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Ethics
Medicine

Can cardiac rescusitation of an individual with an inoperable brain tumor be justified? Who benefits? Glen.
Accepted:
January 14, 2006

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Peter S. Fosl
January 14, 2006 (changed January 14, 2006) Permalink

Hey Glen,

An interesting question, indeed. It reminds me, too, about why medical care is provided to people who've been sentenced to death.

Look at it this way, though, all of us are going to die at some point. You might say that those with inoperable brain tumors just have a clearer picture than most about when and how they'll die. Knowing when and how one's going to die doesn't seem to be a good reason to deny that person medical care.

And notice that even for those with inoperable tumors the picture isn't perfectly clear:

Probability not necessity: Typically, people face some probability of death from the tumor, not certainty. Even one tenth of a percent chance of recovery is a chance and therefore a reason to administer rescusitation.

Time: even if it were certain, a tumor takes time to kill. That time to live is likely to provide grounds for rescusitation. One of my uncles died of a brain tumor. While it was killing him he spent his time visiting family and friends, getting his financial and legal affairs in order, making plans for the care of his spouse and child, attending religious services, listening to music, reading, travelling, etc. Had he suffered a cardiac arrest during that period and been refused rescusitation, many of those goods would have been made impossible. Now, if administering rescusitation were to exact an enormous social cost and prohibit those without tumors from realizing some important goods and if death from the tumor were almost certainly imminent, then there might be grounds for refusing the rescusitation. But the costs of rescusitation are relatively low, and so this scarcity objection doesn't work.

Autonomy: Deciding how to greet one's demise is a terribly important element of human self-determination. It seems meaningful to assist those who wish, as it were, to go down fighting.

Rebellion: The existentialist Albert Camus argues, persuasively in my opnion, that perhaps the central way of rendering life meaningful is to rebel or struggle against death, to not accept with acquiescence the ultimately crushing and annihilating reality of human existence. A story I once heard about the French artist Monet (as I recall) seems to illustrate the sense of Camus's claim: It became at some point impossible for the aging artist to hold his paint brushes any longer. So, in defiance of his degeneration (and ultimately his death), Monet asked his assistant/daughter to take the brush and "tie it to my hand." Telling Monet that he would be dead soon anyway would have been to capitulate to meaningless annihilation and to rebuke his choice about how to face it. She took the time and effot to tie it to his hand, and in doing so she did the right thing.

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