Ethical Dilemma

When Should Life Support Cease?

FACTS Marge Hilton, an inhalation therapist at

Lankard Hospital, was recently assigned to a unit that

has been treating Leslie Andrews. Andrews, a single,

twenty$-$eight$-$year$-$old woman, was in a car accident two

weeks ago and remains in a coma. All of her nutrition

and hydration must be administered through a gastros$-$

tomy tube. Andrews, who was a dental assistant, has no

known relatives, no medical insurance, and no significant

assets.

Her medical condition offers no hope for recovery.

Andrews does not have a living will, and the only evidence

concerning whether she would wish to have life$-$sustaining

efforts continued is a casual statement, related to Lankard's

administrator by two of her friends, that she "would not

want to live like that." She had said this after the three

attended a movie in which a young female character had

been comatose for many years.

When Hilton was performing inhalation therapy for

Andrews, she observed Andrews groan. She brought this to the

attention of two physicians. The doctors explained that this did

not indicate Andrews was showing signs of recovery or was

regaining consciousness. The doctors did state that the patient

may be experiencing discomfort, but reassured Hilton that

properly administered medication should take care of any pain.

Social, Policy, and Ethical Considerations

Under what circumstances should life$-$sustaining mecha$-$

nisms be removed? Who should make the decision?

How would your answer change if Andrews were dis$-$

covered to be six months pregnant?

If attending physicians must make the decision, should

they be subject to civil or criminal liability arising out of

their actions?