Choosing Death Over a Paralyzed Life

Nov 13, 2013   //   by Hank Dunn   //   "Heroic" care, Death & Dying, Withdrawing Life Support  //  4 Comments

It is so easy to theorize about what you would do. What if you were on life support with the prospect of spending the rest of a long life as a quadriplegic on a ventilator.  Would you say “good bye” to your wife who is carrying your unborn child and ask them to turn off the vent?

That is exactly what Tim Bowers did. Click here for the ABC telling of the story.

Just over a week ago Bowers was hunting and fell sixteen feet to the ground from a deer stand. He fractured three vertebrae and damaged his spinal cord. The medical team advised his family that he would be paralyzed from the shoulders down and probably dependent on machines to breathe for him for the rest of his life. The family wanted to see if the patient could participate in the decision-making process.

When he woke up from the sedatives that had kept him unconscious he could not speak but could answer yes-and-no questions. “Do you want this?” they asked, meaning “Do you want to be kept alive on this machine?” He shook his head “No.” They removed him from the ventilator and he died a day after the accident.

Well. Well?

This is what we in the medical community have been advocating. NOT that people be allowed to die. What we want is for patients to be involved in the decision-making that might end his or her life. They woke Bowers up and asked and he essentially said, “Let me die.”

As soon as I read this story I thought, “I know many paralyzed people on vents who might say he made the wrong decision.” Think Stephen Hawking.  Sure enough I found one blogger who is paralyzed who took issue with how this case was handled.

Perhaps the decision came too soon after the injury. Law professor Thaddeus Pope wonders whether Bowers had “sufficient decision making capacity at the time he made the decision?” In states where physician assisted suicide is legal there is a waiting period from the first request for life-ending medication to a second and final request. Pope asks whether or not Bowers was fully informed about the “options and possibilities of life as a paralyzed individual.”

I tend to agree. Give a little time. If the patient persists in his request to be taken off the machine, by all means, comply.

Years ago I was called to the beside of a heavily sedated man on a ventilator after a heart attack. His wife explained that he had been on a vent before with his heart condition and wrote a living will so he would never be on a breathing machine again. I told the ICU nurse about my conversation and she said, “It is too soon to think about that.”

Well, he was able to get off the vent and out of ICU. I visited him a few days later. He was walking around his hospital room gathering things as he prepared for a transfer to another hospital to have a defibrillator implanted in his chest. I asked him, “How do you feel about being on a ventilator again?”

He said, “I am so glad they did?”

There you go.

4 Comments

  • I was saddened by this story. As a Catholic I choose life over death, but am torn on what I would do especially regarding quality of life if it was me that fell from the tree. This was a difficult decision no doubt and I respect the decision as only He knows what’s in his heart. I just thought that there was so little time involved in the decision making process in this story.

    Further, the media seemed to applaud the decision, with the healthcare problems this country is facing, it seemed that the media chooses to terminate over waiting to make an informed decision, just my humble opinion.

  • It was my privilege to help establish the Nathan Adelson Hospice in Las Vegas, NV, 1979, so I have a very long nursing career of supporting the dying patient. I believe the first time I read Hank Dunn’s pamphlet, Hard Choices For Loving People was in the 1980’s when I was practicing LTC in California. It was such a pleasure to finally have such an awesome tool to help families and friends work through this very difficult experience of supporting their loved one’s Advanced Directives.
    Yes, I agree with the concerns stated about this paralyzed hunter and would have encouraged the family to take more time for such a critical and final decision, however, none of us have walked in this family’s shoes or knew the hunter liked they did. I do know from the medical community can become more reluctant and even obstructive in this process the longer the patient remains on life support in these type of cases.
    Thank you Mr. Dunn for your wonderful information, good common sense, and kind empathy for patients, families, friends and health care providers.

  • I’ve had the honour of meeting Stephen Hawking, and there’s no doubt that he has led a rich full life by his own standards. On the other hand, he has recently changed his opinion to say that he would like there to be assistance in dying if life became unbearable in the next few years.

    Two things to note: Firstly, it happened to him gradually, not suddenly, a slow wasting of nerves. Secondly, Hawking has a phenomenal mind and memory that allows him to do mind bendingly complex Physics equations in his head.

    There are very few of us with his capacity to live such a rich, purely cerebral existence. I studied Physics at the same college where he was Lucasian Mathematics professor, but I personally could not begin to face the loss of all the other pleasures of life.

    I think one reason Tim Bowers chose so quickly might have been the fact that he felt it would be his last chance. Once we are connected to machines keeping us alive, it is more difficult to get them removed.

    This is a common issue faced by those who choose assisted dying – they die earlier because they are afraid that if they wait too long they won’t have the physical strength to do it. Others who know they have the option – i.e. where the country allows it – feel like they have been given back control over their fate and are happy to delay a little longer.

    Maybe there is a case for not making too hasty a decision – but I believe that such a delay should be balanced by having the knowledge that you can change your mind and be delivered peacefully.

    In the absence of such peaceful assistance, I’d go with Tim Bower’s choice every time.

    • Thank you Andy for your comments. I can see your point. It could have been that Mr. Bowers could have been successfully weened off the ventilator and even started feeding himself. Then his only option for a morally neutral exit might have been to voluntarily stop eating and drinking. He probably would not have been considered terminal at that point and physician-assisted suicide would not have been an option if he lived in a jurisdiction that allowed it. Very tough choices in any case.
      Hank