The right to die: When does life end and death begin?

The right to die: When does life end and death begin?

Colorado Springs : CO : USA | Jan 04, 2014 at 3:32 PM PST
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A young girl enters a hospital for a complicated but fairly routine procedure. Days later the child goes into acute distress and slips into a deep coma and is placed on life support. Soon afterward the girl is pronounced brain-dead by doctors who recommend she be removed from life support, but her family refuses.

At the outset of this story we see that this is most certainly a terrible tragedy, but even this pales in comparison to what else was about to happen to 13-year-old Jahi McMath. After being declared dead by doctors, Jahi has become the center of a controversy whose outcome could have a profound effect on how we view life and death as well as the moral and ethical conundrums that have been created by advancements in medical science. When does life truly end and, equally important, what defines death and who should make the determination as to when cessation of life has taken place?

Before the development of advanced life-saving and resuscitation techniques, people were pronounced dead when they stopped breathing and there was no longer a detectable heartbeat or pulse. Even during these times it was apparently realized that not everyone who exhibited these signs was actually deceased; thus, other ways of determining life or death were developed. For example, the ancient Romans purportedly used "conclamation," a process by which the name of the deceased was yelled into the ear three times. Smelling salts and pain stimulus were among other things used in later times to ensure that people were in fact dead.

Even now in this age of modern medicine doctors have mistakenly declared people dead who later awoke and went on to live out their lives. For proof, a quick Internet search will reveal scores of stories from reputable sources where people seemingly came back from the dead. From this evidence it is apparent that death, or at least the definition of it, is not as absolute as we might think.

So when should a person be declared dead, especially when modern medicine has developed ways to keep the heart and other vital organs alive? Also, who should be making the determination of actual death? Should it be doctors on the staff of a hospital who may or may not be responsible for the condition of a patient in the first place, as in the case of Jahi McMath, or should it be some qualified third party outside of the loop?

When viewed objectively, the stance of both parties in Jahi's case becomes understandable. The family's rationale appears to be, Why should we put any weight on the word of the hospital doctors after seemingly botching a routine procedure? If this is the family's belief, then the other doctors who have attempted to add credence to the original diagnosis would be meaningless to them. Let us also consider the extreme stress the family must be under as well as likely being haunted by the chilling premonition from Jahi herself that she might not survive the operation.

Conversely, Children's Hospital appears to have taken the position that everything possible has been done and medically speaking, there is no chance Jahi will ever regain consciousness. It also seems to believe that every effort to comfort Jahi and support the family has been made. At this point it would be wonderful to think that the hospital is earnestly doing these things in the best interest of Jahi and her family, but we must realize that the other face of institutions of medicine and healing is that of the corporation, whose objective is to meet the bottom line.

Frankly put, at the end of the day, lives and deaths are quantified and made into statistics that are no doubt added into a stream of other metrics that determine the viability and profitability of the organization. The cold, hard truth is that each day this child lies helpless in that hospital bed she is costing the company money. Though she is considered a person in the public face of the hospital, she is considered a liability in its corporate face.

This also brings up the question of would it not be in the best interest of the company to let Jahi die and be done with her rather than facing the prospect, no matter how remote, of having to provide care for her for the rest of her life if it is determined that the hospital was negligent with her treatment? We now can begin to see the highly contrasting arguments from both sides of the issue. On one side, a family distraught and anguished over the untimely and sheer capriciousness of a tragic incident, desperately searching, praying for a miraculous intervention that will bring her back. It is a mother who, with unwavering love and devotion to her child, clings to the hope that she will spend time with her daughter a while longer.

The other side is that of an organization charged with providing the best possible care it can to those who need it. In addition to this it is also responsible for ensuring that it remains profitable and solvent for those who depend upon it for financial support.

Meanwhile a young girl is caught in the middle; alive to one side but dead to the other, she essentially remains in a state of limbo while each side argues over her final fate. Too dead to be considered truly alive yet too alive to be considered truly dead, what power could have visited such on one so young, so innocent? The simple answer could be that it is the ones who now so hotly contest her existence.

The more complex and debatable one could lie in mankind's newfound ability to play God and to decide who lives and who dies. If there truly is an afterlife then where will Jahi McMath fit in? If religious teachings are correct and there is such a thing as a soul that is somehow attached to our earthly bodies, then how will Jahi's be allowed to pass as long as she remains in this state? Furthermore, who are we to suppose that we know if this is what she would have wanted anyway?

tjlarson is based in Colorado Springs, Colorado, United States of America, and is an Anchor on Allvoices.
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