Health Care Developments and Technological Innovations - Assignment Example

Health Care developments and technological innovations have led to an ambiguity about the nature of death. Critically discuss the implications of this Before the advent of modern medical science death appeared to be a reasonably easy condition to determine. The “mirror by the mouth” to test whether any breathing was occurring, together with the fairly easy determination of whether the heart was beating were the sure ways of discovering a patient’ status. However, even in those times many people were apparently buried alive, as their “death” was in fact some temporary comatose state from which they recovered only to find themselves interred. Often the most adept doctors had difficulty in defining death. In one famous case from 1564, the great anatomist Versalius performed an autopsy on his recently ‘dead’ patient, a nobleman. When Versalius opened the body (before a large crowd of onlookers) the heart was still beating. (Reis) Only the anatomist’s reputation and a quick exit from the country prevented him from being criminally prosecuted. In the modern day, the ability of medical science to “bring patients back to life” through emergency resuscitation and shock/adrenaline therapy to the heart has brought these questions to the fore. In these more ‘enlightened days’ Intensive Care Units (ICUs) are often the start of an uncertain journey for these patients who can be kept physically ‘alive’, but whose brains are to all intents and purposes ‘dead’. The situation of these people brings about a question as to when death occurs and how society deals with it. The Uniform Determination of Death Act was a law proposed by the National Conference of Commissioners on Uniform State Laws that would define the legal meaning of death. The Act states, “an individual who has sustained either 1. Irreversible cessation of circulatory and respiratory functions or 2. Irreversible cessation of all functions of the entire brain, including the brain stem, is dead.” (Uniform Act) The Act continues with the apparent catch-all phrase that “a determination of death must be made in accordance with accepted medical standards.” (Reis) It is perhaps unlikely that most people would have thought much of such matters, let alone written down a living will or let his thoughts be known. It would be well to remember that while someone may say one thing while young and healthy (who has not said that they don’t want to “live on a machine”?) it is quite another to expand that to assuming that is what he would want now. Nearly all families in this situation come to the hospital with stories of people “waking up” from a coma and it would be the responsibility of doctors to explain the difference between the normal coma, (from which there is a narrowing chance of recovery as time goes on) to the “persistent vegetative state” that John seems to be languishing in. Once again, it should be made clear that a persistent vegetative state is not regarded as a state of brain death. As the NIH (National Institutes of Health) maintains, “individuals in such a state have lost their thinking abilities and awareness of their surroundings, but retain non-cognitive function and normal sleeping patterns.” (www.rinds.nih) The fact that a person opens his eyes at times is not sign of deliberative action upon his part but merely a primitive response system that is basically a reflect action. The person may appear alive, and their family may think that they actually are responding to various stimuli in the world around them, but this is actually not the case. Dr David Fleming, an affiliated scholar with the Center for Clinical Bioethics at Georgetown University suggests that there is an air of “futility” in the treatment of patients such as John. (Fleming) He continues that “greater care must be made to minimize inconsistencies in treatment and to more accurately respect the needs of those who cannot speak for themselves.” (Fleming) Accurately respecting John’s needs. . . there, as Shakespeare put it, lies the rub. Because of the state John is in, and because he did not leave any firm statement over what he would want done in such a situation it is up to “us” – the family and professionals, to decide what is to be done. A fuller and more honest debate needs to occur within society about how we should define “death” and what measures should be taken to preserve life in a case such as John’s. While the Uniform Determination of Death Act was a valiant attempt to suggest a concise definition for death, technology has largely rendered it irrelevant. Unless there has been massive structural damage or overwhelming disease, the heart and lungs of most people can be kept functioning virtually indefinitely. As the population ages, and as advances in medical science keep us living longer and longer, we face the prospect of tertiary facilities full of thousands of people living in a kind of limbo. They have no hope of recovery, and yet can be kept alive for many years to come. The country in general, and the medical community in particular, must regard death as a natural part of life. While it is a doctor’s sworn duty to preserve life at any cost, the medical community must forcefully educate society about the apparently “living death” that those in a persistent vegetative state suffer in. The doctor is not helping with the suicide of a patient in this case, nor is he aiding the family in killing their family-member. He is allowing nature to take its course. The Schiavo case should act as a warning to us all: the circus-like atmosphere surrounding her bed must be avoided at all costs so that all of us, when the time comes, can die with dignity we all deserve. The question of medical intervention to keep a body “alive” even when it is to all intents and purposes dead is a powerful cause of the ambiguity surrounding death in the modern age. Medical science used to allow people to move into death in a natural manner because it had no choice in the matter, but this is no longer the case. As Kubler-Ross (2002) suggests, modern societies need to return to a situation in which death is not seen as an enemy to be avoided at all costs, but rather a natural part of the life cycle that moves us all eventually to the same place. Modern societies have often shunted death off into hospitals, hospices and old people’s homes where it can be apparently “invisible”. This is neither natural not healthy for society. As Elias (2001) argues, sociological reactions to death have varied over the centuries because of a number of factors. The greatest influence in the last century has been this medicalization of death and the attempt to avoid it at all costs. This may, as Elias suggests, lead to the “loneliness of the dying” as the process through which they are passing is either ignored or avoided through the use of technology to hide a reality that we all face. In conclusion, health care and technology developments have indeed led to ambiguity about the nature of death. The fact that people can be “brought back” from death several minutes after they have apparently died, as well as the remarkable process by which a person may be “kept alive” virtually indefinitely even though the brain is essentially dead, raise questions as to what it means to be dead and how the process of dying does (and should) occur. In the future, as medical science increases even more in its power, these questions will become more and more relevant as larger numbers of patients are able to make the choice as to when they will die, even though they are terminally ill. ------------------------------------------------------ Bibliography Dowbigin, Ian. A Merciful Eng: The Euthanasia Movement in Modern America. Oxofrd UP, New York: 2003 Elias, Norbert. Loneliness of the Dying. Diane Pub Co., London: 2001. Fleming, David. “A Global Perspective on Healthcare Decisions.” Journal of Regulatory Affairs. October 2004. Uniform Determination of Death Act, 1978 Kubler-Ross, Elizabeth. On Death and Dying. Crown, New York: 2002 (Reprint). Read More