Paralyzed Indiana deer hunter brought out of sedation chooses to end life support


#1

indystar.com/viewart/20131105/NEWS/311040018/Paralyzed-Indiana-deer-hunter-brought-out-sedation-chooses-end-life-support

Tim Bowers got to decide for himself whether he wanted to live or die.

When the avid outdoorsman was badly hurt Saturday in a hunting accident, doctors said he would be paralyzed and could be on a ventilator for life. His family had a unique request: Could he be brought out of sedation to hear his prognosis and decide what he wanted to do?

Doctors said yes, and Bowers chose to take no extra measures to stay alive. He died Sunday, hours after his breathing tube was removed.

“We just asked him, ‘Do you want this?’ And he shook his head emphatically no,” his sister, Jenny Shultz, said of her brother, who was often found hunting, camping or helping his father on his northeastern Indiana farm.

The 32-year-old was deer hunting when he fell 16 feet from a tree and suffered a severe spinal injury that paralyzed him from the shoulders down. Doctors thought he might never breathe on his own again.

Courts have long upheld the rights of patients to refuse life support. But Bowers’ case was unusual because it’s often family members or surrogates, not the patient, who make end-of-life decisions.

Medical ethicists say it’s rare for someone to decide on the spot to be removed from life support, especially so soon after an injury. But standard medical practice is to grant more autonomy to patients.


#2

Church position on this? It seems to me that he was being kept alive by extraordinary measures and could legitimately elect to end them.

Am I correct, please?


#3

Good question; I wondered the same thing.
It would seem to me it is indeed extraordinary measures.
Mary.


#4

You are correct that there is no obligation to utilize extraordinary measures.

However, there is a distinction between “ordinary vs. extraordinary” and “natural vs. artificial.” For example, the Church considers nutrition and hydration (i.e. food and water) to be considered “ordinary care” even when administered via artificial means (i.e. a feeding tube for a patient in a vegetative state).

Whether or not a ventilator is considered “ordinary” or “extraordinary”, I’m honestly not sure. My inclination would be that breathing is in the same category as eating and drinking. But I have no Church document to cite in support.

What gets me about the story is how quickly this all transpired. His accident was on Saturday. They pulled him off the ventilator on Sunday. That scarcely seems to me like enough time to properly evaluate the prognosis and make an informed decision. I certainly wouldn’t throw in the towel that quickly and it seems shocking to me that they would so quickly acquiesce to the life-ending request of someone who just experienced a major trauma. But perhaps there is more to the story. :shrug:


#5

:eek: I missed that. :eek:


#6

That. Is. Suicide.


#7

How do you know that?


#8

I am now alive. Please remove the means that keep me alive.

The guy was in charge of his fate, and he chose death. Isn’t that suicide?


#9

A ventilator is definitely ordinary means. He chose Suicide. I agree with Paulin.


#10

Wait…when did a vent become ordinary means?

My understanding is this is an extra-ordinary means (Pope Pius XII in 1957?)
(Also ERD training through the hospital…)


#11

Here is a reference for use in discussion

Mechanical Ventilation Is a Medical Act
ncbcenter.org/page.aspx?pid=1140


#12

While I don’t think his decision to forgo the the ventilator was suicide, I am very concerned with how quickly this happened. If someone is to make this sort of decision, I feel like there should be some contemplation, much as one person would do before deciding on a DNR.


#13

No. No more than refusing painful chemotherapy is suicide.

You are allowed to decline medical treatment if you view the benefit is not worth the cost.

He acted morally, and I would decide in the same way for myself. I’ve told my wife, if I became a parapalegic, pull the plug.

God Bless


#14

Thank you, Robert.

I don’t know. Is waking someone out of a drug-induced coma and having them make a decision the affects their very life fair? I would think that you should let them get used to the idea.


#15

That may be right. But, I’m sure they didn’t give him a deadline.

God Bless


#16

It has been almost 25 years, but when my son was in a vegetative state, the people at the Georgetown Bioethics Center were a great help. Dr. Pellegrino (God rest his soul) spent an afternoon with us helping us walk through a lot of these issues.

Chemotherapy does not necessarily cure cancer, but can prolong life. If you have a fatal diagnosis, then, yes, discontinuing treatment does not *cause *the death. The cancer does. so, discontinuing the treatment because it is overly burdensome is acceptable.

In the case of ECMO (respirator providing breathing for the rest of your life), you do not have a fatal disease. You have a condition that is not compatible with continued life, but you are not dying. The man could talk and his brain was active. Was a respirator a normal intervention? Ask Christopher Reeve. He thought so.

The respirator had not become overly burdensome to this man. He had not even been awake a week to contemplate the future. It sure seems like it was giving up.


#17

I’m sure a pretty odd situation for all involved.

The ‘choice’ just outside of a sedated state, clarity of mind was probably not all there.

I see a lost opportunity to inspire through great challenge. Obviously, assuming a recovery and release from the hospital.

Technology has come a long way to help with care in this area as well.


#18

INFORMATION FROM THE ARTICLE:

". . . His sister, Jenny Shultz, an intensive care nurse in Las Vegas, has seen it happen in her job. But her medical training also meant she understood the severity of her brother’s injuries. His C3, C4 and C5 vertebrae were crushed.

Though his brain was not injured, his body was irreparably broken. Surgery could fuse the vertebrae, but that would only allow Bowers to sit up. He would never walk or hold his baby. He might live the rest of his life in a rehabilitation hospital, relying on a machine to help him breathe.

Shultz said her brother — the youngest of four siblings — wanted to talk but couldn’t because the ventilator tube was still in place. If the tube were removed, she told him, doctors were not sure how long he would live. But when she asked if he wanted the tube reinserted if he struggled, Bowers shook his head no.

Bowers chose to take no extra measures to stay alive. He died Sunday, hours after his breathing tube was removed.

Doctors asked Bowers the same questions and got the same responses. Then they removed the tube.

The last five hours of Bowers’ life were spent with family and friends, about 75 of whom gathered in the hospital waiting room. They prayed and sang songs.

Through it all, Shultz said, her brother never wavered in his decision to die.

“I just remember him saying so many times that he loved us all and that he lived a great life,” she said. “At one point, he was saying, ‘I’m ready. I’m ready.’”

Shultz said her family had an idea what her brother would want because he had previously talked with his wife, Abbey, whom he married Aug. 3, about never wanting to spend his life in a wheelchair.

She knows that not everyone would make the same decision. But she’s thankful her brother was able to choose for himself.

“No outcome was ever going to be the one that we really want,” she said. “But I felt that he did it on his terms in the end.”. . . . "


#19

I would imagine waking up in his circumstances for awhile was contemplation enough.
Mary.


#20

Most paraplegics, like me, have no difficulty breathing on our own. :smiley: :wink:

But I am guessing you mean extreme tetraplegic (formly quadraplegic)…As this man’s injury left him.


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