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Ethical Reasoning

These actions go beyond any reasonable presumption in favor of life. Instead, they appear to involve a blind inertia to “keep trying” or perhaps an unthinking sanctity-of-life principle. As indicated earlier, we contend that the patient’s explicitly request and his own quality-of-life assessment were sufficient to show that the first resuscitation attempt in this series was morally prohibited. However, even if this had not been so, surely once that effort was completed and the patient’s resulting mental status was assessed, it should have been obvious that the patient’s quality of life was so low as to make further life-sustaining efforts morally optional at best or even morally wrong. 

Each step taken moved further in the direction of heroic or extraordinary measures [Item 30]. The introduction of intravenous nourishment and substances to maintain electrolyte balance was clearly an artificial means of sustaining this life [Item 31] and, as such, morally optional or questionable in this context. Even if these were introduced before the patient’s mental status could be determined, to withdraw them once the patient’s quality of life became clear would not have been an act of killing [Item 32]. The quality of life is so low here as to be below the threshold that creates an obligation to sustain life. 

All in all, the reaction at this stage seems to be undeniably a case of misuse of medical techniques and technology, serving no valid purpose. Lest you take comfort from supposing that this could only happen in an “overseas” hospital and not in our society,you should notice that this case is taken from a British medical journal. The “overseas” hospital may have been in the United States.

Acknowlegements