2 Nov. 2009.

Mills, Terry, and Wilmoth, Janet.  “Intergenerational Differences and Similarities in Life-sustaining

Treatment Attitudes and Decision Factors.”  Family Relations Vol. 1 (2002): 46-57. Web. 30 Oct.

2009.

Wade, Derick, and Johnston, Claire.  “The permanent vegetative state: practical guidance on diagnosis

and management, 1999.”  BMJ: British Medical Journal (1999): 841-844. Web. 1 Nov. 2009.

Wade, Derick.  “Ethical issues in diagnosis and management of patients in the permanent vegetative

state, 2001.”  BMJ: British Medical Journal (2009): 352-354. Web. 1 Nov. 2009.