Roy Exum: Is This What You Want?

Monday, November 11, 2013 - by Roy Exum
Roy Exum
Roy Exum

Tim Bowers was the neighbor almost everybody in America would love to have living next door. When he wasn’t working at his family’s transmission shop in Decatur, Ind., he would be active on the family farm, where everybody pitched in to raise corn and soybeans and laughter. He was an outdoors kind of guy and Saturday before last, when he went deer hunting, he told his wife who is expecting their first child in early spring that he’d likely be home before dark.

But the next time she saw him was in the hospital. Tim had fallen some 15 feet while trying to get onto his tree stand and doctors had discovered he was paralyzed after discovering that his C3, C4 and C5 vertebrae were crushed. It was believed he would remain paralyzed, perhaps requiring a breathing device and constant nursing home care, and the prospects of returning to life as he knew it were virtually non-existent.

His sister, an intensive care trauma nurse, knew exactly what he faced and so did his tightly-knit but obviously grieving family. So in a moment of rare precedence, the family asked that Tim be allowed to awaken from his drug-induced coma, that the tube in his throat be removed, so they could ask if he wanted to continue life-saving treatment or … stop all medical intervention.

Understand in the three years Tim and his wife had dated and were married, he had said on numerous times that he had rather die than live in a wheelchair. “He would never be able to give hugs, to hold his baby, to even walk … to have all that stuff taken away would be devastating. We made sure he knew everything so he could make his own decision.”

So when the family asked him if he wanted the throat tube reinserted if he started struggling to survive, he very emphatically shook his head no. When a team of doctors entered the room and asked him the same type of questions, he once again clearly indicated no. So with 75 family and friends saying prayers and softly singing in a nearby waiting area, Tim Bowers died about five hours later at the age of 32.

His sister, who stayed with his wife as the last hours turned into minutes, told a reporter from the Indianapolis Star, “I just remember him saying so many times that he loved us and had such a great life. At one point he said, ‘I’m ready … I’m ready …’” she added, insisting her brother never wavered from his decision to end his life rather than try to endure it.

In the story that appeared in the Indianapolis Star and has caught the attention of medical ethicists all over the world, Dr. Paul Helft explained to the writers that cases where the patient makes such a decision usually involve a catastrophic disease, like Lou Gehrig’s disease, but added, “We give patients autonomy to make all kinds of decisions about themselves. We recognized that it is important that patients have the right of self-determination.”

But another doctor, Arthur Kaplan at New York University’s Langone Medical Center, said that many patients don’t want to live during the first days of a tragedy but, after speaking to family members and spiritual advisors, sometimes change their minds. He wonders at what point do you ask the question.

“The issue is: Should you say, ‘Look, let’s try this for a week or two to see if you can adjust and then we’ll take your breathing tube away?’ After a terrible injury or a mutilating accident … everybody is like, ‘I can’t go on.’”

But Kaplan said that since Tim had told his wife on several occasions that he had never wanted to live in a wheelchair, “That’s a big help in this mess. At least you are pretty sure … you’d had the conversation and know his views … he’s consistent.”

Kaplan later told CNN that young people as well as older should have such conversations. “I know it is hard, but talk to your family, talk to your friends. Say to them, ‘This is what I want.’”

I believe every able-bodied American should have a “Living Will” (an advanced life directive) and a viable “Power of Attorney.” Whoever you determine to entrust with your “power of attorney” should know specifically your end-of-live wishes in case of a tragedy. The wonderful purpose of medicine is to keep us alive but today, with high-tech devices and more knowledge than ever before, we should be united in honoring one’s request of “This is what I want.”

And, for the record, I’m strictly a ‘do not resuscitate’  guy. Use no life-sustaining procedures. My family is a peace with my decision because that is what I want.

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