Want to Do Hospital Committee Ethics? (2): Ventilating the Dead
The ICU of the hospital is filled to capacity and there is a patient with a myocardial infarction who is awaiting a bed there. One of the patients already in the ICU for the past 2 days is J.W., a 34 year old white male, who lives at home with his widowed mother. There are no other family members. The patient suffered a ruptured aneurysm of the brain with massive bleeding into the brain and is totally unresponsive, cannot breathe without the ventilator and meets all the criteria for death by neurologic criteria (“brain death”). The patient’s physician and a consulting neurosurgeon has told the mother that even though the patient’s heart is still beating for a while if the ventilator continues to work, her son is dead and the physician is going to write an order to stop all treatments including the ventilator.
THE ISSUE: The mother rejects the conclusion that her son is dead and says that he is warm and pink and “breathing” and that he is still alive and may, if the treatment is not stopped, have a chance for a miracle recovery. She says that under no circumstances should the ventilator be stopped and if necessary she will take her son home with a ventilator. She says she can arrange for him to be cared for at home. The physicians call for the hospital ethics committee to meet and the plan of the committee is to have the physicians, attending nurses and the mother sitting together in a quiet room to discuss the issue with the committee.
What should the ethics committee first hope to hear from the mother?
What should the ethics committee ask the mother?
What should the ethics committee ask the physicians?
What ethical issues should be considered?
What other information should the physicians or ethics committee relate to the mother?
What should the ethics committee consider as a reasonable and ethical outcome decision to be made by the physicians and the mother?
If you would be sitting as an impartial ethics committee member what thoughts would be going through your head? ..Maurice.