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">parr\(*>" <gniKyruaL@tenretnitb.moc> wrote:
So celebrate, enjoy the heat, have a barbie.
Tomorrow is Holocaust day ...
http://bulletin.ninemsn.com.au/bulletin/eddesk.nsf/All/DE22D7ECB2529496CA256E21008077C5!open
DEATH WATCH: THE DILEMMA OF THE OFF SWITCH
The person you love is lying in a hospital bed, unconscious, attached to a row of machines that keep their heart pumping and
their lungs breathing. It is time to let them go. But do you have you the strength of will - or the backing of legislation?
Julie-Anne Davies reports.
Noeline Ling and her 26-year-old son James are part the way through the loneliest and most treacherous journey imaginable.
Neither knows when it will end. But the final destination is not in doubt. James is severely brain damaged and paralysed from
the neck down, the result of an accidental heroin overdose when he was 19.
His body clock keeps the same hours as yours and mine. He wakes for breakfast, a nutritional supplement poured into the
feeding tube, which was surgically inserted into his stomach seven years ago. Lunch and dinner are taken the same way. This,
combined with 24-hour, high-level nursing care in a Melbourne hospital, keeps James alive.
And so the days pass. But time has stood still for James Ling. The CD collection next to his bed is the same music he was
listening to in the year of his overdose. Metallica, Triple J's hot 100 from 1997, Paul Kelly's Post album. His hair is still
long and tied back in a ponytail. I introduce myself and he studies my face with eyes that are indisputably alive. He laughs
and snorts when his mother teases him. It seems that James has some comprehension. It is unbearably sad.
The doctors and nurses who care for James believe he has no understanding of his situation, an attitude which, given his
circumstances, could be some consolation to his family. But just as Noeline has never accepted false hope, she refuses to be
comforted by thoughts that her youngest child is oblivious to his plight: "There is someone in there, I absolutely believe
that." And she does, otherwise she would have let her boy die a long time ago. But what if James is alive because he has no
choice?
There are days, says Noeline, when she visits James in hospital and finds his blinds drawn, his television turned off, his CD
player silent. "The staff thinks there's no one home. So why turn on the light?"
AT THE beginning of the 21st century, advances in medical technology have made it possible to maintain life where it was
previously impossible. But those advances have pushed us into new medical, moral and ethical territory. With the use of
sophisticated life-support systems, is life being sustained or is death being deferred?
It is an issue many liken to the abortion debate of the 1960s and one which the medical profession, the church, hospitals and
nursing homes, as well as the broader community, is being forced to confront. All agree that the right of dying is the hot
ethical debate of the age and will only intensify as the pro-rights baby boomer generation increasingly finds itself facing
death.
There are few bodily functions that modern medicine cannot replicate but when to withhold or withdraw that support becomes
not only a clinical decision but also a judgment about when prolonging life is simply futile.
The fine but clear line by which doctors are able to practise in this murky realm is that removing life support is an
omission, not an action, thus allowing nature to take its course. One of the newer life-support treatments, which is causing
considerable unease, is the provision of artificial food and hydration via a feeding tube. It is being used increasingly in
dementia patients in nursing homes, in intensive care units in hospitals and for people being cared for at home. The idea of
taking away something as basic to human survival as food and water is abhorrent to some, notably the Catholic Church, but
others argue it is no different from a respirator, antibiotics or a dialysis machine.
According to federal Department of Health figures, there are 1048 patients receiving funding for artificial tube feeding in
Australia but these statistics do not include hospital or home patients. In the United States, there are more than 60,000
nursing home patients with advanced dementia being kept alive with feeding tubes, according to research published last year
in The Journal of the American Medical Association. "Feeding tube use has no demonstrable health benefits in this population,
and may be associated with increased risks and discomfort," it reported.
The issue gained prominence recently with the case of 40-year-old brain-damaged woman Terri Schiavo, who has been in a
persistent vegetative state for 14 years. The legal battle between her husband, who has sought to disconnect the feeding
tube keeping her alive, and her parents, who want to take care of her, reached crisis point last October after Schiavo's
feeding tube was disconnected for six days on her husband's orders. But in an unprecedented action, Florida Governor Jeb Bush
President George W. Bush's brother intervened, ordering the tube be reinserted. Governor Bush's actions have challenged
the terms of the state's constitution, which guarantees Florida citizens the right to refuse medical treatment and which
keeps separate the legal powers of the executive and judicial branch. The case is still before the US courts. In Australia,
similar cases are beginning to be heard by state and territory guardianship boards that are being asked to rule on whether
feeding tubes can be removed from patients unable to express their own wishes.
But for Noeline Ling there is no choice. From the moment ambulance paramedics resuscitated James after he was found
unconscious, medicine's most sophisticated technology has been deployed to keep him breathing. That, and Noeline insists,
James' own will to live: "I believe James is alive because he wants to be; he has been through too much for me to think
otherwise. In intensive care the focus was on keeping him alive regardless of the result. I wanted him off life support, I
was prepared to let him go if he had to depend on a machine to breathe for him. But the day they were going to perform the
tests to determine whether they could turn it off, he began to breathe on his own. He was in a coma for six months and I had
no expectation he would come out of it but he did."
She has been given the option twice of letting James die. Once, when he was in a nursing home and his weight had plummeted to
42kg and pressure wounds ravaged his body, a nurse took Noeline aside and told her it was time for James to die and suggested
that his medication be stopped. "I believed her but then minutes later as I put my head on his chest and wept and said to
James, 'Someone told me you were very sick', he laughed and I thought, it is not James' time
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| ">parr\(*>" <gniKyruaL@tenretnitb.moc> wrote:
|| >So celebrate, enjoy the heat, have a barbie.
| >
| >Tomorrow is Holocaust day ...
||http://bulletin.ninemsn.com.au/bulletin/eddesk.nsf/All/DE22D7ECB25294
96CA256E21008077C5!open
|| DEATH WATCH: THE DILEMMA OF THE OFF SWITCH
|With all due respect, WTF has your post to do with my original
regarding Australia Day and the next day, and posted ONLY in t.b?
Are you some sort of screwball?
--
)>==beMUSED(> Parr
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AT THE beginning of the 21st century, advances in medical technology have
made it possible to maintain life where it was
previously impossible. But those advances have pushed us into new medical,
moral and ethical territory. With the use of
sophisticated life-support systems, is life being sustained or is death
being deferred?
I believe it has already been addressed by the religious folks. The RC
Church, for one, says pulling the plug is OK.
It is an issue many liken to the abortion debate of the 1960s and one
which the medical profession, the church, hospitals and
nursing homes, as well as the broader community, is being forced to
confront. All agree that the right of dying is the hot
ethical debate of the age and will only intensify as the pro-rights baby
boomer generation increasingly finds itself facing
death.
Baby boomers are no more likely to believe that they are going to "live
forever" than any previous generation. Most baby boomers have lost parents
or grandparents. They have visited old folks who were slowly dying. They
are no more willing to prolong the dying process than the previous
generations.
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