In March I’d come across a few articles about Joseph Maraachli, a baby who was on life support during a terminal illness and doctors fought for the right to let him die. The parents fought for the right to let him linger in suffering instead, even going so far as to send him into the States for the tracheotomy doctors here in Canada deemed too invasive. He’s home again now.
Today I learn about another case in Ontario were an Iranian immigrant named Hassan Rasouli wound up in a coma after having a brain tumour removed. Bacterial meningitis set in after the operation and he’s now completely brain damaged.
As devout Shia Muslims, Ms. Rasouli said, it’s impossible for her family to countenance cutting her husband off from life.
“His life is a gift from God to us. … God wants him to be alive.”
Those emotional and spiritual imperatives have launched the family, and Mr. Rasouli’s doctors, headlong into one of the thorniest issues of medicine. Now judges in Ontario’s Court of Appeal will have to determine who can decide whether to terminate care keeping a patient alive. What constitutes treatment, and is there ever an obligation to continue it against doctors’ advice? When is it in someone’s best medical interest to go against their loved ones’ wishes if that means death?
If loved ones can’t face the reality of no recovery, is it really a good idea to let them have a say in keeping a body plugged in indefinitely? That’s the issue in play.
Doctors from Toronto’s Sunnybrook Hospital were in court on Wednesday seeking to overturn a ruling from Madam Justice Susan Himel of the Ontario Superior Court of Justice that would oblige them to seek consent from the province’s Consent and Capacity Board to stop life support without Ms. Salasel’s permission.
Letting the ruling stand would set a dangerous precedent, the doctors’ lawyer, Harry Underwood, argued in court. It would force doctors to continue treatment as long as a patient or a patient’s surrogates desire, even if it has become useless.
It also becomes necessary to decide on what actions might qualify as treatment. “Treatment” suggests a method by which a situation will improve but if the doctors are right about Rasouli’s chances of recovery (none), can a feeding tube and ventilator count as treatment methods? If he’s past the point where medical science can turn him around, then what good are they doing?
Who should have the most say regarding a patient in this kind of situation, the family who doesn’t want to let go, or the doctors who know they are going to have to?
I have nothing but sympathy for these families. My family had to face the same choice; it is horrible. Even if you don’t believe in a soul you can still see your loved one and you can’t help but think they are inside. For my beloved grandmother we were told we could keep her physically alive, but her brain was too badly damaged for her to recover. We choose not to keep her body going.
Keeping the body alive after the brain has died is not a treatment. Nor did the doctor tell us it was. I am not sure what the laws are in Canada but if the patient is brain dead, they are legally dead in the US. I think.
How can you make a proper comment unless you have been to the hospital to visit Hassan Rasouli. I can because I have been to see him a half dozen time sand I can assure you that this man is not in what would be called a vegetative state. I have seen him move his eyes towards where we are to see us . He has lifted his arms up. Hassan has responded to our question by squeezing our hands.
If that’s the case, that’s good, I guess. What are the chances of recovery, though? How much suffering is he under? If someone did ask him what he wanted in terms of hanging on that way or going, what would his response be? I’m sure it’s not easy on anyone around him. It’s a future I hope I never have to face.