1200words on the following topic
please please have self thinking
and DON’T rehearse the case
A Dispute Over Death: Mr. N, a 44-year-old man with a large extended family, is admitted to an ICU with raised intracranial pressure from an untreatable cerebral malignancy (a brain tumor). Despite various measures, he has continued to decline and is now on a ventilator. It is obvious to the ICU staff that the patient’s brain is too compressed to respond to any treatment. On no sedatives, he has been in a deep coma for several days, completely unresponsive to any stimulation. His score on the Glasgow Coma Scale (GSC), poor from the outset, has been declining for several days. It is now 3—as low as you can get—and there is complete absence of any brainstem reflect activity on two assessments.
Mr. N is in every neurological sense dead, “brain dead,” as that term is used. As is usual practice, confirmatory clinical testing by way of an apnea test is arranged. This entails temporarily removing the patient’s attachment to the ventilator. In response to raising carbon dioxide levels in the body, a brain-dead patient will fail to initiate respiration as would normally occur. The lack of cortical responsiveness, the absence of brainstem reflexes, the lack of movements or breathing, a flat electroencephalogram, are all consistent with death, whatever the state of the patient’s circulation might be.
Mr. N’s loved ones strongly disagree with the diagnosis of death—they are a religious family and feel everything possible must be done to extend his life, arguing: “If God wanted him to die, He wouldn’t have allowed mankind to invent ventilators. He’s not dead until his heart stops beating.”
As the ICU resident and attending neurologist are about the perform the test on Mr. N, a family member exclaims, “Don’t touch him! If you remove him from the breathing machine, we’ll sue you!” According to the family’s (and the patient’s) religious, where there is a heartbeat, there is life, and one may not disconnect a breathing apparatus. [This case is taken from Hébert and Rosen, p. 333.]
How should the doctors and hospital handle this case? Should they accommodate the family’s religious beliefs? Should they insist that the test be performed, since it is important that hospital resources not be used on someone who is already dead? Explain the considerations on both sides of the question and explain your own perspective. In your discussion, draw substantially on the three following readings:
2 and 3 are in the pdf.