Devangshu Datta: The death machine
Life-support gear unquestionably saves lives, but it can also prolong life meaninglessly in situations where there is absolutely no hope of recovery
Somebody I was very fond of died early on Monday morning. He collapsed with pulmonary oedema on Sunday evening. The last coherent remark he made was: “Let me go. Don’t put me on the death machine.” That was what he called the medical ventilator — the mechanical device that keeps pushing air in and out of the lungs when the body is incapable of breathing unaided. Three years ago, he’d watched his wife ebbing away over a period of weeks after she was put onto one of those machines and he’d sworn never to suffer that slow loss of dignity.
So it came to pass that he slipped into unconsciousness and never came around. His son complied with his wishes and refused to hook him up to the machine. The doctors concurred that the prognosis in any case was very poor. But refusing to take the last resort of life support is likely to be a decision that will haunt his son for years to come.
My mother had similar feelings about ventilators, and for similar reasons. She had also watched her spouse of 50-odd years going down that route. When my father suffered his final attack, she’d put him on life support. He was in a coma for days. The night before he died, our mother talked to us about it. She was agonising over the pros and cons of switching off the power. Finally, she decided to give it two more days. Luckily for her peace of mind, my father flatlined the next afternoon.
When the doctors discovered that she had inoperable cancer a year or so later, my mother was pretty clear that she didn’t want life support if the question ever arose. As it happened, she died quickly without it ever being an option.
Being spared that particular choice was a blessing. I’ve known friends who’ve spent long months looking after relatives on life support and existing in a state of grey half-life. I had my fill of it personally during that one stint of hanging around outside the ICU waiting for my father to pass on.
Ironically, this cruellest of dilemmas is created by advances in medical science. Ventilators and other life-support gear unquestionably save lives in many situations and do so on a daily basis. Asthmatics, pneumonia victims, polio victims, premature babies, blast victims, etc often survive and recover from situations that would have been accounted hopeless earlier.
But this equipment can also prolong life meaninglessly in situations where there is absolutely no hope of recovery. The patient has suffered severe brain damage, for instance, and there is no chance that he or she will emerge even marginally capable of functioning. There is no chance of ever achieving an acceptable quality of life for that person again. And yet, the heart may carry on beating and the lungs can be inflated indefinitely. What are relatives supposed to do in that situation?
This is a decision that very rarely needed to be taken in earlier eras because there were no options apart from the big zero. It is a decision that families are faced with often nowadays. Eventually, one must hope that science makes further breakthroughs that enable recoveries from situations that are currently hopeless. Or else, society will have to re-examine and redefine the legal and medical meaning of life and of quality of life.
If you’ve kept pets, you’ve probably had to make a hard decision at some stage when a pet reaches old age, or becomes terminally ill. Do you let them go peacefully or not? Most of us base that decision on the potential future quality of life for the pet. Perhaps the same considerations should apply in this instance. But it’s a little harder to do when one is thinking of human beings.