Andrew Solomon on Right to Death

From The New Yorker website:

My brother and I had by then been authorized by Willie’s next of kin to make his medical decisions. When we asked to discontinue life support, the hospital began putting up barriers; they did all they could to prevent our doing what Trish, my brother, my father, I, and everyone else who knew and cared about Willie agreed he’d have wanted. . . . . Hospital officials repeatedly accused me of murdering him, and wildly misrepresented New York State law relevant to his case. We had, with his biological family, the legal right to decide on his behalf, and having to duke it out with these doctors exacted a great cost we should not have had to pay.

Ugh. I am sorry Andrew did not name the hospital.

6 thoughts on “Andrew Solomon on Right to Death

  1. That’s bad. This would be worse:
    My brother and I had by then been authorized by X’s next of kin to make his medical decisions. When we asked to continue life support, the hospital began putting up barriers; they did all they could to prevent our doing what Y, my brother, my father, I, and everyone else who knew and cared about Willie agreed he’d have wanted. . . . . Hospital officials repeatedly accused me of wanting to keep him alive against his will, at enormous cost, and wildly misrepresented New York State law relevant to his case. We had, with his biological family, the legal right to decide on his behalf, and having to duke it out with these doctors exacted a great cost we should not have had to pay.

  2. I can so relate to Mr. Schulman’s comment. Unlike the state of New York, where I live (north of the 49th), the law states doctors have the final say on who gets to live or die, regardless of family wishes.

  3. Sorry – left off conclusion: since error is inevitable, that it is better for docs and hospitals to err on the side of not-pulling-the-plug than it is to err on the other side, particularly since absolute knowledge about when end of life is coming is rarer than anyone admits. Certainly the self-interest of many “stakeholders” is on the side of pulling the plug – weary family, crowded hospital, profit-seeking insurer (or spending-averse govt), etc. etc. – all against one patient who signed a paper in good health but is unable now to communicate. He’ll have the rest of his life to be dead – what’s the hurry?
    Given the urgency and activity of the hospital in Solomon’s example, I wonder whether there was a genuine medical disagreement about the patient’s condition that Solomon scants.

  4. I suspect the self-interest of the hospital was on the side of not pulling the plug. As a general rule, hospitals make less money when they are less crowded. It was in nobody’s self-interest to accuse the patient’s legal guardians of murder.

  5. Without reference to Solomon’s story: my father, an academic neurologist practicing 50s-80s, had numerous instances of family/friends eager to pull plug, never in doubt, even when there wasn’t a plug to pull – it’s human nature. He had admirable control of his temper; not everyone does. But as Haggus says, mores change, and the gravitational pull is toward institutional control of death, as in Canada, and even more so in the Netherlands. Pain is horrible, and easy to sympathize with – but who bothers to imagine the horror of watching someone kill you when you happen not to want to be killed; and the greater horror of anticipating your own killing.
    Seth, I encourage you and your readers to look at Florence Nightingale’s classic 19th century book “Notes on Nursing: What it is and What it is Not.” There is a tremendous amount of concern about the patient’s state of mind – and the necessity of avoiding whispered conferences at bedside. The patient always imagines the worst, and thinks his death is being discussed (all based on Nightingale’s beautifully observed experience) which has a dreadful affect on recuperation and recovery. Even though medicine lacked most of what works in modern medicine, there was an absolute commitment to the patient that made a difference – and is vanishing these days. The fine-sounding right to die is not going to be a benefit for most of us.

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