Oregon has had government involved in health care for quite a few years. The state electorate also approved the concept of state sanctioned suicide several years ago.
Recently, the board that reviews the medications that are approved for state residents made a determination that was controversial...in my mind if no where else. The board, in essence, said that, given the cost of a certain medication, it would approve suicide for this patient but would not approve use of the medicine given its relative newness and the lack of convincing data as to the outcome. It had essentially set a price on the human life involved.
Today I read the story concerning Denver Children's Hospital and heart transplants in infants that use the heart from another infant that died a 'cardiac-related death'. This differs from a heart harvested from a brain-dead infant in which that heart is beating until removed from the donor body. A decision has been made that the donor that has been pronounced dead and has been in that state for only 75 seconds, is a valid heart donor for purposes of this new program. The earlier line that had existed required death be determined only after some five minutes during which time the heart did not re-start itself. In this instance, the length of time a person had been deemed 'dead' had been reduced to assure that the harvested heart had a decent chance of functioning in the new body. The three cases in which this approach has been employed resulted in three infants alive today. The decisions to withdraw life support were made by the parents in all three instances.
We know so much more today than we did a decade ago. We can do things from a medical perspective that were impossible then, and these procedures have become commonplace now. We are, in this area, pushing the envelope as it has never before been pushed.
I know there are at least two sides to these issues. I have good friends whose daughter lives today because of transplanted organs that were available on a timely basis. I can't even begin to comprehend being placed in the middle of such decisions, and I earnestly hope that never befalls me.
And this leads to my general question: Is there a line we dare not cross? If so, where is or was that line? Am I comfortable with an appointed board making life and death decisions about me? Who among us can claim the right to make such a decision? How do medical ethicists deal with these kinds of issues?
I don't profess to have the answers to these questions. If you do, and you're willing to share, I'd appreciate your comments.
