No Runny Eggs

The repository of one hard-boiled egg from the south suburbs of Milwaukee, Wisconsin (and the occassional guest-blogger). The ramblings within may or may not offend, shock and awe you, but they are what I (or my guest-bloggers) think.

When is a respirator “normal” versus “extraordinary” life-sustaining technology?

by @ 14:12 on November 29, 2010. Filed under Health.

I’m having a hard time deciding just what side to come down in the case of Dan Crews, found in today’s Milwaukee Journal Sentinel. The short version, relying heavily on medical records supplied by Crews, with Froedtert Hospital officials refusing to comment:

  • 24 years ago, 3-year-old Dan Crews was paralyzed from the neck down in a car accident, and was taken to Froedtert Hospital. Though he can eat and is currently otherwise healthy, he requires a respirator to breathe.
  • In a court settlement, Crews received $4 million, which his father said was supposed to just cover his expected 20-year life expectancy. That money continues to allow him to live in Illinois with his mother and hire a pair of nurses to help take care of him, though what hasn’t been put into a trust in order to allow him to apply for Medicaid will run out soon.
  • 1 1/2 years ago, after 22 1/2 years of lviing with the respirator, and realizing that pursuing a law degree beyond the associate’s degree would be logistically difficult, the major reason he decided that life was no longer living, he asked his spinal cord rehab physician at Froedtert, where he continues to receive care that cannot be done at home, about removing the respirator. Froedtert initiated a palliative care review, and even though one doctor initially made a notation on the charts that Crews was competent to make the decision to remove the respirator, the team expressed concerns that the financial situation and depression were clouding his judgement. Talks stalled at that point as Crews refused to be treated for depression.
  • 5 months ago, Crews staged hunger strike, stopped when his mother checked him into Froedtert and he was told that if he continued, he would be fitted with a feeding tube. Also about this time, he started taking anti-depressants, and his desire to die remains unchanged. Froedtert indicated that he would need to undergo a year of counselling and treatment for depression before they would consider his request.

The part that strikes me the most is that Crews was more than content to have for 6 years as a conscious, sane adult, the respirator, something that I would call “extraordinary” life-sustaining technology as for the bulk of human history, not being able to breathe on one’s own meant death. At some point, even “extraordinary” measures, which I have successfully avoided, take on “normal” status, and I’m pretty sure that comes before the 6-years-of-conscious-and-sane-adult-living point.

That being said, the threat of forcing a feeding tube on someone who by all appearances doesn’t want one is tough to swallow.

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