Question for Discussion #10 – A Hard Decision
Instructions:
Read the scenario and perspectives given below. In your post, explain what you think is the most ethically justified course of action. Use material from the text or lectures to help explain and support your view.
Scenario:
Mario is a 30-year-old male who has been severely injured in a motorcycle accident. Mario has sustained extensive neurological damage, including the loss of higher brain function. He is being kept alive in an intensive care unit (ICU) by means of life-sustaining treatment that includes the use of a ventilator, feeding tube, and various intravenous medicines. In the room with Mario are his girlfriend, Johanna, and his parents, Troy and Wendy. Mario lives with Johanna and they have a child together, Agnes, age 4. However, since Mario does not have documented medical power of attorney and because he and Johanna are not married, state law holds that his parents have the authority to make medical decisions on his behalf.
Mario’s doctor, Eula Ellis, comes into the room to examine Mario and explains to the family that he is in a (PVS)
https://www.merckmanuals.com/professional/neurologic-disorders/coma-and-impaired-consciousness/vegetative-state-and-minimally-conscious-state
and that Mario is unlikely to recover. Gently reinforcing this last point, Dr. Ellis explains that the treatment Mario is receiving is keeping him alive, but it will not lead to any cure or recovery. Wendy points out that Mario sometimes opens his eyes and blinks when there is a loud noise. She wonders if that means that there is hope that he recover. Dr. Ellis says that, sadly, that’s not the case. These actions from Mario are brain stem activity – automatic biological responses – and are common with PVS. What made Mario Mario will not come back.
Dr. Ellis asks the family to consider what Mario would want. She suggests that they consider authorizing the withdrawal of all life-sustaining treatment so that Mario can die a “natural death”. A few hours after Dr. Ellis leaves, another doctor, Marcus Horton, and a social worker, Dawn Cunningham, enter the room and ask to speak with the family. Dr. Horton explains that he and Ms. Cunningham are part of the hospital’s Organ Procurement Team. They express their sorrow for what has happened to Mario. They ask the family to consider donating Mario’s organs so that other lives can be saved.
Perspectives:
Mario: The prevailing scientific view holds that Mario is not aware of his circumstances. He might have enough sentience to react to some stimuli such as light and sound. It is uncertain if he feels pain or suffering. Mario is incapable of communication.
Dr. Ellis: Having seen several tragic cases like this, Dr. Ellis believes that keeping Mario alive on life-sustaining treatment is futile. He will die. The family might need some time to come to grips with this difficult decision, but the sooner they make it, the better. Bodies typically don’t do well when they are kept alive for long and Dr. Ellis has seen some very difficult cases in which families kept patients like this alive for months.
Johanna: She is heartbroken. She is wondering what she will tell Agnes and how she will raise Agnes on her own. She worries that Mario is suffering. They had such hopes for their lives, and now he is so broken. She just wishes that he could be at peace.
Agnes: Johanna’s mother is caring for Agnes at the moment. She knows that something is happening and that people are upset. At four years-old, Agnes is just reaching the age where she can comprehend that death is irreversible. When Mario dies, she will be able to recognize that this is final and she will grieve.
Wendy: Mario’s parents are people of faith. They have participated in prayer circles through their church for people who have faced serious health challenges. Wendy believes that miracles can happen. She’d like to call upon the prayer circle at her church. Besides, she saw Mario’s eyes open and turn toward her when spoke. Doctors don’t know everything; they’re not God. She’s offended that Dr. Horton came by so quickly. Organ donation can wait until after they give prayer a chance.
Troy: He is facing the loss of his heir – his contribution to the future. Like Wendy, Troy would like to involve the church prayer circle. God determines when people die, right? Troy is also mad that those vultures came in looking for Mario’s organs. Those doctors would rather sell him than try to save him.
Marcus Horton and Dawn Cunningham: This is the worst part of the job – when families are reeling from the shock of what happened to a loved one who was perfectly healthy just hours ago. They realize that they come across as ghouls but timing is everything when it comes to organ donation. Organs don’t remain viable for long. Stopping life-sustaining treatment has to be coordinated with the harvesting of organs, and that has to be coordinated with the transport and transplantation of those organs. If the family is thinking about withdrawing treatment, then they also need to weigh organ donation in that decision. It’s a hard thing to ask of them, but other lives can be saved.
Discussion Assignments have the following objectives:
- Identify and describe key concepts presented in textbook reading material, video lectures, and other assigned content.
- Draw connections between assigned content material and practical areas of interest.
- Explore ideas in philosophical depth beyond the presentation of course material.
- Draw connections between philosophical discourse and ones practical life.
- Engage in respectful philosophical conversation.
- This objective will be measured according to replies posted to other students or to professors.
When completing discussion assignments, please remember:
- Your main post should take a minimum of 300 words. Explain and support what you say.
- Any sources that you use must – including textbook and video lectures – be cited and referenced responsibly. (APA)
- You should post at least two substantial replies to other participants.
- Please refer to the syllabus and grading rubric for more guidance.
