The ethics of death

Partly as a follow up to the saga of Kaylee Wallace at Toronto's Sick Kids Hospital and partly because I have been thinking about the issue for a while, I wrote a couple of stories published in the Toronto Star today looking at death, how we handle it and how we define it.

Dead is dead, except when it's not.

"Death used to be a little more self-evident," says Kerry Bowman, a medical ethicist specializing in end of life issues at the University of Toronto's Joint Centre for Bioethics.

"Today, you're dead when the doctor says you are."

Deciding when somebody is dead or about to die is quickly emerging as one of the top ethical issues in medicine today as technology makes it increasingly possible to keep people alive who would otherwise have died not so long ago.

"The technology has far outstripped the ethics," says Tim Falconer, author of That Good Night: Ethicists, Euthanasia and End-of-Life Care. "Feeding tubes and ventilators weren't designed to keep people alive for 15 years, but that's what they're being used for."

As well, says Bowman, with organ transplants more common, deciding the precise moment of death has become vital, since under the "dead donor rule" organs can only be harvested once the donor has died. And the sooner after death that happens, the healthier the organs will be.

Fro the rest of the story, click here.

In a companion piece, I also take a closer look at Falconer's book, which I blogged about last week.

Tim Falconer didn't set out to write a book about death. It just worked out that way.

He planned to write about ethicists and the growing role they seem to be playing in our modern lives – from business to government to medicine – and explain how they do their jobs.

But like any journalist, he was attracted like a bug to light to the most intriguing stories. Those were the ones about death and end-of-life ethical issues.

In That Good Night: Ethicists, Euthanasia and End-of-Life Care, which takes its name from the Dylan Thomas poem Do Not Go Gentle Into That Good Night, Falconer takes the reader on his journey through the increasingly ethically complicated ways death is handled in modern society – particularly in hospitals.

Few of us, he says, are prepared.

"We go through life knowing we are going to die, and then it's a surprise when it happens," says Falconer, a magazine writer and journalism professor at Ryerson University.

With all the machines that can keep us alive today, the medications and the medical advances, death, Falconer says, is increasingly more of a "negotiated event" than a sudden thing.

For the rest of the story, click here.

 

Comments

[deana]

People who are keeping their relatives alive on ventilators when the relatives have had all four brain herniations are most often from fundamental religions who believe life is sacred. These people are exceptions to the rule and their nuisance factor should not be used to justify the murder of people who haven't even had one herniation, whose intracranial pressure has been stabilized, and who would survive but for organ donation pitches. Orthodox religions are misguided. When their rules were made these did not envision artificial life.

Artificial life is not sacred. A plastic rose is not a rose.

There is a campaign going on to kill as many brain injured young people as possible. The brain injured require a lot of support in school, in the prison system and the medical system finds them unglamorous. One of the reasons given to justify this slaughter is that "people are being kept artificially alive in hospitals." This is slippery logic because those who are keeping their loved ones alive are doing so because they are allowed to do it? How? Under the Charter of Human Rights and Freedoms as their religious expression.

Some people are allowed to keep their relatives alive because they advertize the presence of Human Rights in one country over another, and at the same time, they serve the purpose of looking like nuisances and fools which the rest of us have to avoid being like. They themselves don't mind because in the wash they get thousands of medical dollars coming their way. And sometimes after months and years, their relatives even wake up. Amazing.

[Louis]

In That Good Night: Ethicists, Euthanasia and End-of-Life Care, which takes its name from the Dylan Thomas poem Do Not Go Gentle Into That Good Night, Falconer takes the reader on his journey through the increasingly ethically complicated ways death is handled in modern society – particularly in hospitals.
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[Michael Kirsch, M.D]

Conflicts are sharpening between those who desperately need organs to survive and the medical professions mission to serve the living. One life must not be sacrficed to save another. I worry about my profession losing its way and the 'revision' of the definition of death in an effort to enlarge the organ donor pool. See www.MDWhistleblower.blogspot.com. If there is a question of whether I am still alive, I want my doctor to decide, not the organ harvesters or others who have a conflict of interest.