Friday, October 19, 2012

Ethics of End-of-Life treatment on "Lateline"

On the day I wrote about needing a public debate on Affordability and The Rights to Basic Healthcare and the Limits of End-of-Life care, ABC's Lateline news program ran a story and interview on the ethics and implications of End-of-Life care:

This is the nub of the ethical debate reported on by Lateline:
SUZANNE SMITH, REPORTER: Across Australia in any one year, doctors and hospitals face more than 40,000 requests for treatment to be withdrawn. And now an issue regarding a pacemaker has revealed the complexity of the issue.

Pacemakers like this one are implanted in your body, but controlled externally by a doctor, who receives information via a radio signal hooked up to a computer.

Pacemakers can be deactivated by a doctor in the office using a computer

But what happens when a person who needs this pacemaker for every heartbeat is dying from another ailment? What if that person is unconscious? In the last 48 hours of life? Can that person's family be assured that it can be turned off in a timely fashion so the distress ends?

This is exactly what happened in Newcastle, north of Sydney.

JAMES LEITCH, SENIOR CARDIOLOGIST: And this patient had a stroke and became unconscious and was expected to die within three to five days. And during the period when the patient unconscious, the relatives were very distressed by this and they felt that the patient was distressed as well, and they requested that the patients pacemaker be turned off, and that would normally result in the patient dying virtually instantaneously. The doctors requested the technician to come and deactivate the pacemaker, but the technician felt it was unethical to do so. And subsequently after a lot of discussion with the relatives and doctor's attendants, the doctor de-activated the pacemaker and the patient died.

SUZANNE SMITH: Senior cardiologist Dr James Leitch says there are not clear guidelines about deactivating pacemakers where patients are dependent on the device.

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