Extraordinary Treatment
Under the heading "A time to live or a time to die?" a woman wrote an article which was published in the British Medical Journal in June 2004. The article told how the medical profession had made the decision to use extraordinary measures to keep her husband alive, overriding her wishes and those of their three adult children.The prior illness of a relative meant that his family were fully aware of his abhorrence of the loss of mental faculty.
The writer told how her husband Michael, who was totally blind, had suffered a massive brain haemorrhage and, shortly after being admitted to hospital, developed pneumonia.
The admitting consultant agreed he should not be treated actively, but Michael's consultant decided he would be more comfortable with antibiotics.
After Michael had recovered from the pneumonia the medical team decided to feed him through a nasogastric tube, which he repeatedly removed.
After some three weeks the time came for consideration of feeding through a percutaneous endoscopic gastrostomy (PEG) tube.
"Michael, we all agreed," his wife wrote, " was in the group for whom a PEG tube was of doubtful benefit.
"We?his wife and three children (all with postgraduate qualifications)? had previously obtained the 1997 Lancet guidelines on PEG feeding and were unanimous that he should be allowed to die with dignity.
"We considered that the effort Michael had to put into living and the frustration blindness caused him meant he already suffered a major disability; he was, as a friend put it, "fiercely independent and impatient with himself"; he could get depressed; and we knew his views."
Three consultants (all working in the same hospital) decided that a PEG tube should be inserted. The family were informed of their decision by a registrar and house officer and were given to understand there was no one to whom they could appeal.
They were unable to meet the consultants to discuss their reasoning. The PEG tube was inserted without the wife's consent and against the wishes of the family.
A doctor replied to the article with his story of his father's last illness and the inner conflict he struggled with both as a son and as a physician. Read The Flip Side of the Coin.