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Discussion 6 to Reflections on Ethics 38
A new doctor's perspective

by Margarita Carrión

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I just came out of medical school, and haven’t had much experience with terminally ill patients. I have attended long lectures on the subject, and I do have a few personal anecdotes.

I hope I never have to suggest a decision to “unplug” a patient, and certainly hope I’m not asked to do it by relatives. But being in this job, I have to be prepared.

There’s something important to take into account when discussing this issues, and that is that a decision will be made based on our own wishes for ourselves. I wouldn’t want to live “at all costs, or at any cost”. In third world countries (I’m from Ecuador ) this implies different things than in more developed parts of the globe. Unfortunately not everyone has access to health care facilities, and in the public hospitals, the quality of health care is deficient for the ones that can complain, and worse for those who cannot.

There’s a lady in the Neurology wing at the hospital. She came 23 years ago to deliver her son. Then, she was in her early 20’s. There was a complication and she had to undergo a cesarean operation. Yet another complication with the anesthesia killed her brain. She doesn’t need more support than a feeding tube.

Her husband married someone else, her son comes once every two years, and the nurses turn her around every time they remember to, not as often as they should because they have a lot of work with the other patients.

I wonder if this is fair. I’m glad I am not her physician, because I think that in this particular case she has the right to die, even more than the right to live. I’m a strong believer that quality of life can be more important than quantity of life.

I don’t think we are near to coming to a clear conclusion in this kind of discussion. Until we have better tools to work with, the best we can do is that which we would like done upon ourselves.