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Human rights and bioethics updates

A blog dedicated to updating you upon legislation and ethical debates around human rights (principally under the angle of law-enforcement forces) and bioethics (under the angle of the protection of vulnerable persons). You are welcome to leave your comments on any of the posts!

Tuesday, October 25, 2005

Septic shock confronts me to practical bioethics

This blog is taking, for once, a much more personal turn. I have been worried for the health of my mother since some times. Two weeks ago, I received a painful confirmation : my mother had to be hospitalised in emergency on the night from the 12 to 13 October. She had to be operated the same night, because she had a perforated ulcer. The operation went well, but then my mother fell into a septic shock and is in an intensive care unit. This massive infection has as consequence that there is generally failure of one or more organs, and a survival rate of 50 %.

After leaving us worried for the best part of a week, my mother eventually recovered enough for the doctors to lower the drugs that maintained her blood pressure (vasopressors), and dialysis was suspended (she suffered from acute renal failure). She had so much recovered that the doctors suspended the sedation, and my father and I could talk to my mother – although she could not reply, she gave signs of having recognised us, and could communicate with us by signs.

Then, one day after she had almost recovered complete consciousness, the doctors called me as I was going to visit my mother. She had just been taken into the operating room, to be operated again for a perforation of an ulcer. The doctors did not hide that it was a dangerous operation, but they explained that they had to perform it or my mother would die by haemorrhage.

My mother survived the operation, only to fall to another septic shock. Friday, the prognosis of the doctors was rather gloomy. Then, on Saturday through Sunday, her situation stabilised. Monday, it was decided to lower slowly the doses of vasopressors, though the situation was always “stable”. Her blood continues to be purified through dialysis. The principal concern was however if her intestines will be resisting long enough for her to recover from shock, in order to start another row of treatment aimed at the intestinal pathology in itself. If there is a new perforation, it might well mean that my mother is doomed.

What are the ethical problems which might arise from this situation? First, if my mother recovers, she will be in measure of deciding for herself. But if the situation evolves unfavourably, then I, as a member of the family, will be called to take some important decisions on her behalf. Since we are Catholic and attached to the teaching of the Church, the question of an interruption of treatment is not even to be discussed, as far as I am concerned. The question will become more tricky if (and I hope with all my heart that it will never be the case) my mother is put on artificial life support machinery (she is already breathing with the aid of a machine which enriches the air at 50 % in oxygen -–normal air we breathe is composed at 21 % of oxygen). In that case, in my opinion, a decision of stopping machines could only be validly be taken if there is a flat EEG (Electroencephalogram), which means clinical death.

The prayers and the thoughts of all those who can spare some for the recovery of my mother shall be very welcome.

I’ll be posting here regular updates on her health, if you are interested; I’ll also try to give you the medical information to understand details of her illness.

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